The participation of physicians in the atrocities of the Holocaust exposed vulnerabilities in medicine’s moral commitment to patients’ best interests that every health professional should recognize. Teaching about this history is challenging, as it is extremely complex and there are no common standards for what basic historical facts students in health professions training programs should learn. Nor is there guidance on how these historical facts can or should be related to contemporary ethical issues facing health professionals. To address these problems, (...) we propose a set of core historical facts about health professional involvement in the Holocaust that every student in a health professional training program should learn. We then identify three ethical lessons from the Holocaust that are pertinent today as physicians struggle to maintain their moral compass and earn the trust of patients and the public: 1) The lesson of commitment to science; maintaining balance between reason and skepticism in the search for truth, The lesson of clinical detachment; maintaining balance between necessary professional distance with a commitment to humanism and intimacy with patients, and 3) The lesson of competing loyalties; maintaining balance in upholding medicine’s multiple responsibilities, including to individual patients and the larger community. Embedding these facts and lessons into the education of health professionals is challenging yet critically important. Today’s physicians struggle with some of the same ethical tensions as did German physicians in the Nazi era, albeit in a much-attenuated fashion. Awareness of these tensions and taking active measures to maintain them in balance are necessary components of humanistic health care, which should be an integral part of health professional training programs. (shrink)

Philosophy of ecology has been slow to become established as an area of philosophical interest, but it is now receiving considerable attention. This area holds great promise for the advancement of both ecology and the philosophy of science. Insights from the philosophy of science can advance ecology in a number of ways. For example, philosophy can assist with the development of improved models of ecological hypothesis testing and theory choice. Philosophy can also help ecologists understand the role and limitations of (...) mathematical models in ecology. On the other side, philosophy of science will be advanced by having ecological case studies as part of the stock of examples. Ecological case studies can shed light on old philosophical topics as well as raise novel issues for the philosophy of science. For example, understanding theoretical terms such as “biodiversity” is important for scientific reasons, but such terms also carry political importance. Formulating appropriate definitions for such terms is thus not a purely scientific matter, and this may prompt a reevaluation of philosophical accounts of defining theoretical terms. We consider some of the topics currently receiving attention in the philosophy of ecology and other topics in need of attention. Our aim is to prompt further exchange between ecology and philosophy of science and to help set the agenda for future work in the philosophy of ecology. The topics covered include: the role of mathematical models, environmental problem formulation, biodiversity, and environmental ethics. (shrink)

Mental disorders such as depression and anxiety are increasingly common. Yet there are too few specialists to offer help to everyone, and negative attitudes to psychological problems and their treatment discourage people from seeking it. As a result, many people never receive help for these problems. The Oxford Guide to Low Intensity CBT Interventions marks a turning point in the delivery of psychological treatments for people with depression and anxiety. Until recently, the only form of psychological intervention available for patients (...) with depression and anxiety was traditional one-to-one 60 minute session therapy - usually with private practitioners for those patients who could afford it. Now Low Intensity CBT Interventions are starting to revolutionize mental health care by providing cost effective psychological therapies which can reach the vast numbers of people with depression and anxiety who did not previously have access to effective psychological treatment. The Oxford Guide to Low Intensity CBT Interventions is the first book to provide a comprehensive guide to Low Intensity CBT interventions. It brings together researchers and clinicians from around the world who have led the way in developing evidence-based low intensity CBT treatments. It charts the plethora of new ways that evidence-based low intensity CBT can be delivered: for instance, guided self-help, groups, advice clinics, brief GP interventions, internet-based or book-based treatment and prevention programs, with supported provided by phone, email, internet, sms or face-to-face. These new treatments require new forms of service delivery, new ways of communicating, new forms of training and supervision, and the development of new workforces. They involve changing systems and routine practice, and adapting interventions to particular community contexts. The Oxford Guide to Low Intensity CBT Interventions is a state-of-the-art handbook, providing low intensity practitioners, supervisors, managers commissioners of services and politicians with a practical, easy-to-read guide - indispensible reading for those who wish to understand and anticipate future directions in health service provision and to broaden access to cost-effective evidence-based psychological therapies. (shrink)

For more than a quarter of a century, Hubert L. Dreyfus has been the leading voice in American philosophy for the continuing relevance of phenomenology, particularly as developed by Edmund Husserl, Martin Heidegger, and Maurice Merleau-Ponty. Dreyfus has influenced a generation of students and a wide range of colleagues, and these volumes are an excellent representation of the extent and depth of that influence.In keeping with Dreyfus's openness to others' ideas, many of the essays in this volume take the form (...) of arguments with various of his positions. The essays focus on the dialogue with the continental philosophical tradition, in particular the work of Heidegger, that has played a foundational role in Dreyfus's thinking. The sections are Philosophy and Authenticity; Modernity, Self, and the World; and Heideggerian Encounters. The book concludes with Dreyfus's responses to the essays.Contributors : William D. Blattner, Taylor Carman, David R. Cerbone, Dagfinn Føllesdal, Charles Guignon, Michel Haar, Beatrice Han, Alastair Hannay, John Haugeland, Randall Havas, Jeff Malpas, Mark Okrent, Richard Rorty, Julian Young, Michael E. Zimmerman. (shrink)

Philosophical interest in ecology is relatively new. Standard texts in the philosophy of biology pay little or no attention to ecology (though Sterelny and Griffiths 1999 is an exception). This is in part because the science of ecology itself is relatively new, but whatever the reasons for the neglect in the past, the situation must change. A good philosophical understanding of ecology is important for a number of reasons. First, ecology is an important and fascinating branch of biology with distinctive (...) philosophical issues that arise from its study. Second, ecology is only one small step away from urgent political, ethical, and management decisions about how best to live in an apparently increasingly-fragile environment. Third, philosophy of ecology, properly conceived, can contribute directly to both our understanding of ecology and help with its advancement. Philosophy of ecology can thus be seen as part of the emerging discipline of “biohumanities”, where biology and humanities disciplines together advance our understanding and knowledge of biology (Stotz and Griffiths forthcoming). In this paper, we focus primarily on this third role of the philosophy of ecology and consider a number of places where philosophy can play an important role in ecology. In the process, we.. (shrink)

For forty years, Harvey Mansfield has been worth reading. Whether plumbing the depths of MachiavelliOs Discourses or explaining what was at stake in Bill ClintonOs impeachment, MansfieldOs work in political philosophy and political science has set the standard. In Educating the Prince, twenty-one of his students, themselves distinguished scholars, try to live up to that standard. Their essays offer penetrating analyses of Machiavellianism, liberalism, and America., all of them informed by MansfieldOs own work. The volume also includes a bibliography of (...) MansfieldOs writings. (shrink)

Global Cumulative Treatment Analysis is a novel clinical research model combining expert knowledge, and treatment coordination based upon global information-gain, to treat every patient optimally while efficiently searching the vast space that is the realm of cancer research.

Role-failure acts (Waters and Bird, 1989) have been described as a form of morally questionable activity involving a failure to perform the managerial role. The present study examined employee perceptions and reactions with regard to one form of role-failure act, failure to maintain adequate privacy of performance appraisal information. The study assessed employees' attitudes toward various performance appraisal facets as an invasion of privacy and determined the relationships between these privacy-related attitudes and employees' satisfaction with components of their appraisal system, (...) the system as a whole, and their jobs. Responses that organizations might take to counteract appraisal privacy concerns were also discussed. (shrink)

This paper shows the remarkable compatibility of the thought of Bernard Williams and Søren Kierkegaard regarding what Williams would call the “limits” of philosophical ethics and practice. In different ways both Williams and Kierkegaard critique a reductionist conception of the ethical life, its obligations, and the prescriptions that ethical theories make based upon such conceptions. Additionally, the high level of reflectiveness in their respective societies worries both. For Williams the concern is an epistemological one, whereas for (...) Kierkegaard the issue is moral. Upon juxtaposing their thought in these areas, I show how Kierkegaard extends the concerns that he shares with Williams by demonstrating a wider vision of what philosophical ethics can and should do. (shrink)

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

Combines documents and analytical essays timed for the bicentennial in 2003. It explains the constitutional, political, philosophical background to judicial review, the historical record leading to this landmark case and the impact of the decision since 1803.

Book reviewed in this article: Clinical Ethics: A Practical Approach to Ethical Decisions in Clinical Medicine. By Albert R. Jonsen, Mark Siegler, and William J. Winslade.

We have begun work on two separate but related ontologies for the study of neurological diseases. The first, the Neurological Disease Ontology (ND), is intended to provide a set of controlled, logically connected classes to describe the range of neurological diseases and their associated signs and symptoms, assessments, diagnoses, and interventions that are encountered in the course of clinical practice. ND is built as an extension of the Ontology for General Medical Sciences — a high-level candidate OBO Foundry ontology that (...) provides a set of general classes that can be used to describe general aspects of medical science. ND is being built with classes utilizing both textual and axiomatized definitions that describe and formalize the relations between instances of other classes within the ontology itself as well as to external ontologies such as the Gene Ontology, Cell Ontology, Protein Ontology, and Chemical Entities of Biological Interest. In addition, references to similar or associated terms in external ontologies, vocabularies and terminologies are included when possible. Initial work on ND is focused on the areas of Alzheimer’s and other diseases associated with dementia, multiple sclerosis, and stroke and cerebrovascular disease. Extensions to additional groups of neurological diseases are planned. The second ontology, the Neuro-Psychological Testing Ontology (NPT), is intended to provide a set of classes for the annotation of neuropsychological testing data. The intention of this ontology is to allow for the integration of results from a variety of neuropsychological tests that assay similar measures of cognitive functioning. Neuro-psychological testing is an important component in developing the clinical picture used in the diagnosis of patients with a range of neurological diseases, such as Alzheimer’s disease and multiple sclerosis, and following stroke or traumatic brain injury. NPT is being developed as an extension to the Ontology for Biomedical Investigations. (shrink)

This project continues our interdisciplinary research into computational and cognitive aspects of narrative comprehension. Our ultimate goal is the development of a computational theory of how humans understand narrative texts. The theory will be informed by joint research from the viewpoints of linguistics, cognitive psychology, the study of language acquisition, literary theory, geography, philosophy, and artificial intelligence. The linguists, literary theorists, and geographers in our group are developing theories of narrative language and spatial understanding that are being tested by the (...) cognitive psychologists and language researchers in our group, and a computational model of a reader of narrative text is being developed by the AI researchers, based in part on these theories and results and in part on research on knowledge representation and reasoning. This proposal describes the knowledge-representation and natural-language-processing issues involved in the computational implementation of the theory; discusses a contrast between communicative and narrative uses of language and of the relation of the narrative text to the story world it describes; investigates linguistic, literary, and hermeneutic dimensions of our research; presents a computational investigation of subjective sentences and reference in narrative; studies children’s acquisition of the ability to take third-person perspective in their own storytelling; describes the psychological validation of various linguistic devices; and examines how readers develop an understanding of the geographical space of a story. This report is a longer version of a project description submitted to NSF. This document, produced in May 2007, is a L ATEX version of Technical Report 89-07 (Buffalo: SUNY Buffalo Department of Computer Science, August 1989), with slightly.. (shrink)

This book is about the ethical issues that clinicians encounter as they care for patients and is written to assist those who serve on hospital ethics committees as they deliberate about appropriate action in difficult ethical cases.

Alienation and Connection addresses social constructs that perpetuate alienation through suffering. The contributors discuss how alienation through suffering in a variety of contexts can be transformed into connection and reconnection: human relationship with the environment, economic and social systems that disconnect and reconnect, cultural constructs that divide or can heal, encountered difference that brings opportunity, and various manifestations of personal pain that can be survived and even overcome.

In 1923, Sir Arthur Keith proposed that many common back problems are due to the stresses caused by our evolutionarily novel form of locomotion, bipedalism. In this article, we introduce an updated version of Keith’s hypothesis with a focus on acquired spinal conditions. We begin by outlining the main ways in which the human spine differs from those of our closest living relatives, the great apes. We then review evidence suggesting there is a link between spinal and vertebral shape on (...) the one hand and acquired spinal conditions on the other. Next, we discuss recent studies that not only indicate that two common acquired spinal conditions—intervertebral disc herniation and spondylolysis—are associated with vertebral shape, but also suggest that the pathology-prone vertebral shapes can be understood in terms of the shift from quadrupedalism to bipedalism in the course of human evolution. Subsequently, we place the aforementioned findings under an umbrella hypothesis, which we call the “Evolutionary Shape Hypothesis.” This hypothesis contends that individuals differ in their propensity to develop different acquired spinal conditions because of differences in vertebral shape that relate to the evolutionary history of our species. We end the article with some possible directions for future research. (shrink)

The essays in this volume apply philosophical analysis to address three kinds of questions: What are the implications of genetic science for our understanding of nature? What might it influence in our conception of human nature? What challenges does genetic science pose for specific issues of private conduct or public policy?

In recent years evolutionary theorists have been engaged in a protracted and bitter disagreement concerning how natural selection affects units such as genes, individuals, kin groups, and groups. Central to this debate has been whether selective pressures affecting group success can trump the selective pressures that confer advantage at the individual level. In short, there has been a debate about the utility of group selection, with noted theorist Steven Pinker calling the concept useless for the social sciences. We surveyed 175 (...) evolutionary anthropologists to ascertain where they stood in the debate. We found that most were receptive to group selection, especially in the case of cultural group selection. The survey also revealed that liberals and conservatives, and males and females, all displayed significant differences of opinion concerning which selective forces were important in humanity’s prehistory. We conclude by interpreting these findings in the context of recent research in political psychology. (shrink)

We investigate the role of personal values in an investment decision in a controlled experimental setting. Participants were asked to choose an investment in a bond issued by a tobacco company or a bond issued by a non-tobacco company that offered an equal or sometimes lower yield. We then surveyed the participants regarding their feelings toward tobacco use to determine whether these values influenced their investment decision. Using factor analysis, we identified investment- and tobacco-related dimensions on which participants’ responses tended (...) to load. Two of these factors, relating to the societal impact of investment decisions and the health effects of tobacco, were highly significant in determining whether participants selected a tobacco or non-tobacco related investment. More importantly, we found that when the rate of return on a tobacco-related investment exceeds the rate of return on an investment not involving tobacco by 1%, the intensity of participant concerns about the societal effects of their investment decisions was especially important in determining investment choices. This finding indicates that traditional wealth-maximization approaches, which do not consider the personal values of the investor, omit an important factor that affects investment decisions. (shrink)

Extracorporeal membrane oxygenation (ECMO) is a form of life support for cardiac and/or pulmonary failure with unique ethical challenges compared to other forms of life support. Ethical challenges with ECMO exist when conventional standards of care apply, and are exacerbated during periods of absolute ECMO scarcity when “crisis standards of care” are instituted. When conventional standards of care apply, we propose that it is ethically permissible to withhold placing patients on ECMO for reasons of technical futility or when patients have (...) terminal, short-term prognoses that are untreatable by ECMO. Under crisis standards of care, it is ethically permissible to broaden exclusionary criteria to also withhold ECMO from patients who have a low likelihood of recovery, to maximize the overall number of lives saved. Unilateral withdrawal of ECMO against a patient’s preferences is unethical under conventional standards of care, but is ethical under crisis standards of care to increase access to ECMO to others in society. ECMO should only be rationed when true scarcity exists, and allocation protocols should be transparent to the public. When rationing must occur under crisis standards of care, it is imperative that oversight bodies assess for inequities in the allocation of ECMO and make frequent changes to improve any inequities. (shrink)

We prove that the set of all recursive functions cannot be inferred using first-order queries in the query language containing extra symbols $\lbrack +, . The proof of this theorem involves a new decidability result about Presburger arithmetic which is of independent interest. Using our machinery, we show that the set of all primitive recursive functions cannot be inferred with a bounded number of mind changes, again using queries in $\lbrack +, . Additionally, we resolve an open question in [7] (...) about passive versus active learning. (shrink)

We prove that the set of all recursive functions cannot be inferred using first-order queries in the query language containing extra symbols $\lbrack +, < \rbrack$. The proof of this theorem involves a new decidability result about Presburger arithmetic which is of independent interest. Using our machinery, we show that the set of all primitive recursive functions cannot be inferred with a bounded number of mind changes, again using queries in $\lbrack +, < \rbrack$. Additionally, we resolve an open question (...) in [7] about passive versus active learning. (shrink)

Written by the great medieval Jewish philosopher Maimonides, The Guide of the Perplexed attempts to explain the perplexities of biblical language--and apparent inconsistencies in the text--in the light of philosophy and scientific reason. Composed as a letter to a student, The Guide aims to harmonize Aristotelian principles with the Hebrew Bible and argues that God must be understood as both unified and incorporeal. Engaging both contemporary and ancient scholars, Maimonides fluidly moves from cosmology to the problem of evil to the (...) end goal of human happiness. His intellectual breadth and openness makes The Guide a lasting model of creative synthesis in biblical studies and philosophical theology. (shrink)

We are developing the Neurological Disease Ontology (ND) to provide a framework to enable representation of aspects of neurological diseases that are relevant to their treatment and study. ND is a representational tool that addresses the need for unambiguous annotation, storage, and retrieval of data associated with the treatment and study of neurological diseases. ND is being developed in compliance with the Open Biomedical Ontology Foundry principles and builds upon the paradigm established by the Ontology for General Medical Science (OGMS) (...) for the representation of entities in the domain of disease and medical practice. Initial applications of ND will include the annotation and analysis of large data sets and patient records for Alzheimer’s disease, multiple sclerosis, and stroke. (shrink)

Here is a rich ethnographic description of Amish education in 21st Century America that describes how literacy, community, and accountability are key values in the Amish educational system.

According to Alberto Coffa in The Semantic Tradition from Kant to Carnap, Kant’s account of mathematical judgment is built on a ‘semantic swamp’. Kant’s primitive semantics led him to appeal to pure intuition in an attempt to explain mathematical necessity. The appeal to pure intuition was, on Coffa’s line, a blunder from which philosophy was forced to spend the next 150 years trying to recover. This dismal assessment of Kant’s contributions to the evolution of accounts of mathematical necessity is fundamentally (...) backward-looking. Coffa’s account of how semantic theories of the a priori evolved out of Kant’s doctrine of pure intuition rightly emphasizes those developments, both scientific and philosophical, that collectively served to undermine the plausibility of Kant’s account. What is missing from Coffa’s story, apart from any recognition of Kant’s semantic innovations, is an attempt to appreciate Kant’s philosophical context and the distinctive perspective from which Kant viewed issues in the philosophy of mathematics. When Kant’s perspective and context are brought out, he can not only be seen to have made a genuinely progressive contribution to the development of accounts of mathematical necessity, but also to be relevant to contemporary issues in the philosophy of mathematics in underappreciated ways. (shrink)

Organic chemists have been able to develop a robust, theoretical understanding of the phenomena they study; however, the primary theoretical devices employed in this field are not mathematical equations or laws, as is the case in most other physical sciences. Instead it is the diagram, and in particular the structural formula, that carries the explanatory weight in the discipline. To understand how this is so, it is necessary to investigate both the nature of the diagrams employed in organic chemistry and (...) how these diagrams are used in the explanations of the discipline. I will begin this paper by describing and characterizing the roles of the most important sort of diagram used in organic chemistry. Next I will present a model of explanations in organic chemistry and describe how diagrams contribute to these explanations. This will be followed by two examples that will support my abstract account of the role of diagrams in the explanations of organic chemistry. (shrink)

In my dissertation, I argue that contemporary interpretive work on Kant's philosophy of geometry has failed to understand properly the diagrammatic aspects of Euclidean reasoning. Attention to these aspects is amply repaid, not only because it provides substantial insight into the role of intuition in Kant's philosophy of mathematics, but also because it brings out both the force and the limitations of Kant's philosophical account of geometry. ;Kant characterizes the predecessors with which he was engaged as agreeing that mathematical judgments (...) are analytic a priori. This is an inadequate account of geometrical judgments for Kant, because it cannot be reconciled with the evident success of the Euclidean practice in producing a priori knowledge of the nature of space. The ubiquitous presence of diagrams in Euclidean proofs suggests that, at least in Kant's time, any plausible account of the establishment of geometrical judgments must provide for the role of quasi-perceptual representations of individuals. Kant's claim that mathematical judgments are synthetic a priori reflects, in its positive aspect, his recognition of the importance of these 'intuitive' representations to Euclidean reasoning. Furthermore, Kant's doctrine that geometrical knowledge is established by the construction of concepts in intuition can be usefully understood as an attempt to accommodate the role of diagrams in the establishment of synthetic a priori geometrical judgments. ;Both Kant's rejection of the analytic a priori account of mathematics and his positive account of geometry depend on the plausibility of his appeals to Euclidean practice. Attention to the role of diagrams in Euclidean proof supports Kant's contention that intuitive representations are an essential component of Euclidean reasoning; however, the role of diagrams in both reductio proofs and in proofs by cases brings out tensions in Kant's positive account. The use of diagrams to represent impossible geometrical situations in reductio proofs indicates that Kant's notion of 'construction in intuition' can have a broader application than the construction of instances of geometrical concepts . Similarly, proofs by cases undermine Kant's attempts to explain the generality of judgments established through the consideration of individuals by appeal to the rules for the construction of those individuals. ;Contemporary interpretive debates about Kant's philosophy of geometry have centered on the philosophical role played by his appeal to intuition. This appeal cannot be primarily understood as an attempt to establish that the fundamental assumptions of Euclidean geometry are necessary truths about space. Nor can the role for intuition be regarded as merely licensing moves in geometrical proofs like an inference rule in modern logic. Instead, by understanding Kant's appeal to intuition as, at least in part, an attempt to accommodate the diagrammatic features of Euclidean reasoning, a much richer role for intuition is revealed. Intuition is required to play a logical role by expressing spatial relationships and establishing the existence of geometrical entities. In addition, it plays a quasi-perceptual role by supporting the truth of certain claims appealed to during the course of Euclidean proof. (shrink)

A commentary on “Patient-Satisfaction Surveys on a Scale of 0 to 10: Improving Health Care, or Leading It Astray?,” byAlexandra Junewicz and Stuart J. Youngner in the May-June 2015 issue.

According to Alberto Coffa in The Semantic Tradition from Kant to Carnap, Kant’s account of mathematical judgment is built on a ‘semantic swamp’. Kant’s primitive semantics led him to appeal to pure intuition in an attempt to explain mathematical necessity. The appeal to pure intuition was, on Coffa’s line, a blunder from which philosophy was forced to spend the next 150 years trying to recover. This dismal assessment of Kant’s contributions to the evolution of accounts of mathematical necessity is fundamentally (...) backward-looking. Coffa’s account of how semantic theories of the a priori evolved out of Kant’s doctrine of pure intuition rightly emphasizes those developments, both scientific and philosophical, that collectively served to undermine the plausibility of Kant’s account. What is missing from Coffa’s story, apart from any recognition of Kant’s semantic innovations, is an attempt to appreciate Kant’s philosophical context and the distinctive perspective from which Kant viewed issues in the philosophy of mathematics. When Kant’s perspective and context are brought out, he can not only be seen to have made a genuinely progressive contribution to the development of accounts of mathematical necessity, but also to be relevant to contemporary issues in the philosophy of mathematics in underappreciated ways. (shrink)

Globalization generates new structures of human interdependence and vulnerability while also posing challenges for models of democracy rooted in territorially bounded states. The diverse phenomena of globalization have stimulated two relatively new branches of political theory: theoretical accounts of the possibilities of democracy beyond the state; and comparative political theory, which aims at bringing non-Western political thought into conversation with the Western traditions that remain dominant in the political theory academy. This article links these two theoretical responses to globalization by (...) showing how comparative political theory can contribute to the emergence of new global “publics” around the common fates that globalization forges across borders. Building on the pragmatist foundations of deliberative democratic theory, it makes a democratic case for comparative political theory as an architecture of translation that helps deliberative publics grow across boundaries of culture. (shrink)

Coral bleaching has impacted reefs worldwide and the predictions of near‐annual bleaching from over two decades ago have now been realized. While technology currently provides the means to predict large‐scale bleaching, predicting reef‐scale and within‐reef patterns in real‐time for all reef users is limited. In 2020, heat stress across the Great Barrier Reef underpinned the region's third bleaching event in 5 years. Here we review the heterogeneous emergence of bleaching across Heron Island reef habitats and discuss the oceanographic drivers that (...) underpinned variable bleaching emergence. We do so as a case study to highlight how reef end‐user groups who engage with coral reefs in different ways require targeted guidance for how, and when, to alter their use of coral reefs in response to bleaching events. Our case study of coral bleaching emergence demonstrates how within‐reef scale nowcasting of coral bleaching could aid the development of accessible and equitable bleaching response strategies on coral reefs. Also see the video abstract here: https://youtu.be/N9Tgb8N-vN0. (shrink)