Given that health systems research involves different aims, approaches, and methodologies as compared to more traditional clinical trials, the ethical issues present in HSR may be unique or particularly nuanced. This article outlines eight pertinent ethical issues that are particularly salient in HSR and argues that the ethical review process should be better tailored to ensure more efficient and appropriate oversight of HSR with adequate human protections, especially in low- and middle-income countries. The eight ethical areas we discuss include the (...) nature of intervention, types of research subjects, units of intervention and observation, informed consent, controls and comparisons, risk assessment, inclusion of vulnerable groups, and benefits of research. HSR involving human participants is necessary to ensure health systems strengthening and quality of care and to guide public policy intelligently. Health systems researchers must carefully define their intent and goals and openly clarify the values that may influence the premises and design of protocols. As new types of population-level research activities become more commonplace, it is critical that institutional review board and research ethics committee review processes evolve to evaluate these research protocols in ways that address the nuanced features of these studies. (shrink)

203 surveys were considered complete and were included in the analysis. Written consent was not used by nearly 40% of the researchers.

Abstract: Tomatoes are part of the major crops in food security. Tomatoes are plants grown in temperate and hot regions of South American origin from Peru, and then spread to most countries of the world. Tomatoes contain a lot of vitamin C and mineral salts, and are recommended for people with constipation, diabetes and patients with heart and body diseases. Studies and scientific studies have proven the importance of eating tomato juice in reducing the activity of platelets in diabetics, which (...) helps in protecting them from developing deadly blood clots. A tomato classification approach is presented with a data set containing approximately 5,266 images with 7 species belonging to tomatoes. The Neural Network Algorithms (CNN), a deep learning technique applied widely in image recognition, is used for this task. (shrink)

We show in this paper that the AGM postulates are too weak to ensure the rational preservation of conditional beliefs during belief revision, thus permitting improper responses to sequences of observations. We remedy this weakness by proposing four additional postulates, which are sound relative to a qualitative version of probabilistic conditioning. Contrary to the AGM framework, the proposed postulates characterize belief revision as a process which may depend on elements of an epistemic state that are not necessarily captured by a (...) belief set. We also show that a simple modification to the AGM framework can allow belief revision to be a function of epistemic states. We establish a model-based representation theorem which characterizes the proposed postulates and constrains, in turn, the way in which entrenchment orderings may be transformed under iterated belief revision. (shrink)

Refusing consent to organ donation remains unacceptably high, and improving consent rates from family or next-of-kin is an important step to procuring more organs for solid organ transplantation in countries where this approval is sought. We have thus far failed to translate fully our limited understanding of why families refuse permission into successful strategies targeting consent in the setting of deceased organ donation, primarily because our interventions fail to target underlying cognitive obstacles. Novel interventions to overcome these hurdles, incorporating an (...) understanding of cognitive psychology and behavioral change therapy, may be beneficial. One potential intervention is to use the concept of nudge theory, where decision-making is influenced by encouraging positive reinforcement and indirect suggestion. Purposefully nudging families to given consent for organ donation by understanding, and then overcoming, their inherent cognitive biases is novel but also controversial. This article explores the roles of relatives in decisions about organ donation, how nudge theory translates to organ donation and discusses the arguments for and against its application. (shrink)

Every person has his/her own unique signature that is used mainly for the purposes of personal identification and verification of important documents or legal transactions. There are two kinds of signature verification: static and dynamic. Static(off-line) verification is the process of verifying an electronic or document signature after it has been made, while dynamic(on-line) verification takes place as a person creates his/her signature on a digital tablet or a similar device. Offline signature verification is not efficient and slow for a (...) large number of documents. To overcome the drawbacks of offline signature verification, we have seen a growth in online biometric personal verification such as fingerprints, eye scan etc. In this paper we created CNN model using python for offline signature and after training and validating, the accuracy of testing was 99.70%. (shrink)

This article draws attention to the limited amount of scholarship on what constitutes fairness and equity in resource allocation to health research by individual funders. It identifies three key decisions of ethical significance about resource allocation that research funders make regularly and calls for prioritizing scholarship on those topics – namely, how health resources should be fairly apportioned amongst public health and health care delivery versus health research, how health research resources should be fairly allocated between health problems experienced domestically (...) versus other health problems typically experienced by disadvantaged populations outside the funder's country, and how domestic and non-domestic health research funding should be further apportioned to different areas, e.g. types of research and recipients. These three topics should be priorities for bioethics research because their outcomes have a substantial bearing on the achievement of health justice. The proposed agenda aims to move discussion on the ethics of health research funding beyond its current focus on the mismatch between worldwide basic and clinical research investment and the global burden of disease. Individual funders’ decision-making on whether and to what extent to allocate resources to non-domestic health research, health systems research, research on the social determinants of health, capacity development, and recipients in certain countries should also be the focus of ethical scrutiny. (shrink)

Several protective cellular mechanisms protect against the accumulation of reactive oxygen species (ROS) and the concomitant oxidative stress. Therefore, any reduction in glucose or fatty acid flux into cells leading to a decrease in the production of reducing equivalents would also lead to a decreased ROS production and protect cells against oxidative stress. In the presence of insulin, FOXO proteins are localized from the nucleus to the cytoplasm and degraded. An increase in cellular glucose uptake will lead to increased production (...) of ROS. This in turn activates the stress‐responsive Jun‐N‐terminal kinase (JNK), which promotes nuclear translocation of FOXO proteins, upregulating some important target genes including stress resistance. Consequently, insulin resistance should result in decreased cellular ROS production. For this reason, insulin resistance could be a physiological mechanism activated at the cellular level in response to conditions stimulating ROS production and leading to the prevention of oxidative stress, and extension of life. Concerning the whole organism, however, IR is a maladaptive process in the long term causing a diabetic state. BioEssays 29:811–818, 2007. © 2007 Wiley Periodicals, Inc. (shrink)

Ways of Being Free: Introduction -- War Is Everything's Father: History and Death as Causes of Existential Angst -- Introduction: Causes of Existential Angst -- Change and Changelessness in Midnight's Children -- The Road of Existential Struggle in The Famished Road -- History and the "Nervous Condition" in The English Patient -- Death as a Drive to Meaningful Existence in Midnight's Children -- Becoming Dead-to-the-World in The English Patient -- Ideological Re-appropriation through Death in The Famished Road -- Authenticity -- (...) Authenticity: Introduction -- From Self-Sufficiency to Inoperative Community in The English Patient -- Revolution Revisited in The Famished Road -- From Communalism to the Comic Absurd in Midnight's Children. (shrink)

Alzheimer’s disease is the most common form of dementia which is estimated to impact 350,000 people over 65 years of age in Canada. The lack of effective treatment and the growing number of people who are expected to be diagnosed with Alzheimer’s disease in the near future are compelling reasons why continued research is in this area is necessary. With additional research, there needs to be greater recognition of the complexity of seeking ongoing informed consent from those with Alzheimer’s disease. (...) This complexity is because the impairment of memory and cognitive ability does not diminish in a linear manner, but rather fluctuates between periods of impairment and relatively normal cognitive lucidness. There is limited discussion in the guidelines of those progressing from early stages of Alzheimer’s disease who have intermittent cognitive function. Guidelines to research and Research Ethics Boards require further development to facilitate researcher including those with Alzheimer’s disease while protecting this growing pool of potential participants. (shrink)

Business Ethics, the Environment &Responsibility, EarlyView.

ABSTRACT In recent years there has been intense debate regarding the level of medical care provided to ‘standard care’ control groups in clinical trials in developing countries, particularly when the research sponsors come from wealthier countries. The debate revolves around the issue of how to define a standard of medical care in a country in which many people are not receiving the best methods of medical care available in other settings. In this paper, we argue that additional dimensions of the (...) standard of care have been hitherto neglected, namely, the structure and efficiency of the national health system. The health system affects locally available medical care in two important ways: first, the system may be structured to provide different levels of care at different sites with referral mechanisms to direct patients to the appropriate level of care. Second, inefficiencies in this system may influence what care is available in a particular locale. As a result of these two factors locally available care cannot be equated with a national ‘standard’. A reasonable approach is to define the national standard of care as the level of care that ought to be delivered under conditions of appropriate and efficient referral in a national system. This standard is the minimum level of care that ought to be provided to a control group. There may be additional moral arguments for higher levels of care in some circumstances. This health system analysis may be helpful to researchers and ethics committees in designing and reviewing research involving standard care control groups in developing country research. (shrink)

We address in this paper the problem of counting the models of a propositional theory under incremental changes to its literals. Specifcally, we show that if a propositional theory Δ is in a special form that we call smooth, deterministic, decomposable negation normal form, then for any consistent set of literals S, we can simultaneously count the models of Δ ∪ S and the models of every theory Δ ∪ T where T results from adding, removing or flipping a literal (...) in S. We present two results relating to the time and space complexity of compiling propositional theories into sd-DNNF. First, we show that if a conjunctive normal form has a bounded treewidth, then it can be compiled into an sd-DNNF in time and space which are linear in its size. Second, we show that sd-DNNF is a strictly more space efficient representation than Free Binary Decision Diagrams. Finally, we discuss some applications of the counting results to truth maintenance systems, belief revision, and model-based diagnosis. (shrink)

Recent work has shown that the input-output behavior of some common machine learning classifiers can be captured in symbolic form, allowing one to reason about the behavior of these classifiers using symbolic techniques. This includes explaining decisions, measuring robustness, and proving formal properties of machine learning classifiers by reasoning about the corresponding symbolic classifiers. In this work, we present a theory for unveiling the _reasons_ behind the decisions made by Boolean classifiers and study some of its theoretical and practical implications. (...) At the core of our theory is the notion of a _complete reason,_ which can be viewed as a necessary and sufficient condition for why a decision was made. We show how the complete reason can be used for computing notions such as sufficient reasons (also known as PI-explanations and abductive explanations), how it can be used for determining decision and classifier bias and how it can be used for evaluating counterfactual statements such as “a decision will stick even if...because....” We present a linear-time algorithm for computing the complete reasoning behind a decision, assuming the classifier is represented by a Boolean circuit of appropriate form. We then show how the computed complete reason can be used to answer many queries about a decision in linear or polynomial time. We finally conclude with a case study that illustrates the various notions and techniques we introduced. (shrink)

Are the employees working in different countries and enjoying healthy compensation truly loyal to their organization? Our study attempts to answer this question by examining the role of perception of politics on the affective commitment of expatriates in the Sultanate of Oman. Following the axiom of equity theory, the relationships between the perception of politics (POP) to affective commitment (AC) and Islamic work ethics (IWE) to affective commitment (AC) was tested. The moderating role of Islamic work ethics was also examined (...) in the POP-AC relationship. Responses from 146 employees were collected following a simple random sampling technique. Employees working in different organizations at various managerial levels were approached for data collection. Descriptive statistics, correlation, and regression tests were applied to test hypotheses using SPSS-22.0 and SmartPLS-4. Results confirmed the positive relationship between Islamic work ethics to affective commitment and the negative relationship between perception of politics to affective commitment. Moreover, the negative relationship between the perception of politics with affective commitment was weaker when Islamic work ethics were high. Practical implications of the study are presented based on the results. (shrink)

We address in this paper the problem of counting the models of a propositional theory under incremental changes to its literals. Specifcally, we show that if a propositional theory Δ is in a special form that we call smooth, deterministic, decomposable negation normal form (sd-DNNF), then for any consistent set of literals S, we can simultaneously count (in time linear in the size of Δ) the models of Δ ∪ S and the models of every theory Δ ∪ T where (...) T results from adding, removing or flipping a literal in S. We present two results relating to the time and space complexity of compiling propositional theories into sd-DNNF. First, we show that if a conjunctive normal form (CNF) has a bounded treewidth, then it can be compiled into an sd-DNNF in time and space which are linear in its size. Second, we show that sd-DNNF is a strictly more space efficient representation than Free Binary Decision Diagrams (FBDDs). Finally, we discuss some applications of the counting results to truth maintenance systems, belief revision, and model-based diagnosis. (shrink)

History in this age needs to record and analyze the events in the light of modern concept of contemporary world. When the historians narrate the brutal condition of Indo-Pak history, they never forget the work and services of Shaykh Ahmad Sirhindi to transform the society according to the current values. For his services, he is hailed as Mujaddid Alf-I-Thani. The Muslim society had degenerated when Mujaddid Alf-I-Thani appeared on the horizon. A number of Hindu customs and practices had become the (...) part of their creed. The commandments of Shariat and Sunnah were being floated. Moreover, the Mughal emperor Akbar had adopted controversial policies detrimental to the very existence of Muslim society. Mujaddid Alf -Thani made strenuous and constant efforts to turn the tide. When Mujadded-Alf-Thani started his social reform movement, he found that the Muslim society was embracing un-Islamic practices such as widespread belief in Karamat had developed under the influence of Hindu thinking. Moreover, the Islamic teachings had been vitiated by adopting customs and practices of other religions such as inter marriages between Hindus and Muslims and ban on cow slaughter etc. Shaykh Ahmad Sirhindi never entered into any political conflict directly. He endeavored to restore pure doctrine to Islamic thought and to compel the Muslims to follow Shariat and Sunnah in letter and spirit. He was a social reformer, great Alim, Sufi and Mujaddid. He initiated a process of social change, inspired by Islamic Ideal, in an age, which was becoming secular. This research paper is an attempt to mention the role of Shaykh Ahmad Sirhindi for saving the society from un-Islamic values and customs in the sub-continent and its impact on society. By utilizing the historical method, this paper aims at analyzing the effect of social reforms of Shaykh Ahmed Sirhindi on Muslim society. (shrink)

Given that health systems research involves different aims, approaches, and methodologies as compared to more traditional clinical trials, the ethical issues present in HSR may be unique or particularly nuanced. This article outlines eight pertinent ethical issues that are particularly salient in HSR and argues that the ethical review process should be better tailored to ensure more efficient and appropriate oversight of HSR with adequate human protections, especially in low- and middle-income countries. The eight ethical areas we discuss include the (...) nature of intervention, types of research subjects, units of intervention and observation, informed consent, controls and comparisons, risk assessment, inclusion of vulnerable groups, and benefits of research. HSR involving human participants is necessary to ensure health systems strengthening and quality of care and to guide public policy intelligently. Health systems researchers must carefully define their intent and goals and openly clarify the values that may influence the premises and design of protocols. As new types of population-level research activities become more commonplace, it is critical that institutional review board and research ethics committee review processes evolve to evaluate these research protocols in ways that address the nuanced features of these studies. (shrink)

The early period Ismaili jurist Al-Qādî al-Nu'mān appears as an important figure in the formation of Ismaili jurisprudence. There is very little information about Kadı Nu'mân's family, childhood, education and intellectual environment. His full name is Abû Hanîfah Nu'man b. Muhammad b. Mansûr al-Qādî at-Tamîmî Al Qayrawānî. He was born around 290/903 (late 3rd (9th) century) into an educated family in Qayravan in North Africa. There are different opinions about the sect he belonged to when he was growing up. On (...) the other hand, it is difficult to say for certain whether Nu’mān received education in the Ismaili sect due to the understanding of taqiyya in the madhhab. However, it is understood from the basic jurisprudence texts Nu’mān wrote that he most likely did not receive a Sunni education. Historians refer to him as 'Qadi Nu’mān or Abu Hanifah al-Shi'i' in order not to confuse him with the imam of the Hanafi school. Qādî Nu’mān served at different levels of the Fatimid State. Around 313/925, he entered the service of the first Fatimid caliph, Mahdi (r. 909-934 CE/297-322 AH), as a copyist and secretary. During the reigns of the third caliph Mansur and the fourth Fatimid caliph Mu’izz (d. 365/975), Qādî Nu’mān first served as a judge in Tripoli and then in Mansouriya, the Fatimid capital. After the Fatimids conquered Egypt and the center of government was moved to Cairo, Qādî Nu’mān was appointed by the fourth caliph Mu’izz as the head of the appellate courts (maẓālim). Qadi Numans career was at the peak in the period of Caliph Muiz. Qādî Nu’mān worked as a judge in the Fatimid State for about twenty-six years and continued this duty until his death in 363 (973). After the fall of the Fatimid caliphate, there haven’t been any other Fatimid or Ismaili jurists. Qādî Nu’mān is considered by contemporary Ismaili writers as a figure who systematically transformed Ismaili fiqh into an independent sect of fiqh. It can be said that Ismaili fiqh was developed through his works in the Fatimid period. His works continued as the main references in the fiqh studies and after the Fatimid period. With the death of Qādî Nu’mān, the period of ijtihad in Ismaili fiqh and its the establishment phase of Ismaili fiqh came to an end; The sect, in which esoteric interpretations were at the forefront, emerged as a distinctive school of fiqh by discarding ambiguity. Qādî Nu’mān was a very productive writer. He wrote important works related to the field of furu al-fiqh and usûl al-fiqh. Among his works, Ikhtilāf uṣūl al-madhāhib is undoubtedly one of the most important works in the early history of fiqh methodology. The work in question, which was originally written with the aim of rejecting the Sunni fiqh method, discusses the approaches of the Sunni schools of fiqh on ikhtilāf, taqlid, ijma, nazar, qiyas, istihsan, ijtihad and ra’y in a polemical manner. It reveals the differences of the Ismaili method from the Sunni method in terms of the sources on which the fiqh is based, the authority to make ijtihad and the theory of interpretation of the texts. Qādî Nu’mān examined the relationship between reason and revelation in general and the role of religious authority in comprehending and interpreting the texts while criticizing Sunni methods. Ikhtilāf uṣūl al-madhāhib has the characteristics of the works of development period as a form. It is possible to observe the question-answer and dialectic form which can be seen in the works of the development period throughout the work in question. Qādî Nu’mān endeavoured to persuade his opponents with a dialectical and argumentative style. Again, he replied to the Sunnis, who were his interlocutors, with their own proofs. In addition to these, Ikhtilāf uṣūl al-madhāhib has a unique feature in the matter of content. Because it is not very familiar to any Sunni handbook of usûl al-fiqh. It does not mention the hâss, âmm, ijma, qiyas, amir, nahy, alfaz bets, etc. The text is very similar to the Ahbari movement of the Jafari sect for it rejects all forms of ijtihad. It was written at a time when fiqh was not yet stable. Ikhtilāf uṣūl al-madhāhib gives us crucial information about the development of different usûl and fiqh sources in the middle of the fourth century. However, what is interesting here is that the information he gives about Ismaili method and fiqh is very little compared to the one about Sunni method and fiqh. Much of it centered on Sunni thought and its rejection. However, his ultimate goal was to defend the Ismaili doctrine. (shrink)

With developed country governments and high resource institutions engaging in research in low- and middle-income countries, we argue that these entities have a moral obligation to help build and strengthen research infrastructure and capacity so local scientists and institutions can adequately conduct studies to understand and resolve the health burdens in low and middle income countries. We explore the moral justifications and motivations behind engaging in research capacity strengthening in the health sector in LMIC at multiple levels. In highlighting these (...) issues, this paper aims to initiate a global discourse around why capacity development in LMIC has a moral basis at the individual, institutional and system levels. (shrink)

Despite the fact that in order to become a liveable space for humankind the world owes many things to the scientific point of view, to fill that space with meaning so that it can be our home, is only possible due to the aesthetic relation which man establishes with life. The meaning which is required so that man could make sense of this space can only be brought into this world through the fictional strength of language. Existence which in itself (...) alone is meaningless, indifferent and neutral can only become a stage where humanity dares to appear, thanks to the attributes that it gains through the act of making sense. By overlooking that point the theoretical approach which is symbolized by the Enlightenment destroys according to Nietzsche the basics of the relation between man and life. Today the scientific and technological Perspective which have become the forces of our culture and civilization have already withdrawn themselves from the question of the meaning of life to the point of ignoring its importance. On the other side, due to its natural mechanism, the advantage which the artistic approach possesses comes from the capacity to transform the reality through fiction. Hence, art is maybe one of the most important accomplishments which contributes to the creation of meaning so that man won't perish against this essential indifference of existence. (shrink)

Özgür istemeyi bir illüzyona dönüştüren deterministik öğelere sahip olan bir ideoloji içerisinde insan varoluşunun anlamsız ve saçma bir nitelik arz edeceğini düşünen Dostoyevski, Yeraltından Notlar’da kurguladığı yeraltı adamı karakteri aracılığıyla, doğa yasalarını temel alan ve Çernişevski gibi materyalist düşünürler tarafından savunulan toplumsal mühendislik fikrinin hiçbir şekilde uygulamaya konulmayacağını göstermek ister. Bunu gerçekleştirmek için dolaylı bir yol izleyen ve yeraltı adamı aracılığıyla determinist bir ideolojinin penceresinden dünyaya bakan bir karakter yaratan Dostoyevski, bu karakterin bakışından hareketle tüm insani edimlerin zorunlu bir nedensellik (...) tarafından belirlendiğini idrak eden bilincin verdiği irrasyonel, çelişkili ve bir anlamda saçma tepkileri gün yüzüne çıkarır. Karşıt olduğu öğretinin perspektifinden bir anlatı ortaya koyan Dostoyevski böylece materyalist bir determinizm ileri süren ideolojiyi adeta içeriden çürütmeye çalışır. Bu makalenin amacı Dostoyevski’nin Yeraltından Notlar’ını takip ederek, istemelerini, arzularını ve seçimlerini özgürce hayata geçiremeyeceğinin bilincine varan yeraltı adamının düştüğü çelişkili varoluşu irdelemek ve böylece determinist öğretilerin kabul edilmesi güç olan pratik sonuçlarını anlaşılır kılmaktır. (shrink)

The increase in the volume of research conducted in Low and Middle Income Countries (LMIC), has brought a renewed international focus on processes for ethical conduct of research. Several programs have been initiated to strengthen the capacity for research ethics in LMIC. However, most such programs focus on individual training or development of ethics review committees. The objective of this paper is to present an approach to institutional capacity assessment in research ethics and application of this approach in the form (...) of a case study from an institution in Africa. (shrink)

ABSTRACT Post-abortion care (PAC) research is increasingly being conducted in low- and middle-income countries (LMICs) to help reduce the high burden of unsafe abortion. This study aims to help address the evidence gap about ethical challenges that researchers in LMICs face when carrying out PAC research with adolescents. Employing an explorative qualitative approach, the study identified several ethics challenges encountered by PAC researchers in Zambia, including those associated with seeking ethics and regulatory approvals at institutional and national levels. Persistent stigma (...) around abortion and community perceptions that PAC studies encourage adolescents to seek abortion affected adolescents’ right to exercise their autonomy and to make decisions as well as exposed adolescents to social stigmatization risks. Challenges with recruitment was reported to result in abandoning of studies, thereby undermining development of PAC services that are more responsive to adolescent needs. Training needs identified included knowledge of best practices for conducting and disseminating PAC research. Strategies for addressing the ethical challenges included trust building and using less value-laden terminology when seeking permission and consent. It is essential to the future of PAC research in Zambia and globally that these important challenges be addressed through the development of comprehensive ethics guidance. (shrink)

ABSTRACT The amount of biomedical research being conducted around the world has greatly expanded over the past 15 years, with particularly large growth occurring in low- and middle-income countries (LMICs). This increased focus on understanding and responding to disease burdens around the world has brought forth a desire to help LMIC institutions enhance their own capacity to conduct scientifically and ethically sound research. In support of these goals the Johns Hopkins-Fogarty African Bioethics Training Program (FABTP) has, for the past six (...) years, partnered with three research institutions in Africa (University of Botswana, Makerere University in Uganda, and the University of Zambia) to support research ethics capacity. Each partnership began with a baseline evaluation of institutional research ethics environments in order to properly tailor capacity strengthening activities and help direct limited institutional resources. Through the course of these partnerships we have learned several lessons regarding the evaluation process and the framework used to complete the assessments (the Octagon Model). We believe that these lessons are generalizable and will be useful for groups conducting such assessments in the future. (shrink)

ABSTRACT There are disagreements among ethicists on what comprises an “appropriate” good to offer research participants. Debates often focus on the type, quantity, timing, and ethical appropriateness of such offers, particularly in settings where participants may be socio-economically vulnerable, such as in parts of Zambia. This was a Cross-sectional online survey of researchers and Research Ethics Committees (RECs) designed to understand practices, attitudes and policies associated with provision of goods to research participants. Of 122 responding researchers, 69 met eligibility criteria. (...) Responses were also received from five of the six Zambian RECs involved in reviewing research proposals. Forty-nine researchers (71.0%) confirmed previous experience offering goods to participants. Of these, 21 (42.9%) offered participants money only, 18 (36.7%) offered non-monetary goods, while the rest offered both monetary and non-monetary goods. Generally, goods were offered and approved by RECs to compensate for time, lost wages and transportation. One REC and 34.8% of researchers reported being subject to an institutional policy on offering goods to participants. While reimbursement is the main reason for offering goods to participants in Zambia, caution is required when deciding on the type and quantity of goods to offer given the potential for community mistrust and manipulation. (shrink)