The manager as a teacher: selected aspects of stimulation of scientsfsc thinking
Functional condition of system.
Functional condition of the system is defined by the number of active SFU. If
all SFU function simultaneously, it shows high functional condition which
arises in case of maximum external influence. If none SFU is active it shows
minimum functional condition. It may occur in the absence of external
influence. External environment always exerts some kind of influence on
some systems, including the systems of organism. Even in quiescent state the
Earth gravitational force makes part of our muscles work and consequently
absolute rest is non-existent. So, when we are kind of in quiescent state we
actually are in one of the low level states of physical activity with the
corresponding certain low level of functional state of the organism. Any
external influence requiring additional vigorous activity would transfer to a
new level of a functional condition unless the SFU reserve is exhausted. When
new influence is set at a new invariable (stationary) level, functional
condition of a system is set on a new invariable (stationary) functional level.
Stationary states/modes.
Stationary state is such a mode of systems when one and the same number of SFU
function and no change occurs in their functional state. For example, in
quiescence state all systems of organism do not change their functional mode as
far as about the same number of SFU is operational. A female runner who runs a
long distance for quite a long time without changing the speed is also in a
stationary state/mode. Her load does not vary and consequently the number of
working (functioning) SFU does not change either, i.e.
the functional state of her organism does not change. Her organism has already
“got used” to this unchangeable loading and as there is no increase of load
there is no increase in the number of working SFU, too. The number of working
SFU remains constant and therefore the functional state/mode of the organism
does not change. What may change in this female runner’s body is, e.g. the
status of tissue energy generation system and the status of tissue energy
consumption system, which is in fact the process of
exhaustion of organism. However, if the female runner has duly planned her run
tactics so that not to find herself in condition of anaerobic metabolism, the
condition of external gas metabolism and blood circulation systems would not
change. So, regardless of whether or not physical activity is present, but if
it does not vary (stationary physical loadings /steady state/, provided it is
adequate to the possibilities of the organism), the organism of the subject
would be in a stationary state/mode. But if the female runner runs in
conditions of anaerobic metabolism the “vicious circle”
will be activated and functional condition of her organism will
start change steadily to the worse. (The vicious circle is the
system’s reaction to its own result of action. Its basis is hyper reaction of
system to routine influence, since the force of routine external influence is
supplemented by the eigen result of action of the system which is independent
of the latter and presents external influence in respect to it. Thus, routine
external influence plus the influence of the system’s own result of action all
in all brings about hyper influence resulting in hyper reaction of the system (system
overload). The outcome of this reaction is the destruction own SFU coupled with
accumulation of defects and progressing decline in the quality of life. At the
initial stages while functional reserves are still large, the vicious circle
becomes activated under the influence of quite a strong external action (heavy
load condition). But in process of SFU destruction and accumulation of defects
the overload of adjacent systems and their destruction would accrue (the domino
principle), whereas the level of load tolerance would recede and with the lapse
of time even weak external influences will cause vicious circle actuation and
may prove to be excessive. Eventually even the quiescent state will be the
excessive loading for an organism with destroyed SFU which condition is
incompatible with life. Usually termination of loading would discontinue this
vicious circle.
Dynamic processes. Dynamic
process is the process of changing functional state/mode/condition of the
system. The system is in dynamic process when the change in the number of its
actuated SFU occurs. The number of continually actuated SFU would determine
stationary state/mode/condition of the system. Hence, dynamic process is the process
of the system’s transition from one stationary level to another. If the speed
of change in external influences exceeds the speed of fixing the preset result
of action of the system, transition processes (multi-micro-cycles) occur during
which variation of number of functioning SFU also takes place. Therefore, these
transition processes are also dynamic. Consequently, there are two types of
dynamic processes: when the system is shifting from one stationary condition
(level) to another and when it is in transient multi-micro-cycle. The former is
target-oriented, whereas the latter is caused by imperfection of systems and is
parasitic, as its actions take away additional energy which was intended for
target actions. When the system is in stationary condition some definite number
of SFU (from zero to all) is actuated. The minimum step of change of level of
functional condition is the value determined by the level of operation of one
SFU (one quantum of action). Hence, basically transition from one level of
functional condition to another is always discrete (quantized) rather than
smooth, and this discrecity is determined by the SFU “caliber”. Then umber of
stationary conditions is equal to the number of SFU of the system. Systems with
considerable quantity of “small” SFU would pass through dynamic processes more
smoothly and without strenuous jerks, than systems with small amount of “large”
SFU. Hence, dynamic process is characterized by an amplitude of increment of
the system’s functions from minimum to maximum (the system’s minimax; depends
on its absolute number of SFU), discrecity or pace of increment of functions
(depends on the “caliber” or quantum of individual SFU) and parameters of the
function’s cyclic recurrence (speed of increase of actions of system, the
period of phases of a cycle, etc.). It can be targeted or parasitic. It should
be noted that stationary condition is also a process, but it’s the steady-state
(stationary) process. In such cases the condition of systems does not vary from
cycle to cycle. But during each cycle a number of various dynamic processes
take place in the system as the system itself consists of subsystems, each of
which in turn consists of cycles and processes. The steady-state process keeps
system in one and the same functional condition and at one and the same
stationary level. In accordance with the above definition, if a system does not
change its functional condition, it is in stationary condition. Consequently,
the steady-state process and stationary condition mean one the same thing,
because irrespective of whether the systems are in stationary condition or in
dynamic process, some kind of stationary or dynamic processes may take place in
their subsystems. For example, even just a mere reception by the “Х” receptor is
a dynamic process. Hence, there are no absolutely inert (inactive) objects and
any object of our World somewise operates in one way or another. It is assumed
that the object may be completely “inactive” at zero degrees of Kelvin scale
(absolute zero). Attempts to obtain absolutely inactive systems were undertaken
by freezing of bodies up to percentage of Kelvin degrees. It’s unlikely though,
that any attempts to freeze a body to absolute zero would be a success, because
the body would still move in space, cross some kind of magnetic, gravitational
or electric fields and interact with them. For this reason at present it is
probably impossible in principle to get absolutely inert and inactive body. The
integral organism represents mosaic of systems which are either in different
stationary conditions, or in dynamic processes. One could possibly make an
objection that there are no systems in stationary condition in the organism at
all, as far as some kind of dynamic processes continually occur in some of its systems.
During systole the pressure in the aorta increases and during diastole it goes
down, the heart functions continuously and blood continuously flows through the
vessels, etc. That is all very true, but evaluation of the system’s functions
is not made based on its current condition, but the cycles of its activity.
Since all processes in any systems are cyclic, including in the organism, the
criterion of stationarity is the invariance of integral condition of the system
from one cycle to another. Aorta reacts to external influence (stroke/systolic
discharge of the left ventricle) in such a way that in process of increase of
pressure its walls’ tension increases, while it falls in process of pressure
reduction. However, take, for example, the longer time period than the one of
the cardiocycle, the integrated condition of the aorta would not vary from one
cardiocycle to another and remain stationary.
Evaluation of functional state
of systems. Evaluation may be qualitative and quantitative. The presence (absence)
of any waves on the curve presents quality evaluation, whereas their amplitude
or frequency is their quantitative evaluation. For the evaluation of functional
condition of any systems comparison of the results of measurements of function
parameters to those that should be with the given system is needed. In order to
be able to judge about the presence (absence) of pathology, it is not enough to
measure just any parameter. For example, we have measured someone’s blood
pressure and received the value of 190/100 mm Hg. Is it a high pressure or it
is not? And what it should be like? To answer these questions it is necessary
to compare the obtained result to a standard scale, i.e. to the due value. If
the value obtained differs from the appropriate one, it speaks of the presence
of pathology, if it does not, then it means there is no pathology. If blood
pressure value of an order of 190/100 mm Hg is observed in quiescent state it
would speak of pathology, while at the peak maximum load this value would be a
norm. Hence, due values depend on the condition in which the given system is.
There exist standard scales for the estimation of due values. There exist
maximum and minimum due values, due values of quiescence state and peak load
values, as well as due curves of functions. Minimum and maximum due values
should not always correspond to those of quiescence state or
peak load. For example, total peripheral vascular resistance should be maximum
in quiescence state and minimum when loaded. Modern medicine makes extensive
use of these kinds of due values, but is almost unfamiliar with the concept of
due curves. Due value is what may be observed in most normal and healthy
individuals with account taken of affiliation of a subject to certain standard
group of alike subjects. If all have such-and-such value and normally exist in
the given conditions, then in order for such subject to be also able to exist
normally in the same conditions, he/she should be characterized by the
same value. For this purpose statistical standard scales are applied which are
derived by extensive detailed statistical research in specific groups of
subjects. These are so-called statistical mathematical models. They show what
parameters should be present in the given group of subjects. However, the use
of standard tables is a primitive way of evaluation of systems’ functions.
First, they provide due values characterizing only a group of healthy
individuals rather than the given concrete subject. Secondly, we already know
that systems at each moment of time are in one of their functional states and
it depends on external influences. For example, when the system is in
quiescence state it is at its lowest level of functional condition, while being
at peak load it is at its highest level. What do these tables suggest then?
They probably suggest due values for the systems of organism in quiescence
state or at their peak load condition. But, after all, the problems of patients
are not those associated with their status in quiescence state, and the level of
their daily normal (routine) load is not their maximum load. For normal
evaluation of the functional condition of the patient’s organism it is
necessary to use not tabular data of due values, but due curves of functions of
the body systems which nowadays are almost not applied. Coincidence or
non-coincidence of actual curves of the body systems’ functions with due curves
would be a criterion of their sufficiency or insufficiency. Hence, application
of standard tables is insufficient and does not meet the requirements of
adequate diagnostics. Application of due curves is more of informative
character (see below). Statistical mathematical models do not provide such
accuracy, howsoever exact we measure parameters. They show what values of
parameters should be in a certain group of subjects alike in terms of certain
properties, for example, males aged 20-30 years, of 165-175 cm height, smokers
or non-smokers, married or single, paleface, yellow- or black-skinned, etc.
Statistical models are much simpler than those determined, but less exact
though, since in relation to the given subject we can only know something with
certain degree (e.g. 80%) of probability. Statistical models apply when we do
not know all elements of the system and laws of their interaction. Then we hunt
for similar systems on the basis of significant features, we somewise measure
the results of action of all these systems operating in similar conditions
(clinical tests) and calculate mean value of the result of action. Having
assumed that the given subject closely approximates the others, because
otherwise he/she would not be similar to them, we say: “Once these (people)
have such-and-such parameters of the given system in such-and-such conditions
and they live without any problems, then he/she should have these same
parameters if he/she is in the same conditions”. However, a subject’s living
conditions do always vary. Change or failure to account even one significant
parameter can change considerably the results of statistical researches, and this
is a serious drawback of statistical mathematical models. Moreover, statistical
models often do not reveal the essence of pathological process at all. The
functional residual capacity (FRC) of lungs shows volume of lungs in the end of
normal exhalation and is a certain indicator of the number of functional units
of ventilation (FUV). Hence, the increase in FRC indicates the increase in the
number FUV? But in patients with pulmonary emphysema FRC is considerably
oversized. All right then, does this mean that the number of FUV in such
patients is increased? It is nonsense, as we know that due to emphysema
destruction of FUV occurs! And in patients with insufficiency of pumping
function of left ventricle reduction of FRC is observed. Does this mean that the
number of FUV is reduced in such patients? It is impossible to give definite
answer to these questions without the knowledge of the dynamics of external
respiration system function and pulmonary blood circulation. Hence, the major
drawback of statistical models consists in that sufficiently reliable results
of researches can be obtained only in the event that all significant conditions
defining the given group of subjects are strictly observed. Alteration or
addition of one or several significant conditions of research, for example,
stature/height, sex, weight, the colour of eyes, open window during sleep,
place of residence, etc., may alter very much the final result by adding a new
group of subjects. As a result, if we wish to know, e.g. vital capacity
of lungs in the inhabitants of New York we must conduct research among the
inhabitants of New York rather than the inhabitants of Moscow, Paris or
Beijing, and these data may not apply, for example, to the inhabitants of Rio
de Janeiro. Moreover, standards/norms may differ in the
inhabitants of different areas of New York depending on national/ethnic/
identity, environmental pollution in these areas, social level and etc. Surely,
one may investigate all conceivable variety of groups of subjects and develop
specifications/standards, for example, for males aged from... to..., smokers
or non-smokers of cigars (tobacco pipes, cigarettes or cigarettes with
cardboard holder) with high (low) concentration of nicotine, aboriginals
(emigrants), white, dark- or yellow-skinned, etc. It would require enormous
efforts and still would not be justified, since the world is continually
changing and one would have to do this work every time again. It’s all the more
so impossible to develop statistical specifications/standards for infinite
number of groups of subjects in the course of dynamic processes, for example,
physical activities and at different phases of pathological processes, etc.,
when the number of values of each separate parameter is quite large. When the
system’s details are completely uncertain, although the variants of the
system’s reaction and their probabilistic weighting factors are
known,
statistical mathematical model of system arises.
Inaccuracy of these models is of fundamental character and is stipulated by
probabilistic character of functions. In process of studying of the system
details of its structure become apparent. As a result an empirical model
emerges in the form of a formula. The degree of accuracy of this model is
higher than that of statistical, but it is still of probabilistic character.
When all details of the system are known and the mechanism of its operation is
entirely exposed the deterministic mathematical model
appears in the form of the formula. Its accuracy is only stipulated by the accuracy
of measurement methods. Application of statistical mathematical models is
justified at the first stages of any cognition process when details of
phenomenon in question are unknown. At this stage of cognition a “black box”
concept is introduced when we know nothing about the structure of this “box”,
but we do know its reaction to certain influences. Types of its reactions are
revealed by means of statistical models and thereafter, with the help of logic,
details of its systems and their interaction are becoming exposed. When all
that is revealed, deterministic models come into play and the evaluation of the
systems’ functions is made not on the basis of tabular data, but on the basis
of due curve of the system function. Due curve of a system’s function is a due
range of values of function of the given concrete system in the given concrete
subject, with its load varying from minimum to maximum. Nowadays due curves are
scarcely used, instead extreme minimum and maximum due values are applied. For
example, due ventilation of lungs in quiescence state
and in the state of peak load. For this purpose maximum load is given to
individuals in homotypic groups and pulmonary ventilation in quiescence state
and in the state of peak load is measured. Following statistical processing due
values of pulmonary ventilation for the conditions of rest and peak load are
obtained. The drawback of extreme due values consists in that this method is of
little use for the patients. Not all patients are able to
normally perform a stress test and discontinue it long before due maximum value
is achieved. The patient, for example, could have shown due pulmonary
ventilation, but he/she just stopped the load test too early. How can the
function be estimated then? It can be only done by means of due curve. If the
actual curve coincides with the due curve, the function is normal at the site
where coincidence occurred. If actual curve is lower than the due one, it is a
lagging curve. Inclined straight line consisting of vertical pieces of line is
the due curve. Vertical dotted straight line is the boundary of transition of
normal or lagging function into the inadequate line (a plateau). The drawback
of due curves is that in order to build them it is necessary to use
deterministic mathematical models of systems which number is currently very
low. They are built on the basis of knowledge of cause-and-effect relationship
between the system elements. These models are the most complex, labor-consuming
and for the time being are in many cases impracticable. Therefore, these models
are scarcely used in the sphere of applied
medicine and this is the reason for the absence of
analytical medicine. But they are the most accurate and show what parameters
should be present in the given concrete subject at any point of time. Only the
use of due curve functions allows for evaluating actual curves properly. The
difference of the deterministic mathematical models from statistical tables
consists in that in the first case due values for the concrete given subject (the
individual’s due values) are obtained, while in the second case due values for
the group of persons alike the given subject are developed. The possibility of
building deterministic models depends only on the extent of our knowledge of
executive elements of the system and laws of their interaction. Calculation of
probability of a thrown stone hitting a designated target can be drawn as an
example of statistical standard scale in the mechanic. After a series of
throws, having made certain statistical calculations it is possible to predict
that the next throw with such degree of probability will hit the mark. If
deterministic mathematical model (ballistics) is used for this purpose, then
knowing the stone weight, the force and the angle of throw, viscosity of air,
speed and direction of wind, etc., it is possible to calculate and predict
precisely the place where a stone will fall. “Give me a spot of support and I
will up-end the globe”, said Archimedes, having in view that he had
deterministic mathematical model of mechanics of movements. Any living organism
is a very complex and multi-component system. It’s impossible to account all
parameters and their interrelations, therefore statistical mathematical models
cannot describe adequately the condition of systems of organism. However, joint
use of statistical and deterministic models allows, with sufficient degree of
accuracy, to evaluate parameters of living system. In the lapse of time in
process of accumulation of knowledge statistical models are replaced by
deterministic. Engineering/technology is much simpler than
biology and medicine because the objects of its knowledge are rather simple
systems (machinery/vehicles) constructed by a man. Therefore, its development
and process of replacement of statistical mathematical models for deterministic
ones has made great strides as compared with medicine. Nevertheless, on the
front line of any science including technical, where there is still no clarity
about many things and still a lot has to be learnt, statistics stands its
ground as it helps to reveal elements of systems and laws of their interaction.
What do we examine the subject and conduct estimation of functions of the
systems of his organism for? Do we do it in order to know to which extent
he/she differs from the homothetic subject? Probably, yes. But, perhaps, the
main objective of examination of a patient is to determine whether he/she can
normally exist without medical aid and if not, what kind of help might be
provided. Pathological process is a process of destruction of some SFU of the
organism’s systems in which one of the key roles is played by a vicious circle.
However, vicious circles start to actuate only if certain degree of load is
present. They do not emerge below this level and do not destroy SFU, i.e. no
pathological process emerges and no illness occurs below a certain threshold of
loading (mechanical, thermal, toxic, etc.). Hence, having defined a threshold
of the onset of the existence of vicious circle, we can learn the upper
“ceiling” of quality of life of the given patient. If his/her living conditions
(tempo of life) allow him/her not to exceed this “ceiling”, it suggests that
the given subject will not be in poor health under these conditions. If the
tempo of life requires more than the capacity of his/her organism may provide,
he/she will be in poor health. In order not to be ill he/she should stint
himself/herself in some actions. To limit oneself in actions means to reduce
one’s living standard, to deprive oneself of the possibility to undertake
certain actions which others can do or which he/she did earlier, but which are
now inaccessible to the given patient on the grounds of restricted resources of
his/her organism because of defects. If these restrictions have to do only with
pleasure/delight, such as, for example, playing football, this may be somehow
sustained. But if these restrictions have to do with conditions of life of the
patient it has to be somehow taken into account. For example, if his/her
apartment is located on the ground floor, then to provide for quite normal way
of life his/her maximum consumption of О2 should be, e.g., 1000
ml a minute. But what one should do if he/she lives, e.g., on the third floor
and in the house with no elevator, and to be able to get to the third floor on
foot
he/she
should be able to take up 2000 ml/min О2, while he/she is able
to uptake take up only 1000 ml/min О2,? The patient would
then have a problem which can be solved only by means of some kind of health
care actions or by changing conditions of life. In clinical practice we almost
do not assess the patient’s functional condition from the stand point of its
correspondence to living conditions. Of course, it is trivial and we guess it,
but for the time being there are no objective criteria and corresponding
methodology for the evaluation of conformity of the functional reserves of the
patient’s organism with the conditions of his/her life activity. Ergonomics is
impossible without systemic analysis. Major criterion of sufficiency of the organism’s
functions in the given conditions of life is the absence of the occurrence of
vicious circles (see below) at the given level of routine existential loads. If
vicious circles arise in the given conditions, it is necessary either to
somehow strengthen the function of the organism’s systems or the patient will
have to change his/her living conditions so that vicious circles do not work,
or otherwise he/she will always be in poor health with all the ensuing
consequences. So, we need not only to know due minimum or maximum values which
we may obtain using statistical mathematical models. We also need to know the
patient’s everyday due values of the same parameters specific for the given
concrete patient so that his/her living conditions do not cause the development
of pathological processes and destroy his/her organism. To this effect we need
deterministic mathematical models.
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