Traffic congestion on urban roadways is a serious problem requiring novel ways to detect and mitigate it. Determining the routes that lead to the traffic congestion segment is also vital in devising mitigation strategies. Further, crowdsourcing this information allows for use of these strategies quickly and in places where infrastructure is not available. In this work, we present an unconventional method, using the barometer sensor of mobile phones to (a) detect road traffic congestion and (b) estimate the paths that lead to the congested road segment. We make the observation that roads are not completely flat and very often, altitude varies along the road. The barometer sensor chips are sensitive enough to measure these variations and consume very little energy of the mobile phone, compared to other sensors such as the GPS or accelerometer. We devise a feature set to map the rate of change of this altitude as the user moves into activities characterized as “still” and “motion,” which are further used by the traffic congestion detection algorithm (RoadSphygmo) to classify the group of users as being in “moving,” “congestion,”  or “stuck” states. To estimate the paths that lead to the congested road segment, we compare the user’s barometer sensor readings with a pre-stored road signature of barometer values using Dynamic Time Warping (DTW). We show that by using correlation of barometer sensor values, we can determine if users are in the same vehicle. We crowdsource this information from multiple mobile phones and use majority voting technique to improve the accuracy of traffic congestion detection and path estimation. We find a significant increase in the accuracies using crowdsourced information as compared to individual mobile phones. Further, we show that we can use barometer sensor for other applications such as bus occupancy, boarding/deboarding of a vehicle, and so on. The validation of the state determined by RoadSphygmo is done by comparing it with average GPS speed calculated during the same time period. The path estimation is validated over different intersections and considering various cases of commuter travel. The results obtained are promising and show that the traffic state determination and the estimation of the path taken by the commuter can achieve high accuracy.

BACKGROUND: Coronary artery fistulae are abnormal communications of coronary arteries with systemic vasculature, pulmonary vasculature, or cardiac chambers. Use of multimodality imaging can be paramount to understanding anatomical and functional features of these complex vascular lesions, therefore optimizing success of potential curative interventions. CASE SUMMARY: We present two patients with incidentally discovered giant aneurysmal coronary arteries with distal fistulous connections to the coronary sinus, which were successfully closed percutaneously with Amplatzer Septal Occluders using the assistance of three-dimensional (3D) printed heart models. CONCLUSION: Computed tomography-guided reconstruction with 3D multiplanar, multicolour printed models can help augment visuospatial understanding of the size, origin, course, and drainage of giant aneurysmal coronary artery-to-coronary sinus fistulae, and with manual bench testing can assist with choosing accurately sized and shaped devices for closure.

Background Existing data on predictors of late mortality and prevention of sudden cardiac death after atrial switch repair surgery for D-transposition of the great arteries (D-TGA) are heterogeneous and limited by statistical power. Methods and Results We conducted a systematic review and meta-analysis of 29 observational studies, comprising 5035 patients, that reported mortality after atrial switch repair with a minimum follow-up of 10 years. We also examined 4 additional studies comprising 105 patients who reported rates of implantable cardioverter-defibrillator therapy in this population. Average survival dropped to 65% at 40 years after atrial switch repair, with sudden cardiac death accounting for 45% of all reported deaths. Mortality was significantly lower in cohorts that were more recent and operated on younger patients. Patient-level risk factors for late mortality were history of supraventricular tachycardia (odds ratio [OR] 3.8, 95% CI 1.4-10.7), Mustard procedure compared with Senning (OR 2.9, 95% CI 1.9-4.5) and complex D-TGA compared with simple D-TGA (OR 4.4, 95% CI 2.2-8.8). Significant risk factors for sudden cardiac death were history of supraventricular tachycardia (OR 4.7, 95% CI 2.2-9.8), Mustard procedure (OR 2.2, 95% CI 1.1-4.1), and complex D-TGA (OR 5.7, 95% CI 1.8-18.0). Out of a total 124 implantable cardioverter-defibrillator discharges over 330 patient-years in patients with implantable cardioverter-defibrillators for primary prevention, only 8% were appropriate. Conclusions Patient-level risk of both mortality and sudden cardiac death after atrial switch repair are significantly increased by history of supraventricular tachycardia, Mustard procedure, and complex D-TGA. This knowledge may help refine current selection practices for primary prevention implantable cardioverter-defibrillator implantation, given disproportionately high rates of inappropriate discharges.