Transport risk management is one of the predominant issues to any industry for supplying their goods safely and in time to their beneficiaries. Damaging goods or delaying the shipping both make penalty to the company ...Transport risk management is one of the predominant issues to any industry for supplying their goods safely and in time to their beneficiaries. Damaging goods or delaying the shipping both make penalty to the company and also reduce the goodwill of the company. Every way of transportation routes has to be comfy which can make sure the supplies will attain without damaging goods and in time and additionally cost efficiently. In this paper, we find a few not unusual risks which might be concerned about all types of way of routes which include Highway, Waterway, Airway, Railway and so forth. Additionally, we proposed a technique to attain multiple optimal solutions by using Modified Distribution Method (MODI) of a transportation problem. Finally, we reduce the risks by minimizing the possible number of transportation routes using multi-optimality technique of the transportation problem.展开更多
目的目的基于Lasso方法分析重症监护病房(Intensive Care Unit,ICU)危重症患者发生营养不良的危险因素以及不同营养评估法的预测价值。方法方法纳入2021年6月-2024年6月于我院ICU接受治疗的危重症患者354例,依据NUTRIC分为:良好组(NUTRI...目的目的基于Lasso方法分析重症监护病房(Intensive Care Unit,ICU)危重症患者发生营养不良的危险因素以及不同营养评估法的预测价值。方法方法纳入2021年6月-2024年6月于我院ICU接受治疗的危重症患者354例,依据NUTRIC分为:良好组(NUTRIC=0分)216例、不良组(NUTRIC≥1分)138例;其中不良组又包括:低风险(1分≤NUTRIC≤3分)69例、中风险(4分≤NUTRIC≤5分)47例以及高风险(NUTRIC≥6分)22例;分析影响ICU危重症患者发生营养不良的危险因素,并探究其与不同营养评估法的预测价值。结果结果两组患者年龄、体质指数(Body Mass Index,BMI)、慢性胃肠道症状、合并症数量、入ICU前住院天数、血红蛋白、白蛋白、前白蛋白、淋巴细胞计数、CD4阳性T淋巴细胞(CD4-positive T lymphocytes,+CD4 T)、磷离子水平、急性生理与慢性健康评分Ⅱ(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ评分)、序贯器官衰竭评分(Sequential Organ Failure Assessment,SOFA)以及NRS 2002、修改版营养风险评分(Modified Nutritional Risk Score,mNUTRIC)对比,差异存在统计学意义(P<0.05);对上述候选变量进行Lasso回归分析,选择了最简单模型并进行多因素Logistic回归分析结果显示,年龄(OR=2.435,95%CI:2.021-2.934)、BMI(OR=1.775,95%CI:1.509-2.089)、合并慢性胃肠道症状(OR=0.958,95%CI:0.925-0.992)、合并症数量(OR=2.181,95%CI:1.850-2.572)、血红蛋白水平(OR=0.936,95%CI:0.895-0.979)、白蛋白水平(OR=0.919,95%CI:0.886-0.954)、前白蛋白水平(OR=0.948,95%CI:0.908-0.990)、淋巴细胞计数(OR=0.912,95%CI:0.882-0.943)、NRS 2002评分(OR=2.166,95%CI:1.866-2.514)、mNUTRIC评分(OR=1.908,95%CI:1.621-2.245)是ICU危重症患者发生营养不良的影响因素(P<0.05);ROC曲线分析结果显示,在预测ICU危重症患者发生营养不良上,列线图、NRS 2002评分以及mNUTRIC评分的AUC分别为0.716、0.783、0.758。结论结论年龄、低BMI、慢性胃肠道症状、多重合并症及低血红蛋白、白蛋白、前白蛋白和淋巴细胞计数是ICU患者营养不良的独立危险因素,基于危险因素构建的列线图模型预测性能仍达临床可接受水平。鉴于NRS 2002与mNUTRIC为国际公认标准,列线图可作为补充工具,在资源受限或需个体化评估时提供可靠的床旁决策支持。展开更多
文摘Transport risk management is one of the predominant issues to any industry for supplying their goods safely and in time to their beneficiaries. Damaging goods or delaying the shipping both make penalty to the company and also reduce the goodwill of the company. Every way of transportation routes has to be comfy which can make sure the supplies will attain without damaging goods and in time and additionally cost efficiently. In this paper, we find a few not unusual risks which might be concerned about all types of way of routes which include Highway, Waterway, Airway, Railway and so forth. Additionally, we proposed a technique to attain multiple optimal solutions by using Modified Distribution Method (MODI) of a transportation problem. Finally, we reduce the risks by minimizing the possible number of transportation routes using multi-optimality technique of the transportation problem.
文摘目的目的基于Lasso方法分析重症监护病房(Intensive Care Unit,ICU)危重症患者发生营养不良的危险因素以及不同营养评估法的预测价值。方法方法纳入2021年6月-2024年6月于我院ICU接受治疗的危重症患者354例,依据NUTRIC分为:良好组(NUTRIC=0分)216例、不良组(NUTRIC≥1分)138例;其中不良组又包括:低风险(1分≤NUTRIC≤3分)69例、中风险(4分≤NUTRIC≤5分)47例以及高风险(NUTRIC≥6分)22例;分析影响ICU危重症患者发生营养不良的危险因素,并探究其与不同营养评估法的预测价值。结果结果两组患者年龄、体质指数(Body Mass Index,BMI)、慢性胃肠道症状、合并症数量、入ICU前住院天数、血红蛋白、白蛋白、前白蛋白、淋巴细胞计数、CD4阳性T淋巴细胞(CD4-positive T lymphocytes,+CD4 T)、磷离子水平、急性生理与慢性健康评分Ⅱ(Acute Physiology and Chronic Health EvaluationⅡ,APACHEⅡ评分)、序贯器官衰竭评分(Sequential Organ Failure Assessment,SOFA)以及NRS 2002、修改版营养风险评分(Modified Nutritional Risk Score,mNUTRIC)对比,差异存在统计学意义(P<0.05);对上述候选变量进行Lasso回归分析,选择了最简单模型并进行多因素Logistic回归分析结果显示,年龄(OR=2.435,95%CI:2.021-2.934)、BMI(OR=1.775,95%CI:1.509-2.089)、合并慢性胃肠道症状(OR=0.958,95%CI:0.925-0.992)、合并症数量(OR=2.181,95%CI:1.850-2.572)、血红蛋白水平(OR=0.936,95%CI:0.895-0.979)、白蛋白水平(OR=0.919,95%CI:0.886-0.954)、前白蛋白水平(OR=0.948,95%CI:0.908-0.990)、淋巴细胞计数(OR=0.912,95%CI:0.882-0.943)、NRS 2002评分(OR=2.166,95%CI:1.866-2.514)、mNUTRIC评分(OR=1.908,95%CI:1.621-2.245)是ICU危重症患者发生营养不良的影响因素(P<0.05);ROC曲线分析结果显示,在预测ICU危重症患者发生营养不良上,列线图、NRS 2002评分以及mNUTRIC评分的AUC分别为0.716、0.783、0.758。结论结论年龄、低BMI、慢性胃肠道症状、多重合并症及低血红蛋白、白蛋白、前白蛋白和淋巴细胞计数是ICU患者营养不良的独立危险因素,基于危险因素构建的列线图模型预测性能仍达临床可接受水平。鉴于NRS 2002与mNUTRIC为国际公认标准,列线图可作为补充工具,在资源受限或需个体化评估时提供可靠的床旁决策支持。
