Using an evolutionary game, we show that patients and physicians can interact with predator-prey relationships. Litigious patients who seek compensation are the ‘predators’ and physicians are their ‘prey’. Physicians can adapt to the risk of being sued by performing defensive medicine. We find that improvements in clinical safety can increase the share of litigious patients and leave unchanged the share of physicians who perform defensive medicine. This paradoxical result is consistent with increasing trends in malpractice claims in spite of safety improvements, observed for example in empirical studies on anesthesiologists. Perfect cooperation with neither defensive nor litigious behaviors can be the Pareto-optimal solution when it is not a Nash equilibrium, so maximizing social welfare may require government intervention. It can also take the form of assurance behavior and is called positive defensive medicine when it is performed using extra tests or procedures. Positive defensive medicine, which we study in this paper, leads to unnecessary diagnostic and therapeutic interventions, which may be invasive and costly. Theoretical research often considers the inefficient provision of medical services as a principal-agent problem and describes its market failures as being due to asymmetric information, moral hazard and conflicts of interest  represent the share of physicians playing strategy D in their total population, and let l(t)∈ represent the share of patients playing strategy L in their total population, at time t. Consequently, 1−d(t) and 1−l(t) represent the shares of physicians playing strategy ND and of patients playing strategy NL, respectively.Starting from the payoff matrices (1) and (2), we define the evolutionary game as follows. In each instant of time D and ND are, by matrix (1):l and 1−l represent the probabilities that a physician is matched with a patient who respectively plays strategy L or NL.The physicians’ expected payoffs from playing strategies L and NL are, by matrix (2):d and 1−d represent the probabilities that a patient is matched with a physician who plays, respectively, strategy D or ND.The patients’ expected payoffs from playing strategies The average payoffs in the populations of physicians and patients are respectively:d and l is described by the standard replicator dynamics 2}. All sides of this square are invariant; namely, if the pair  initially lies on one side, then the whole correspondent trajectory also lies on that side.The system  is defind = 0,1 or:l* > 0 always, and l* < 1 if:Eqs  and 4)  4) implyl>l*, and that l<l*. The term CD−CND, on the left in inequality (p(END−ED), on the right in inequality   5) implyd<d*, and that d>d*. The term CL, on the left in inequalities l˙>0 for ualities  or (10),d,l) = ,,, of the square S are always stationary states of the dynamic system  =  all physicians play D and all patients play L; in  =  all physicians play ND and all patients play NL; and so on. Another stationary state of the system  =  of the straight lines ; therefore,  =  belongs to the interior of S and all the strategies D, ND, L and NL coexist in such a state. Finally, all the points belonging to the side of S with l = 1 are stationary states in the case where l* = 1 ,,d,l) =  and andd,l) nditions  are satiequality  is satisequality  is satisThe dynamics that may be observed by the system  have beeIf CD−CND<p(END−ED) and ED<CL<ENDhold, there exists a (Lyapunov) stable stationary state  =  with 0<d*<1 and 0<l*<1, and all the trajectories in the interior of S are closed curves surrounding it see .to not defend against the not-litigious patient (because CD>CND), and to defend against the litigious one  and and9) anequality ). Similaequality ).d,l) =  exists, the values d and l oscillate clockwise around  =  for any initial distribution of strategies ≠, with d0,l0∈. The initial distribution  =  will be reached again at the end of every cycle. The trajectories around  =  are cyclic because of the signs of the payoff differentials (S delimited by the straight lines (6) and (8)  decreases predators’ fitness  and, therefore, causes a decrease in the share of predators .rentials  and 5)  d,l) = (The remaining ‘robust’ regimes that can be observed by the system (3) are described in the following proposition.The stationary state that is globally attractive in the interior of the square S is :ualities , 9) and andThe s,  and ):d,l) =  if CD−CND<p(END−ED) and CL<EDhold see ; =  if either:CD−CND<p(END−ED) and CL>ENDhold see ;CD−CND>p(END−ED) and CL>ENDhold see ; =  if CD−CND>p(END−ED) and CL<ENDhold (see L<EDor CL>ED). =  in Proposition 1 may differ if different sign-preserving dynamics are used [Propositions 1 and 2 can be verified by standard results in evolutionary game theory –45. Propare used .The interpretation of Propositions 1 and 2 is simple if we keep in mind the meaning of conditions , 9) and and9) anto defend against litigious patients and to not defend against not-litigious patients. Then, the defensive strategy performs better than the not-defensive one , while it performs worse than that , as in to not defend and that the performance of the not-defensive strategy is always better, whatever the share of litigious patients; consequently, S, as in Inequality  states tInequality  states tto litigate. If inequality  while it performs worse than that , as in to not litigate to litigad,l) =  when existing, and the states  = , ,  when attractive, are Nash equilibria. Consequently, the defensive medicine game always admits a unique Nash equilibrium. This finding follows from standard results in evolutionary game theory [d,l) = , in which all the available strategies coexist, corresponds to the mixed-strategy Nash equilibrium of the one-shot defensive medicine game. Accordingly, the physician chooses to practice defensive medicine with probability d* and the patient chooses to litigate with probability l*; therefore,  =  would represent the equilibrium if all individuals were perfectly rational. We can also interpret  =  as the average values of the shares of defensive physicians and litigious patients, over the cycles in d,l) =  can estimate the behavior of individuals in random observations over long time periods [The interior stationary state  =  of changing the parameters of the model. These effects have been estimated from the partial derivatives of the equilibrium coordinates d* and l*. Surprisingly, the equilibrium share of defensive physicians d* does not depend on physicians’ costs CD and CND, nor on clinical risk p, which still affects the equilibrium share of litigious patients. Conversely, the equilibrium share of litigious patients does not depend on patients’ cost of litigating CL, which still affects the equilibrium share of defensive physicians. These paradoxical results can be explained by the predator-prey relationship between patients and physicians. Accordingly, an evolutionary advantage for a species can be completely offset by a consequent mutation of its competitors. For example, a decrease in clinical risk p favors not-defensive physicians and pushes, ceteris paribus, the share of defensive physicians below its equilibrium level; therefore, the fitness of litigious patients improves (with respect to not-litigious ones) and their equilibrium share l* permanently increases. When the population of patients becomes more litigious, the fitness of defensive physicians improves (with respect to not-defensive ones) and the share of defensive physicians goes back to its initial equilibrium value d*. Increasing safety in clinical practice, then, may not affect the level of defensive medicine in the long run, but it can increase malpractice litigation against physicians when adverse events occur. Similarly, lowering legal costs CL will not affect the equilibrium share of litigious patients l*, because the upwards pressure on the share of litigious patients will be contained by a permanent increase in the equilibrium share of defensive physicians d*. Note that a decrease in legal costs CL may be associated with a reduction in patients’ compensation R; for example, when contingency fees give the successful attorneys a percentage of the compensation awarded in favor of their clients, the equilibrium share of litigious patients l* can permanently increase, while that of defensive physicians d* can move either upwards or downwards if, respectively, the change in CL or R is predominant.PH and ΠPA, which correspond, at the stationary states of our dynamic system, to the expected individual payoffs of physicians and patients, respectively. The following two propositions illustrate the most interesting results (see We compare the stationary states of the game in terms of welfare. A state is more efficient (in the economic sense of Pareto) than another state if, when moving from the former to the latter, the welfare of at least one individual decreases. We measure welfare by means of the population average payoffs ΠWhen the mixed-strategy Nash equilibrium  =  exists see , then ΠPH>ΠPH always holds; furthermore, it results that ΠPA≥ΠPA if H≥0.d,l) =  can never be more efficient than the non-attractive stationary state with perfect cooperation  = , while  =  is always more efficient than the state  =  whenever defensive medicine has no direct benefit to patients . Remember that, according to the replicator dynamics [d* and l* represent the time averages of the shares d and l, respectively, over the closed trajectories in PH and ΠPA measure the average values along these trajectories of ΠPH and ΠPA, respectively. Consequently, the results in Proposition 3 can also be used to compare, in terms of welfare, the stationary state  =  and the closed trajectories around  = .According to Proposition 3, the equilibrium ≥ΠPH and ΠPA≥ΠPA if, respectively, :equality ):CD−CNDd,l) =  is attractive  =  is more efficient than  =  for high enough ratios H/p  =  exists  =   =  and at the social optimum  = . We measure social welfare by means of the classic utilitarian or Benthamite social welfare function; that is, as the sum of the population average payoffs of physicians and patients at any given state. These population average payoffs correspond, in both states, to the expected individual payoffs of physicians and patients. Accordingly, the price of anarchy results in the following:Finally, we present an illustrative example of calculation of the s agents ,53. For ists see  and is P0,0) see , when thCL, because it also results that H≥0; therefore, in such a specific scenario, the policy-maker can improve efficiency by raising these legal costs.The price of anarchy in the previous equation is negatively correlated to the patient’s costs of litigation ceteris paribus, the share of defensive physicians below its equilibrium; in turn, the abundance of vulnerable prey improves the predators’ fitness, so the equilibrium share of litigious patients permanently increases until the share of defensive physicians returns to its initial equilibrium. This interaction can explain why increasing safety in clinical practice may not affect the level of defensive medicine in the long run, but it can increase malpractice litigation against physicians when adverse events occur. Our explanation is complementary to that based on the traditional argument proposed earlier by Mechanic [This paper has studied the interactions between defensive medicine, malpractice litigation and clinical risk by means of evolutionary game theory. We proposed an original ‘defensive medicine game’ played by physicians and patients, which explains the paradoxical positive relationship between clinical safety and litigation rates observed in empirical studies ,41. UsinMechanic . AccordiWe concluded our analysis by comparing the possible equilibria of the game in terms of efficiency and welfare. When defensive medicine has no direct benefit to patients, perfect cooperation between physicians and patients is always more efficient than any mixed-strategy Nash equilibrium in which the non-cooperative strategies are partially played. When the harm for patients from defensive medicine is high enough, perfect cooperation is also more efficient than the non-cooperative Nash equilibrium in which everybody litigates or defends. The preceding welfare properties depend crucially on the assumption that defensive medicine is not beneficial for patients . Conversely, when defensive medicine provides benefit to patients, they can improve their welfare through litigation at the expense of physicians, who should resort to practicing defensive medicine .The model can be adapted to different concepts of defensive medicine in literature and to other cases of the over-provision of care ,16. The Our results would be unchanged if we assumed that patients were assisted by lawyers operating under perfect competition conditions. Indeed, a perfectly competitive market would push lawyers’ fees to their marginal cost, and such identical compensation is implicitly included in the model parameters. Also, lawyers paid on a contingency basis might directly replace patients in the game, with minor changes in parameters. Extending the game to lawyers would be suitable to study the impact of information asymmetry on defensive medicine and malpractice settlement costs, which is beyond the scope of this paper.The possible cyclic dynamics of our model may suggest additional explanations to the observed fluctuations in prices of malpractice insurance , which aThe policy implications of our study are various. First, policy-makers should consider the overall underlying dynamics of defensive medicine and malpractice litigation rather than their irregular (and sometimes misleading) short-term trends. Second, because of the predator-prey relationship, clinical advances and legal reforms can have unexpected long-term consequences on the frequency of defensive medicine and malpractice claims. Third, increasing safety in clinical practice can increase the risk for physicians of being sued by patients when accidents occur. Fourth, perfect cooperation can be the social optimum when it is not a Nash equilibrium; therefore, government intervention is needed to maximize social welfare. Policies for this purpose may draw on the experience of Sweden and New Zealand, where physicians are not financially liable for treatment-related adverse events ,50. HoweS1 Appendix(DOC)Click here for additional data file.S2 Appendix(DOC)Click here for additional data file.


Two main open questions in current consciousness research concern (i) the neural correlates of consciousness (NCC) and (ii) the relationship between neural activity and first-person, subjective experience. Here, possible answers are sketched for both of these, by means of a model-based analysis of what is required for one to admit having a conscious experience. To this end, a model is proposed that allows reasoning, albeit necessarily in a simplistic manner, about all of the so called “easy problems” of consciousness, from discrimination of stimuli to control of behavior and language. First, it is argued that current neuroscientific knowledge supports the view of perception and action selection as two examples of the same basic phenomenon, such that one can meaningfully refer to neuronal activations involved in perception as covert behavior. Building on existing neuroscientific and psychological models, a narrative behavior model is proposed, outlining how the brain selects covert (and sometimes overt) behaviors to construct a complex, multi-level narrative about what it is like to be the individual in question. It is hypothesized that we tend to admit a conscious experience of X if, at the time of judging consciousness, we find ourselves acceptably capable of performing narrative behavior describing X. It is argued that the proposed account reconciles seemingly conflicting empirical results, previously presented as evidence for competing theories of consciousness, and suggests that well-defined, experiment-independent NCCs are unlikely to exist. Finally, an analysis is made of what the modeled narrative behavior machinery is and is not capable of. It is discussed how an organism endowed with such a machinery could, from its first-person perspective, come to adopt notions such as “subjective experience,” and of there being “hard problems,” and “explanatory gaps” to be addressed in order to understand consciousness. The philosophical and scientific discussion of consciousness is age-old, but has also increased notably in intensity and level of detail during the last few decades, not least thanks to advances in the neurosciences. Many would argue that achieving a better understanding of consciousness, of how and why and under what circumstances it occurs, would be a fundamental step forward in our understanding of what it means to be human. Also, practical and ethical motivations can be raised, for example relating to assessing the degree of consciousness of human patients in comatose states, animals, or even man-built machines such as robots.neural correlates of consciousness (NCC), the “minimal neuronal mechanisms jointly sufficient for any one specific conscious percept”  from brain activity corresponding to prerequisites for or consequences of that awareness . Experience is something we do and its qualitative features are aspects of this activity”  the NCC and (ii) first-person subjective consciousness, with an argument that is inspired from and related to those of Dennett, Blackmore, O'Regan, Noë, and others. The main means for extending beyond these previous contributions will be a model that, while simplistic, allows structured reasoning about both perception and consequent overt behavior, for example in terms of subjective reports about perceptions. A foundational observation behind this X precisely when we attempt to exhibit a covert narrative behavior describing X, and find ourselves capable of doing so. This proposal will be tested against some existing empirical findings from contrastive experiments, previously used to support competing hypotheses about the NCC, and it will be argued that apparent conflicts between these findings are resolved by the proposed account of consciousness. Specifically, the proposed account predicts that there need not be any well-defined, paradigm-independent NCCs to be found at the putative moment of conscious experience, and that any (approximate) common neural denominators should rather be sought around the moment of judging consciousness.It will then be illustrated how the narrative behavior model can be put to use in a heterophenomenological approach to consciousness: It will be proposed that we tend to say that we are having a conscious experience of Finally, it will be argued that an organism functioning in accordance with the narrative behavior model would, given its narrative abilities and inabilities, have good reasons for thinking about its own “subjective experience” as something rather astonishing, enigmatic, and non-physical, such that the narrative behavior model could help explain the human tendency for postulating explanatory gaps and hard problems.biased competition  is requested in the current task context. Using this type of model, it has been possible to explain various brain activation phenomena observed in object recognition paradigms , which also relies heavily on the idea of lateral inhibition between competing percepts or overt behaviors  selection of overt actions and (ii) perception, as in discrimination, classification, and to some extent interpretation of sensory stimuli, as being two examples of the same basic phenomenon. However, they have often been modeled quite similarly. This is especially clear in cases where the same mathematical model has been used for both. One such example is available from Deco and Rolls , 2005, wThe basic idea of biased competition arose from the study of visual attention , similarly to how some overt actions depend on other overt actions . Furthermore, for the present purposes the shared framework outlined above seems useful in at least three ways:behavior. Thus, an individual can be regarded as capable of both overt behavior, when exhibiting externally observable body movement, and covert behavior, when exhibiting neuronal activation encoding percepts or overt actions, that may or may not be immediately associated with body movement. One of the aims of this paper is to show that using the term behavior in this way establishes a mindset that can lead to more fruitful discussions of consciousness. (ii) The framework clarifies in more operational detail what one might mean by claiming perception to be a type of behavior, as some authors have  It allows the suggestion that activation patterns  could be referred to with a shared term, regardless of whether they encode percepts or overt actions. Based on the idea that both are learned and selected to optimize for survival and reproduction, the shared term that will be adopted here is Skinner, . (iii) INow, the following is defined:Narrative behavior: A behavior which can be interpreted, by a third-party observer, as a communication, to one or more recipients, of some aspect of how the behaving individual is currently classifying the state of the world .subpersonal level, whereas “understanding” is a phenomenon on the personal level.Such narrative behavior can be overt, such as when an individual speaks  statements like “my foot hurts” or “there is a lion in the bushes over there,” typically with one or more other individuals as the recipients. Narrative behavior can also be covert, in which case the recipients are simply all the parts of the individual's brain to which the involved neurons project. It should be noted that it is not required that these recipients “understand” what is being communicated, in the sense of understanding as we attribute it to entire individuals. In Dennett's  terms, aquasi-depiction and quasi-description, respectively , BUSHES(2), and so on, of which the sensory stimuli at hand will activate only one (or perhaps a few?). For this reason, the word “bushes” will be an imperfect approximation of the activated BUSHES(i), just as BUSHES(i) will be an imperfect approximation of the specific quasi-depictions that triggered it.At higher hierarchical levels, the covert narrative behaviors communicating about the scene with the lion will start becoming less like depictions, and more like verbal descriptions. This could amount to classification of quasi-depictions into learned perceptual completion phenomena  clearly is.To finalize the example with the lion Figure , based oIf, after giving my overt verbal report about the lion in the bushes, someone asks me whether I have “a conscious experience of seeing the lion” or “a conscious visual experience of the lion,” I am likely to answer in the positive. Why is this? In this section, the narrative behavior model will be applied in a heterophenomenological analysis, to begin with of the the special case of “seeing.” In practice, this will amount to introducing a set of hypotheses on what is required for an individual to admit to be seeing under various circumstances. These proposed hypotheses, in effect operational definitions of what “seeing” means, will then be generalized across sensory modalities, to consciousness in general.If someone asks me “do you see the lion?,” and I answer yes, this has to depend on some acquired concept of mine of what it means to “see.” In the terms of the model introduced above, just as one can hypothesize quasi-descriptions LION and BUSHES, one can hypothesize a quasi-description I AM SEEING, which is excited whenever I engage in covert narrative behavior of a visual nature. Specifically, the following operational definition is proposed:“Seeing”: We tend to say that we see X when we attempt to describe X by means of covert narrative behaviors providing visual detail about X, and find ourselves acceptably capable of doing so.X by means of covert narrative behaviors providing visual detail about X.” In line with what has been said above, this attempt is suggested to require PFC activation, to keep the SAY WHETHER I SEE A LION complex active, and perhaps also DLPFC to single out and bias further specific quasi-depictions directly. If I am already looking at the lion when the question is asked, some of the lion-associated visual quasi-depictions may already be active, but if the top-down excitation triggered by the question is successful, the total amount of such activation will increase, resulting in enough bottom-up excitation to push the SAY WHETHER I SEE A LION complex to a threshold of activation where the SAY YES behavior is generated. The reaching of this threshold is thus an example of me “finding myself acceptably capable” of generating the “covert narrative behaviors providing visual detail about X.”This needs clarification. As illustrated in Figure sensorimotor contingencies of a visual type; i.e., narrative behaviors that change in typical, predictable ways in response to for example eye movements.Regarding the “narrative behaviors providing visual detail,” assumed to excite I AM SEEING, which are these? One answer could be “any narrative behavior that is implemented along the brain's visual pathways.” However, as suggested by O'Regan and Noë , a more Figure 5A.) The less my exhaled air sounds like hissing and instead like a tone, the more the whistling-related quasi-depictions will become activated, the more activated I AM WHISTLING will be, and the more likely I will be to admit success. In other words, admitting to seeing the lion requires producing enough of the neuronal activations that associate with I AM SEEING and LION, just as admitting to whistling requires producing enough of the neuronal activations that associate with I AM WHISTLING. The major difference is that only in the latter case are there concurrent externally observable effects, such that a third party can also provide judgment of success or failure.The above account of what I do before confirming to be seeing the lion clarifies further how seeing could be likened to an overt behavior, since my judgments of my own attempts at overt behavior can be modeled in much the same way. If I am monitoring my own success at whistling, for example, this can be described in the present model as attempting to activate a quasi-description I AM WHISTLING, associated with specific quasi-depictions that encode the auditory and perhaps lip and tongue-related somatic sensations of successful whistling.  Suppose, for example, that I am only briefly shown the photo with the hiding lion, and then asked the question: “Did you see the lion?” For this type of case, a modification to the operational definition above is proposed, as follows:“Just having seen”: We tend to say that we just saw X when we attempt to describe X by means of covert narrative behaviors providing visual detail about X, and, with the support of short-term visual memory, find ourselves acceptably capable of doing so.In other words, it is suggested here that admitting to just having seen the lion also requires that I find myself acceptably capable of covert narratives describing the lion, the important difference being that now these covert narrative behaviors have to be activated without bottom-up input. As has been discussed previously, such top-down-only maintenance of recently active covert visual narratives seems to require DLPFC involvement. Another aspect to note is that without bottom-up input, the threshold for what is an acceptable level of visual detail might very well be lower, perhaps more so the longer the duration between stimulus and question.If this temporal duration starts outgrowing the “just having seen” denomination, why not even with other stimuli in between , a positive answer to the question “did you see the lion?” could be hypothesized to require only very imprecise reactivated covert narratives, perhaps even at a more quasi-descriptive than quasi-depictive level, i.e., simply LION without any details. Also, rather than (or in addition to) being dependent on structures such as DLPFC, one could hypothesize that such reactivation relies on brain structures that have been implicated in longer-term memory recall, in the form of episodic recollection or familiarity  when we attempt to describe X by means of covert narrative behaviors providing visual detail about X, and, with the support of visual input , find ourselves acceptably capable of doing so .What about “consciousness,” then? It is suggested here that (i) the above operational definitions of “seeing” can be modified to definitions of “hearing,” “smelling,” “feeling,” and so on, simply by replacing “visual detail” by “auditory detail,” “olfactory detail,” “tactile/proprioceptive/nociceptive/… detail,” and so on, and (ii) one will tend to admit “having a conscious experience” precisely in those cases where one admits to one or more of “seeing” or “hearing” or “smelling” or “feeling,” etc. Thus, in summary form, one arrives at the following proposed operational definition of “consciousness,” i.e., the following hypothesis on what it takes to admit consciousness:Current or historical “consciousness”: We tend to say that we have a conscious experience of X (or that we had a conscious experience of X) when we attempt to describe X by means of covert narrative behaviors providing perceptual, as in visual/auditory/olfactory/etc., detail about X, and, with the support of current sensory input  find ourselves acceptably capable of doing so .Tx when X took place, to the time Tj when we judge whether we are (for Tj = Tx) or were (Tj > Tx) conscious of X. Under this view, there is no need to assume that there are any neural correlates of consciousness in the way this term is normally understood, i.e., there need not be any well-defined, precise common denominator for all brain states that will engender a concurrent or later report of consciousness. The proposed common denominator lies instead in the moment of introspection, where consciousness of present or past events will be subjectively judged based on the ability for covert narrative about them. However, even this common denominator could be rather imprecise, given that the criterion for judgment may not be constant, but instead relaxed over time, with variations also in which brain mechanisms related to short or long term memory are involved.The main difference between this account of consciousness and most existing theories, is that it shifts the focus from around the point in time These differences between the proposed account and others will be considered in more detail further below. First, however, the proposed account will be tested against some existing empirical data.Here, three experiments from the literature will be described and analyzed. These specific experiments have been chosen because they have been previously used in arguments for competing, rather different theories of consciousness and the NCC (the theories as such will be discussed in the next section).attentional blink paradigm reported a characteristic low visibility of a target stimulus T2 (a four-letter number word), when simultaneously performing a discrimination task on a target stimulus T1 (one of the two strings OXXO or XOOX), presented a stimulus onset asynchrony (SOA) interval earlier. As also illustrated in the figure, using the narrative behavior model this phenomenon can be understood as brain structures needed for establishing a task definition behavior (including PFC) and top-down biasing of quasi-depictions (DLPFC), becoming occupied with discriminating and storing T1 after its presentation. During this process, the T2 stimulus arrives and generates, bottom-up, some quasi-depiction and quasi-description, consistent with the early occipital and occipitotemporal activations that Sergent et al. , the quasi-depictive activation just selected, and judges whether it is strong enough for admitting to having seen the stimulus. If (i) this judgment instead depends on something more like the s et al. , that TMFinally, consider the experiment by Pitts et al. , in whicFigure X?,” but the experiments by Sergent et al.  theory of consciousness, originally suggested by Baars , but on higher-order representations, “that represent oneself as being in the relevant first-order mental states” . Such quasi-descriptions can clearly be regarded as metacognitive, representing the subject as being in the state of “seeing X” or “having seen X.” Furthermore, just as suggested by Lau and Rosenthal However, one can possibly discern an additional, unstated assumption in the reasoning of Lau and Rosenthal , that isThe NCC assumption: When an individual is exposed to a stimulus X at a time Tx, this may or may not give rise to a conscious experience C(X) of this stimulus at a time Tc = Tx + ϵ, where ϵ is some rather short duration, and if this conscious experience C(X) occurs, it is because of a specific, well-defined neural correlate of C(X) also occurring, in the brain, at time Tc.C(X) are continuously generated in or by the brain, for the subject to introspect and the neuroscientist to detect. Rather, it is proposed that consciousness is only ever subjectively judged, and that this judgment occurs in the moments of introspection or remembrance, or at requests of subjective reports. Thus, a possible divergence between what has been proposed here and higher-order theories could occur in the interpretation of an experiment such as that of Pitts et al. , since these subjects were apparently “conscious” of the pattern, then that theorist is not in line with the present proposal . If, however, the higher-order theorist holds that the metacognition, e.g., in the form of a quasi-description I SAW THE SQUARE PATTERN, occurred at a later time Tj, just after the time Tqwhen the question was asked, then that higher-order theory and the account presented here align.The account proposed here does not assume that well-defined conscious experiences s et al. . If a hiAnother type of interpretation of the experiment by Pitts et al.  is that Tq, and thus indirectly on the entire preceding sequence of stimuli and brain events, but instead only on whether or not an assumed NCC, with its associated conscious experience, was formed at Tc.The NCC assumption, as defined above, and the type of reasoning it often inspires is further illustrated in Figure Tc between brain states which do and do not engender a later report of consciousness, for instance because of covert introspective judgment carried out at Tc, such that Tj = Tc, or some other threshold effect occurring somewhere in the brain around this time. However, what is suggested here is that if the experimental paradigm is modified, the same identifiable difference in brain state at Tc, or the same threshold effect, might no longer be what makes the difference for the report after Tq.There is nothing wrong in general with making this type of simplification. For example, within a given, fixed experimental paradigm there might well be a clearly identifiable difference at some multiple drafts theory  when the subject will be asked about his or her perceptual experience, what other stimuli will be presented before that point in time, and whether the subject knows that the question is coming. This critique of the NCC assumption comes close to what has been argued by Blackmore , 2015. IDennett,  and his Dennett, , but whaThere is compatibility and partial overlap also with the sensorimotor account of O'Regan and Noë . It has physicalist  is that it shapes the narrative behavior pyramid, by establishment of new quasi-descriptions in the functional hierarchy, with a one-to-many association to nodes at lower levels. In practice, this amounts to a form of labeling of the organism's own behaviors, which as discussed previously could occur either together with learning of actual words in a shared language, or without any such association.For all of these behaviors, whether covert or overt, innate or learned, there are a number of things which can happen in conjunction with them. For instance, by means of mechanisms for familiarity or episodic memory, the organism may discrimination of differences, for example between two quasi-descriptions LION and CAT. This ability of discrimination is present also at lower, quasi-depictive levels, for example as discrimination between examples within a quasi-description: discrimination between two different lions, two different hues of green, two different ways of reaching for an object.The other side of similarity, recognition, and labeling, is something, whether this is something that the organism has done before, when it is different from another something, and the narrative behavior machinery also puts different labels on different somethings, which may or may not be associated with words in a language. In general, however, the machinery does not have any privileged access to what, in more detail, the organism is doing, or how it is doing itIn sum, the narrative behavior machinery is capable of creating narratives about the fact that the organism is doing what in detail and how questions. Consider, again, the example of whistling: Once the organism can say of itself “I am whistling” , it can proceed to observe its own lip positioning, tongue movements, and exhalation, and since there are commonly agreed words for all of these things in the language it shares with other individuals, the organism can construct an explanation of what it is doing when it is whistling . However, for successful whistling performance the organism still need not be anywhere near a detailed description of the shape of its lip aperture, exactly where it is putting its tongue, how much air pressure it is applying, and definitely not of what brain structures and neurons are involved. If the organism is particularly inquisitive and motivated, and has access to appropriate observational technology, it can certainly proceed toward such descriptive ability. If the organism does so, it will in the end  find that what is required for itself to admit to being whistling is a certain pattern of neuronal activation (I AM WHISTLING), which in turn is activated by a constrained set of other activation patterns, presumably related to quasi-depictions of tones and of the involved overt, muscular activations; see Figure However, for overt behaviors, which by definition cause externally observable effects, the organism will generally be able to provide at least cursory answers also to the not undertake and complete these two research projects, the organism could come to think rather differently of seeing green than of whistling. With whistling, as with overt behavior in general, the organism knows when it is doing it, and may feel that it has a rather good grasp of how it is doing it (even though in fact it ignores most of what is going on). With seeing green, as with covert behavior in general, the organism also knows when it is doing it, but it is more or less clueless as to how. For this reason, the organism might not think about covert narrative behaviors, such as those involved in “seeing green,” as behavior at all, not at all as “doing” something, but may instead use other words, for example “perception,” “subjective experience,” or “subjective state,” to describe “seeing green” and other phenomena that only involve covert behaviors.Now, compare the above to a situation where the organism could say of itself “I am seeing green,” illustrated in Figure i) is active, as opposed to I AM SEEING GREEN(i + 1), as well as between individual and even more specific quasi-depictions, and it can therefore conclude that there are details regarding its “subjective state” which are “private,” as in available to itself, from its own first-person perspective, but not to the third-person perspective of other individuals, and “ineffable,” as in not possible to fully communicate to other individuals.Lacking the third-party perspective of a scientifically advanced empirical research project, the organism can nevertheless, from within its own first-person perspective, reach some conclusions about its “perception” or “subjective state,” i.e., about its own covert narrative behaviors. For example, the organism can pick up on the converging nature of the narrative behavior hierarchy. Since it is capable of discriminating between, say, different hues of green, the organism can detect that the overt statement “I am seeing green” is a very crude approximation of what it is actually “perceiving:” The organism can discriminate between when I AM SEEING GREEN(i) is accompanied by the same quasi-depictions, diffuse emotional responses etc., as usual. When the organism detects this specificity, it could, if it thought of its perception as behavior, make a statement like “I am doing something very specific when this green color is presented to me.” However, without this perspective, the organism might rather say “I see this green color in a very specific way” or “there is something very specific which it is like for me to see this color,” and, if the organism is of the philosophically inclined sort, maybe also things like “I will call the specific way I see this green color a quale, and use the word qualia to speak, in general, of the specific ways I see things, hear things, smell things, etc.”Furthermore, a certain green color will trigger a very specific complex of quasi-depictions and quasi-descriptions, with associated activations of for example color-specific predictions of how the narratives will change with motor activity , or weak activations of color-specific episodic memories, which might in turn evoke subtle color-specific emotional responses. The specificity of this compound reaction is detectable to the organism from its first-person perspective, in the sense that the organism can react with familiarity to the entire complex; the organism can note that all the “somethings” come in their usual grouping, i.e., I AM SEEING GREEN from how physical objects, like for example the body or the bike, exist, and in this sense the organism would not be entirely mistaken if it considered its “subjective experience” to exist in a non-physical way, or felt unsure regarding its physicality. An impression of non-physicality could be further bolstered by the fact that in contrast with “biking,” the “subjective experience” is without direct traces in the external, physical world, and detectable only to the organism itself. One can therefore not blame the organism if it meets with incredulity the statement that this seemingly non-physical “subjective experience” is, deep down, just patterns of neuronal activations, and expresses this incredulity as there being a fundamentally hard problem of consciousness to be solved , any general common denominator is instead to be sought at Tj, the moment of judging the conscious experience. Specifically, it has been suggested that an individual will admit to a conscious experience of X at time Tx ≈ Tc if at time Tj the individual finds itself acceptably capable of covert narrative behavior describing X, with increases in Tj − Tx probably leading to lowered thresholds for what is acceptable, and to changes in what brain mechanisms are involved in the judgment. Note that this point does not hinge upon the view of perception as behavior; the previous sentence could just as well be reformulated as “if at time Tj the individual finds that it can establish an acceptable perceptual representation of X.”The suggestion that instead of assuming that there are general and identifiable neural correlates of consciousness at not replacing “covert narrative behavior about X” with “perceptual representation of X” above, can be helpful in dispelling some of the sense of mystery surrounding consciousness. Perhaps the main benefit of this change of semantics is that it casts perception as one region within a spectrum of differences in degree, rather than as a fundamentally distinct phenomenon. On this view, humans engage in narrative behavior describing what it is like to be themselves along a full range from overt narratives in a shared language, via language-like covert narratives where the units of description are not words in a language, but comparable to such (here referred to as quasi-description), all the way to covert narratives where the unit of description is more specific, for example comparable to fragments of a picture (here referred to as quasi-depiction). Furthermore, it can help to think of a human detecting that it is engaged in covert narrative behavior as doing something very similar to detecting that it is engaged in an overt behavior, in both cases with equally limited ability of determining, from its first-person perspective, how it is performing these behaviors.The suggestion that talking about perception as behavior, i.e., exactly the same mechanisms. If they were, it would be very clear that we ought to refer to the two with one single term, for example “behavior”. If the two are instead just roughly similar (which seems more probable), we can absorb perception into the term behavior and use this way of talking as a possible handle on consciousness, all the while acknowledging that covert and overt behavior are slightly different types of behavior, just as one might discern subtypes of overt behavior, with differing neural underpinnings.These two main points have been supported by a number of auxiliary arguments, all of which could individually be further developed: The proposed similarity in neural mechanisms between perception and action selection could be investigated in more detail, perhaps starting from existing theories of brain function which emphasize the question of how perceptual and motor systems relate to each other  above had to cover a very wide range of phenomena, from low-level sensory processing to language; basically all of the so called “easy problems” of consciousness , to maintaining or recalling a very recently presented stimulus, to recognizing a stimulus that was presented a longer while ago. But it is also possible that even minor experimental modifications, such as small changes to Tq − Tx, could engender slight shifts in observed neural correlates. Again, experimental paradigms that do not instruct subjects on exactly what stimuli they will be asked about later could be especially useful.This empirical grounding can also be further extended, by considering additional experiments from the literature, or carrying out new ones. One possible direction would be to study neural events not only at The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


While this relationship has been studied in the past, this is the first time it has been studied among a diverse pediatric sample of this size.A recent article by Chaput and colleagues  provideslunar effect, a phenomenon that purports increased violence, crime, and birth-rate, occurring in the full moon phase. While this concept may seem far-fetched to some, to many people it is not. In fact, according to a survey of 325 people (n = 50), Danzl , Danzl  found th), Danzl , the porn = 205), Della Monica and colleagues (n = 795), Sjödin and colleagues  suggests the findings are consistent, independent of location, for children in this age group (9–11 years) around the world.In conclusion, Chaput and colleagues  have movBoth authors contributed to the content, writing, and review of this commentary.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Global literature has suggested a negative impact of acculturative stress on both physical and mental health among international migrants. In China, approximately 20 percent of its population is rural-to-urban migrant workers and there are significant cultural differences between rural and urban societies, but no data are available regarding the acculturative stress of Chinese migrant workers. This study aimed to explore the forms and contexts of acculturative stress among Chinese migrant workers.Qualitative data were collected from four focus group discussions with 17 Chinese rural-to-urban migrant workers and three individual interviews with three medical professionals who provided mental health services for factory-workers in Shenzhen, China.The data in the current study showed that rural-to-urban migrant workers in China had experienced various forms of acculturative stress including difficulties in adapting to the environment, work-related stress, family-related stress, financial hardship, and lack of sense of belonging to cities.Rural-to-urban migration in China is a challenging transition with significant acculturative stress and demands for major adjustments among migrant workers. The assessment and management of acculturative stress is a necessary first step in providing mental health services to migrant workers. Rural-to-urban migrants constitute a special social entity, as they are officially rural residents according to the Chinese household registration system  had accounted for 45.1% of all migrant workers in 2014 . FurtherThe discrepancies between rural and urban cultures so far discussed apparently has face validity but the intuitively assumed acculturative stress under the internal migration context is still inadequately addressed in research. Thus, the aim of this study is to explore the forms and contexts of acculturative stress among Chinese migrant workers.Participants were fully informed of the study’s objectives, content, and procedures, and principles of confidentiality. Subjects who were migrant workers signed a written informed consent form before the interview. Because medical professionals involved in this study were only asked to discuss their experiences in providing mental health services to migrant workers and this procedure does not cause any harm or damage to them, participating medical professionals were only required to give oral consent prior to the interview. Although the use of written informed consent was waived for medical professionals, we still provided them with a statement describing the purpose and procedures of the study before they agreed to participate. The study protocol and the above-mentioned consent procedures received approval from the Survey and Behavioral Research Ethics Committee of the Chinese University of Hong Kong.The present study was conducted in four factories of Shenzhen, China, between April and May 2012. Shenzhen is the largest migrant city of China with 7.8 million migrants from various parts of China in 2012, which accounted for 74.4% of its total population. Qualitahukou. For a selected factory, the research assistant randomly selected several migrant workers from the list of workers that was provided by the factory, and invited them one by one, until four to five eligible migrant workers agreed to participate in our study. A total of 23 migrant workers were invited, six rejected to join the study because they were very busy. Participant characteristics of the 17 migrant workers who joined the four FGDs are shown in Researchers contacted local factory owners/managers through the local mental health service provider  for permission to conduct the interviews in their promises. Migrant workers are eligible to participate in the study if they are at least 18 years old, originated from rural areas, working in factories, and living in Shenzhen without Shenzhen permanent Of the four selected factories, three had medical professionals who were providing mental health services. The three professionals, two men and one woman, were counselors with basic training in mental health assessment and psychological intervention and one to five years of experience in psychological consultation. They all agreed to join the individual interview. Their ages were 39, 44 and 47 years, respectively.Interview topic guides were developed for the FGDs and for the individual interviews , includiData analysis was conducted in a trial version of QSR NVivo 8  using thematic content analysis. First, Nearly all study participants (16/17) admitted that their primary goal of out-migration for working in cities was to earn money, and the majority (15/17) reported being better off economically compared with their previous situation in rural hometowns. Six migrant workers said that they had adapted in cities, but 15 believed that Shenzhen was not a good place for permanent settlement, and 12 had plans to return to their hometowns. When asked about stress and difficulties related to the migration, all respondents, including the medical professionals, were able to describe many aspects which they perceived or observed as stressful or difficult for migrant workers. Five main themes emerged from the analysis of qualitative data: difficulties in adapting to the city environment, work-related stress, family-related stress, financial hardship and lack of sense of belonging to cities.Since all subjects grew up in the quiet and natural environment of rural areas, most (14/17) complained of the noise, busy traffic, crowded streets, polluted air, and strange flavor of disinfected tap water. Those were particularly unacceptable during the early stage of their migration. They felt more difficult to adapt to the city environment. Three interviewees even ascribed their current medical conditions  to the polluted urban environment including noise, polluted air, and the “dirty” running water with a bleaching powder smell. As one respondent stated,You know, after my arrival in Shenzhen, I often sneezed, and even sometimes had a runny nose. Initially, I thought what I just got was a cold, but this condition happened frequently, even more severe on days with heavier air pollution. Unfortunately, the doctor told me that I had an allergic rhinitis and needed to receive long-term medication treatment. I felt depressed, as I did not have such disease prior to my arrival.”“Work-related stress was recognized as a major difficulty by all migrant workers. As a result of their low level of education, limited work experience and specific skills, most of the migrant workers were employed in labor-intensive industries. Sixteen respondents said that, they had to work overtime, get up early and go to bed late. Working 27–28 days per month and 12–14 hours per day was not uncommon. Sixteen interviewees complained about the extremely high workload and extended work hours. Work environment with latent health hazard was identified as another main source of work-related stress for all the 17 migrant workers. Working night shift was further recognized as complicating their daily life. The discipline at the four factories was also reportedly very strict by the 17 migrant workers; anyone who violated the regulations, made minor mistakes or could not complete assigned output quota, would therefore result in loss of bonus salary. Ten participants said that their supervisors were very harsh on workers and even strictly controlled workers’ time spent in washroom. If the time exceeded a pre-defined limit , the violators would be penalized. In the words of a participant,I have to arrive 15 minutes before our shift starts, to meet up for check-in. If I arrive five minutes late, I will be fined one-hour’s salary. We are not allowed to speak to others at work. The supervisors yell at us in public if we make mistake. I have been a front-line worker for five years and have never been so tired. Even if my father was hospitalized due to serious illness, and I need to ask for leave to my hometown, I will have to find our group supervisor, unit director, unit manager, and human resource department manager, one by one, to sign the note for leave. If you are not approved, but you really need to go back, the only choice is to voluntarily withdraw. What’s wrong with talking to others? What’s wrong with going back home to see my father? I can not work like a robot.”“Two of the medical professionals also expressed their concerns for the possible adverse effects of migrant workers’ excessive workload. As one medical professional said:These migrant workers are very busy, and often work under high pressure. On the one hand, they should work very fast to satisfy their production quota. On the other hand, they should be careful to avoid making mistakes. Several of my clients told me that they could not endure such high-demand job. They were overtired, and so they were stressed.”“Because of the high urban living costs in cities, some migrant workers, who are parents of pre-school and school-aged children, and/or sons and daughters of their old parents, have to leave their children and/or parents in their rural hometowns. The separation between migrant workers and their family members, often induce frequent anxiety and feeling of guilt. All the 12 young parents in our study believed that the separation was harmful to their kids and/or old parents. Seven of them reported their uncontrollable worries about their children’s academic performance and all the 17 workers expressed concerns over their parents’ health. One migrant worker parent showed her worries as follows:Now, I’m out for working in distant cities, with my husband, and we are lucky that we have two cute sons. However, we can’t live with them in Shenzhen, because they can’t be admitted to public schools to receive high-quality education and the tuition fees for private schools are too expensive for us. In my hometown, their grandparents are now living with them, and helping us raise them, but both grandparents are not very healthy. What should I do when one day I find that my parents also need to be taken care of? What should I do if my children acquire bad habits without parental monitoring? I sometimes feel nervous and lonely and I miss my family very much. I would be relaxed only if I was seated with them. I even can’t easily find a suitable time to talk to them on the phone. If I don’t need to earn money to support my family, I would not be so nervous like this.”“In addition to the worries concerning the left-behind children and elders, a 20-year-old single young woman also shared her feelings of homesickness:I have three younger brothers at school in my hometown and I have not been home for nearly three years. I have not played with them for a long time; even I don’t know what they’ve become. I miss them, my parents, and the little dog of my home.”“Financial difficulties were reported to be the main reason why migrant workers had emigrated from rural lands, and seemed to continue to be a major source of stress after migration. Participants complained much more about their low wages (17/17), high living expenses (17/17), heavy economic burden to support parents and children (7/17), and expensive house rent (6/17). Other issues surrounding financial problems included excess expenditure in case of disease (11/17), insufficient pension after retirement (5/17), no other benefits except for wages (15/17), and no source of income in case of unemployment (13/17). One female migrant worker said:I have very heavy financial burden that you can’t imagine! I’m the only person who has a paid job to support the whole family. My parents are farming in my village, and my two younger brothers and one younger sister are receiving education in schools. They all need money from me. Their living and schooling expenditures all rely on my slender income. Every month, when I receive their calls for money, I feel very anxious and helpless, as I have no more money to give them, I only retain 35USD for each month’s meal. For many years, I have not bought a new piece of clothing for myself.”“All the medical professionals agreed that financial hardship was one of the leading stressors for migrant workers. The female medical professional said:You have to know, migrant workers, who are married and middle-aged, the so-called“sandwich generation”, have many family members to support, including the parents-in-law, parents, and children. Thus, these workers are at higher risk for psychological problems.”“The loss of familiar social contact in a strange urban society emerged as another issue of concern. Many respondents felt “unsafe in cities” (11/17), said “should leave the city one day” (14/17), had “no friends, lonely” (15/17), believed they were “temporary people of the city” (16/17), and stated “there is no home here” (14/17). Fourteen interviewees mentioned difficulties when making friends with urban counterparts and other migrant workers, who were reported not to be interested in friendships but mainly focused on money and work. As one male migrant worker, who had migrated for work for many years and did more than 20 jobs in 19 cities, described:For many, many years, in many, many cities, I work, I get fired, I start a new job again, and I get fired again…. I, look like someone loses his heart, work here, work there, come here, and go there; the only constant companion is the bag I have been carrying for years. I never know when there is an end to my wandering.”“Nine participants complained that they were required to apply for Temporary Residence Permits (TRPs) if they are ready to work and live long in Shenzhen. They believed such requirement was unfair:It is a joke! I’m a Chinese citizen from the rural area, and the city residents are also Chinese citizens. We are living and working in the same territory, we are all Chinese. Why only I should apply for the residence permit?”“When migrant workers were asked about their social ties with local urban residents and colleagues, 15 interviewees reported that they had little dealings with them, except for work-related matters, because most of the time they were working and living in factories. One middle-aged man, who was living in a rented flat nearby the factory, described:I have no local dweller friends, all my friends here are the acquaintances from my village. The only urban person, whom I frequently contact with, is the landlord, but I just have a tenancy relationship with him. After work, what I can do are just watching TV and sleep; I seldom go outside for window-shopping, therefore my social connection with the urban residents is very limited. As a temporary worker in the city, I believe“the less contacts with local people the better”“.“The qualitative data in the present study revealed that Chinese migrant workers were confronted with a variety of sources of stress in their process of migration, including environment, occupation, family affairs, economic burden, and psychological sense of belonging. Overall, these findings on sources of stress are similar to those reported in sociological, anthropological and public health studies regarding disadvantages or difficulties of migrant workers –48. HoweIn Chinese society, the traditional culture emphasizes more on “reverence for nature” and “people should live in harmony with nature”. Modern The second theme, work-related stress, identified in this study, mainly reflects the conflicts between two types of economic productivity styles: agricultural and industrial productions. In traditional farming production, the Chinese farmers have been accustomed to working and resting as sunrise and sunset at a more natural and slower pace than the urban counterparts. Indeed, there is a high job demand for migrant workers employed in industry, but they only have very limited prior work experience that is largely from farming. The speed of modernized industrial production line creates an enduring daytime stress in work hours. Such work habit is perpetuated by at an institutional level. For instance, the industrial culture highly values efficiency, cost control and mass production at the expense of individual differences. The strict discipline on the migrant workers imposed by the factory’s managers and supervisors mirrors such values, which contrast starkly with the basic assumptions held by farmers in rural China and elsewhere in the world that productivity are not controlled by human discipline but largely “at the mercy of the force of nature”.In the context of a traditional agricultural culture, Chinese people have an ingrained sense of family and they believe the well-being of all family members is more important than individuals. The thiIt is interesting to find that migrant workers had too many complaints about their poor economic conditions while they still admitted that their economic situation had been improved. The traditional production mode of the “man ploughing and woman weaving" in rural China is self-sufficient, at least, Chinese farmers can directly get staple food such as rice and wheat through farming. In induhukou, they have limited access to local resources enjoyed by their urban counterparts, including social welfare, public service, medical care assurance, and other social security benefits[The Chinese migrant workers are faced with unresolved social and economic barriers imposed by China’s national household registration system. Due to the restriction of their rural  benefits. Despite benefits, but thehukou system is an overt discriminatory measure against migrant workers in the provision of public services. On the other hand, a general type of discrimination, being looked down upon by urban residents, was not endorsed by our subjects, mainly because they were living and working together in a relatively homogenous environment, i.e., factories. Although several participants raised their concerns about their rural hukou, i.e., being required to apply for TRPs, we consider it more related to cultural identity, thus we finally classified hukou-related discrimination into “lack sense of belonging to cities”. Another finding that is very insistent with previously identified domains of international migrants’ stress is work-related stress, which is primarily explained by different reasons of the two populations’ migration: migrant workers migrate for work while international migrants for permanent settlement. Apparently, both Chinese migrant workers and international migrants are confronted with environment related stress, however, their specific forms are quite distinct, as migrant workers had more complaints about “hard environment”, such as noise and air pollution, but international migrants focused on “soft environment”, such as loosening ties with countries of origin and difficulties in getting occupational promotion[Previous transnational acculturative stress theories conceptualize the acculturative stress from various dimensions: social, attitudpromotion. These pThere are some potential limitations in the present study. First, our results are based on four rounds of FGDs and three in-depth interviews conducted in factories of Shenzhen. Further, Shenzhen is mainly a city of migrants, while migrant workers are in the minority in other cities of China. As such, whether these results could be generalized to migrant workers working in service industry or other migrant workers of other cities is still questionable. Nevertheless, these findings shed light on understanding the rural-to-urban acculturative stress experienced by migrant workers. Second, the identified rural-to-urban acculturative stressors might be confounded by other forms of general stress due to the cross-sectional nature of this study, these identified stress needs to be further verified in longitudinal studies.Although there are certain limitations, our findings suggest that the rural-to-urban migration in China is a challenging process of transition with significant acculturative stress, indicating rural-to-urban cross-cultural maladjustment may be a fundamental pathogenic mechanism of poor mental health of migrant workers. Due to the high unmet psychological needs and the very large number of migrant workers, and man


An increasing number of researchers and practitioners are working to develop smart cities. Considerable attention has been paid to the college campus as it is an important component of smart cities. Consequently, the question of how to construct a smart campus has become a topical one. Here, we propose a scheme that can facilitate the construction of a smart and friendly campus. We primarily focus on three aspects of smart campuses. These are: the formation of social circles based on interests mining, the provision of educational guidance based on emotion analysis of information posted on a platform, and development of a secondary trading platform aimed at optimizing the allocation of campus resources. Based on these objectives, we designed and implemented a mobile platform called OnCampus as the first step towards the development of a smart campus that has been introduced in some colleges. We found that OnCampus could successfully accomplish the three above mentioned functions of a smart campus. Information technology has brought tremendous changes to our lifestyles and living environments that are evident in daily life, and specifically, in areas such as communication, public security, energy, and water resources. Equipped with pervasive networks, advanced electronics, and various kinds of sensors, urban areas are evolving into smart cities. A smart city can be defined as “multiple sectors cooperating to achieve sustainable outcomes through the analysis of contextual real-time information shared among sector-specific information and operational technology systems”  is equipped with a personal device . Devices owned by users and the associated infrastructure form the basis of a smart campus system. In a campus situation, users maintain constant connections with each other, thereby benefiting from pervasive access to networks such as social and learning networks . This communication frequently occurs via the XMPP protocol to archive real-time service and refresh data. Data responses obtained immediately after each refresh are not adequate in relation to energy consumption and network flow. Thus, we propose a practical communication mechanism to stipulate data transportation process between servers and clients. This section further illustrates the server structure and provides details of the communication process.To provide a complex LBS in an energy-saving and efficient way, OnCampus uses a two-tier server structure: a Location Search Server and a Message Sending Server to Client LM2C), as shown in Fig. C, as shoUsing the LM2C server, the OnCampus architecture regulates the process of data transfer between servers and clients to support system services. The communication process for establishing location-based instant messaging between clients and the two-tier servers is illustrated in Fig. This two-tier LM2C architecture is designed to accomplish energy-efficient conveyance of location-based instant messages. A set of areas will be designated to the client, as noted above. However, attributes associated with the exact locations of these areas will not be designated. This design feature enables an irredundant connection to be made to the LSS when the client’s location changes. The client can determine the next MSS according to given datasets. Thus, the OnCampus system entails an efficient method of using resources and server bandwidths. It further supports passive receipt of messages by clients, who are not required to initiate a process to obtain messages, thus reducing their energy consumption.Whether in terms of its architecture entailing the use of location contexts or its functional modules designed for clients, OnCampus offers a potentially feasible way to implement our above-described scheme. In this section, we discuss three functional modules aimed at service provision involving learning, living and entertainment. They are the “Group” module, the “Buy & Sell” module and the “Forum” module, all of which enable interests mining, scientific guidance, and resource optimization to be conducted. For example, data obtained from circle communication and local trading are conducive to mining users’ interests, enabling customized recommendations to be made. Moreover, inference of campus emotion within the forum enables the formulation of scientific guidance.This OnCampus prototype was implemented on an android platform designed for the clients, while the server component was implemented using Java either on a Windows operating system or a Linux operating system. Figures The “Group” module provides highly popular social network functions within the campus, which meet the students’ needs relating to social communication. Circles with various topics can be developed for students to communicate with other users who have similar interests. This helps students to develop friendships, improve their perception, and broaden their horizons. As with some instant messaging systems, personal friends can be added, and status delivery, sharing, and retweeting within circles are also supported in this module. For example, users can show their current status as being happy, which can be viewed by everyone within their circles. Users’ friends have the option to reply, share, or forward this status.The “Buy & Sell” module has a practical function within the campus, enabling students to exchange their goods. This module is designed to solve the problem of resource waste resulting from students discarding their commonly used articles or books that other students would find useful. Using the “Buy & Sell” module, students can broadcast information about what items they do not need and are willing to sell to others. Customers will thus be able to find what they need and complete transactions using the information provided in this module. Users have the ability to view product lists, search for certain products, release products offered for sale, and manage their lists of products for sale. Product lists are displayed according to various product categories. Consequently, students can scan a certain type of product using easy slide on type tabs. The products in these lists are usually designated as being for sale, whereas products that have already been sold can either be marked accordingly or deleted from the lists as desired by owners.The “Forum” module is a practical application for knowledge sharing, affective interaction and developing “Q & A” sessions. This module is designed to provide a platform for students to share their knowledge, broadcast news, express their feelings, and ask for help. Any registered OnCampus member can read and reply to the posts. The posters can delete, edit, or share their posts. They have full privileges to manage them. Everyone here enjoys complete freedom of speech.The design and implementation of OnCampus is of great significance. OnCampus offers optimal convenience and efficiency to college students. The practicability of this initiative is demonstrated by its wide range of useful applications within campus life. For example, Jack maybe very interested in skiing and is looking for students with similar interests. One solution is to look for student circles that have discussed this topic in OnCampus’s “Group” module. If Jack cannot find any such circles, he can himself develop a circle focusing on the topic of skiing to attract students. He will develop strong friendships who share his hobbies within this circle. Another example can be cited involving a new computer keyboard. Students would rather sell their old but functional keyboards using the “Buy & Sell” module to other students who need this item in an economical and environmental friendly way. There are many scenarios within universities in which convenience is valued, and OnCampus can offer this convenience in such circumstances.OnCampus can provide college students with intelligent assistance, not only because of its practical client-server architecture, but also because of its energy-efficient characteristics. The use of the LM2C server structure to provide LBS can save energy. Specifically, when first connecting to LSS, a client receives extra information for computing MSS without the need to repeatedly connect to this LSS. This communication mechanism is designed to save energy. An experiment involving five repetitions was conducted to evaluate its performance on three different smart phones with the same configurations. Phone 1 was set to run no applications to obtain a standard standby time. Phone 2 used our OnCampus prototype to calculate location and server-based information, and Phone 3 used a controlled prototype without the LM2C architecture that communicated each time with the server to identify its location. The results of the experiment revealed that on three occasions, our architecture performed better than the prototype without the LM2C architecture. The experimental settings and results have been published  were active. The statistical data obtained for each module are shown in Fig. 5.47 % weApart from the substantial services offered by OnCampus, and its efficiency, it has considerable potential for actualizing our scheme toward the development of a smart campus. Specifically, users’ interests can be identified through the use of the OnCampus system, especially within the “Group” module. Data and information are generated when users interact with other circle members. Information is available on location, user track, proximity, activities, and other relevant topics. Moreover, data on preferences and profile data can be collected when users use the “Buy & Sell” and “Forum” modules. All of these kinds of information have unpredictable potential in relation to the implementation of the scheme that we have presented here.In this paper, we have suggested that smart campuses are an inevitable trend in the context of smart cities. We have proposed a feasible scheme entailing interests mining, scientific guidance, and optimization of resource use within an initiative that contributes toward the development of smart campuses. We designed and implemented a prototype system based on our proposed OnCampus scheme. We adopted the XMPP protocol and our proposed LM2C structure to implement the system in a manner that was energy saving and efficient. We further developed three functional modules, namely “Group”, “Buy & Sell”, and “Forum” modules to provide services related to learning, living, and entertainment. OnCampus can significantly contribute in the following ways: through the creation of social circles based on interests mining, the provision of educational guidance based on emotion analysis, as an information-sharing platform, and by developing a secondary trading platform aimed at the optimal allocation of campus resources.The application of OnCampus enables the conduct of interests mining, the provision of scientific guidance, and the optimization of resources. For instance, data from communication occurring within student circles and local trading are conducive to mining users’ interests, thus enabling the customization of recommendations. Moreover, scientific guidance can be formulated if we can infer campus emotions reflected on the campus forum. Future work will engage with these issues.


Here, we argue that scale free patterns, found throughout nature, present convincing evidence that this demarcation is only imaginary. Therefore, all systems ought to be regarded alike, i.e., all are consuming free energy in least time. This way evolutionary processes can be understood as a series of changes from one state to another, so that flows of energy themselves naturally select those ways and means, such as species and societies or gadgets and galaxies to consume free energy in the least time in quest of attaining thermodynamic balance in respective surroundings. This holistic worldview, albeit an accurate account of nature, was shelved soon after its advent at the turn of the 18 The nature and mathematical basis for material stability in the chemical and biological worlds by Robert Pascal and Addy Pross elaborates on conceptual conundrums that hinder us from relating animate to inanimate [could have emerged from inanimate matter. Moreover, Pascal and Pross are alarmed that biology, as a discipline, has by today grown apart from physical sciences, although chemistry did become biology on this planet some 3.5 to 4 billion years ago. Hence, the logical conclusion is that all disciples must have a common conceptual basis.The recent perspective on nanimate . The autWe have hardly anything to add on this sharp analysis of the status quo. Yet, we wish to emphasize that only by convention we refer to some systems as living while others as nonliving, but nature itself does not make the divide: scale free patterns are ubiquitous -10. ThroFor example, lengths of genes distribute in the same skew manner as lengths of words. Animal and plant populations, irrespective of a species, spread out on terrestrial and marine environments in the same manner as economic wealth, irrespective of assets, spreads out in diverse societies. Likewise, chemical reactions and economic transactions proceed along sigmoid curves toward stationary cycles such as citric acid cycle in a cell and annual cycles of production. Also a cyclone whirls in a temperature gradient in the same way as a galaxy spirals in the universal density. These logarithmic spirals appear also in many other familiar forms such as shells, cones and inflorescences.Moreover, ecological succession advances in the same way as technological progress, that is, by punctuating from one innovation to another along a sigmoid curve. Production of goods branches out just as a phylogenic tree of species fans out. So does also an electric discharge disperse in a medium, for instance, lighting in the air. Furthermore, neural activity recorded from cortex follows a power law just as seismic activity recorded from Earth’s mantle. A metabolic network across a cell displays the same power-law degree distribution of intersections as the nodes of a transportation network across a city or the communication network World Wide Web across the Globe as well as the network of galaxies across the Universe. These universal patterns present compelling evidence that there is a natural law that encompasses everything.Principia address the same relation between forces and motion: Rational Mechanics will be the science of motions resulting from any forces whatsoever and of the forces required to produce any motions, accurately proposed and demonstrated [F = dtp between the force F and the change in momentum p, i.e., the change in the course. No system has any choice but to move along the resultant force, i.e., along the path where free energy is consumed in least time.The basic law of nature is no mystery. It says that energy differences of any kind, i.e., free energy of any kind will be consumed in least time when a system of any kind moves from one state to another -15. The nstrated . SubsequAll substances in nature can be employed for the production of impelling power. Power P equals the consumption of free energy. Since P = F · v = dpt · v = dt2K, no energy in motion with velocity v, i.e., kinetic energy 2K, has any option but to direct along the steepest gradient on the energy landscape, i.e., along the least-time path.Also Carnot recognizes the universality without divide between animate and inanimate : All subFor example, a brook will vary its path, and this flow of energy will all by itself, i.e., naturally, select the steepest descent to run down the hill slope as soon as possible. Conversely, any rivulet cannot but drain dry when the flow finds a faster way to consume gravitational potential. According to this tenet also an animal population will vary its ways of making living, and the associated flows of energy will themselves naturally select among alternatives, e.g., genetic, epigenetic, behavioral mechanisms, or any other function that facilitates the least-time free energy consumption. Conversely, no species has any freedom but to adapt or perish, when more effective consumers of a common free energy reservoir come around. These courses toward thermodynamic balance with superior surroundings are not unlikely processes, but natural for all systems. It is only a trivial mathematical exercise to show that the least-time imperative, in the form of equation of motion, gives rise to the scale free patterns . Of courv = dtx and 2K = p · v = TS, the force F = dtp = dx2K = TdxS = dxQ is equated with temperature T multiplied by the change in entropy dS along the piece of path dx, which, in turn, is caused by the change in energy dQ along dx. The mathematical equivalence leaves us without any options but to conclude that evolutionary courses advance along the direction of resultant force. This path of least-time free energy consumption is, in turn, equivalent to the path of maximal rate of entropy increase. However, the mathematical formalism does not imply determinism. On the contrary, evolutionary courses are inherently intractable, because the driving forces are consumed by motions [As Pross and Pascal point out, Darwin’s tenet is only a catching narrative without a firm mathematical form. In contrast the universal imperative of least-time free energy consumption as given by Newton’s second law of motion, Maupertuis’ principle of least action or Carnot’s the second law of thermodynamics can be rigorously analyzed ,19. Thes motions . In othem, equal to energy dE = dmc2 dissipated to the vacuum characterized c2, from the complete form F = dtp = ma + vdtm, where a = dtv, deprives us from understanding any change from one state to another, i.e., evolution. Not even a simple chemical reaction can be understood without dissipation, and hence the textbook thermodynamics and kinetics appear as incongruent. In reality no kinetics runs a reaction, but kinetics is a manifestation the least-time consumption of free energy. Likewise, conceptual conundrums will arise, when entropy is mistaken for a measure of disorder, i.e., incoherence, instead of appreciating it as a sum of both bound and free forms of energy. At the maximum entropy state of a thermodynamic balance all energy is bound, since all free energy has been consumed.It is worth emphasizing that the standard way to omit the change in mass dProtein folding, for instance, is obviously not determined by an amino acid sequence alone, but depends also on dissipation to the surroundings whose properties, temperature, pH, ionic strength, chaperons, etc. have a say on the outcome . TherefoNewton’s, Maupertuis’ and Carnot’s understanding of natural processes across all scales was once as a breath-taking theory as it is today. What the pioneers reasoned complies with reality, and hence with common sense, but not with expectations of a deterministic law. Later, when discrepancy between the looked-for clockwork idealism and reality grew indisputable, imperfect deterministic interpretations of the pioneers’ original prints were not reconsidered, but science went on with disciplinary specialization. As a result, today we find many approximate mathematical models of nature to mimic many a data but to provide only little understanding of underlying causes. Hence, we should return to the exact, albeit intractable evolutionary equation to gain complete comprehension of nature.Every time in the past when our delusions about uniqueness and particularity have narrowed, our worldview has widened toward entirety. By the same token, we should no longer imagine that animate would be qualitatively distinct from inanimate. Amazing diversity and awesome complexity in mechanistic details, which have accumulated over eons, should no longer distract us from seeing that both simple and sophisticated systems follow the universal principle of least-time free energy consumption.