
Early in the COVID-19 pandemic, medical care providers at an acute illness hospital received increasing numbers of post-acute advanced COVID-19 patients from referring hospitals where they were showing no signs of improvement after receiving treatments from standard Emergency Use Authorization (EUA)-type protocols. The care providers turned to repurposing medications to treat these patients and added hydroxyurea, a medication commonly used for treating sickle cell anemia, to the hospital's COVID-19 treatment protocol and began to see notable clinical improvements. As the pandemic continued and new concerns arose concerning COVID-19 complications, those same care providers again turned to repurposing drugs. Focusing on the neuromuscular effects seen in COVID-19 patients, care providers turned to medications used to treat chronic neuromuscular conditions. Post-acute advanced Covid-19 patients initially received an abbreviated course of hydroxyurea followed by titrated doses of pyridostigmine. Positive responses were noted with cognition, diminished oxygen demands, progressive decrease in ventilator support, improved swallowing, and mobility. The authors suggest repurposed drugs could have great utility for treating COVID-19. It is recommended larger, COVID-19 clinical trials be completed to include hydroxyurea and pyridostigmine for validating the outcomes and clinical observations seen in these presented cases.
Citation: Melissa R. Bowman Foster, Ali Atef Hijazi, Raymond C. Sullivan Jr, Rebecca Opoku. Hydroxyurea and pyridostigmine repurposed for treating Covid-19 multi-systems dysfunctions[J]. AIMS Medical Science, 2023, 10(2): 118-129. doi: 10.3934/medsci.2023010
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Early in the COVID-19 pandemic, medical care providers at an acute illness hospital received increasing numbers of post-acute advanced COVID-19 patients from referring hospitals where they were showing no signs of improvement after receiving treatments from standard Emergency Use Authorization (EUA)-type protocols. The care providers turned to repurposing medications to treat these patients and added hydroxyurea, a medication commonly used for treating sickle cell anemia, to the hospital's COVID-19 treatment protocol and began to see notable clinical improvements. As the pandemic continued and new concerns arose concerning COVID-19 complications, those same care providers again turned to repurposing drugs. Focusing on the neuromuscular effects seen in COVID-19 patients, care providers turned to medications used to treat chronic neuromuscular conditions. Post-acute advanced Covid-19 patients initially received an abbreviated course of hydroxyurea followed by titrated doses of pyridostigmine. Positive responses were noted with cognition, diminished oxygen demands, progressive decrease in ventilator support, improved swallowing, and mobility. The authors suggest repurposed drugs could have great utility for treating COVID-19. It is recommended larger, COVID-19 clinical trials be completed to include hydroxyurea and pyridostigmine for validating the outcomes and clinical observations seen in these presented cases.
In the present paper we study the effective conductivity of an
(λ+,λ−)∈[0,+∞[2∗≡[0,+∞[2∖{(0,0)}. |
We note that the limit case of zero conductivity corresponds to a thermal insulator. On the other hand, if the conductivity tends to
We now introduce the geometry of the problem. If
q=(q110⋯00⋱⋯0⋮⋮⋱⋮00⋯qnn), | (1) |
and
Q≡n∏j=1]0,qjj[⊆Rn. | (2) |
The set
˜Q≡]0,1[n,˜q≡In≡(10⋯00⋱⋯0⋮⋮⋱⋮00⋯1). |
Then we take
α∈]0,1[ and a bounded open connected subset Ω of Rn of class C1,α such that Rn∖¯Ω is connected. | (3) |
The symbol '
Sq[qI[ϕ]]≡⋃z∈Zn(qz+qI[ϕ]),Sq[qI[ϕ]]−≡Rn∖¯Sq[qI[ϕ]]. |
The set
With the aim of introducing the definition of the effective conductivity, we first have to introduce a boundary value problem for the Laplace equation. If
{Δu+j=0in Sq[qI[ϕ]],Δu−j=0in Sq[qI[ϕ]]−,u+j(x+qeh)=u+j(x)+δhjqjj∀x∈¯Sq[qI[ϕ]],∀h∈{1,…,n},u−j(x+qeh)=u−j(x)+δhjqjj∀x∈¯Sq[qI[ϕ]]−,∀h∈{1,…,n},λ+∂∂νqI[ϕ]u+j−λ−∂∂νqI[ϕ]u−j=0on ∂qI[ϕ],u+j−u−j=0on ∂qI[ϕ],∫∂qI[ϕ]u+jdσ=0, | (4) |
where
Definition 1.1. Let
λeff[q,ϕ,(λ+,λ−)]≡(λeffij[q,ϕ,(λ+,λ−)])i,j=1,…,n |
is the
λeffij[q,ϕ,(λ+,λ−)]≡1|Q|n{λ+∫qI[ϕ]∂∂xiu+j[q,ϕ,(λ+,λ−)](x)dx+λ−∫Q∖¯qI[ϕ]∂∂xiu−j[q,ϕ,(λ+,λ−)](x)dx}∀i,j∈{1,…,n}. |
Remark 1.2. Under the assumptions of Definition 1.1, by applying the divergence theorem, one can verify that
λeffij[q,ϕ,(λ+,λ−)]=1|Q|n{λ+∫qI[ϕ]Du+i[q,ϕ,(λ+,λ−)](x)⋅Du+j[q,ϕ,(λ+,λ−)](x)dx+λ−∫Q∖¯qI[ϕ]Du−i[q,ϕ,(λ+,λ−)](x)⋅Du−j[q,ϕ,(λ+,λ−)](x)dx}∀i,j∈{1,…,n}. |
Indeed, if we set
˜u+k[q,ϕ,(λ+,λ−)](x)=u+k[q,ϕ,(λ+,λ−)](x)−xk∀x∈¯Sq[qI[ϕ]]˜u−k[q,ϕ,(λ+,λ−)](x)=u−k[q,ϕ,(λ+,λ−)](x)−xk∀x∈¯Sq[qI[ϕ]]−∀k∈{1,…,n}, |
then
1|Q|n{λ+∫qI[ϕ]Du+i[q,ϕ,(λ+,λ−)](x)⋅Du+j[q,ϕ,(λ+,λ−)](x)dx+λ−∫Q∖¯qI[ϕ]Du−i[q,ϕ,(λ+,λ−)](x)⋅Du−j[q,ϕ,(λ+,λ−)](x)dx}=1|Q|n{λ+∫qI[ϕ]Du+j[q,ϕ,(λ+,λ−)](x)⋅D(xi+˜u+i[q,ϕ,(λ+,λ−)](x))dx+λ−∫Q∖¯qI[ϕ]Du−j[q,ϕ,(λ+,λ−)](x)⋅D(xi+˜u−i[q,ϕ,(λ+,λ−)](x))dx}=1|Q|n{λ+∫qI[ϕ]Du+j[q,ϕ,(λ+,λ−)](x)⋅Dxidx+λ+∫qI[ϕ]Du+j[q,ϕ,(λ+,λ−)](x)⋅D˜u+i[q,ϕ,(λ+,λ−)](x)dx+λ−∫Q∖¯qI[ϕ]Du−j[q,ϕ,(λ+,λ−)](x)⋅Dxidx+λ−∫Q∖¯qI[ϕ]Du−j[q,ϕ,(λ+,λ−)](x)⋅D˜u−i[q,ϕ,(λ+,λ−)](x)dx}=1|Q|n{λ+∫qI[ϕ]∂∂xiu+j[q,ϕ,(λ+,λ−)](x)dx+λ+∫qI[ϕ]Du+j[q,ϕ,(λ+,λ−)](x)⋅D˜u+i[q,ϕ,(λ+,λ−)](x)dx+λ−∫Q∖¯qI[ϕ]∂∂xiu−j[q,ϕ,(λ+,λ−)](x)dx+λ−∫Q∖¯qI[ϕ]Du−j[q,ϕ,(λ+,λ−)](x)⋅D˜u−i[q,ϕ,(λ+,λ−)](x)dx}. |
Therefore, in order to conclude that the two definitions are equivalent, we need to show that
λ+∫qI[ϕ]Du+j[q,ϕ,(λ+,λ−)](x)⋅D˜u+i[q,ϕ,(λ+,λ−)](x)dx+λ−∫Q∖¯qI[ϕ]Du−j[q,ϕ,(λ+,λ−)](x)⋅D˜u−i[q,ϕ,(λ+,λ−)](x)dx=0. | (5) |
By an application of the divergence theorem for
∫qI[ϕ]Du+j[q,ϕ,(λ+,λ−)](x)⋅D˜u+i[q,ϕ,(λ+,λ−)](x)dx=∫∂qI[ϕ](∂∂νqI[ϕ]u+j[q,ϕ,(λ+,λ−)](x))˜u+i[q,ϕ,(λ+,λ−)](x)dσx | (6) |
and
∫Q∖¯qI[ϕ]Du−j[q,ϕ,(λ+,λ−)](x)⋅D˜u−i[q,ϕ,(λ+,λ−)](x)dx=∫∂Q(∂∂νQu−j[q,ϕ,(λ+,λ−)](x))˜u−i[q,ϕ,(λ+,λ−)](x)dσx−∫∂qI[ϕ](∂∂νqI[ϕ]u−j[q,ϕ,(λ+,λ−)](x))˜u−i[q,ϕ,(λ+,λ−)](x)dσx. | (7) |
By the periodicity of
∫∂Q(∂∂νQu−j[q,ϕ,(λ+,λ−)](x))˜u−i[q,ϕ,(λ+,λ−)](x)dσx=∫∂Q(∂∂νQxj)˜u−i[q,ϕ,(λ+,λ−)](x)dσx+∫∂Q(∂∂νQ˜u−j[q,ϕ,(λ+,λ−)](x))˜u−i[q,ϕ,(λ+,λ−)](x)dσx=∫∂Q(νQ(x)⋅ej)˜u−i[q,ϕ,(λ+,λ−)](x)dσx+∫∂Q(νQ(x)⋅D˜u−j[q,ϕ,(λ+,λ−)](x))˜u−i[q,ϕ,(λ+,λ−)](x)dσx=0, | (8) |
since contributions on opposite sides of
λ+∫qI[ϕ]Du+j[q,ϕ,(λ+,λ−)](x)⋅D˜u+i[q,ϕ,(λ+,λ−)](x)dx+λ−∫Q∖¯qI[ϕ]Du−j[q,ϕ,(λ+,λ−)](x)⋅D˜u−i[q,ϕ,(λ+,λ−)](x)dx=λ+∫∂qI[ϕ](∂∂νqI[ϕ]u+j[q,ϕ,(λ+,λ−)](x))˜u+i[q,ϕ,(λ+,λ−)](x)dσx−λ−∫∂qI[ϕ](∂∂νqI[ϕ]u−j[q,ϕ,(λ+,λ−)](x))˜u−i[q,ϕ,(λ+,λ−)](x)dσx. | (9) |
Since the validity of (4) implies that
˜u+i[q,ϕ,(λ+,λ−)](x)=˜u−i[q,ϕ,(λ+,λ−)](x)∀x∈∂qI[ϕ] |
and that
λ+∂∂νqI[ϕ]u+j[q,ϕ,(λ+,λ−)](x)−λ−∂∂νqI[ϕ]u−j[q,ϕ,(λ+,λ−)](x)=0∀x∈∂qI[ϕ], |
we then deduce by (9) that (5) holds true.
As a consequence, the effective conductivity matrix of Definition 1.1 coincides with the one analyzed by Ammari, Kang, and Touibi [5,p. 121] for a periodic two-phase composite and which can be deduced by classical homogenization theory (see, e.g., Allaire [1], Bensoussan, Lions, and Papanicolaou [6], Jikov, Kozlov, and Oleĭnik [27], Milton [41]). We emphasize that the justification of the expression of the effective conductivity via homogenization theory holds for 'small' values of the periodicity parameters. For further remarks on the definition of effective conductivity we refer to Gluzman, Mityushev, and Nawalaniec [24,§2.2].
The main goal of our paper is to give an answer to the following question:
What can be said on the regularity of the map(q,ϕ,(λ+,λ−))↦λeff[q,ϕ,(λ+,λ−)]? | (10) |
We answer to the above question by proving that for all
Λij:D+n(R)×(C1,α(∂Ω,Rn)∩A˜Q∂Ω)×]−1−ε,1+ε[→R |
such that
λeffij[q,ϕ,(λ+,λ−)]=δijλ−+(λ++λ−)Λij[q,ϕ,λ+−λ−λ++λ−] | (11) |
for all
In particular, in the present paper we follow the strategy of [39] where we have studied the behavior of the longitudinal flow along a periodic array of cylinders upon perturbations of the shape of the cross section of the cylinders and the periodicity structure, when a Newtonian fluid is flowing at low Reynolds numbers around the cylinders. More precisely, we transform the problem into a set of integral equations defined on a fixed domain and depending on the set of variables
Formula (11) implies that the effective conductivity
(q,ϕ,(λ+,λ−))↦λeffij[q,ϕ,(λ+,λ−)] | (12) |
from
λeffij[qδ,ϕδ,(λ+δ,λ−δ)]=∞∑k=0ckδk | (13) |
for
Furthermore, such a high regularity result can be seen as a theoretical justification which guarantees that differential calculus may be used in order to characterize critical periodicity-shape-conductivity triples
As already mentioned, our method is based on integral equations, that are derived by potential theory. However, integral equations could also be deduced by the generalized alternating method of Schwarz (cf. Gluzman, Mityushev, and Nawalaniec [24] and Drygaś, Gluzman, Mityushev, and Nawalaniec [19]), which also allows to produce expansions in the concentration.
Incidentally, we observe that the are several contributions concerning optimization of effective parameters from many different points of view. For example, one can look for optimal lattices without confining to rectangular distributions. In this direction, Kozlov [29] and Mityushev and Rylko [44] have discussed extremal properties of hexagonal lattices of disks. On the other hand, even if, in wide generality, the optimal composite does not exist (cf. Cherkaev [13]), one can discuss the dependence on the shape under some specific restrictions. For example, one could build composites with prescribed effective conductivity as described in Lurie and Cherkaev [38] (see also Gibiansky and Cherkaev [22]). In Rylko [49], the author has studied the influence of perturbations of the shape of the circular inclusion on the macroscopic conductivity properties of 2D dilute composites. Inverse problems concerning the determination of the shape of equally strong holes in elastic structures were considered by Cherepanov [12]. For an experimental work concerning the analysis of particle reinforced composites we mention Kurtyka and Rylko [30]. Also, we mention that one could apply the topological derivative method as in Novotny and Sokołowski [46] for the optimal design of microstructures.
Let
Let
Sq[ΩQ]≡⋃z∈Zn(qz+ΩQ),Sq[ΩQ]−≡Rn∖¯Sq[ΩQ]. |
If
Ckb(¯Sq[ΩQ]−)≡{u∈Ck(¯Sq[ΩQ]−):Dγu is bounded ∀γ∈Nn s. t. |γ|≤k}, |
and we endow
‖u‖Ckb(¯Sq[ΩQ]−)≡∑|γ|≤ksupx∈¯Sq[ΩQ]−|Dγu(x)|∀u∈Ckb(¯Sq[ΩQ]−), |
where
Ck,βb(¯Sq[ΩQ]−)≡{u∈Ck,β(¯Sq[ΩQ]−):Dγu is bounded ∀γ∈Nn s. t. |γ|≤k}, |
and we endow
‖u‖Ck,βb(¯Sq[ΩQ]−)≡∑|γ|≤ksupx∈¯Sq[ΩQ]−|Dγu(x)|+∑|γ|=k|Dγu:¯Sq[ΩQ]−|β∀u∈Ck,βb(¯Sq[ΩQ]−), |
where
Ckq(¯Sq[ΩQ]−)≡{u∈Ckb(¯Sq[ΩQ]−):u is q-periodic}, |
which we regard as a Banach subspace of
Ck,βq(¯Sq[ΩQ]−)≡{u∈Ck,βb(¯Sq[ΩQ]−):u is q-periodic}, |
which we regard as a Banach subspace of
Our method is based on a periodic version of classical potential theory. In order to construct periodic layer potentials, we replace the fundamental solution of the Laplace operator by a
ΔSq,n=∑z∈Znδqz−1|Q|n, |
where
Sq,n(x)=−∑z∈Zn∖{0}1|Q|n4π2|q−1z|2e2πi(q−1z)⋅x |
in the sense of distributions in
We now introduce periodic layer potentials. Let
vq[∂ΩQ,μ](x)≡∫∂ΩQSq,n(x−y)μ(y)dσy∀x∈Rn,wq,∗[∂ΩQ,μ](x)≡∫∂ΩQνΩQ(x)⋅DSq,n(x−y)μ(y)dσy∀x∈∂ΩQ, |
for all
v+q[∂ΩQ,μ]≡vq[∂ΩQ,μ]|¯Sq[ΩQ] v−q[∂ΩQ,μ]≡vq[∂ΩQ,μ]|¯Sq[ΩQ]−. |
We collect in the following theorem some properties of
Theorem 2.1. Let
(i) The map from
(ii) Let
∂∂νΩQv±q[∂ΩQ,μ]=∓12μ+wq,∗[∂ΩQ,μ]on ∂ΩQ. |
Moreover,
∫∂ΩQwq,∗[∂ΩQ,μ]dσ=(12−|ΩQ|n|Q|n)∫∂ΩQμdσ. |
(iii) Let
Δvq[∂ΩQ,μ]=0in Rn∖∂Sq[ΩQ]. |
(iv) The operator
In order to consider shape perturbations of the inclusions of the composite, we introduce a class of diffeomorphisms. Let
A˜Q∂Ω≡{ϕ∈A∂Ω:ϕ(∂Ω)⊆˜Q},A˜Q¯Ω′≡{Φ∈A¯Ω′:Φ(¯Ω′)⊆˜Q}. | (14) |
If
We conclude this section of preliminaries with some results on problem (4). By means of the following proposition, whose proof is of immediate verification, we can transform problem (4) into a
Proposition 2.2. Let
(u+j,u−j)∈C1,αloc(¯Sq[qI[ϕ]])×C1,αloc(¯Sq[qI[ϕ]]−) |
solves problem (4) if and only if the pair
(˜u+j,˜u−j)∈C1,αq(¯Sq[qI[ϕ]])×C1,αq(¯Sq[qI[ϕ]]−) |
delivered by
˜u+j(x)=u+j(x)−xj∀x∈¯Sq[qI[ϕ]],˜u−j(x)=u−j(x)−xj∀x∈¯Sq[qI[ϕ]]−, |
solves
{Δ˜u+j=0in Sq[qI[ϕ]],Δ˜u−j=0in Sq[qI[ϕ]]−,˜u+j(x+qeh)=˜u+j(x)∀x∈¯Sq[qI[ϕ]],∀h∈{1,…,n},˜u−j(x+qeh)=˜u−j(x)∀x∈¯Sq[qI[ϕ]]−,∀h∈{1,…,n},λ+∂∂νqI[ϕ]˜u+j−λ−∂∂νqI[ϕ]˜u−j=(λ–λ+)(νqI[ϕ])jon ∂qI[ϕ],˜u+j−˜u−j=0on ∂qI[ϕ],∫∂qI[ϕ]˜u+jdσ=−∫∂qI[ϕ]yjdσy. | (15) |
Next, we show that problems (4) and (15) admit at most one solution.
Proposition 2.3. Let
(i) Problem (4) has at most one solution in
(ii) Problem (15) has at most one solution in
Proof. By the equivalence of problems (4) and (15) of Proposition 2.2, it suffices to prove statement (ⅱ), which we now consider. By the linearity of the problem, it clearly suffices to show that if
{Δ˜u+j=0in Sq[qI[ϕ]],Δ˜u−j=0in Sq[qI[ϕ]]−,˜u+j(x+qeh)=˜u+j(x)∀x∈¯Sq[qI[ϕ]],∀h∈{1,…,n},˜u−j(x+qeh)=˜u−j(x)∀x∈¯Sq[qI[ϕ]]−,∀h∈{1,…,n},λ+∂∂νqI[ϕ]˜u+j−λ−∂∂νqI[ϕ]˜u−j=0on ∂qI[ϕ],˜u+j−˜u−j=0on ∂qI[ϕ],∫∂qI[ϕ]˜u+jdσ=0, | (16) |
then
Let
∂∂νqI[ϕ]˜u−j=0on ∂qI[ϕ]. |
Accordingly, the divergence theorem implies that
0≤∫Q∖¯qI[ϕ]|D˜u−j(y)|2dy=∫∂Q˜u−j(y)∂∂νQ˜u−j(y)dσy−∫∂qI[ϕ]˜u−j(y)∂∂νqI[ϕ]˜u−j(y)dσy=0. |
Indeed, by the
∫∂Q˜u−j(y)∂∂νQ˜u−j(y)dσy=0. |
Then, there exists
Next we consider the case
∂∂νqI[ϕ]˜u+j=0on ∂qI[ϕ]. |
By the uniqueness of the solution of the interior Neumann problem up to constants, there exists
In this section, we convert problem (4) into an equivalent integral equation. As done in [39] for the longitudinal flow along a periodic array of cylinders, we do so by representing the solution in terms of single layer potentials, whose densities solve certain integral equations. Therefore, we first start with the following proposition regarding the invertibility of an integral operator that will appear in such integral formulation of problem (4).
Proposition 3.1. Let
Kγ[μ]=12μ−γwq,∗[∂qI[ϕ],μ]on ∂qI[ϕ],∀μ∈C0,α(∂qI[ϕ]). |
Then the following statements hold.
(i)
(ii)
Proof. We first consider statement (ⅰ). If
γ=γ+−γ−γ++γ−. |
Accordingly, we have to consider only the limit cases
K1[μ]=12μ−wq,∗[∂qI[ϕ],μ]=0on ∂qI[ϕ]. |
The jump formula for the normal derivative of the single layer potential of Theorem 2.1 (ⅱ) implies that
μ=∂∂νqI[ϕ]v−q[∂qI[ϕ],μ]−∂∂νqI[ϕ]v+q[∂qI[ϕ],μ]=0on ∂qI[ϕ]. |
Next, we consider the case
K−1[μ]=12μ+wq,∗[∂qI[ϕ],μ]=0on ∂qI[ϕ]. |
The jump formula for the normal derivative of the single layer potential of Theorem 2.1 (ⅱ) implies that
μ=∂∂νqI[ϕ]v−q[∂qI[ϕ],μ]−∂∂νqI[ϕ]v+q[∂qI[ϕ],μ]=0on ∂qI[ϕ]. |
Next, we consider statement (ⅱ). The Fredholm alternative theorem and the compactness of
Kγ[μ]=12μ−γwq,∗[∂qI[ϕ],μ]=0, | (17) |
then
0=∫∂qI[ϕ]Kγ[μ]dσ={12−γ(12−|qI[ϕ]||Q|)}∫∂qI[ϕ]μdσ. |
A straightforward computation shows that
We are now ready to show that problem (4) can be reformulated in terms of an integral equation which admits a unique solution.
Theorem 3.2. Let
(u+j[q,ϕ,(λ+,λ−)],u−j[q,ϕ,(λ+,λ−)])∈C1,αloc(¯Sq[qI[ϕ]])×C1,αloc(¯Sq[qI[ϕ]]−). |
Moreover
u+j[q,ϕ,(λ+,λ−)](x)=v+q[∂qI[ϕ],μj](x)−−∫∂qI[ϕ]v+q[∂qI[ϕ],μj](y)dσy−−∫∂qI[ϕ]yjdσy+xj∀x∈¯Sq[qI[ϕ]],u−j[q,ϕ,(λ+,λ−)](x)=v−q[∂qI[ϕ],μj](x)−−∫∂qI[ϕ]v−q[∂qI[ϕ],μj](y)dσy−−∫∂qI[ϕ]yjdσy+xj∀x∈¯Sq[qI[ϕ]]−, | (18) |
where
12μj−λ+−λ−λ++λ−wq,∗[∂qI[ϕ],μj]=λ+−λ−λ++λ−(νqI[ϕ])jon ∂qI[ϕ]. | (19) |
Proof. We first note that, by Proposition 2.3 (ⅱ), problem (4) has at most one solution in
(νqI[ϕ])j∈C0,α(∂qI[ϕ])0, |
Proposition 3.1 (ⅰ) implies that there exists a unique solution
λ+(−12μj+wq,∗[∂qI[ϕ],μj])−λ−(12μj+wq,∗[∂qI[ϕ],μj])=(λ–λ+)(νqI[ϕ])jon ∂qI[ϕ],v+q[∂qI[ϕ],μj]−−∫∂qI[ϕ]v+q[∂qI[ϕ],μj]dσ−v−q[∂qI[ϕ],μj]+−∫∂qI[ϕ]v−q[∂qI[ϕ],μj]dσ=0on ∂qI[ϕ]. |
Accordingly, the properties of the single layer potential (see Theorem 2.1) together with Proposition 2.2 imply that the pair of functions defined by (18) solves problem (4).
The previous theorem provides an integral equation formulation of problem (4) and a representation formula for its solution. We conclude this section by writing the effective conductivity in a form which makes use of the density
∫qI[ϕ]∂∂xiu+j[q,ϕ,(λ+,λ−)](x)dx=∫∂qI[ϕ]u+j[q,ϕ,(λ+,λ−)](y)(νqI[ϕ](y))idσy=∫∂qI[ϕ](v+q[∂qI[ϕ],μj](y)−−∫∂qI[ϕ]v+q[∂qI[ϕ],μj](z)dσz−−∫∂qI[ϕ]zjdσz+yj)(νqI[ϕ](y))idσy=∫∂qI[ϕ]v+q[∂qI[ϕ],μj](y)(νqI[ϕ](y))idσy−∫∂qI[ϕ](νqI[ϕ](y))idσy−∫∂qI[ϕ]v+q[∂qI[ϕ],μj](z)dσz−∫∂qI[ϕ](νqI[ϕ](y))idσy−∫∂qI[ϕ]zjdσz+δij|qI[ϕ]|n. |
Similarly, we have
∫Q∖¯qI[ϕ]∂∂xiu−j[q,ϕ,(λ+,λ−)](x)dx=∫∂Qu−j[q,ϕ,(λ+,λ−)](y)(νQ(y))idσy−∫∂qI[ϕ]u−j[q,ϕ,(λ+,λ−)](y)(νqI[ϕ](y))idσy=δij|Q|n−∫∂qI[ϕ]v−q[∂qI[ϕ],μj](y)(νqI[ϕ](y))idσy+∫∂qI[ϕ](νqI[ϕ](y))idσy−∫∂qI[ϕ]v−q[∂qI[ϕ],μj](z)dσz+∫∂qI[ϕ](νqI[ϕ](y))idσy−∫∂qI[ϕ]zjdσz−δij|qI[ϕ]|n. |
Indeed
∫∂Q(v−q[∂qI[ϕ],μj](y)−−∫∂qI[ϕ]v−q[∂qI[ϕ],μj](z)dσz−−∫∂qI[ϕ]zjdσz+yj)(νQ(y))idσy=∫∂Qyj(νQ(y))idσy=δij|Q|n. |
Moreover, by the divergence theorem, we have
∫∂qI[ϕ](νqI[ϕ](y))idσy=0∀i∈{1,…,n}. |
Accordingly, by the continuity of the single layer potential, we have that
λeffij[q,ϕ,(λ+,λ−)]=1|Q|n{λ+∫qI[ϕ]∂∂xiu+j[q,ϕ,(λ+,λ−)](x)dx+λ−∫Q∖¯qI[ϕ]∂∂xiu−j[q,ϕ,(λ+,λ−)](x)dx}=1|Q|n{δijλ−|Q|n+(λ+−λ−)(∫∂qI[ϕ]vq[∂qI[ϕ],μj](y)(νqI[ϕ](y))idσy−∫∂qI[ϕ](νqI[ϕ](y))idσy−∫∂qI[ϕ]vq[∂qI[ϕ],μj](z)dσz−∫∂qI[ϕ](νqI[ϕ](y))idσy−∫∂qI[ϕ]zjdσz+δij|qI[ϕ]|n)}=δijλ−+(λ++λ−){1|Q|n(λ+−λ−)(λ++λ−)(∫∂qI[ϕ]vq[∂qI[ϕ],μj](y)(νqI[ϕ](y))idσy+δij|qI[ϕ]|n)}. | (20) |
Thanks to Theorem 3.2, the study of problem (4) can be reduced to the study of the boundary integral equation (19). Therefore, our first step in order to study the dependence of the solution of problem (4) upon the triple
Before starting with this plan, we note that equation (19) is defined on the
Lemma 4.1. Let
12θj(t)−λ+−λ−λ++λ−∫qϕ(∂Ω)DSq,n(qϕ(t)−s)⋅νqI[ϕ](qϕ(t))(θj∘ϕ(−1))(q−1s)dσs=λ+−λ−λ++λ−(νqI[ϕ](qϕ(t)))j∀t∈∂Ω, | (21) |
if and only if the function
μj(x)=(θj∘ϕ(−1))(q−1x)∀x∈∂qI[ϕ] | (22) |
solves equation (19). Moreover, equation (21) has a unique solution in
Proof. The equivalence of equation (21) in the unknown
Inspired by Lemma 4.1, for all
Mj:D+n(R)×(C1,α(∂Ω,Rn)∩A˜Q∂Ω)×]−2,2[×C0,α(∂Ω)→C0,α(∂Ω) |
by setting
Mj[q,ϕ,γ,θ](t)≡12θ(t)−γ∫qϕ(∂Ω)DSq,n(qϕ(t)−s)⋅νqI[ϕ](qϕ(t))(θ∘ϕ(−1))(q−1s)dσs−γ(νqI[ϕ](qϕ(t)))j∀t∈∂Ω, | (23) |
for all
Mj[q,ϕ,λ+−λ−λ++λ−,θ]=0 on ∂Ω. | (24) |
Our aim is to recover the regularity of the solution
Lemma 4.2. Let
(i) The map from
is real analytic.
(ii) The map from
is real analytic.
Next, we state the following technical lemma about the real analyticity upon the diffeomorphism
Lemma 4.3. Let
(i) For each
Moreover, the map
(ii) The map from
We are now ready to prove that the solutions of (24) depend real analytically upon the triple 'periodicity-shape-contrast'. We do so by means of the following.
Proposition 4.4. Let
(i) For each
and we denote such a function by
(ii) There exist
to
Proof. The proof of statement (ⅰ) is a straightforward modification of the proof of Lemma 4.1. Indeed, it suffices to replace
Next we turn to consider statement (ⅱ). As a first step we have to study the regularity of the map
for all
In this section we prove our main result that answers to question (10) on the behavior of the effective conductivity upon the triple 'periodicity-shape-conductivity'. To this aim, we exploit the representation formula in (20) of the effective conductivity and the analyticity result of Proposition 4.4.
Theorem 5.1. Let
(25) |
for all
Proof. Let
for all
for all
clearly
Then, by taking into account that the pointwise product in Schauder spaces is bilinear and continuous, and that the integral in Schauder spaces is linear and continuous, Lemma 4.3 implies that the map from
In the present paper we considered the effective conductivity of a two or three dimensional periodic two-phase composite material. The composite is obtained by introducing into a homogeneous matrix a periodic set of inclusions of a large class of sufficiently smooth shapes. We proved a regularity result for the effective conductivity of such a composite upon perturbations of the periodicity structure, of the shape of the inclusions, and of the conductivities of each material. Namely, we showed the real analytic dependence of the effective conductivity as a functional acting between suitable Banach spaces.
The consequences of our result are twofold. First, this high regularity result represents a theoretical justification to guarante that differential calculus may be used in order to characterize critical periodicity-shape-conductivity triples
for
Both the authors are members of the 'Gruppo Nazionale per l'Analisi Matematica, la Probabilità e le loro Applicazioni' (GNAMPA) of the 'Istituto Nazionale di Alta Matematica' (INdAM) and acknowledge the support of the Project BIRD191739/19 'Sensitivity analysis of partial differential equations in the mathematical theory of electromagnetism' of the University of Padova. P.M. acknowledges the support of the grant 'Challenges in Asymptotic and Shape Analysis - CASA' of the Ca' Foscari University of Venice. The authors wish to thank the anonymous referees for many valuable comments that have improved the presentation of the paper.
[1] |
Asselah T, Durantel D, Pasmant E, et al. (2021) COVID-19: discovery, diagnostics, and drug development. J Hepatol 74: 168-184. https://doi.org/10.1016/j.jhep.2020.09.031 ![]() |
[2] | Huarcaya WV, Monzón JAM, Saldaña EON, et al. (2022) Impact of COVID-19 on mortality in Peru using triangulation of multiple data sources. Rev Panam Salud Publica 46: e53. https://doi.org/10.26633/RPSP.2022.53 (Article in Spanish) |
[3] |
Pinilla-Roncancio M, Caicedo NR (2022) Data collection and inclusion of the population with disabilities during the COVID-19 pandemic in Latin America and the Caribbean. Rev Panam Salud Publica 46: e44. https://doi.org/10.26633/RPSP.2022.44 (Article in Spanish) ![]() |
[4] |
Schonhaut L, Costa-Roldan I, Oppenheimer I, et al. (2022) Scientific publication speed and retractions of COVID-19 pandemic original articles. Rev Panam Salud Publica 46: e25. https://doi.org/10.26633/RPSP.2022.25 ![]() |
[5] |
Eslava-Schmalbach J, Rosero EB, Garzón-Orjuela N (2021) Global control of COVID-19: good vaccines may not suffice. Rev Panam Salud Publica 45: e148. https://doi.org/10.26633/RPSP.2021.148 ![]() |
[6] |
Behera BK, Radhakrishnan RV, Mohanty CR, et al. (2021) COVID-19 pandemic and its impact on peer review speed of anesthesiology journals: an observational study. J Anaesthesiol Clin Pharmacol 37: 57-62. https://doi.org/10.4103/joacp.JOACP_652_20 ![]() |
[7] |
Duan K, Liu B, Li C, et al. (2020) Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proc Natl Acad Sci U S A 117: 9490-9496. https://doi.org/10.1073/pnas.2004168117 ![]() |
[8] |
Jorda A, Kussmann M, Kolenchery N, et al. (2022) Convalescent plasma treatment in patients with Covid-19: a systematic review and meta-analysis. Front Immunol 13: 817829. https://doi.org/10.3389/fimmu.2022.817829 ![]() |
[9] |
Korley FK, Durkalski-Mauldin V, Yeatts SD, et al. (2021) Early convalescent plasma for high-risk outpatients with COVID-19. N Engl J Med 385: 1951-1960. https://doi.org/10.1056/NEJMoa2103784 ![]() |
[10] |
Beigel JH, Tomashek KM, Dodd LE, et al. (2020) Remdesivir for the treatment of Covid-19—final report. N Engl J Med 383: 1813-1826. https://doi.org/10.1056/NEJMoa2007764 ![]() |
[11] |
Bansal V, Mahapure KS, Bhurwal A, et al. (2021) Mortality benefit of remdesivir in COVID-19: a systematic review and meta-analysis. Front Med 7: 606429. https://doi.org/10.3389/fmed.2020.606429 ![]() |
[12] |
Lim SCL, Hor CP, Tay KH, et al. (2022) Efficacy of ivermectin treatment on disease progression among adults with mild to moderate COVID-19 and comorbidities: the I-TECH randomized clinical trial. JAMA Intern Med 182: 426-435. https://doi.org/10.1001/jamainternmed.2022.0189 ![]() |
[13] |
Foster MRB, Hijazi AA, Opoku R, et al. (2021) The use of hydroxyurea in the treatment of COVID-19. J Crit Care Med 7: 312-317. https://doi.org/10.2478/jccm-2021-0019 ![]() |
[14] | Cassiani SHDB, Dias BM (2021) Lessons learned from the COVID-19 pandemic: why we need to invest in advanced practice nurses. Rev Panam Salud Publica 45: e92. https://doi.org/10.26633/RPSP.2021.92 |
[15] |
Disser NP, De Micheli AJ, Schonk MM, et al. (2020) Musculoskeletal consequences of COVID-19. J Bone Joint Surg Am 102: 1197-1204. https://doi.org/10.2106/JBJS.20.00847 ![]() |
[16] | Hasan LK, Deadwiler B, Haratian A, et al. (2021) Effects of COVID-19 on the musculoskeletal system: clinician's guide. Orthop Res Rev 13: 141-150. https://doi.org/10.2147/ORR.S321884 |
[17] |
Saltis LM, Martin BR, Traeger SM, et al. (1993) Continuous infusion of pyridostigmine in the management of myasthenic crisis. Crit Care Med 21: 938-940. https://doi.org/10.1097/00003246-199306000-00025 ![]() |
[18] |
Juel VC, Massey JM (2007) Myasthenia gravis. Orphanet J Rare Dis 2: 44. https://doi.org/10.1186/1750-1172-2-44 ![]() |
[19] |
Skolka M, Lamb CJ, Rubin DI, et al. (2022) Electrodiagnostic characteristics suggestive of muscle-specific kinase myasthenia gravis. Neurol Clin Pract 12: 211-217. https://doi.org/10.1212/CPJ.0000000000001166 ![]() |
[20] |
Andersen JB, Engeland A, Owe JF, et al. (2010) Myasthenia gravis requiring pyridostigmine treatment in a national population cohort. Eur J Neurol 17: 1445-1450. https://doi.org/10.1111/j.1468-1331.2010.03089.x ![]() |
[21] |
Gergalova G, Lykhmus O, Kalashnyk O, et al. (2012) Mitochondria express α7 nicotinic acetylcholine receptors to regulate Ca2+ accumulation and cytochrome c release: study on isolated mitochondria. PLoS One 7: e31361. https://doi.org/10.1371/journal.pone.0031361 ![]() |
[22] |
Richtsfeld M, Yasuhara S, Fink H, et al. (2013) Prolonged administration of pyridostigmine impairs neuromuscular function with and without down-regulation of acetylcholine receptors. Anesthesiology 119: 412-421. https://doi.org/10.1097/ALN.0b013e318291c02e ![]() |
[23] |
Hatzimouratidis K (2006) Sildenafil in the treatment of erectile dysfunction: an overview of the clinical evidence. Clin Interv Aging 1: 403-414. https://doi.org/10.2147/ciia.2006.1.4.403 ![]() |
[24] |
Gns HS, Saraswathy GR, Murahari M, et al. (2019) An update on drug repurposing: re-written saga of the drug's fate. Biomed Pharmacother 110: 700-716. https://doi.org/10.1016/j.biopha.2018.11.127 ![]() |
[25] |
Suh J, Amato AA (2021) Neuromuscular complications of coronavirus disease-19. Curr Opin Neurol 34: 669-674. https://doi.org/10.1097/WCO.0000000000000970 ![]() |
[26] |
Tseng YH, Chen TH (2021) Care for patients with neuromuscular disorders in the COVID-19 pandemic era. Front Neurol 12: 607790. https://doi.org/10.3389/fneur.2021.607790 ![]() |
[27] |
Pisella LI, Fernandes S, Solé G (2021) A multicenter cross-sectional French study of the impact of COVID-19 on neuromuscular diseases. Orphanet J Rare Dis 16: 450. https://doi.org/10.1186/s13023-021-02090-y ![]() |
[28] |
Asadi-Pooya AA, Akbari A, Emami A, et al. (2022) Long COVID syndrome-associated brain fog. J Med Virol 94: 979-984. https://doi.org/10.1002/jmv.27404 ![]() |
[29] |
Sun L, Zhao M, Yu XJ, et al. (2013) Cardioprotection by acetylcholine: a novel mechanism via mitochondrial biogenesis and function involving the PGC-1α pathway. J Cell Physiol 228: 1238-1248. https://doi.org/10.1002/jcp.24277 ![]() |
[30] |
Moftah MB, Eswayah A (2022) Repurposing of hydroxyurea against COVID-19: a promising immunomodulatory role. Assay Drug Dev Technol 20: 55-62. http://doi.org/10.1089/adt.2021.090 ![]() |
[31] |
Que Y, Hu C, Wan K, et al. (2022) Cytokine release syndrome in COVID-19: a major mechanism of morbidity and mortality. Int Rev Immunol 41: 217-230. https://doi.org/10.1080/08830185.2021.1884248 ![]() |
[32] |
Cai J, Chen-Goodspeed A, Idowu M (2022) Risk and protective factors for severe COVID-19 infection in a cohort of patients with sickle cell disease. J Investig Med 70: 1243-1246. https://doi.org/10.1136/jim-2021-002196 ![]() |
[33] |
Yasara N, Premawardhena A, Mettananda S (2021) A comprehensive review of hydroxyurea for β-haemoglobinopathies: the role revisited during COVID-19 pandemic. Orphanet J Rare Dis 16: 114. https://doi.org/10.1186/s13023-021-01757-w ![]() |
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