Dear Plamen,
Thanks for the synthetic attempt. You have put together pretty complex
strands of thought that become too demanding for a general response. I
will concentrate in a few points.
What is Medicine? In what extent is it amenable to "integration"? Is
reductionism an anathema in medicine? Can we regularly ascend from
cellular info flows to organs/systems, and to healthy
individuals/environments?
The history of Medicine shows messiness in the highest degree. To note
that it was not included in the Trivium/Quadrivium medieval scheme of
knowledge, and was only accepted within the "mechanical arts" after Hugh
of St. Victor compilation (XIII Century), many decades after the first
Faculties of Medicine were created in Italy. Why medicine is so messy?
Just go the wiki pages on the topic: hundreds of subspecialties are
listed, and under all those terms we imply all the internal and external
("natural") phenomena that can derail and put out of track the
advancement of a life cycle. Each one of those specialties has to
arrange its own world of knowledge, with lots of analytical and
synthetic avenues not amenable to neat overall schemes and to formal
approaches except in some reduced pockets. Successful reductionist
strategies and analytical techniques are piled up with holistic views,
and reams of tacit knowledge (indeed medicine is a very stratified small
world of "lords", "masters", "disciples", "servants", and "beginners").
So, like in engineering, one has to be suspicious of far reaching
implications for the term "integrative". Not necessarily in this case
with the "3φ" connotation. But the strong reliance on criticality could
be subject to scrutiny. Quite many cellular / biomolecular phenomena do
not especially rely on criticality --perhaps the most essential ones,
related to "codes", genomic maintenance, protein synthesis, protein
degradation, signaling, apoptosis, etc. Why the integrative strategy
should rely on a term that notwithstanding strong physical grounds,has
relatively thin explanatory capability in the biological? It is a long
story of looking for responses "where the physical/math light is" and
not where the biol. problems are.
My view, I can be wrong but I have worked considerably on the matter, is
that cellular signaling, the crisscrossing of info flows that provide
the singular intelligence and adaptability of organisms, is not well
articulated yet. Neither in evo-devo, nor in physiology, medicine and
health. In this regard all the present parlance on information
processing that accompanies the tremendous technological info-tech
revolution does not represent a help, maybe the opposite. The deep info
problems are taken as already solved and articulated synthesis are
undertaken as mere agglutinations. Maybe the problem is too deeply
complex, and medicine is as always too messy.
Sorry if seemingly I have joined the "Cassandra" club!
Best--Pedro
El 14/05/2016 a las 9:49, Dr. Plamen L. Simeonov escribió:
Dear Colleagues,
My contribution will finalize the discussion on phenomenology in the
domains of biology, mathematics, cyber/biosemiotics and physics by the
previous speakers (Maxine, Lou, Sœren and Alex) with a “challenging
topic” in _3φ integrative medicine_. *You may wish to skip the small
font text notes following each underscored phrase like the one below.*
_Note 1:_Although this term is often used as synonym for holistic
healing (s. ref. list A), its meaning in this context with the prefix
3φ goes much “deeper” into the disciplines’ integration leaving no
room for speculations by mainstream scientists. The concept is a
linguistic choice of mine for the intended merge of the complexity
sciences _ph_ysics and _ph_ysiology with _ph_enomenology for
application in modern medicine along the line of integral biomathics
(s. ref. list B).
It is rooted in the last presentation of Alex Hankey, since it
naturally provides the link from physics to physiology and medicine,
and thus to an anthropocentric domain implying a leading part of
phenomenological studies. To begin, I compiled a précis of Alex’
thesis about self-organized criticality (s. ref. list C) from his
paper “A New Approach to Biology and Medicine” -- the download link to
it was distributed in a previous email of him -- and extended it with
my reflections including some questions I hope you will resonate on.
I am curious of your opinion about how to apply the scientific method,
and in particular mathematics and information science, to study
illness and recovery as complex phenomena.
*Alex Hankey: self-organized criticality and regulation in living systems*
*There is a continuous growth and change at the end of a phase
transition in an organism, i.e. at its critical point, which is the
end point of phase equilibrium.*
**
*Both endo and exo, genetics and epigenetics are important for life.*
**
*Self-organized criticality*is a characteristic state of a system at
its critical point generated by self-organization during a long
transient period at the complexity edge between
order/stability/predictability and disorder/chaos/unpredictability.
*/Regulation of growth, form and function as a balance between health
and illness./*The role of regulation and homeostasis in maintaining
the structure and function of living systems is critical. Every
deviation from a regulated state of being leads to imbalances,
failures and subsystem dysfunction that is usually transitory, but
could also become life-threatening, if the organism cannot find a way
to restore quickly to a balanced, healthy state. Living beings are
robust and fault-tolerant with respect to hazards; they possess
multiple alternative pathways for supplying and maintaining their
existential functions. However, some state transitions in response to
severe harms can become practically irreversible, because of the deep
evolutionary interlocking between the participating entities and
processes. Sometimes the normal functioning of the organism cannot be
easily restored by its natural repair processes, especially when
adversities reoccur frequently, and the organism fails ill.
*Synchronicity of action and information between the building blocks
of a living system.*There is a need for every physiological function
to be correctly coordinated with all other “peer” functions.
Information flows within a living system interconnect all
physiological functions and organs at multiple levels into a single
mesh of regulatory interconnections. Multiple feedback-control loops
enable the cross-functional interlocking of both healthy and ill state
changes of the organism. Adjacent/peripheral/secondary homeostasis
processes act as fine-tuning catalyzers of substrate ratios and
process rates exchanged within the living system. Imbalances of these
quantities lead to excess/blockage or scarcity/draining of essential
nourishment and information exchange pathways.
**
*Regulation at criticality*not only fine-tunes a process, it
/optimizes/ it for survival: with respect to a given generation’s
available possibilities in the light of the past generations’
possibilities. To survive an organism or a species needs to develop
optimal /response-ability/ to environmental distress.
*
*
*New ecological definition of life according to Hankey:
self-regulating, self-reproducing systems that maximize efficiency of
function to maximize competitiveness in their chosen environment. *
**
*Summary: Elements of self-organized criticality*
**
1. Criticality
2. Edge of the chaos
3. Self-organized criticality
4. 1/f fractal patterns of response
*… and beyond*
I wish to add a 5^th aspect to this definition from the perspective of
integral biomathics:
5. /Phenomenology/
The latter is a largely studied matter in contemporary medicine (s.
ref. list D), at least at the macro, interpersonal _level_.
_Note 2_: A level refers to the compositional hierarchy defining
levels by scale.
*The key question in such a “deep holistic”
physically-phenomenological physiology (*3φ_)_*is how to define or
comprehend (self-organized) criticality operationally within the
unifying framework of biomathematics and biocomputation*. Indeed, a
single temporary imbalance within a living system regarded as disease
involves multiple agents, perspectives and interpretations at all
levels altogether, moreover _simultaneously_.
_Note 3_: Simultaneously at different levels involves very different
sized 'moments' at the different scales.
So, how should we approach and take into account the other
levels/scales in order to derive a reliable diagnosis and _therapy_?
_Note 4_: The notion of “subject” becomes plural (“subjects”) as
superposition of quantum states to survive the integration of the
multiple first-person subjective descriptions and the standard
third-person objective one.
Until now criticality has been _non-phenomenological_.
_Note 5:_In their 2012 paper “No entailing laws, but enablement in the
evolution of the biosphere” Longo, Montévil and Kauffman claim that
biological evolution “marks the end of a physics world view of law
entailed dynamics” (http://arxiv.org/abs/1201.2069). They argue that
the evolutionary phase space or space of possibilities constituted of
interactions between organisms, biological niches and ecosystems is
“ever changing, intrinsically indeterminate and even (mathematically)
unprestatable”.Hence, the authors' claim that it is impossible to know
“ahead of time the 'niches' which constitute the boundary conditions
on selection” in order to formulate laws of motion for evolution. They
call this effect “radical emergence”, from life to life. Yet this
applies to abiotic dissipative structures like tornadoes as well.
Living beings are not radically different in this respect. In their
study of biological evolution, Longo and colleagues carried close
comparisons with physics. They investigated the mathematical
constructions of phase spaces and the role of symmetries as invariant
preserving transformations, and introduced the notion of “enablement”
to restrict causal analyses to Batesonian differential cases (1972:
“the difference that makes a difference”). The authors have shown that
mutations or other “causal differences” at the core of evolution
enable the establishment of non-conservation principles, in contrast
to physical dynamics, which is largely based on conservation
principles as symmetries. Their new notion of “extended criticality”
also helps to understand the distinctiveness of the living state of
matter when compared to the non-animal one. However, their approach to
both physics and biology is also /non-phenomenological/. The
possibility for endo states that can trigger the “(genetic/epigenetic)
switches of mutation” has not been examined in their model. This is
intended to be different in 3φ/integrative medicine/.
If we split a human body into macro (patient), mezzo (systems) and
micro levels (cells) three distinct questions regarding phenomenology
arise: i) /how/ these levels pervade into each other with larger scale
providing context (boundary conditions) and lowest scale providing raw
materials for middle scale to function,monitor and control vital
processes, ii) /who/which/ are the agents taking care for this to
happen spontaneously, and iii) /what kind and role/ plays information
in the context of i) and ii). After all what we are concerned about is
modeling the agency of the systems in the mezzo level.
Where should we go from here?
In particular, I am interested to know *what kind of
/scientific-phenomenological methodology/ can be developed and applied
for investigating *the following three major groups of ailments:
1. *oncological diseases*with a particular focus on spatial and
temporal heterogeneity both in terms of flawed histological
structures and biochemical reactions;
2. *neuro-degenerative disorders*such as vascular dementia, Parkinson
and Alzheimer diseases:
3. *altered organ and physiological system failures*such as the
Multiple Organ Dysfunction Syndrome (MODS), cardiovascular and
autoimmune diseases.
In the first group, the *extreme diversity of cancer tissue structures
and circulating tumor cells (CTC) concentrations over both spatial and
temporal scales* makes the reliable classification, diagnosis,
model/hypothesis generation, forecast and treatment of individual
patients very difficult. This is a real challenge for modern
pathology. Another problem is that pathologists are actually dealing
with random tissue and blood samples over irregular periods, which
hinder the exact 3D histological reconstruction of the tumor
formations and tracing their development over time and space. Using
additional means such as diagnostic sonography, CT, MRT and PET images
do not improve sufficiently the hypotheses about the individual cancer
morphology and development. All this makes tumor classification and
diagnosis, even when analyzing high-resolution digital images from
biopsy slices by means of virtual microscopy, very difficult and often
a guesswork also for experts. The recent advances in high-performance
medical scanning and automation systems, computerized visualization
and graphical modeling tools, as well the collection of huge amounts
of anonymous patient data in specialized medical databases make the
impression that the solution of these problems is only a question of
more automation, performance, investment and time. However, many
pathologists begin to realize a third problem, namely that *tumors
appear to be /unique/ in their histological structure and
development*, related to the personal history and the overall state of
health of the individual patients. This argument reveals the need for
developing a more personalized and differentiated medicine that goes
over scales without becoming purely symptomatic, causality-driven and
reductionistic.
Recent research in the other two fields leads to the same conclusion.
Therefore, I think that we may be able to develop and test hypotheses
about emergence and development of deficiency and illness that will
lead to individual therapies in /3φ/ integrative medicine. Your ideas
regarding this assumption are very welcome.
Some interesting questions bridging the previous discussion sessions
to this one are:
-Why does a human embryo repeat the evolutionary history of its
species when going through its development stages? Is it because it is
more secure to project and set up the execution of a future life plan
by tracing and bodily memorizing a series of evolutionary encoded
(successful) “locks” through equilibrium states at the edge of
criticality?
-Which is the /vital /role of recursion and repetition of life
processes including their material and information exchange flows in
the criticality driven self-regulation for recovery from imbalances
and the reversibility and healing of diseases? How can we effectively
model such processes?
-Do we make difference between a physicist’s time and a biologist’s
time in complex living systems?
* I look forward to your feedback and notes on the subject.*
**
*References:*
*A.**_Integrative Medicine_*
Integrative Medicine:
https://en.wikipedia.org/wiki/Integrative_medicine
<http://www.wikiwand.com/en/Integrative_medicine>
What Is Integrative Medicine?:
http://www.webmd.com/a-to-z-guides/features/alternative-medicine-integrative-medicine
Integrative Medicine Research:
http://www.journals.elsevier.com/integrative-medicine-research/
Advances in Integrative Medicine
http://www.journals.elsevier.com/advances-in-integrative-medicine
*B.**_Integral Biomathics_*
Integral Biomathics:
https://en.wikipedia.org/wiki/Integral_Biomathics
<http://www.wikiwand.com/en/Integral_Biomathics>*//*
Integral Biomathics: A Post-Newtonian View into the Logos of Bios
https://arxiv.org/ftp/cs/papers/0703/0703002.pdf
On Some Recent Insights in Integral Biomathics:
https://arxiv.org/ftp/arxiv/papers/1306/1306.2843.pdf.
Integral Biomathics Reloaded: 2015 (free access until July 19^th 2016):
http://www.sciencedirect.com/science/article/pii/S0079610715001509
*C.**_Self-organized criticality_*_:_
Self-organized criticality:
https://en.wikipedia.org/wiki/Self-organized_criticality
<http://www.wikiwand.com/en/Self-organized_criticality>
Self-organized criticality (SOC):
http://www.johnboccio.com/courses/SOC26/15-SOC.pdf
Self-organized criticality:
http://web.mit.edu/8.334/www/grades/projects/projects12/V.%20A.%20Golyk.pdf
Self-organized criticality – what it is and what it isn’t
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.96.8017&rep=rep1&type=pdf.
*D.**_Phenomenology in Medicine_*
The meaning of illness: a phenomenological approach to the
physician/patient relationship:
https://baylor-ir.tdl.org/baylor-ir/handle/2104/8286 ;
http://hdl.handle.net/2104/8286.
Body Matters: A Phenomenology of Sickness, Disease, and Illness:
http://philpapers.org/rec/AHOBMA.
Suffering Transfigured: Phenomenological Personalism In the
Doctor-Patient Relationship:
http://elischolar.library.yale.edu/cgi/viewcontent.cgi?article=1658&context=ymtdl.
The challenge of neuroscience: Psychiatry and phenomenology today:
https://www.klinikum.uni-heidelberg.de/fileadmin/zpm/psychatrie/fuchs/Challenge_of_Neuroscience.pdf.
Rediscovering Psychopathology: The Epistemology and Phenomenology of
the Psychiatric Object:
http://cfs.ku.dk/staff/zahavi-publications/Rediscovering_Psychopathology.pdf.
PHENOMENOLOGY IN PSYCHIATRY:
http://www.wpanet.org/uploads/Sections/Philosopy_and_Humanities/Phenomenology-in-Psychiatry.pdf.
**
*Plamen*
____________________________________________________________
2015 JPBMB Special Issue on Integral Biomathics: Life Sciences,
Mathematics and Phenomenological Philosophy
<http://www.sciencedirect.com/science/journal/00796107/119/3>
(note: free access to all articles until July 19th, 2016)
2013 JPBMB Special Issue on Integral Biomathics: Can Biology Create a
Profoundly New Mathematics and Computation?
<http://www.sciencedirect.com/science/journal/00796107/113/1>
2012 Integral Biomathics: Tracing the Road to Reality
<http://www.springer.com/engineering/computational+intelligence+and+complexity/book/978-3-642-28110-5>
2011 INtegral BIOmathics Support Action (INBIOSA) <http://www.inbiosa.eu>
____________________________________________________________
--
-------------------------------------------------
Pedro C. Marijuán
Grupo de Bioinformación / Bioinformation Group
Instituto Aragonés de Ciencias de la Salud
Centro de Investigación Biomédica de Aragón (CIBA)
Avda. San Juan Bosco, 13, planta X
50009 Zaragoza, Spain
Tfno. +34 976 71 3526 (& 6818)
pcmarijuan.i...@aragon.es
http://sites.google.com/site/pedrocmarijuan/
-------------------------------------------------
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