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Effective tight glycemic control (TGC) can improve outcomes in intensive care unit (ICU)
patients, but is difficult to achieve consistently. Glycemic level and variability, particularly early in a
patient’s stay, are a function of variability in insulin sensitivity/resistance resulting from the level and
evolution of stress response, and are independently associated with mortality. This study examines the
daily evolution of variability of insulin sensitivity in ICU patients using patient data (N = 394 patients,
54019 hours) from the SPRINT TGC study. Model-based insulin sensitivity (SI) was identified each hour
and hour-to-hour percent changes in SI were assessed for Days 1-3 individually and Day 4 Onward, as
well as over all days. Cumulative distribution functions (CDFs), median values, and in...
Frictional contact interfaces have to be modeled in practice when industrial problems such as metal forming operations, crashworthiness, and so on, have to be simulated. Usually a Coulomb model is used in order to describe the constitutive law for the frictional case. Following a standard non associated plasticity approach to Coulomb law a non-symmetric tangent operator results, and so a non-symmetric solver has to be used in order to take full advantage of consistent operators. With respect to symmetric ones, these non-symmetric operators lead to prohibitive computational times. However, in practice different schemes have been proposed in order to recover the symmetric operator, and consequently, use a symmetric solver. In this work an alternative approach based on an idea due to Garcia Garino and Oliver (1992) is defined in order to ...
We estimate a factor requirement frontier for European railways using a panel data approach in which technical efficiency is assumed to be endogencously determined. This approach has two main outcomes. On one hand, it allows the identification of factors influencing technical efficiency, and on the other hand, it allows the estimation of alternative efficiency indicators free of these influences. In the case under study, a particular attention is devoted to an autonomy indicator representing the managerial freedom, with respect to public authorities, experienced by firms, that appears to be positively correlated with technical efficiency.
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