BACKGROUND Inpatient telemetry heart rhythm monitoring overuse has been linked to higher healthcare costs.AIM To evaluate if CHA2DS2-VASc score could be used to indicate if a patient admitted with possible cerebrovasc...BACKGROUND Inpatient telemetry heart rhythm monitoring overuse has been linked to higher healthcare costs.AIM To evaluate if CHA2DS2-VASc score could be used to indicate if a patient admitted with possible cerebrovascular accident(CVA)or transient ischemic attack(TIA)requires inpatient telemetry monitoring.METHODS A total of 257 patients presenting with CVA or TIA and placed on telemetry monitoring were analyzed retrospectively.We investigated the utility of telemetry monitoring to diagnose atrial fibrillation/flutter and the CHA2DS2-VASc scoring tool to stratify the risk of having CVA/TIA in these patients.RESULTS In our study population,63(24.5%)of the patients with CVA/TIA and telemetry monitoring were determined to have no ischemic neurologic event.Of the 194(75.5)patients that had a confirmed CVA/TIA,only 6(2.3%)had an arrhythmia detected during their inpatient telemetry monitoring period.Individuals with a confirmed CVA/TIA had a statistically significant higher CHA2DS2-VASc score compared to individuals without an ischemic event(3.59 vs 2.61,P<0.001).CONCLUSION Given the low percentage of inpatient arrhythmias identified,further research should focus on discretionary use of inpatient telemetry on higher risk patients to diagnose the arrhythmias commonly leading to CVA/TIA.A prospective study assessing event rate of CVA/TIA in patients with higher CHA2DS2-VASc score should be performed to validate the CHA2DS2-VASc score as a possible risk stratifying tool for patients at risk for CVA/TIA.展开更多
Marine risers play a key role in the deep and ultra-deep water oil and gas production. The vortex-induced vibration （VIV） of marine risers constitutes an important problem in deep water oil exploration and productio...Marine risers play a key role in the deep and ultra-deep water oil and gas production. The vortex-induced vibration （VIV） of marine risers constitutes an important problem in deep water oil exploration and production. VIV will result in high rates of structural failure of marine riser due to fatigue damage accumulation and diminishes the riser fatigue life. In-service monitoring or full scale testing is essential to improve our understanding of V1V response and enhance our ability to predict fatigue damage. One ma- rine riser fatigue acoustic telemetry scheme is proposed and an engineering prototype machine has been developed to monitor deep and ultra-deep water risers＇ fatigue and failure that can diminish the riser fatigue life and lead to economic losses and eco-catastrophe. Many breakthroughs and innovation have been achieved in the process of developing an engineering prototype machine. Sea trials were done on the 6th generation deep-water drilling platform HYSY-981 in the South China Sea. The inclination monitoring results show that the marine riser fatigue acoustic telemetry scheme is feasible and reliable and the engineering prototype machine meets the design criterion and can match the requirements of deep and ultra-deep water riser fatigue monitoring. The rich experience and field data gained in the sea trial which provide much technical support for optimization in the engineering prototype machine in the future.展开更多
文摘BACKGROUND Inpatient telemetry heart rhythm monitoring overuse has been linked to higher healthcare costs.AIM To evaluate if CHA2DS2-VASc score could be used to indicate if a patient admitted with possible cerebrovascular accident(CVA)or transient ischemic attack(TIA)requires inpatient telemetry monitoring.METHODS A total of 257 patients presenting with CVA or TIA and placed on telemetry monitoring were analyzed retrospectively.We investigated the utility of telemetry monitoring to diagnose atrial fibrillation/flutter and the CHA2DS2-VASc scoring tool to stratify the risk of having CVA/TIA in these patients.RESULTS In our study population,63(24.5%)of the patients with CVA/TIA and telemetry monitoring were determined to have no ischemic neurologic event.Of the 194(75.5)patients that had a confirmed CVA/TIA,only 6(2.3%)had an arrhythmia detected during their inpatient telemetry monitoring period.Individuals with a confirmed CVA/TIA had a statistically significant higher CHA2DS2-VASc score compared to individuals without an ischemic event(3.59 vs 2.61,P<0.001).CONCLUSION Given the low percentage of inpatient arrhythmias identified,further research should focus on discretionary use of inpatient telemetry on higher risk patients to diagnose the arrhythmias commonly leading to CVA/TIA.A prospective study assessing event rate of CVA/TIA in patients with higher CHA2DS2-VASc score should be performed to validate the CHA2DS2-VASc score as a possible risk stratifying tool for patients at risk for CVA/TIA.
基金supported in part by the National Science and Technology Major Project of China (2011ZX 05026-001-06)the National Natural Science Foundation of China (51249005 60972153)
文摘Marine risers play a key role in the deep and ultra-deep water oil and gas production. The vortex-induced vibration （VIV） of marine risers constitutes an important problem in deep water oil exploration and production. VIV will result in high rates of structural failure of marine riser due to fatigue damage accumulation and diminishes the riser fatigue life. In-service monitoring or full scale testing is essential to improve our understanding of V1V response and enhance our ability to predict fatigue damage. One ma- rine riser fatigue acoustic telemetry scheme is proposed and an engineering prototype machine has been developed to monitor deep and ultra-deep water risers＇ fatigue and failure that can diminish the riser fatigue life and lead to economic losses and eco-catastrophe. Many breakthroughs and innovation have been achieved in the process of developing an engineering prototype machine. Sea trials were done on the 6th generation deep-water drilling platform HYSY-981 in the South China Sea. The inclination monitoring results show that the marine riser fatigue acoustic telemetry scheme is feasible and reliable and the engineering prototype machine meets the design criterion and can match the requirements of deep and ultra-deep water riser fatigue monitoring. The rich experience and field data gained in the sea trial which provide much technical support for optimization in the engineering prototype machine in the future.
