This paper discusses the post-trial access to drugs for patients who participated in clinical trials in Brazil. The ethical guidance for clinical trials in Brazil is arguably one of the clearest in the world in attributing to research sponsors the responsibility for providing post-trial drugs to patients who participated in their experiments. The Federal Constitution recognizes health as a fundamental right to be fulfilled by the State. Based on the Brazilian constitution and on the National Health Council resolutions, courts have (...) been accepting patients' claims and ordering the State and the pharmaceutical companies to provide these patients with the tested treatment in the quantity and duration they need it. This generous interpretation of the duties of the pharmaceutical companies and the State makes the Brazilian model for post-trial access unique when compared to the experience of other countries and thus should be followed with attention by future research in order to assess its consequences for patients, research sponsors, and the public health system. (shrink)

This paper discusses so-called post-trial access to drugs for patients who participated in clinical trials in Brazil. Brazil is currently a relevant country for the pharmaceutical industry due to the dimensions of its actual and potential market. As a consequence, the number of pharmaceutical trials has been rising. It is the largest market for pharmaceutical companies in Latin America, the 8th biggest in the world and second only to China among the so-called BRICS’s emerging countries. The demand for pharmaceutical products (...) in the country has been increasing by double digits over the last few years, reaching 20% in 2008. Not surprisingly, we are also witnessing a steady increase in the number of applications by national and international pharmaceutical companies before ethical research authorities for authorization to perform clinical trials of drugs. (shrink)

In a recent paper, Charles Foster argued that the epistemic uncertainties surrounding prolonged disorders of consciousness make it impossible to prove that the withdrawal of life-sustaining treatment can be in a patient’s best interests and, therefore, the presumption in favour of the maintenance of life cannot be rebutted. In the present response, I argue that, from a legal perspective, Foster has reached the wrong conclusion because he is asking the wrong question. According to the reasoning in two leading cases —Bland (...) and James —the principle of respect for autonomy creates a persuasive presumption against treatment without consent. Therefore, it is the continuation of treatment that requires justification, rather than its withdrawal. This presumption also works as the tiebreaker determining that treatment should stop if there is no persuasive evidence that its continuation is in the best interests of the patient. The presumption in favour of the maintenance of life, on the other hand, should be understood as an evidential presumption on a factual issue that is assumed to be true if unchallenged. However, the uncertainties regarding PDOC actually give reasons for displacing this evidential presumption. Consequently, decision-makers will have to weigh up the pros and cons of treatment having the presumption against treatment without consent as the tiebreaker if the evidence is inconclusive. In conclusion, when the right question is asked, Foster’s argument can be turned on its head and uncertainties surrounding PDOC weigh in to justify the interruption of treatment in the absence of compelling contrary evidence. (shrink)

Both developing and developed countries face an increasing mismatch between what patients expect to receive from healthcare and what the public healthcare systems can afford to provide. Where there has been a growing recognition of the entitlement to receive healthcare, the frustrated expectations with regards to the level of provision has led to lawsuits challenging the denial of funding for health treatments by public health systems. This book analyses the impact of courts and litigation on the way health systems set (...) priorities and make rationing decisions. In particular, it focuses on how the judicial protection of the right to healthcare can impact the institutionalization, functioning and centrality of Health Technology Assessment (HTA) for decisions about the funding of treatment. Based on the case study of three jurisdictions - Brazil, Colombia, and England - it shows that courts can be a key driver for the institutionalization of HTA. These case studies show the paradoxes of judicial control, which can promote accountability and impair it, demand administrative competence and undermine bureaucratic capacities. The case studies offer a nuanced and evidence-informed understanding of these paradoxes in the context of health care by showing how the judicial control of priority-setting decisions in health care can be used to require and control an explicit scheme for health technology assessment, but can also limit and circumvent it. (shrink)

This co-edited volume compares Chinese and Western experiences of engineering, technology, and development. In doing so, it builds a bridge between the East and West and advances a dialogue in the philosophy of engineering. Divided into three parts, the book starts with studies on epistemological and ontological issues, with a special focus on engineering design, creativity, management, feasibility, and sustainability. Part II considers relationships between the history and philosophy of engineering, and includes a general argument for the necessity of dialogue (...) between history and philosophy. It continues with a general introduction to traditional Chinese attitudes toward engineering and technology, and philosophical case studies of the Chinese steel industry, railroads, and cybernetics in the Soviet Union. Part III focuses on engineering, ethics, and society, with chapters on engineering education and practice in China and the West. The book’s analyses of the interactions of science, engineering, ethics, politics, and policy in different societal contexts are of special interest. The volume as a whole marks a new stage in the emergence of the philosophy of engineering as a new regionalization of philosophy. This carefully edited interdisciplinary volume grew out of an international conference on the philosophy of engineering hosted by the University of the Chinese Academy of Sciences in Beijing. It includes 30 contributions by leading philosophers, social scientists, and engineers from Australia, China, Europe, and the United States. (shrink)

Host-microbiome interactions (HMIs) are critical for the modulation of biological processes and are associated with several diseases, and extensive HMI studies have generated large amounts of data. We propose that the logical representation of the knowledge derived from these data and the standardized representation of experimental variables and processes can foster integration of data and reproducibility of experiments and thereby further HMI knowledge discovery. A community-based Ontology of Host-Microbiome Interactions (OHMI) was developed following the OBO Foundry principles. OHMI leverages established (...) ontologies to create logically structured representations of microbiomes, microbial taxonomy, host species, host anatomical entities, and HMIs under different conditions and associated study protocols and types of data analysis and experimental results. (shrink)

© 2017. The American Astronomical Society. All rights reserved.We present new observations of the low-mass companion to HD 984 taken with the Gemini Planet Imager as a part of the GPI Exoplanet Survey campaign. Images of HD 984 B were obtained in the J and H bands. Combined with archival epochs from 2012 and 2014, we fit the first orbit to the companion to find an 18 au orbit with a 68% confidence interval between 14 and 28 au, an eccentricity (...) of 0.18 with a 68% confidence interval between 0.05 and 0.47, and an inclination of 119°with a 68% confidence interval between 114°and 125°. To address the considerable spectral covariance in both spectra, we present a method of splitting the spectra into low and high frequencies to analyze the spectral structure at different spatial frequencies with the proper spectral noise correlation. Using the split spectra, we compare them to known spectral types using field brown dwarf and low-mass star spectra and find a best-fit match of a field gravity M6.5 ±1.5 spectral type with a corresponding temperature of K. Photometry of the companion yields a luminosity of log=2.88 ± 0.07 dex with DUSTY models. Mass estimates, again from DUSTY models, find an age-dependent mass of 34 ±1 to 95 ±4 M Jup. These results are consistent with previous measurements of the object. (shrink)

To solve the problem of user privacy disclosure caused by attacks on anonymous areas in spatial generalization privacy protection methods, a K and P Dirichlet Retrieval method based on k-anonymity mechanism is proposed. First, the Dirichlet graph model is introduced, the same kind of information points is analyzed by using the characteristics of Dirichlet graph, and the anonymous set of users is generated and sent to LBS server. Second, the relationship matrix is generated, and the proximity relationship between the user (...) position and the target information point is obtained by calculation. Then, the private information retrieval model is applied to ensure the privacy of users’ target information points. Finally, the experimental results show that the KPDR method not only satisfies the diversity of l 3 / 4, but also increases the anonymous space, reduces the communication overhead, ensures the anonymous success rate of users, and effectively prevents the disclosure of user privacy. (shrink)

The lack of a standardized reliable and valid instrument makes it difficult to measure attitudes toward lesbian women and gay men consistently and thus poses a challenge to compare and contrast intervention measures. This study aimed to validate Herek’s ATLG scale among undergraduates in mainland China and identify factors associated with negative attitudes toward LG. A total of 6,036 eligible undergraduates conveniently drawn from 30 provinces across mainland China were randomly split in half. Item analysis was first used to select (...) unrelated or redundant items for deletion. Exploratory factor analysis were then conducted on the first half of the sample, followed by confirmatory factor analysis and reliability analysis in the second half. Logistic regression analyses were finally carried out to identify their determinants. Six items were removed from the item analysis. EFA supported the existence of two factors. CFA results indicated that the two-factor model fit the data better than the one-factor model. Logistic regression analyses indicated that being female, majoring in non-health-related disciplines, attributing homosexuality to uncontrollable causes, non-adherence to traditional gender norms and exposure to homosexual content were significantly associated with less negative attitudes toward both L and G. Urban students were marginally less likely to express negative attitudes toward L but not G, while non-heterosexuals and those who had prior personal contact with homosexuals exhibited less negative attitudes toward G but not L. However, grade showed no significant associations with either ATL or ATG. The retained 14-item version of Herek’s ATLG scale has been proven to be a reliable and valid tool. Furthermore, ATL and ATG were determined by different factors and thus would be treated separately. In order to reduce negative attitudes toward LG among undergraduates in mainland China, a comprehensive intervention plan such as conducting comprehensive sex education and pushing the process of legalizing same-sex marriage should be designed, implemented and evaluated. (shrink)

The service failure of online shopping has always plagued online stores, but the current academic circles still need to explore the service recovery of online shopping from the perspective of empathy and consumer forgiveness. Based on the service failure cases of real online shopping, this article uses the method of situational experiment to carry out empirical research, discusses the impact mechanism of service recovery effect from the perspective of empathy and consumer forgiveness, and tests the moderating role of online store (...) reputation. The results show that in the online shopping service recovery scenario, empathy has a positive impact on consumer forgiveness, consumer forgiveness has a positive impact on consumer repurchase intention, and consumer forgiveness plays a mediating effect between empathy and consumer repurchase intention. Online store reputation plays a moderating role in the relationship between consumer forgiveness and consumer repurchase intention. The research conclusion of this article will help to expand the application of empathy and consumer forgiveness in the research of service recovery, enrich the theory of online shopping service recovery, improve the effect of online shopping service recovery, and promote the healthy development of online shopping business models. (shrink)

An effective approach is introduced to predict the magnitude of reservoir-triggered earthquake, based on support vector machines and fuzzy support vector machines methods. The main influence factors on RTE, including lithology, rock mass integrity, fault features, tectonic stress state, and seismic activity background in reservoir area, are categorized into 11 parameters and quantified by using analytical hierarchy process. Dataset on 100 reservoirs in China, including the 48 well-documented cases of RTE, are collected and used to train and validate the prediction (...) models established with SVM and FSVM, respectively. Through numerical tests, it is found that both the SVM and FSVM models are effective in the prediction of the magnitude of RTE with high accuracy, provided that sufficient samples are collected. While the results of FSVM which is extended from SVM by introducing a fuzzy membership to reduce the influence of noises or outliers are found to be slightly less accurate than those of SVM in the current analysis of RTE cases. The reason might be attributed to the high discreteness of the sample data in the current study. (shrink)

Although stressful life events have been shown to be a key risk factor for adolescent NSSI, the potential mediators and moderators of this relationship are unclear. Based on the social development theory and the organism-environment interaction model, we tested whether the link between stressful life events and adolescent NSSI was explained in part by deviant peer affiliation, and whether this process was buffered by gratitude. Chinese adolescents anonymously completed questionnaires to assess the study variables. The present study demonstrated that stressful (...) life events was linked to NSSI in part because of deviant peer affiliation, and high gratitude was a key protective factor to buffer this indirect effect. Teaching gratitude may be a helpful component of prevention and intervention programs to reduce adolescent NSSI. (shrink)

In order to improve the iris classification rate, a novel biogeography-based optimization algorithm based on local search and nonuniform variation was proposed in this paper. Firstly, the linear migration model was replaced by a hyperbolic cotangent model which was closer to the natural law. And, the local search strategy was added to traditional BBO algorithm migration operation to enhance the global search ability of the algorithm. Then, the nonuniform variation was introduced to enhance the algorithm in the later iteration. The (...) algorithm could achieve a stronger iris classifier by lifting weaker similarity classifiers during the training stage. On this base, the convergence condition of NBBO was proposed by using the Markov chain strategy. Finally, simulation results were given to demonstrate the effectiveness and efficiency of the proposed iris classification method. (shrink)

A trenchant defense of hierarchy in different spheres of our lives, from the personal to the political All complex and large-scale societies are organized along certain hierarchies, but the concept of hierarchy has become almost taboo in the modern world. Just Hierarchy contends that this stigma is a mistake. In fact, as Daniel Bell and Wang Pei show, it is neither possible nor advisable to do away with social hierarchies. Drawing their arguments from Chinese thought and culture as (...) well as other philosophies and traditions, Bell and Wang ask which forms of hierarchy are justified and how these can serve morally desirable goals. They look at ways of promoting just forms of hierarchy while minimizing the influence of unjust ones, such as those based on race, sex, or caste. Which hierarchical relations are morally justified and why? Bell and Wang argue that it depends on the nature of the social relation and context. Different hierarchical principles ought to govern different kinds of social relations: what justifies hierarchy among intimates is different from what justifies hierarchy among citizens, countries, humans and animals, and humans and intelligent machines. Morally justified hierarchies can and should govern different spheres of our social lives, though these will be very different from the unjust hierarchies that have governed us in the past. A vigorous, systematic defense of hierarchy in the modern world, Just Hierarchy examines how hierarchical social relations can have a useful purpose, not only in personal domains but also in larger political realms. (shrink)

Frequent and open interaction between venture capitalists and entrepreneurs is necessary for venture capital investments to occur. Increasingly, these investments are made across jurisdictions. The vast majority of these cross-border investments are carried out in a syndicate of two or more VCs, indicating the effects of intra-industry networks needing further analysis. Using China as a model, we provide a novel multidimensional framework to explain cross-border investments in innovative ventures across developed and emerging economies. By analyzing a unique international dataset, we (...) examine worldwide venture capital investment flows from 2000–2012 and consider the effects of geographical, cultural, and institutional proximity as well as institutional and relational trust. We find trust to mitigate the negative effects of geographical and cultural distance, where institutional trust is more relevant for investments in emerging economies, and relational trust is more relevant for investments in developed economies. (shrink)

We conduct a laboratory experiment using the Monty Hall problem to study how simplified examples improve learning behavior and correct irrational choices in probabilistic situations. In particular, we show that after experiencing a simplified version of the MHP, subjects perform better in the MHP, compared to the control group who only experienced the 3-door version. Our results suggest that simplified examples strongly induces learning.

The art of interpretation has traditionally been an integral part of medical practice, but little attention has been devoted to its theory. Hermeneutics or the study of interpretation has grown as a methodological interest primarily within the humanities. Borrowing from the medieval fourfold sense of scripture, which organizes interpretive activity both logically and comprehensively, I propose a hermeneutical model of clinical decision-making. According to the model, a patient is analogous to a literary text which may be interpreted on four levels: (...) (1) the literal facts of the patient's body and the literal story told by the patient, (2) the diagnostic meaning of the literal data, (3) the praxis (prognosis and therapeutic decisions) emanating from the diagnosis, and (4) the change effected by the clinical encounter in both the patient's and clinician's life-worlds. The model is illustrated through application to a medical case. (shrink)

Essays by Thomasma and ten Have recommend hermeneutical clinical ethics. The use Thomasma makes of hermeneutics is not radical enough because it leaves out basic interpretation of clinical practice and focuses narrowly on ethical principles and rules. Ten Have, while failing to notice that the hyperreality of clinical ethics is a feature of all language, rightly distinguishes four characteristic parameters of a thoroughgoing interpretive clinical ethics: experience, attitudes and emotions, community, and ambiguity. Suggestions are made for implementing hermeneutical ethics in (...) clinical teaching. (shrink)

Increasingly, genomic analysis is being utilized to diagnose children with developmental delay or dysmorphic facial features suggestive of a congenital disorder. Genetic testing has rapidly evolved, and the genome-wide tests that we use today are significantly different from the more targeted single-gene tests of the last decade. Chromosomal microarray analysis is now a first line test for children with multiple birth defects, children with intellectual impairment, and children with an unusual constellation of symptoms that do not fit with a known (...) disease. There are three types of CMA that are currently clinically available. CMA by oligonucleotide array-based comparative genomic hybridization compares the hybridization signal from the patient's DNA to that of a reference DNA sample for each oligonucleotide on the array. Depending on the specific array, this can range from tens of thousands to hundreds of thousands of oligonucleotides. (shrink)

Increasingly, genomic analysis is being utilized to diagnose children with developmental delay or dysmorphic facial features suggestive of a congenital disorder. Genetic testing has rapidly evolved, and the genome-wide tests that we use today are significantly different from the more targeted single-gene tests of the last decade. Chromosomal microarray analysis is now a first line test for children with multiple birth defects, children with intellectual impairment, and children with an unusual constellation of symptoms that do not fit with a known (...) disease. There are three types of CMA that are currently clinically available. CMA by oligonucleotide array-based comparative genomic hybridization compares the hybridization signal from the patient's DNA to that of a reference DNA sample for each oligonucleotide on the array. Depending on the specific array, this can range from tens of thousands to hundreds of thousands of oligonucleotides. (shrink)

The social facilitation of eating plays a significant role in influencing individuals’ eating decisions. However, how social eating cues are processed in health promotion messages is unclear. This study examined individuals’ food craving in response to social cues in images and emotional experiences, perceived threat, perceived efficacy, behavioral intentions, and motivational coactivation elicited by social eating cues in obesity prevention fear appeals. Results suggested that the presence of a group of people eating in an image facilitated food craving for the (...) presented foods. Moreover, fear appeals that presented obesity and its consequences with more social eating cues, versus individual eating cues, generated greater positive emotional responses, perceived threat severity, response and self-efficacy, and motivational coactivation indicating more attention and threat vigilance. However, these cues also generated fewer self-reported intentions to change unhealthy eating behaviors. Implications and suggestions for future research are discussed. (shrink)

The general proposition of the positive youth development approach is that developmental assets such as psychosocial competence can promote healthy adolescent development and reduce problem behavior. Despite that many Western studies have shown that PYD attributes are negatively related to adolescent delinquency, not all empirical findings support the negative associations. Although different dimensions of PYD attributes may bear differential relationships with delinquency, this possibility has not been properly examined so far. In addition, related studies in mainland China do not exist. (...) Finally, the possible mediating role of life satisfaction in linking PYD attributes to delinquency has rarely been studied. To address the research gaps and understand how PYD attributes are associated with adolescent delinquency and the underlying mediating effect of life satisfaction, matched longitudinal data were collected from 2,648 mainland Chinese secondary school students at two waves which were separated by one year. On each occasion, participants completed a questionnaire containing validated measures of PYD attributes, life satisfaction, and delinquency. Congruent with the general theoretical prediction of the PYD approach, different PYD attributes were inversely related to concurrent and future adolescent delinquency in separate regression analyses. In addition, the negative predictions were mediated by life satisfaction. When all PYD attributes were included in a single path analysis model, three findings were observed. First, two PYD dimensions, including self-identity and general PYD attributes, showed robust negative predictions on delinquency via life satisfaction. Second, prosocial attributes displayed a weak and unstable negative predictive effect. Third, cognitive-behavioral competence showed an unexpected positive predictive effect on delinquency directly or via its negative effects on life satisfaction. The present findings add value to the existing literature by revealing the predictive role of PYD attributes on life satisfaction and delinquency among mainland Chinese adolescents. The findings also reinforce the importance of investigating individual dimensions of PYD attributes simultaneously in the research field. The present study suggests that it is promising to cultivate PYD attributes as a strategy to reduce delinquency among adolescents in mainland China. (shrink)

The current financial stress in the countryside and the future of the family farm are likely to be major issues in the formulation of the 1990 Farm Bill. Medium-sized commercial family farms may be especially targeted for support. These farms are the basis of rural economies and settlement patterns in many parts of nonmetropolitan America.Two possible changes in farm policy are debt restructuring and the decoupling of farm payments from commodity production. Many medium-sized family farms continue to face substantial debt (...) problems, but most of these farms could be viable with some debt restructuring. Ccmmodity programs have become extremely expensive and encourage overproduction and the consolidation of farming resources into ever larger units. Federal farm programs may become based on need, with a sensitivity to differences in regional farming systems. Such a policy could support medium-sized family farms, slow the growth in superfarms, reduce surpluses, and reduce the overall cost of farm programs. (shrink)

Those most intimate with the works of H. Richard Niebuhr, who return to them time after time for theological and ethical sustenance, know that they exemplify a more interesting thinker than his brother, Reinhold. Of course, Reinhold was and remains the more public figure, read seriously in his time by politicians and theologians, celebrated by our current president, and enjoying renewed scholarly interest resulting in new editions of out-of-print works and a number of critical studies. Meanwhile, H. Richard continues to (...) exert decisive influence on American Protestant thought. Such diverse thinkers as Paul Ramsey, James Gustafson, Stanley Hauerwas, William Schweiker, Kathryn Tanner, Gordon Kaufman, Emilie Townes .. (shrink)

Placing politics in an ecological perspective that discerns an inextricable connection between human political agency and the forces of nonhuman nature would seem to be a difficult task. While we have grown accustomed to understanding our personal capacities for thought and action as well as the shape of our intimate relations as aspects of our natural inheritance, our political life and reflection remain rife with human exceptionalism. We understand animals to have rudimentary reasoning skills and physical capabilities incredible to us. (...) We also understand some animals gather in social groupings held together by mutual dependence for fulfilling affective needs. But it is difficult to imagine that animals have .. (shrink)

The goals and values of economic development strategies vary according to the individual communities that employ them. While economic development strategies are aimed at increasing jobs, income, and community wealth, the issue of who gains and who loses from economic change is often overlooked. The industrial development strategies of the 1960s and 1970s are giving way to local initiatives based on services. Although local efforts may mean greater local control, the globalization of the economy has exposed formerly remote areas to (...) international competition. The challenge to communities will be to achieve a moderate, steady, and manageable pace of “good” growth. Each community will ultimately need to develop a strategy for economic growth that matches community desires with community resources. (shrink)

This study, which is based on survey data provided by 445 employees of a Chinese enterprise, examines the impact of authentic leadership on the proactive behavior of subordinates, in particular the mediating effect of subordinate psychological capital and the moderating effect of the compassion at work. The results of our structural equation model reveal that: (1) There is a significant positive correlation between authentic leadership and the proactive behavior of subordinates; (2) Psychological capital plays a full mediating role between authentic (...) leadership and subordinate proactive behavior; (3) Compassion at work has a moderating effect on the positive relationship between authentic leadership and subordinate psychological capital and proactive behavior. (shrink)

This book is born out of two contradictions: first, it explores the making of meaning in a musical form that was made to lose its meaning at the turn of the nineteenth century; secondly, it is a history of a music that claims to have no history - absolute music. The book therefore writes against that notion of absolute music which tends to be the paradigm for most musicological and analytical studies. It is concerned not so much with what music (...) is, but with why and how meaning is constructed in instrumental music and what structures of knowledge need to be in place for such meaning to exist. From the thought of Vincenzo Galilei to that of Theodore Adorno, Daniel Chua suggests that instrumental music has always been a critical and negative force in modernity, even with its nineteenth-century apotheosis as 'absolute music'. (shrink)

Adolescence is a developmental stage when adolescents are vulnerable to addictive behaviors, such as Internet addiction, which refers to pathological use of the Internet. Although there are views proposing that the links between IA and adolescent problem behavior may be bidirectional in nature, few studies have examined the reciprocal relationships between IA and other maladjustment indicators, and even fewer studies have simultaneously employed both emotional and behavioral maladjustment indicators in a single study. To address the above research gaps, the present (...) study investigated how IA is associated with both depression and delinquency among Chinese adolescents. Two waves of data were collected at two consecutive years, respectively, with 1year apart, from 3,010 students in four junior high schools in mainland China. These students completed the same questionnaire containing measures of IA, depression, and delinquency at each wave. The proposed cross-lagged panel model fitted the data very well, and there were significant positive reciprocal effects between IA and depression as well as delinquency after controlling for background socio-demographic factors. Gender differences were also observed in multi-group comparisons. Specifically, IA showed a stronger longitudinal impact on delinquency among boys than among girls. While depression significantly predicted IA in 1year among boys, such a prediction was not significant among girls. These findings delineate the bidirectionality of the associations between IA and emotional and behavioral maladjustment indexed by depression and delinquency, respectively. The findings also suggest that researchers and practitioners have to take gender differences as well as different developmental indicators in understanding the bidirectional influences between IA and adolescent behavioral and emotional development. (shrink)

Even as human rights provide the most widely shared moral language of our time, they also spark highly contested debates among scholars and policymakers. When should states protect human rights? Does the global war on terror necessitate the violation of some rights? Are food, housing, and health care valid human rights? Debating Human Rights introduces the theory and practice of international human rights by examining fourteen controversies in the field. Daniel Chong presents the major arguments on both sides of (...) each debate, encouraging readers to think critically and form their own opinions. Designed for classroom use, the structure of the book makes it easy for students to become familiar with the major political and legal actors in the global human rights system and to understand the practical challenges of protecting civil, political, social, and economic rights. (shrink)