“Evidence based medicine” is often seen as a scientific tool for quality improvement, even though its application requires the combination of scientific facts with value judgments and the costing of different treatments. How this is done depends on whether we approach the problem from the perspective of individual patients, doctors, or public health administrators. Evidence based medicine exerts a fundamental influence on certain key aspects of medical professionalism. Since, when clinical practice guidelines are created, costs affect the content of EBM, (...) EBM inevitably becomes a form of rationing and adopts a public health point of view. This challenges traditional professionalism in much the same way as managed care has done in the US. Here we chart some of these major philosophical issues and show why simple solutions cannot be found. The profession needs to pay more attention to different uses of EBM in order to preserve the good aspects of professionalism. (shrink)

The approach used by physics is based on the identification and study of ideal objects, which is also the basis of biophysics, in combination with von Neumann heuristic modeling and functional fractionation according to R.Rosen is discussed as a tool for studying the properties of consciousness. The object of the study is a kind of line of analog systems: the human brain, the vertebrate brain, the invertebrate brain and artificial neural networks capable of reflection, which is a key property characteristic (...) of consciousness. Reflection in the broad sense of the word, understood as an internal representation of the external world, is characteristic of a wide range of animals, and some of them (bumblebees, fish) even demonstrate reflection in the narrow sense of the word, understood as an inner self-representation. This complex behavior is realized by miniature brains of ~1 million neurons. The use of simple recurrent neural networks (RNNs) to obtain answers to general questions is illustrated. For example, it has been shown a small RNS is able to pass delayed matching to sample (DMTS) test, forming an individual dynamic representation of the received stimulus, allowing decoding by a special external neural detector.. It has been demonstrated in the reflexive game “even-odd”, the RNS has a huge advantage over a multi-layered neural network, with the same and a larger number of neurons – reflection defeats regression. It was found that the asymmetry of outcomes in the odd-even game, which was explained by various causes, including psychological ones – “it’s easier to catch up than to run away”, is reproduced in the game of two RNNs. Obviously, there are no psychological causes here and the advantage of the player playing for “even” is explained by the more complex strategy of the “odd” player – he needs to predict the opponent’s move and choose the opposite one. (shrink)

Given the current division of modern Orthodox in Ukraine, the study of the history of the church movement of the 1920s, a significant component of which was the activity of the updated clergy, has not only scientific and cognitive but also practical significance, since it helps to clarify the causes and trends of inter-church confrontation in the conditions of existence of several Orthodox churches and to define conceptual approaches to the formation in the state of a single independent Ukrainian Orthodox (...) Church. (shrink)