Essential New Complexity-Based Themes for Patient-Centered Diagnosis and Treatment of Dementia and Predementia in Older People: Multimorbidity and Multilevel Phenomenology

Dementia is a highly prevalent condition with devastating clinical and socioeconomic sequela. It is expected to triple in prevalence by 2050. No treatment is currently known to be effective. Symptomatic late-onset dementia and predementia (SLODP) affects 95% of patients with the syndrome. In contrast to trials of pharmacological prevention, no treatment is suggested to remediate or cure these symptomatic patients. SLODP but not young onset dementia is intensely associated with multimorbidity (MUM), including brain-perturbating conditions (BPCs). Recent studies showed that MUM/BPCs have a major role in the pathogenesis of SLODP. Fortunately, most MUM/BPCs are medically treatable, and thus, their treatment may modify and improve SLODP, relieving suffering and reducing its clinical and socioeconomic threats. Regrettably, the complex system features of SLODP impede the diagnosis and treatment of the potentially remediable conditions (PRCs) associated with them, mainly due to failure of pattern recognition and a flawed diagnostic workup. We suggest incorporating two SLODP-specific conceptual themes into the diagnostic workup: MUM/BPC and multilevel phenomenological themes. By doing so, we were able to improve the diagnostic accuracy of SLODP components and optimize detecting and favorably treating PRCs. These revolutionary concepts and their implications for remediability and other parameters are discussed in the paper.

Goals as Emergent Autopoietic Processes

While the phenomena of reaching a goal is generally represented in the framework of optimization, the phenomena of becoming of a goal is more similar to a "self-organization and emergent" rather than an "optimization and preexisting" process. In this article we provide a modeling framework for the former alternative by representing goals as emergent autopoietic structures. In order to conceptually situate our approach, we first review some of the most remarkable attempts to formally define emergence, and identify that in most cases such definitions rely on a preexisting system to be observed prior and post emergence, being thus inadequate for a formalization of emergent goals corresponding to the becoming of a systems as such (e.g. emergence of life). Next, we review how an implementation of the reaction networks framework, known as Chemical Organization Theory (COT), can be applied to formalize autopoietic structures, providing a basis to operationalize goals as an emergent process. We next revisit the definitions of emergence under the light of our approach, and demonstrate that recent taxonomies developed to classify different forms of emergence can be naturally deduced from recent work aimed to explain the kinds of changes of the organizational structure of a reaction network.

Engineering the emergence of norms: a review

Complex systems often exhibit emergent behaviour, unexpected macro-level behaviour caused by the interaction of micro-level components. In multiagent systems, these micro-level components may be autonomous agents and the emergent behaviour may be expressed as norms—patterns of behaviour that arise among the agents in response to their environment and each other. These emergent norms may be beneficial (e.g. by encouraging cooperative behaviour), or detrimental, but in either case it is useful to recognize these norms as they emerge and either encourage or discourage their establishment. We term this process engineering the emergence of norms and have identified three steps: the identification of a possible norm, evaluation of its benefit and its encouragement (or discouragement). This paper is an attempt to provide a survey of existing research related to these steps. We also provide an analysis of the approaches based upon their suitability for a variety of normative systems: we examine the requirements for agents to have autonomy over their choice of norms, the degree of observability required in the system, and the norm enforcement methods. The paper concludes with an discussion of open issues.

Explaining a complex living system: dynamics, multi-scaling and emergence

Complex living systems are difficult to understand. They obey the laws of physics and chemistry, but these basic laws do not explain their behaviour; each component part of a complex system participates in many different interactions and these interactions generate unforeseeable, emergent properties. For example, microscopic interactions between non-living molecules, at the macroscopic level, produce a living cell. Here we discuss how to explain such complexity in the format of a dynamic model that is mathematically precise, yet understandable. Precise, computer-aided modelling will make it easier to formulate novel experiments and attain understanding and control of key biological processes.

Modeling immune behavior for experimentalists

This article outlines the requirements for useful models of biologic systems. Such models should fulfill three conditions: (i) suit the bottom-up data of the living system, not merely adhere to top-down logic; (ii) abet experimentation by stimulating new ideas for novel experiments; and (iii) engage the mind of the experimentalist with understandable, visual representations. Seven characteristics of a useful model are discussed.