{"id":"https://openalex.org/W7204906588","doi":"https://doi.org/10.64898/2026.08.26.747449","title":"Predictability failure in glucose-insulin system for ICU patients","display_name":"Predictability failure in glucose-insulin system for ICU patients","publication_year":2026,"publication_date":"2026-09-01","ids":{"openalex":"https://openalex.org/W7204906588","doi":"https://doi.org/10.64898/2026.08.26.747449"},"language":"en","primary_location":{"id":"doi:10.64898/2026.08.26.747449","doi":"https://doi.org/10.64898/2026.08.26.747449","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.26.747449","pdf_url":null,"source":{"id":"https://openalex.org/S4306402567","display_name":"bioRxiv (Cold Spring Harbor Laboratory)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2750212522","host_organization_name":"Cold Spring Harbor Laboratory","host_organization_lineage":["https://openalex.org/I2750212522"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"bioRxiv","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://doi.org/10.64898/2026.08.26.747449","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5015352247","display_name":"Deepjyoti Ghosh","orcid":"https://orcid.org/0009-0002-1793-9201","observed_orcids":["https://orcid.org/0009-0002-1793-9201"]},"institutions":[{"id":"https://openalex.org/I40347166","display_name":"University of Chicago","ror":"https://ror.org/024mw5h28","country_code":"US","type":"education","lineage":["https://openalex.org/I40347166"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Deepjyoti Ghosh","raw_affiliation_strings":["Section of Genetic Medicine, Department of Medicine, University of Chicago, USA"],"raw_orcid":"https://orcid.org/0009-0002-1793-9201","affiliations":[{"raw_affiliation_string":"Section of Genetic Medicine, Department of Medicine, University of Chicago, USA","institution_ids":["https://openalex.org/I40347166"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5015352247"],"corresponding_institution_ids":["https://openalex.org/I40347166"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10244","display_name":"Chaos control and synchronization","score":0.5,"subfield":{"id":"https://openalex.org/subfields/3109","display_name":"Statistical and Nonlinear Physics"},"field":{"id":"https://openalex.org/fields/31","display_name":"Physics and Astronomy"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},"topics":[{"id":"https://openalex.org/T10244","display_name":"Chaos control and synchronization","score":0.5,"subfield":{"id":"https://openalex.org/subfields/3109","display_name":"Statistical and Nonlinear Physics"},"field":{"id":"https://openalex.org/fields/31","display_name":"Physics and Astronomy"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11623","display_name":"Hyperglycemia and glycemic control in critically ill and hospitalized patients","score":0.18330000340938568,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10560","display_name":"Diabetes Management and Research","score":0.07930000126361847,"subfield":{"id":"https://openalex.org/subfields/2712","display_name":"Endocrinology, Diabetes and Metabolism"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/glucose-insulin-system","display_name":"glucose-insulin system","score":0.9190000295639038},{"id":"https://openalex.org/keywords/temporal-chaos","display_name":"temporal chaos","score":0.7319999933242798},{"id":"https://openalex.org/keywords/lyapunov-exponents","display_name":"Lyapunov exponents","score":0.9049999713897705},{"id":"https://openalex.org/keywords/glycemic-control","display_name":"glycemic control","score":0.6150000095367432},{"id":"https://openalex.org/keywords/intensive-care-unit","display_name":"intensive care unit","score":0.7260000109672546},{"id":"https://openalex.org/keywords/hormone-regulation","display_name":"hormonal regulation","score":0.6980000138282776},{"id":"https://openalex.org/keywords/markov-processes","display_name":"Markov processes","score":0.5730000138282776}],"concepts":[{"id":"https://openalex.org/C197640229","wikidata":"https://www.wikidata.org/wiki/Q2534066","display_name":"Predictability","level":2,"score":0.6322000026702881},{"id":"https://openalex.org/C136792703","wikidata":"https://www.wikidata.org/wiki/Q377893","display_name":"Ultradian rhythm","level":3,"score":0.5845999717712402},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.5044000148773193},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.49149999022483826},{"id":"https://openalex.org/C79191276","wikidata":"https://www.wikidata.org/wiki/Q7259620","display_name":"Pulsatile flow","level":2,"score":0.4832000136375427},{"id":"https://openalex.org/C2780473172","wikidata":"https://www.wikidata.org/wiki/Q5572518","display_name":"Glycemic","level":3,"score":0.4616999924182892},{"id":"https://openalex.org/C2987404301","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care","level":2,"score":0.3978999853134155},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.37940001487731934},{"id":"https://openalex.org/C151201525","wikidata":"https://www.wikidata.org/wiki/Q177239","display_name":"Limit (mathematics)","level":2,"score":0.3716999888420105},{"id":"https://openalex.org/C191544260","wikidata":"https://www.wikidata.org/wiki/Q1238630","display_name":"Lyapunov exponent","level":3,"score":0.34549999237060547},{"id":"https://openalex.org/C47446073","wikidata":"https://www.wikidata.org/wiki/Q5165890","display_name":"Control theory (sociology)","level":3,"score":0.3305000066757202},{"id":"https://openalex.org/C33923547","wikidata":"https://www.wikidata.org/wiki/Q395","display_name":"Mathematics","level":0,"score":0.31049999594688416},{"id":"https://openalex.org/C2991859549","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Critically ill","level":2,"score":0.3084000051021576},{"id":"https://openalex.org/C60640748","wikidata":"https://www.wikidata.org/wiki/Q2337858","display_name":"Lyapunov function","level":3,"score":0.30489999055862427},{"id":"https://openalex.org/C2780668416","wikidata":"https://www.wikidata.org/wiki/Q202758","display_name":"Hypoglycemia","level":3,"score":0.29120001196861267},{"id":"https://openalex.org/C197115733","wikidata":"https://www.wikidata.org/wiki/Q1003136","display_name":"Forcing (mathematics)","level":2,"score":0.29010000824928284},{"id":"https://openalex.org/C2987469083","wikidata":"https://www.wikidata.org/wiki/Q166314","display_name":"Chaotic systems","level":3,"score":0.27379998564720154},{"id":"https://openalex.org/C149782125","wikidata":"https://www.wikidata.org/wiki/Q160039","display_name":"Econometrics","level":1,"score":0.26919999718666077},{"id":"https://openalex.org/C2777052490","wikidata":"https://www.wikidata.org/wiki/Q5072826","display_name":"Chaotic","level":2,"score":0.25999999046325684}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.64898/2026.08.26.747449","doi":"https://doi.org/10.64898/2026.08.26.747449","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.26.747449","pdf_url":null,"source":{"id":"https://openalex.org/S4306402567","display_name":"bioRxiv (Cold Spring Harbor Laboratory)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2750212522","host_organization_name":"Cold Spring Harbor Laboratory","host_organization_lineage":["https://openalex.org/I2750212522"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"bioRxiv","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.64898/2026.08.26.747449","doi":"https://doi.org/10.64898/2026.08.26.747449","is_oa":true,"landing_page_url":"https://doi.org/10.64898/2026.08.26.747449","pdf_url":null,"source":{"id":"https://openalex.org/S4306402567","display_name":"bioRxiv (Cold Spring Harbor Laboratory)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2750212522","host_organization_name":"Cold Spring Harbor Laboratory","host_organization_lineage":["https://openalex.org/I2750212522"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by-nc","license_id":"https://openalex.org/licenses/cc-by-nc","version":"acceptedVersion","is_accepted":true,"is_published":false,"raw_source_name":"bioRxiv","raw_type":"posted-content"},"sustainable_development_goals":[{"score":0.8048999905586243,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":29,"referenced_works":["https://openalex.org/W1844237527","https://openalex.org/W1978864042","https://openalex.org/W1979929562","https://openalex.org/W1981626449","https://openalex.org/W1985940938","https://openalex.org/W1996236894","https://openalex.org/W2003890998","https://openalex.org/W2006964789","https://openalex.org/W2008082177","https://openalex.org/W2026749068","https://openalex.org/W2043415677","https://openalex.org/W2046453766","https://openalex.org/W2059279902","https://openalex.org/W2094631910","https://openalex.org/W2098177993","https://openalex.org/W2103414686","https://openalex.org/W2115631661","https://openalex.org/W2148839848","https://openalex.org/W2171689276","https://openalex.org/W2318850400","https://openalex.org/W2491160177","https://openalex.org/W2608902687","https://openalex.org/W2791905413","https://openalex.org/W3037797010","https://openalex.org/W3106610573","https://openalex.org/W3113053863","https://openalex.org/W3131160493","https://openalex.org/W4213388037","https://openalex.org/W4294031233"],"related_works":["https://openalex.org/W3113053863","https://openalex.org/W3043578067","https://openalex.org/W7163023544","https://openalex.org/W3091821254","https://openalex.org/W2043415677","https://openalex.org/W4412593194","https://openalex.org/W4387390045","https://openalex.org/W4413043636","https://openalex.org/W7099573120","https://openalex.org/W2546135336"],"abstract_inverted_index":{"ABSTRACT":[0],"Modern":[1],"medicine":[2],"implicitly":[3],"assumes":[4],"that":[5,51,76,174],"physiological":[6,17,83,123],"responses":[7],"to":[8,144,188],"intervention":[9],"are":[10],"predictably":[11],"determined":[12],"by":[13,44],"administered":[14],"treatments.":[15],"However,":[16],"systems":[18],"containing":[19],"intrinsic":[20,125],"delays":[21],"between":[22,122],"the":[23,29,38,45,82,120,135,181,185,199],"detection":[24],"of":[25,81,150,184],"a":[26,128,148],"stimulus":[27],"and":[28,48,60,99,104,131,152],"biological":[30],"response":[31],"may":[32,77,178],"violate":[33],"this":[34],"assumption.":[35],"We":[36],"investigate":[37],"human":[39],"glucose\u2013insulin":[40,137],"system":[41],"as":[42,56],"described":[43],"Ultradian":[46,136],"model":[47],"mathematically":[49],"demonstrate":[50],"clinically":[52],"relevant":[53],"forcing":[54,154],"protocols\u2014such":[55],"pulsatile":[57,151],"insulin":[58,105],"delivery":[59],"step-wise":[61,153],"glucose":[62,103],"infusion,":[63],"both":[64],"commonly":[65],"used":[66,187],"in":[67,95,106,198],"intensive":[68],"care":[69,110],"units":[70],"(ICUs)\u2014can":[71],"induce":[72],"sustained":[73,169],"temporal":[74],"chaos":[75],"hamper":[78],"accurate":[79],"prediction":[80],"response.":[84],"If":[85],"not":[86],"accounted":[87],"for,":[88],"these":[89],"chaotic":[90],"dynamics":[91],"could":[92],"create":[93],"difficulties":[94],"achieving":[96],"optimal":[97],"dosing":[98],"timing":[100],"when":[101],"administering":[102],"clinical":[107,196],"or":[108],"home":[109],"settings.":[111],"This":[112],"phenomenon,":[113],"termed":[114],"delay-induced":[115],"uncertainty":[116],"(DIU),":[117],"arises":[118],"from":[119,160],"interaction":[121],"delay,":[124],"shear":[126],"near":[127],"limit":[129,180],"cycle,":[130],"external":[132],"forcing.":[133],"Using":[134],"model,":[138],"we":[139,163],"compute":[140],"top":[141],"Lyapunov":[142,166],"exponents":[143],"quantify":[145],"predictability.":[146],"Across":[147],"range":[149],"regimes,":[155],"including":[156],"stochastic":[157],"amplitudes":[158],"drawn":[159],"Markov":[161],"processes,":[162],"observe":[164],"positive":[165],"exponents,":[167],"indicating":[168],"chaos.":[170],"Our":[171],"results":[172],"suggest":[173],"delayed":[175],"endocrine":[176],"regulation":[177],"fundamentally":[179],"predictive":[182],"value":[183],"models":[186],"develop":[189],"glycemic":[190],"management":[191],"strategies,":[192],"with":[193],"implications":[194],"for":[195],"protocols":[197],"ICU.":[200]},"counts_by_year":[],"updated_date":"2026-10-28T10:33:24.094632","created_date":"2026-09-02T00:00:00"}
