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Many differential equations have been proposed (see [8,11,13], [17]-[19], [21]-[22], [24,27] and references therein) to model the dynamic changes of substrate concentration and product one in enzyme-catalyzed reactions. Among those models, a typical form ([7]) is the following skeletal system
$
\left\{
˙x=v−V1(x,y)−V3(x),˙y=q(V1(x,y)−V2(y)), \right.
\label{sp0}
$
|
(1) |
where
$ V_{1}(0, y)=0, ~~ \partial V_{1}/\partial x>0, ~~ \partial V_{1}/\partial y>0, ~~ V_2(y)\geq0, ~~ \forall x, y>0, $ |
and
The case that
$
\left\{
˙x=1−xmyn−lx,˙y=q(xmyn−y), \right.
$
|
called the multi-molecular reaction model sometimes, where
$
\left\{
˙x=v−γxmyn−βx,˙y=γxmyn−v2yμ2+y, \right.
$
|
where
$
\left\{
˙x=v−V1(x,y)−v3xu3+x,˙y=q(V1(x,y)−v2yu2+y) \right.
$
|
with
$
\label{sp1} \left\{
˙x=v−v1xy−v3xu3+x,˙y=q(v1xy−v2yu2+y) \right.
$
|
(2) |
with
$
\left\{
˙x=a−xy−bx1+x,˙y=κy(x−c1+y), \right.
\label{xy0}
$
|
(3) |
where we still use
$
\left\{
˙x=(1+y){(1+x)(a−xy)−bx},˙y=κ(1+x)y{(1+y)x−c}, \right.
\label{xy1}
$
|
(4) |
in the first quadrant
In this paper we continue the work of [27] to give conditions for the existence of a cusp and compute the parameter curves for the Bogdanov-Takens bifurcation, which induces the appearance of homoclinic orbits and periodic orbits, indicating the tendency to steady-states or a rise of periodic oscillations for the concentrations of the substrate and product.
It is proved in [27] that system (4) has at most 3 equilibria, i.e.,
$
p1:=−12{(a−b−c+1)−[(a−b−c+1)2−4(a−c)]1/2},p2:=−12{(a−b−c+1)+[(a−b−c+1)2−4(a−c)]1/2}.
\label{p12}
$
|
(5) |
Moreover, if
$
TE0:={(a,b,c,κ)∈R4+|a=bc/(1+c),b≠(c+1)2}:=4⋃i=1T(i)E0,PE0:={(a,b,c,κ)∈R4+|a=bc/(1+c),b=(c+1)2},HE1:={(a,b,c,κ)∈R4+|κ=κ1,bc/(1+c)<a<c,0<b≤1}∪{(a,b,c,κ)∈R4+|κ=κ1,bc/(1+c)<a<c+(b1/2−1)2,1<b<(c+1)2},SNE∗:={(a,b,c,κ)∈R4+|a=a∗, 1<b<(c+1)2,κ≠κ∗}:=4⋃i=1SN(i)E∗,B1:={(a,b,c,κ)∈R4+|a=c},B2:={(a,b,c,κ)∈R4+|a=b},
$
|
which divide
$
R1:={(a,b,c,κ)∈R4+|c<a<a∗,1<b<c,c>1, or b<a<a∗,c<b<(c+1)2/4,c>1},R2:={(a,b,c,κ)∈R4+|b<a<c,0<b<c}R3:={(a,b,c,κ)∈R4+|bc/(1+c)<a<b,0<b<c or bc/(1+c)<a<c,c<b<c+1},R4:={(a,b,c,κ)∈R4+|0<a<bc/(1+c),0<b<c+1 or 0<a<c,b>c+1},R5:={(a,b,c,κ)∈R4+|c<a<bc/(1+c),b>c+1},R6:={(a,b,c,κ)∈R4|c<a<b,c<b<(c+1),c>3 or bc/(1+c)<a<b,c+1<b<(c+1)2/4,c>3 or bc/(1+c)<a<a∗,(c+1)2/4<b<(c+1)2,c>3 or c<a<b,c<b<(c+1)2/4,1<c≤3 or c<a<a∗,(c+1)2/4<b<c+1,1<c≤3 or bc/(1+c)<a<c+(b1/2−1)2,(c+1)<b<(c+1)2,c≤3 or c<a<a∗,1<b<c+1,c≤1},R7:={(a,b,c,κ)∈R4+|c+(b1/2−1)2<a<b,(c+1)2/4<b<(c+1)2,c>1 or bc/(1+c)<a<b,b>(c+1)2 or c<a<b,c<b<1,c≤1 or c+(b1/2−1)2<a<b,1<b<(c+1)2,c≤1},R0:=R4+∖{PE0∪SNE∗∪TE0∪(2⋃i=1Bi)∪B∪(7⋃i=1Ri)},
$
|
where
$
T(1)E0:={(a,b,c,κ)∈R4+|a=bc/(1+c),0<b<c+1},T(2)E0:={(a,b,c,κ)∈R4+|a=bc/(1+c),c+1<b<(c+1)2},T(3)E0:={(a,b,c,κ)∈R4+|a=bc/(1+c),b>(c+1)2},T(4)E0:={(a,b,c,κ)∈R4+|a=bc/(1+c),b=c+1},SN(1)E∗:={(a,b,c,κ)∈R4+|a=a∗, 1<b<(c+1)2/4,c>1,κ≠κ∗},SN(2)E∗:={(a,b,c,κ)∈R4+|a=a∗, b=(c+1)2/4,c>1,κ≠κ∗},SN(3)E∗:={(a,b,c,κ)∈R4+|a=a∗, (c+1)2/4<b<(c+1)2,c>1,κ≠κ∗},SN(4)E∗:={(a,b,c,κ)∈R4+|a=a∗, 1<b<(c+1)2,c≤1,κ≠κ∗},κ1:=p−21{(p1+1)(c−p1)}−1c{p1(c−p1)+a},κ∗:=(c−b1/2+1)−1(b1/2−1)−2c2.
\label{pa0k0}
$
|
(6) |
The following lemma is a summary of Theorems 1, 2 and 3 of [27].
Lemma 2.1. (ⅰ) System (4) has a saddle-node
(ⅱ) System (4) has a weak focus
$
H(2)E1:={(a,b,c,κ)∈HE1:2p1(p1+1)a3+{(p21+p1+1)c2+p1(2p21+p1−2)c−3p31(p1+1)}a2−(c−p1){(p31+3p21+p1+1)c2+2p21(p21+3p1+3)c+3p41(p1+1)}a+p21{(p1+2)c+p21}{c−p1(p1+1)}(c−p1)2=0}.
$
|
(ⅲ) System (4) has a saddle-node
The above Lemma 2.1 does not consider parameters in the set
$ \mathcal{B} := \{(a, b, c, \kappa)\in \mathbb{R}_+^4| a=a_*, ~1<b<(c+1)^2, \kappa=\kappa_*\}, \label{BT} $ | (7) |
where
This paper is devoted to bifurcations in
Lemma 2.2. If
$ \mathcal{C}:=\big\{(a, b, c, \kappa)\in \mathcal{B} | c=\varsigma(b):=\frac{1}{4b^{1/2}}(b^{1/2}-1)\{b^{1/2}+2+(17b-12b^{1/2}+4)^{1/2}\}\big\}, $ |
then equilibrium
Proof. For simplicity in statements, we use the notation
$ p:=b^{1/2}-1. \label{p} $ | (8) |
For
$
\left\{
˙x=y+c(p2+cp+c)p3x2+1p+1xy−pc2(p+1)y2−c(p2+c)p4x3−p2+2pc+2cp2c(p+1)x2y−2p+1c2(p+1)2xy2−c2p4x4−2p2(p+1)x3y−1c2(p+1)2x2y2,˙y=−c3(p+1)p3x2−c2(p+1)p2(c−p)xy−1c−py2−(p+1)(p2+c)p5(c−p)x3−c(p2+2pc+2c)p3(c−p)x2y−2p+1p(p+1)(c−p)xy2−c4(p+1)p5(c−p)x4−2c2p3(c−p)x3y−1p(p+1)(c−p)x2y2, \right.
\label{bt0}
$
|
(9) |
by translating
$
\left\{
˙u=v,˙v=−c3(p+1)p3u2+c{(2p+2)c2−(p2+3p)c−2p3}p3(c−p)uv+c−2p−1(p+1)(c−p)v2+c3(p2+c)p4(c−p)u3−c{(p+1)(p+3)c2+p(p2−3p−3)c−p3(3p+2)}p4(p+1)(c−p)u2v−(5p2+8p+4)c+2p2(p+1)cp2(p+1)2uv2−1c2(p+1)v3−c2(c2+2p2c−p3)p5(c−p)u4+1p5(p+1)2(c−p){(p+4)(p+1)2c3+p(7p3+7p2−3p−4)c2−p3(8p2+15p+8)c−2p5(p+1)}u3v+(3p3+6p2+6p+2)c2+p(2p+1)(2p2+2p−1)c−p3(p+1)(7p+4)cp3(p+1)3(c−p)u2v2−(3p+4)c2−3p(p+2)c−2p3c3p(p+1)2(c−p)uv3−2c−3pc4(p+1)2(c−p)v4+O(|u,v|5). \right.
\label{bt1}
$
|
(10) |
Since the linear part is nilpotent, by Theorem 8.4 in [14] system (10) is conjugated to the Bogdanov-Takens normal form, i.e., the right-hand side of the second equation is a sum of terms of the form
$
\left\{
˙u=v,˙v=−c3(p+1)p3u2+c{(2p+2)c2−(p2+3p)c−2p3}p3(c−p)uv+O(|u,v|3), \right.
\label{bt2}
$
|
(11) |
where the term of
$ c^2-\frac{p^2+3p}{2(p+1)}c-\frac{p^3}{p+1}=0, \label{eq2} $ | (12) |
which comes from the numerator of the coefficient of
$ c=\frac{1}{4}(p+1)^{-1}p\{p+3+(17p^2+22p+9)^{1/2}\}, $ |
which defines the function
In this section we discuss in the case that
Theorem 3.1. If
$
SN+:={(a,κ)∈U|a=a∗, κ>κ∗,0<c<ς(b)}∪{(a,κ)∈U|a=a∗, κ<κ∗,c>ς(b)},SN−:={(a,κ)∈U|a=a∗, κ<κ∗,0<c<ς(b)}∪{(a,κ)∈U|a=a∗, κ>κ∗,c>ς(b)},H:={(a,κ)∈U|a=a∗−((2b1/2+1)c2−((b1/2−1)2+3(b1/2−1))c −2(b1/2−1)3)−2b1/2(b1/2−1)6(c−b1/2+1)4(κ−κ∗)2+O(|κ−κ∗|3), κ>κ∗,0<c<ς(b)}∪{(a,κ)∈U|a=a∗−((2b1/2+1)c2−((b1/2−1)2+3(b1/2−1))c −2(b1/2−1)3)−2b1/2(b1/2−1)6(c−b1/2+1)4(κ−κ∗)2+O(|κ−κ∗|3), κ<κ∗,c>ς(b)},L:={(a,κ)∈U|a=a∗−49/25((2b1/2+1)c2−((b1/2−1)2+3(b1/2−1))c −2(b1/2−1)3)−2b1/2(b1/2−1)6(c−b1/2+1)4(κ−κ∗)2+O(|κ−κ∗|3), κ>κ∗,0<c<ς(b)}∪{(a,κ)∈U|a=a∗−49/25((2b1/2+1)c2−((b1/2−1)2+3(b1/2−1))c −2(b1/2−1)3)−2b1/2(b1/2−1)6(c−b1/2+1)4(κ−κ∗)2+O(|κ−κ∗|3), κ<κ∗,c>ς(b)},
$
|
such that system (4) produces a saddle-node bifurcation near
The above bifurcation curve
Proof. Let
$ \varepsilon_{1}:=a-a_*, \varepsilon_{2}:=\kappa-\kappa_*, \label{eee} $ | (13) |
and consider
$
\label{btb0} \left\{
˙x=c(p+1)pε1+(−c2(p+1)p2+cpε1)x+(−c(p+1)+(p+1)ε1)y−c(c−p)p2x2+(−c(2+3p)p+ε1)xy−p(p+1)y2+O(‖(x,y)‖3),˙y=(c3(p+1)p4+c(p+1)(c−p)p2ε2)x+(c2(p+1)p2+(p+1)(c−p)ε2)y+(c3p4+c(c−p)p2ε2)x2+(c3(2+3p)−c2p(2p+1)(c−p)p3+c(3p+2)−p(2p+1)pε2)xy+(c2(p+1)(c−p)p+p(p+1)ε2)y2+O(‖(x,y)‖3). \right.
$
|
(14) |
Introducing new variables
$
\left\{
˙ξ1=η1,˙η1=E00(ε1,ε2)+E10(ε1,ε2)ξ1+E20(ε1,ε2)ξ21+F(ξ1,ε1,ε2)η1+E02(ε1,ε2)η21, \right.
$
|
(15) |
where
$ F(0, 0, 0)=0, ~~~ \frac{\partial F}{\partial\xi_{1}}(0, 0, 0)=E_{11}(0, 0)=(2p+2)(c^2-\frac{p^2+3p}{2(p+1)}c-\frac{p^3}{p+1})\ne 0. $ |
By the Implicit Function Theorem, there exists a function
$ \xi_{2}=\xi_{1}-\xi_{1}(\varepsilon_{1}, \varepsilon_{2}), \eta_{2}=\eta_{1} $ |
to vanish the term proportional to
$
\label{btphi} \left\{
˙ξ2=η2,˙η2=ψ1(ε1,ε2)+ψ2(ε1,ε2)ξ2+E20(ε1,ε2)ξ22+E11(ε1,ε2)ξ2η2+E02(ε1,ε2)η22, \right.
$
|
(16) |
where
$
ψ1(ε1,ε2):=E00(ε1,ε2)+E10(ε1,ε2)ξ1(ε1,ε2)+E20(ε1,ε2)ξ21(ε1,ε2),ψ2(ε1,ε2):=E10(ε1,ε2)+2ξ1(ε1,ε2)E20(ε1,ε2).
$
|
In order to eliminate the
$ \xi_3= \xi_2, ~~~ \eta_3= \eta_2-E_{02}(\varepsilon_{1}, \varepsilon_{2})\xi_2\eta_2 $ |
together with the time-rescaling
$
\label{btphi2} \left\{
˙ξ3=η3,˙η3=ζ1(ε1,ε2)+ζ2(ε1,ε2)ξ3+˜E20(ε1,ε2)ξ23+E11(ε1,ε2)ξ3η3, \right.
$
|
(17) |
where
$
ζ1(ε1,ε2):=ψ1(ε1,ε2), ζ2(ε1,ε2):=ψ2(ε1,ε2)−ψ1(ε1,ε2)E02(ε1,ε2),˜E20(ε1,ε2):=E20(ε1,ε2)−E10(ε1,ε2)E02(ε1,ε2).
$
|
Further, in order to reduce coefficient of
$ u=\frac{\tilde{E}_{20}(\varepsilon_{1}, \varepsilon_{2})}{E_{11}^2(\varepsilon_{1}, \varepsilon_{2})}\xi_{3}, v={\rm sign}\Big(\frac{E_{11}(\varepsilon_{1}, \varepsilon_{2})}{\tilde{E}_{20}(\varepsilon_{1}, \varepsilon_{2})}\Big) \frac{\tilde{E}_{20}^2(\varepsilon_{1}, \varepsilon_{2})}{E_{11}^3(\varepsilon_{1}, \varepsilon_{2})}, $ |
where
$
\label{btf} \left\{
˙u=v,˙v=ϕ1(ε1,ε2)+ϕ2(ε1,ε2)u+u2+ϑuv, \right.
$
|
(18) |
where
$
ϕ1(ε1,ε2):=E411(ε1,ε2)˜E320(ε1,ε2)ζ1(ε1,ε2)={(2p+2)c2−(p2+3p)c−2p3}4ε1ϕ11(ε1,ε2)p4(c−p)4ϕ212(ε1,ε2), ϕ2(ε1,ε2):=E211(ε1,ε2)˜E220(ε1,ε2)ζ2(ε1,ε2)=√2{(2p+2)c2−(p2+3p)c−2p3}ϕ21(ε1,ε2)c3/2(c−p)2(p+1)1/2pϕ3/212(ε1,ε2),
$
|
and polynomials
Let
$ \label{muphi} \mu_{1}=\phi_{1}(\varepsilon_{1}, \varepsilon_{2}), \mu_{2}=\phi_{2}(\varepsilon_{1}, \varepsilon_{2}), $ | (19) |
where
$
\left|
∂ϕ1(ε1,ε2)∂ε1∂ϕ1(ε1,ε2)∂ε2∂ϕ2(ε1,ε2)∂ε1∂ϕ2(ε1,ε2)∂ε2
\right|_{(\varepsilon_{1}, \varepsilon_{2})=(0, 0)}
=
-\frac{\{(2p+2)c^2-(p^2+3p)c-2p^3\}^5}{p^6c^4(c-p)^4(p+1)}\neq0,
\label{Jacob}
$
|
(20) |
implying that (19) is a locally invertible transformation of parameters. This transformation makes a local equivalence between system (18) and the versal unfolding system
$
\label{btw} \left\{
˙˜u=˜v,˙˜v=μ1+μ2˜u+˜u2+ϑ˜u˜v, \right.
$
|
(21) |
where
$
\label{btbifur}
SN+:={(μ1,μ2)∈V0 | μ1=0, μ2>0},SN−:={(μ1,μ2)∈V0 | μ1=0, μ2<0},H:={(μ1,μ2)∈V0 | μ1=−μ22, μ2>0},L:={(μ1,μ2)∈V0 | μ1=−4925μ22+o(|μ2|2), μ2>0},
$
|
(22) |
where
In what follows, we present above bifurcation curves in parameters
$ \varepsilon_1=\omega_1(\mu_1, \mu_2), ~~~~\varepsilon_2=\omega_2(\mu_1, \mu_2) \label{eps12} $ | (23) |
in a small neighborhood of
$ \mu_1=\phi_1(\omega_1(\mu_1, \mu_2), \omega_2(\mu_1, \mu_2)), ~~~ \mu_2=\phi_2(\omega_1(\mu_1, \mu_2), \omega_2(\mu_1, \mu_2)). \label{compare-coeff} $ | (24) |
Substitute the second order formal Taylor expansions of
$
ϕ1(ε1,ε2)={(2p+2)c2−(p2+3p)c−2p3}4ε1/{p6c2(c−p)4(p+1)}−{(2p+2)c2−(p2+3p)c−2p3}4(24p2c4+42c4p+21c4−8p3c3−54c3p2−44c3p−36c2p4−12p3c2+27p2c2+8p5c+32cp4+16p6)ε21/{2c4p8(c−p)6(p+1)2}−{(2p+2)c2−(p2+3p)c−2p3}4ε1ε2/{(c4p4(c−p)3(p+1)}+o(|ε1,ε2|2),
$
|
(25) |
$
ϕ2(ε1,ε2)={(2p+2)c2−(p2+3p)c−2p3}ε1/{2c2(p3−2cp+p2+c2p+c2−2cp2)p4}−{(2p+2)c2−(p2+3p)c−2p3}ε2/c2−{(2p+2)c2−(p2+3p)c−2p3}(−243p3c3+832p3c4+513p2c4+455p4c3−594p5c2−1347p3c5−1209p2c5+165p4c4+1138p5c3−324p6c2−424p7c−200p5c4+382p6c3+512p7c2−520cp8−396c5p−48p9+108c6−48p10+384c6p3+414c6p−104cp9+264c2p8+594c6p2−672c5p4+96c6p4−136c5p5−44c4p6−76c3p7)ε21/{4c3(p+1)2(c−p)4p6}−{(2p+2)c2−(p2+3p)c−2p3}(8p2c4+23c4p+12c4+30p3c3+8c3p2−22c3p−58c2p4−85p3c2+6p2c2−8p5c+46cp4+24p6)ε1ε2/{4c4p2(p+1)(c−p)2}+(c−p)p2{(2p+2)c2−(p2+3p)c−2p3}ε22/c4+o(|ε1,ε2|2).
$
|
(26) |
Then, comparing the coefficients of terms of the same degree in (24), we obtain the second order approximations
$
ε1=c2p6(c−p)4(p+1)μ1/{(2p+2)c2−(p2+3p)c−2p3}4+c2p10(c−p)6(p+1)(32p2c4+56c4p+27c4−16p3c3−79c3p2−59c3p−48c2p4−19p3c2+36p2c2+12p5c+50cp4+24p6)μ21/{2{(2p+2)c2−(p2+3p)c−2p3}8}+c2p8(c−p)5(p+1)μ1μ2/{(2p+2)c2−(p2+3p)c−2p3}5+o(|μ1,μ2|2),
$
|
(27) |
$
ε2=c2p2(c−p)2(−8p5−12cp4−18cp3+8c3p2−11p2c2−9c2p+14c3p+6c3)μ1/{2{(2p+2)c2−(p2+3p)c−2p3}4}−c2μ2/{(2p+2)c2−(p2+3p)c−2p3}+c2p6(c−p)4(1314c7p2+630pc7−270p3c4+2068p3c5+612p2c5+677p4c4−1134p5c3+4387p5c4−1056p6c3−1804p7c2−3741c6p3+756c5p4+1160c3p8−2268c6p4+1176c7p3−1272c5p6−352c6p5+384c7p4−320p11+108c7−704cp10+224c2p9−2046c5p5+4258c4p6+832p7c4−1464p8c2−2289c6p2+1544p7c3−450c6p−1344cp9)μ21/{8{(2p+2)c2−(p2+3p)c−2p3}8}+c2p4(c−p)2(40p2c4+61c4p+24c4−78p3c3−158c3p2−68c3p−14c2p4+43p3c2+48p2c2+32p5c+62cp4+24p6)μ1μ2/{4{(2p+2)c2−(p2+3p)c−2p3}5}+c2p2(c−p)μ22/{(2p+2)c2−(p2+3p)c−2p3}2+o(|μ1,μ2|2).
$
|
(28) |
Then we are ready to express those bifurcation curves in parameters
For curves
$ \varepsilon_2=-\frac{c^2}{(2p+2)\Psi(c)}\mu_2+O(|\mu_2|^2), \label{Psi(c)} $ | (29) |
where
$
SN+:={(ε1,ε2) | ε1=0,ε2>0,0<c<ς(b)}∪{(ε1,ε2) | ε1=0,ε2<0,c>ς(b)},SN−:={(ε1,ε2) | ε1=0,ε2<0,0<c<ς(b)}∪{(ε1,ε2) | ε1=0,ε2>0,c>ς(b)}.
$
|
For curve
$ \frac{\partial\Upsilon}{\partial \varepsilon_1}\Big|_{(\varepsilon_{1}, \varepsilon_{2})=(0, 0)} = \{ (2p+2)\Psi(c) \}^4 / \{p^6c^2(c-p)^4(p+1)\}\ne 0. $ |
By the Implicit Function Theorem, there exists a unique
$ \varepsilon_1=\epsilon_1(\varepsilon_2) = -\frac{p^6(c-p)^4}{4(p+1)\Psi^2(c)}\varepsilon_2^2+o(|\varepsilon_2|^2). \label{Hp} $ | (30) |
Further, replacing
$ \varepsilon_2=-\frac{c^2}{(2p+2)\Psi(c)}\mu_2+o(|\mu_2|). $ |
Similarly to (29), from (22) we obtain that
$
H:={(ε1,ε2) | ε1=−p6(c−p)44(p+1)Ψ2(c)ε22+o(|ε2|2), ε2>0,0<c<ς(b)}∪{(ε1,ε2) | ε1=−p6(c−p)44(p+1)Ψ2(c)ε22+o(|ε2|2), ε2<0,c>ς(b)}.
$
|
For curve
$ \varepsilon_{1}=-\frac{49p^6(c-p)^4}{100(p+1)\Psi^2(c)}\varepsilon_{2}^2+o(|\varepsilon_{2}|^{2}). $ |
Similarly to (29), from (22) we obtain that
$
L:={(ε1,ε2) | ε1=−49p6(c−p)4100(p+1)Ψ2(c)ε22+o(|ε2|2), ε2>0,0<c<ς(b)}∪{(ε1,ε2) | ε1=−49p6(c−p)4100(p+1)Ψ2(c)ε22+o(|ε2|2), ε2<0,c>ς(b)}.
$
|
Finally, with the replacement (13) we can rewrite the above bifurcation curves
In this paper we analyzed the dynamics of system (4) near the equilibrium
More concretely, in this case,
$ a_*=\frac{(c+1)^2}{4}, ~\kappa_*=\frac{8c^2}{(c+1)(c-1)^2}. $ |
Moreover, the four bifurcation curves divide the neighborhood
$
DI:={(a,κ)∈U| a<(c+1)24, κ≤8c2(c+1)(c−1)2}⋃{(a,κ)∈U| a<(c+1)24−49(c−1)6(c+1)33200(2c2+c+1)2{κ−8c2(c+1)(c−1)2}2+O(|κ−8c2(c+1)(c−1)2|3), κ>8c2(c+1)(c−1)2},DII:={(a,κ)∈U| (c+1)24−49(c−1)6(c+1)33200(2c2+c+1)2{κ−8c2(c+1)(c−1)2}2+O(|κ−8c2(c+1)(c−1)2|3)<a<(c+1)24−(c−1)6(c+1)3128(2c2+c+1)2{κ−8c2(c+1)(c−1)2}2+O(|κ−8c2(c+1)(c−1)2|3), κ>8c2(c+1)(c−1)2},DIII:={(a,κ)∈U| (c+1)24−(c−1)6(c+1)3128(2c2+c+1)2{κ−8c2(c+1)(c−1)2}2+O(|κ−8c2(c+1)(c−1)2|3)<a<(c+1)24, κ>8c2(c+1)(c−1)2},DIV:={(a,κ)∈U| a>(c+1)24}.
$
|
Theorem 3.1 gives dynamical behaviors of system (4) near
$ p_1:=-\frac{1}{2}\big\{(a-b-c+1)-\{(a-b-c+1)^2-4(a-c)\}^{1/2}\big\}, \\ p_2:=-\frac{1}{2}\big\{(a-b-c+1)+\{(a-b-c+1)^2-4(a-c)\}^{1/2}\big\} $ |
as in [27].
Parameters |
Equilibria | Limit cycles and homoclinic orbits | Region in bifurcation diagram | |||
saddle | unstable focus | saddle | ||||
saddle | unstable focus | saddle | one homoclinic rrbit | |||
saddle | unstable focus | saddle | one limit cycle | |||
saddle | stable focus | saddle | ||||
saddle | stable focus | saddle | ||||
saddle-node | ||||||
cusp | ||||||
saddle-node |
The appearance of limit cycle displays a rise of oscillatory phenomenon in system (4). Choosing parameters
In this paper we only considered parameters in
The functions in system (15) are
$
E00:={(2p+2)c2−(p2+3p)c−2p3}4ε1/{c2(p+1)p6(c−p)4},E10:=−{(2p+2)c2−(p2+3p)c−2p3}2ε1{(−6c3p−4c3p2−4p3c2+3p2c2+4cp4+4c4p+3c4)−(p2c2−3c3p−3c2p+cp2+2cp3−2p4)ε1−(p3c2−2cp4+p5+4c2p4−5p5c−p3c3+2p6)ε2}/{(p+1)p4c3(c−p)4},E20:={(−2c6(p+1)2(c−p)2)+(9c3p2+4c2p4−13c4p+4p5c2+6p3c3+9c5p−15p2c4−2p4c3+4p2c5−4p3c4+6c5)ε1−(2p7c−6p7c2−6p6c2−2p5c4+6p6c3+2cp8−2p4c4+6p5c3)ε2+(6p5c2−2p4c3−6p6c−6p7c+6p6c2−2p5c3+2p7+2p8)ε1ε2+(6p3c3−4p2c4−2c2p4−10p3c2−9c4p−2cp4+17c3p2−2p5c+13c3p−9p2c2−6c4)ε21}/{2c3p2(c−p)2(p+1)},E01:=−{(2p+2)c2−(p2+3p)c−2p3}{2c3ε1+(cp4−2p3c2+c3p2)ε2+(2p4−6cp3+4p2c2)ε1ε2+(12c2−6cp)ε21}/{p2(c−p)2c3},E11:={(3c3p2−8p2c4−p4c3+2c5+2c2p4+4c5p+2p2c5−5c4p+2p5c2+2p3c3−3p3c4)+(3c2p4+3c3p+p2c2+2p5c+3p2c4+3p3c2+2c4p+2cp4−4p3c3+c3p2)ε1+(5p6c2−2p7c−3p6c+7p5c2+2c2p4−p5c−5p4c3−p3c3+p3c4+p4c4−4p5c3)ε2−(5p6c−4p5c2+p4c3−5c2p4−p3c2+7p5c+p3c3+2cp4−2p7−p5−3p6)ε1ε2+(13cp2−8cp4+9c3p2−38p2c2+5cp3+10p4+10p5+19c3p+10c3−13p3c2−25c2p)ε21}/{c2(p+1)(−p+c)},E02:={(c−2p−1)+(5c3−2c2p)ε1−(3p3c2−2c3p2−cp4)ε2+(p4−cp3)ε1ε2−(2cp−c2)ε21}/{(p+1)2(c−p)2}.
$
|
The functions below system (18) are
$
ϕ11:=24c6p5+4c8p2−16c7p4+4c8p3−16c5p6+4p7c4+24c6p4−16c7p3−16c5p5+4c4p6+(9p4c4−16p6c3+40c3p7+68p5c4−26p3c5+3c8−6c8p+42c6p3+36c6p4−94c5p4+6c7p2−4c4p6−16c2p8−56c5p5−8c8p2+8c7p3+28c6p2−14c7p)ε1+(4c7p4+40c5p7−4c2p9−4c2p10+20c3p8+20c3p9−20c6p5+40c5p6−20c6p6−40c4p8+4c7p5−40p7c4)ε2−(40p2c5+12p4c3+32c7p2+8p5c3+12c7+92p3c5+8p6c2−32p3c4−12p6c3−28p7c2+4c5p4−88c6p2−56p4c4+36c7p+48p5c4−60c6p3+16cp8−32c6p)ε21+(12cp9−24p7c4−8c7p4−6c7p3−88c5p5−32c2p8+20cp10−24c5p4+6c6p3+2c3p7−24p6c3+36c6p5+72c4p6+96c3p8−76c2p9+36p5c4+40c6p4−44c5p6+6p7c2)ε1ε2+(8p7c−9p2c4−16p5c2+6p3c3−c2p4+11p4c4+6p3c5+10p4c3−16p5c3−18p2c5+12p3c4−9c6p2+4p6c−4p8)ε31+(−34c4p6+2c3p7+4p9−28cp9−16cp8+6p4c4+8p10−2p7c+32c2p8+32p7c2−32p6c3−14p5c3+10p6c2−6c6p4+26c5p5+12p5c4)ε21ε2+(4c3p7−c6p6+44c3p9−41c2p10−c4p6+4cp9+2c5p6−4p11+28c3p8−32c2p9+8c5p7−26c4p8+20p11c−12p7c4−p10−4p12+18cp10−6c2p8)ε1ε22,ϕ12:=(2p5c3−4p3c4+2p4c3+2p3c5+2p2c5−4p4c4)+(9c3p2+4c2p4−13c4p+4p5c2+6p3c3+9c5p−15p2c4−2p4c3+4p2c5−4p3c4+6c5)ε1+(−2p7c+6p7c2+6p6c2+2p5c4−6p6c3−2cp8+2p4c4−6p5c3)ε2+(6p3c3−4p2c4−2c2p4−10p3c2−9c4p−2cp4+17c3p2−2p5c+13c3p−9p2c2−6c4)ε21+(6p5c2−2p4c3−6p6c−6p7c+6p6c2−2p5c3+2p7+2p8)ε1ε2,ϕ21:=(6c10+12c8p5+69c8p4−77c9p3+20c7p6+9c6p4−33c7p3+18c5p6−34c6p5+45c8p2−26c7p4+102c8p3−27c9p−80c9p2+27c7p5+6c5p7+8c4p8−12c5p8−55c6p6−12c6p7+8c4p9+22c10p2−24c9p4+8c10p3+20c10p)ε1+(4p10c4+20p9c6−10p10c5−4p5c9+2p11c4−2c9p4−2p6c9+10p7c8+20p6c8+10c8p5−20p9c5+2c4p9−40p7c7−20c7p8−10c5p8−20c7p6+40c6p8+20c6p7)ε2+(−12c9+12c3p9−47c8p4+10c9p3−86c6p4−19c7p3+102c5p6−220c6p5+60c8p2+159c7p4−40c8p3+61c5p5+2c4p6−16p7c4−18c9p+3c9p2+92c7p5+12c3p8+26c5p7−14c4p8+53c8p+35c6p3−76c7p2−79c6p6)ε21+(2p5c9−34c8p5+2c3p9+19c8p4−10c9p3+151c7p6−17c5p6+39c6p5−45c7p4+26c8p3−2c3p10+3p7c4−6c9p2+23c7p5+77c5p7−26c4p8+145c5p8−85c6p6−227c6p7−31c4p9−2c9p4−103c6p8+83p7c7+51p9c5−2p10c4−4p11c3−27p6c8)ε1ε2+(−4p7c8−2p6c8−30p10c4−60p11c4+40p9c5−2p8c8+12p11c3+24c7p8+12c7p9−60p9c6+12p13c3−30p10c6+40p11c5−30p12c4−4p13c2−2p14c2−2p12c2+24p12c3−30c6p8+80p10c5+12p7c7)ε22+(−30c8+69p3c5−16p4c4−212p5c4+58p6c3+331c5p4−232c6p4+79c7p3+117c5p6−65c6p5−21c8p2−3c7p4+5c8p3+379c5p5−187c4p6+4p7c4−94c3p8+44c2p8+44c2p9+91c7p−53c8p−263c6p3+163c7p2−106c6p2−38c3p7)ε31+(36c2p10−10c8p5−199c3p9−41c8p4+9c7p6+18c2p11−166c6p4+84c7p3+165c5p6−297c6p5−18c8p2+193c7p4−48c8p3−110c3p10+164c5p5−76c4p6+47p7c4+123c7p5−78c3p8+18c2p9−208c5p7+351c4p8−219c5p8−62c6p6+79c6p7+233c4p9+12c3p7)ε21ε2+(−2p14c+c2p10−4c3p9−8c7p6+21c2p11−2p12c−72c3p10−4p13c−4c5p7+6c4p8−102c5p8+c6p6+45c6p7+118c4p9+58p9c6−114p10c5+121p11c4+102c6p8−22p7c7−212p9c5+233p10c4−138p11c3+40p12c2−70p12c3+20p13c2−14c7p8+p7c8+p6c8)ε1ε22(−176p3c4+41p4c3+769p3c5+293p2c5−388p4c4+27p5c3+28p6c2−178p5c4−58p6c3+4p7c2+20cp8+20cp9+603c5p4−192c6p4+75c7p3+127c5p5+34c4p6+72c7−234c6p−24c2p8+210c7p−616c6p3+213c7p2−658c6p2−44c3p7)ε41+(−286p5c4+154p6c3−32p7c2+136c2p10−56cp10−198c3p9−24cp9+262c5p4−32cp11−330c6p4+70c7p3+438c5p6−284c6p5+68c7p4+636c5p5−580c4p6−210p7c4+22c7p5−154c3p8+30c2p8+198c2p9+64c5p7+84c4p8−122c6p3+24c7p2−76c6p6+198c3p7)ε31ε2+(4p12+102c2p10−cp10−158c3p9−c7p6+198c2p11−64p12c−33cp11−c5p6−313c3p10−32p13c+4p7c4+8p13−6c3p8+4c2p9−57c5p7+132c4p8−126c5p8+10c6p6+26c6p7+272c4p9+4p14+16c6p8−p7c7−70p9c5+144p10c4−161p11c3+100p12c2)ε21ε22.
$
|
[1] | Ballard DW, Derlet RW, Rich BA, et al. (2006) EMTALA, two decades later: A descriptive review of fiscal year 2000 violations. Am J Emerg Med 24: 197–205. |
[2] | Care E (2001) EMTALA Implementation and enforcement issues. United States General Accounting Office, 1. |
[3] |
Chen J, Vargas-Bustamante A, Mortensen K, et al. (2016) Racial and Ethnic Disparities in Health Care Access and Utilization Under the Affordable Care Act. Med Care 54: 140–146. doi: 10.1097/MLR.0000000000000467
![]() |
[4] | Clarke T, Norris T, Schiller J (2017) Early release of selected estimates based on data from the 2016 National Health Interview Survey. National Center for Health Statistics. |
[5] | Congressional Budget Office (2017a) H.R. 1628 Better Care Reconciliation Act of 2017. |
[6] | Congressional Budget Office (2017b) H.R. 1628, Obamacare Repeal Reconciliation Act of 2017. |
[7] | Cunningham P, Rudowitz R, Young K, et al. (2016) Understanding Medicaid Hospital Payments and the Impact of Recent Policy Changes. Kaiser Family Foundation. |
[8] |
Dranove D, Garthwaite C, Ody C (2016) Uncompensated care decreased at hospitals in medicaid expansion states but not at hospitals in nonexpansion states. Health Aff 35: 1471–1479. doi: 10.1377/hlthaff.2015.1344
![]() |
[9] | Garfield R, Damico A, Stephens J, et al. (2016) The coverage gap: Uninsured poor adults in states that do not expand medicaid-an update. Menlo Park, CA: Kaiser Family Foundation. |
[10] | HHS.gov. (2015) Insurance Expansion, Hospital Uncompensated Carem and the Affordable Care Act, Retrieved August, 2017. Available from: https://aspe.hhs.gov/system/files/pdf/139226/ib_UncompensatedCare.pdf. |
[11] | Hiltzik M (2018) Anthem Expands its Policy of Punishing Patients for "Inappropriate" ER Visits. Los Angeles Times. Available from: http://www.latimes.com/business/hiltzik/la-fi-hiltzik-anthem-er-20180124-story.html. |
[12] |
Hsuan C, Horwitz JR, Ponce NA, et al. (2018) Complying with the Emergency Medical Treatment and Labor Act (EMTALA): Challenges and solutions. J Healthc Risk Manage 37: 31–41. doi: 10.1002/jhrm.21288
![]() |
[13] | Mach AL (2017) HR 1628: The American Health Care Act (AHCA). |
[14] |
Mcdonnell WM, Gee CA, Mecham N, et al. (2013) Does the emergency medical treatment and labor act affect emergency department use? J Emerg Med 44: 209–216. doi: 10.1016/j.jemermed.2012.01.042
![]() |
[15] |
Mckenna RM, Alcala HE, Le-Scherban F, et al. (2017) The Affordable Care Act Reduces Hypertension Treatment Disparities for Mexican-heritage Latinos. Med Care 55: 654–660. doi: 10.1097/MLR.0000000000000726
![]() |
[16] |
Neuhausen K, Davis AC, Needleman J, et al. (2014) Disproportionate-share hospital payment reductions may threaten the financial stability of safety-net hospitals. Health Aff 33: 988–996. doi: 10.1377/hlthaff.2013.1222
![]() |
[17] | Office of Inspector General (2017) OIG Budget. Retrieved March 10th, 2017. |
[18] |
Ossei-Owusu S (2017) Code Red: The Essential Yet Neglected Role of Emergency Care in Health Law Reform. Am J Law Med 43: 344–387. doi: 10.1177/0098858817753404
![]() |
[19] | Qualtrics I (2013) Qualtrics. com: Qualtric Research Suite Provo, UT. |
[20] | R Core Team (2017) R: A language and environment for statistical computing. Vienna, Austria R Foundation for Statistical Computing. Available from: http://www.R-project.org/. |
[21] |
Rosenau AM, Augustine JJ, Jones S, et al. (2015) The growing evidence of the value of emergency care. Acad Emerg Med 22: 224–226. doi: 10.1111/acem.12592
![]() |
[22] |
Rosenbaum S (2013) The enduring role of the emergency medical treatment and active labor act. Health Aff 32: 2075–2081. doi: 10.1377/hlthaff.2013.0660
![]() |
[23] | Rosenbaum S, Cartwright-Smith L, Hirsh J, et al. (2012) Case studies at Denver Health: "patient dumping" in the emergency department despite EMTALA, the law that banned it. Health Aff 31: 1749–1756. |
[24] |
Sommers BD (2013) Stuck between health and immigration reform-care for undocumented immigrants. New Engl J Med 369: 593–595. doi: 10.1056/NEJMp1306636
![]() |
[25] |
Sommers BD, Gunja MZ, Finegold K, et al. (2015) Changes in Self-reported Insurance Coverage, Access to Care, and Health Under the Affordable Care Act. Jama 314: 366–374. doi: 10.1001/jama.2015.8421
![]() |
[26] |
Taubman SL, Allen HL, Wright BJ, et al. (2014) Medicaid Increases Emergency-Department Use: Evidence from Oregon's Health Insurance Experiment. Science 343: 263–268. doi: 10.1126/science.1246183
![]() |
[27] | Terp S, Seabury SA, Arora S, et al. (2017) Enforcement of the Emergency Medical Treatment and Labor Act, 2005 to 2014. Ann Emerg Med 69: 155–162. |
[28] |
Terp S, Wang B, Raffetto B, et al. (2017) Individual Physician Penalties Resulting From Violation of Emergency Medical Treatment and Labor Act: A Review of Office of the Inspector General Patient Dumping Settlements, 2002–2015. Acad Emerg Med 24: 442–446. doi: 10.1111/acem.13159
![]() |
[29] | Thomson Healthcare (2007) Profiles of U.S. Hosptials, 2007. Ann Arbor, MI: Thomson Healthcare. |
[30] | United States Department of Commerce. Bureau of the, C. (2012) Census of Population and Housing, 2010 [United States]: National Summary File of Redistricting Data. Available from: http://doi.org/10.3886/ICPSR33442.v1. |
[31] | Zibulewsky J (2001) The Emergency Medical Treatment and Active Labor Act (EMTALA): What it is and what it means for physicians. Proceedings 14: 339. |
[32] | Zuabi N, Weiss LD, Langdorf MI (2016) Emergency Medical Treatment and Labor Act (EMTALA) 2002-15: Review of Office of Inspector General Patient Dumping Settlements. West J Emerg Med 17: 245. |
1. | Juan Su, Zhaoxia Wang, Global Dynamics of an Enzyme-Catalyzed Reaction System, 2020, 43, 0126-6705, 1919, 10.1007/s40840-019-00780-2 | |
2. | Juan Su, Bifurcation Analysis of an Enzyme Reaction System with General Power of Autocatalysis, 2019, 29, 0218-1274, 1950079, 10.1142/S0218127419500792 | |
3. | Juan Su, Bing Xu, Local bifurcations of an enzyme-catalyzed reaction system with cubic rate law, 2018, 94, 0924-090X, 521, 10.1007/s11071-018-4375-y |
Parameters |
Equilibria | Limit cycles and homoclinic orbits | Region in bifurcation diagram | |||
saddle | unstable focus | saddle | ||||
saddle | unstable focus | saddle | one homoclinic rrbit | |||
saddle | unstable focus | saddle | one limit cycle | |||
saddle | stable focus | saddle | ||||
saddle | stable focus | saddle | ||||
saddle-node | ||||||
cusp | ||||||
saddle-node |
Parameters |
Equilibria | Limit cycles and homoclinic orbits | Region in bifurcation diagram | |||
saddle | unstable focus | saddle | ||||
saddle | unstable focus | saddle | one homoclinic rrbit | |||
saddle | unstable focus | saddle | one limit cycle | |||
saddle | stable focus | saddle | ||||
saddle | stable focus | saddle | ||||
saddle-node | ||||||
cusp | ||||||
saddle-node |