bluuebunny/crossref_metadata_2025 huggingface dataset:
P016 IMPROVING TUBERCULOSIS RE SCREENING IN INFLAMMATORY BOWEL DISEASE PATIENTS RECEIVING BIOLOGIC THERAPY: A SINGLE CENTER QUALITY IMPROVEMENT INITIATIVE.
Authors: Drevno David , Hickok Sherry , Ali Sabina
Published: January 2020

Background

Biological agents have revolutionized the management of inflammatory bowel disease (IBD). There is a known increased risk of tuberculosis (TB) reactivation with biologic therapy (1). ACG guidelines recommend screening for active and latent TB infection (LTBI) prior to starting certain biologic agents (2). However, there are no consensus guideline on the utility of yearly screening testing in IBD patients without TB risk factors. With a number of patients now receiving the biologic therapy outside their primary care centers it has become increasingly difficult to effectively provide ongoing TB screening. With this quality improvement exercise, we aim to improve TB re-screening in patients receiving biologics by completing a yearly phone screening for exposure history.

Method

An interdisciplinary team from GI and ID developed a TB risk factor screening questionairre, adapting the California Department of Public Health’s Pediatric TB Risk Assessment tool (3). A list of patients receiving biologics was sorted by month of birth in the EMR. When the current calendar month aligned with the patient’s birth month, a GI RN reviewed the TB questionnaire with the patient (≥18 yo) and/or legal guardian by phone. If one or more TB risk factors were identified, the GI RN would notify the provider and a QuantiFERON-TB Gold (QFT) was ordered to be completed.

Results

60 patients were found on biologic therapy (median age 17 yo) (38 males, 22 females) (68% CD, 28% UC, 3.3% IBD-U)(75% IFX, 12% ADA, and 3% other) to be to eligible TB screening between January - July 2019, 48 patients completed the phone screening. All 61 patients had completed TB screening prior to starting biologic therapy, which was reported to be negative. 13 patients were unable to be reached. 6/48 were identified as having at least 1 risk factor for TB. 5/6 patients with a positive screen had a negative QFT. 1 patient was away at college and a request to his adult GI managing his biologic was sent.

Conclusion

Screening for LTBI is required prior to starting a biologic therapy, though there are no guidelines for routine TB screening following initiation of the biologic. We propose performing an annual phone screening for TB exposure history for IBD patients on biologic therapy. QTF testing remains appropriate in patients with potential risk factors, such as being a health care worker or travel to/living in high endemic TB regions.

References
P028 URGENT MEDICAL ACCESS FOR PATIENTS WITH INFLAMMATORY BOWEL DISEASE AT A PRIVATE COMMUNITY GASTROENTEROLOGY PRACTICE
Authors: Kwon Michelle , Tse Chung Sang , Danielewicz Michael , van Deen Welmoed , Shah Samir
Published: January 2020

Background

Patients with inflammatory bowel disease (IBD) have chronic, life-long diseases with relapsing-remitting pattern that often require frequent utilization of healthcare services.[1] Urgent access to specialty care can help identify patients with acute medical needs so they can receive appropriate care in a timely manner. This can avoid unnecessary high-cost medical interventions, such as visits to the emergency department (ED), which often lead to excess use of steroids, narcotics, and radiographic imaging, all important measures of quality of IBD care.[2] We sought to introduce an access/quality improvement program at a private gastroenterology practice with the goal of triaging and returning urgent calls from IBD patients in a timely manner and mitigate avoidable visits to the ED.

Methods

Gastroenterologists, nurses, and support staff at our private practice developed four criteria for “urgent” IBD calls: new, severe abdominal pain; new, severe anal pain; fever greater than 101 Fahrenheit; and refractory emesis. Patient calls that met any of these criteria were highlighted with a red flag and labelled as “IBD URGENT” by support staff in the electronic medical system. The primary gastroenterologist (or covering provider) then responded to these calls as soon as possible with a goal of responding within 4 hours. Subsequently, patients were advised to go to the ED for further emergent evaluation, given same/next day clinic visits, and/or given advice, such as medication changes, by the gastroenterologists.

Results

Over a 15-month period from June 2018 to August 2019, we received a total of 167 “IBD URGENT” calls (average 11 calls per month); of these, 92% (153 calls) received a response from a gastroenterologist within 4 hours. Abdominal pain, diarrhea, blood in the stools, and vomiting were the most common reasons for urgent calls. Only 10% (16 calls) of calls were patients with worrisome symptoms in which they were advised to go to the ED, 37% of calls led to same/next day clinic visits (62 calls), and 58% resulted in advice/orders from the gastroenterologist such as laboratory testing, medication continuation/changes (97 calls); 12% (20 calls) resulted in both urgent clinic visits and advice (e.g., obtain laboratory testing and then present for office visit).

Conclusion

We piloted an urgent care hotline for IBD patients to receive rapid medical access at a private community gastroenterology practice. The majority of patients were successfully managed with outpatient medical care, including same/next-day office visits and advice for laboratory testing/medication changes. Only a minority (10%) of calls resulted in ED visits. We plan to continue this project with the aim to return more than 90% of the urgent calls within 4 hours.

References
P049 RESPONSIVENESS OF THE PATIENT-REPORTED OUTCOME MEASUREMENT INFORMATION SYSTEM (PROMIS) TO CHANGES IN DISEASE STATUS AND QUALITY OF LIFE AMONG PEDIATRIC PATIENTS WITH CROHN’S DISEASE
Authors: Brenner Erica , Long Millie , Mann Courtney , Chen Wenli , Reyes Camila , Lin Li , Reeve Bryce , Kappelman Michael
Published: January 2020

Background

Patient Reported Outcome Measurement Information System (PROMIS) provides valid, self-reported measures of physical, emotional, and social health that can inform research and clinical care in children with chronic conditions. Prior research in pediatric Crohn’s disease (CD) has demonstrated robust correlations between PROMIS and disease activity. However, responsiveness, defined as sensitivity to clinical change, has not been yet been thoroughly evaluated.

Aims

We sought to evaluate the responsiveness of the PROMIS Pediatric measures relative to changes in 1) disease activity and 2) disease-specific health-related quality of life (HRQOL).

Methods

IBD Partners Kids & Teens is an internet-based cohort of children with IBD. Participants age 9 to 17 report symptoms related to disease activity [Short Crohn’s Disease Activity Index (SCDAI)], the IMPACT III HRQOL measure, and PROMIS domains of Anxiety, Depression, Pain Interference, Fatigue, and Peer Relationships. We conducted longitudinal analyses using mixed linear models to examine the extent to which PROMIS measures were responsive to changes in SCDAI and IMPACT III, adjusting for time and taking into account the clustering of individual participants. A change threshold of 70 points in SCDAI was used as a minimally important difference (MID). We also graphically depicted changes in PROMIS domains corresponding to improved, stable, or worsened disease activity and evaluated changes in PROMIS versus changes in IMPACT III using Pearson’s correlation.

Results

Our study sample included 544 participants with CD (mean age 13 years, 44% female) from 44 states. All PROMIS domains were responsive to changes in SCDAI, indicating improved physical, emotional, and social health corresponding to improved disease activity (Table 1, p< 0.001). Observed effect estimates ranged from 1.9 for Peer Relationships to 6.9 for Fatigue, in line with estimates of MID in both adult IBD and other pediatric chronic conditions. Of 246 participants with 2 or more completed reports (689 pairs of consecutive reports), disease activity was stable in 527, worse in 72, and improved in 67. Figure 1 demonstrates changes in PROMIS scores as a function of change in disease activity. Changes in PROMIS scores were also strongly associated with changes in IMPACT 35 scores (R=-0.5 for Anxiety, R=-0.5 for Depression, R=-0.6 for Pain Interference, R= -0.7 for Fatigue, and R=0.35 for Peer Relationships).

Conclusion

This study provides evidence for the longitudinal responsiveness of the PROMIS Pediatric measures to change in disease status and HRQOL in pediatric CD patients. The results support use of the PROMIS Pediatric measures in clinical outcomes research.
26 USTEKINUMAB DOSE ESCALATION EFFECTIVE IN REAL-WORLD USE FOR LUMINAL AND PERIANAL CROHN’S DISEASE
Authors: Glass Jason , Alsamman Yasser , Chittajallu Punya , Ahmed Tasneem , Fudman David
Published: January 2020

Introduction

Ustekinumab (UST) is effective for induction and maintenance of remission in Crohn’s disease (CD) as demonstrated in the UNITI trials. There is paucity of data in real world experience for dose escalation with UST, particularly for perianal disease. This study examines the effectiveness and safety of dose escalation in both luminal and perianal CD at a tertiary IBD referral center.

Methods

A retrospective, single center cohort study was conducted at the University of Texas Southwestern Medical Center examining outcomes of UST dose escalation in CD. Dose escalation was defined as increasing frequency to every four or six weeks. The primary outcomes were improvement in perianal disease as documented by the treating clinician and a composite outcome reflecting disease response. Patients who met the composite outcome had at least one of the following: steroid-free clinical response, objective improvement in disease activity on follow up CT, MRI or endoscopy, or normalization of CRP. Secondary outcomes included IBD-related surgery and adverse events. Patients were followed up to 6 months after dose intensification.

Results

38 patients underwent dose intensification. 28 patients (74%) were escalated to every 4 week dosing and 10 patients (26%) were escalated to every 6 weeks. Baseline characteristics were recorded (see Table 1). 18/38 (48%) were escalated for primary non-response. Median time from UST induction to dose escalation was 10 months (IQR 2–24 months). Following escalation, patients were followed for a medianof 4.5 months (range 1–6 months). Nearly all (92%) patients had prior exposure to anti-TNF therapies and 74% had prior exposure to an anti-integrin therapy. Pre-escalation inflammatory markers included median CRP of 9.55 mg/Land median fecal calprotectin of 340 μg/mg. Median UST trough prior to escalation was 1.3 μg/mL(IQR 0.8–2.1).

Overall, half (19/38) of patients who underwent dose escalation met the primary composite outcome of disease response and 50% (12/24) of patients with active perianal disease showed evidence of improvement after escalation. 60% (6/10) of the patients on steroids at time of escalation achieved steroid-free response. 72% (8/11) of those who underwent follow-up endoscopy showed endoscopic improvement. 50% (6/12) of patients who had radiographic follow-up showed signs of improvement. 27% (9/33) had normalization of CRP after dose escalation. 8% (3/38) patients required an IBD-related surgery after dose escalation. Two patients had adverse events recorded (see table 3).

Conclusion

Patients who underwent UST dose escalation demonstrated improvement in perianal disease as well as steroid-free clinical, endoscopic, radiographic, and biochemical response. No increase in serious adverse events was seen in this cohort. Dose escalation is an effective option for non-responders to every 8-week dosing.
Human Papillomavirus Genotype Replacement: Still Too Early to Tell?
Authors: Man Irene , Vänskä Simopekka , Lehtinen Matti , Bogaards Johannes A
Published: January 2020

Background

Although human papillomavirus (HPV) vaccines are highly efficacious in protecting against HPV infections and related diseases, vaccination may trigger replacement by nontargeted genotypes if these compete with the vaccine-targeted types. HPV genotype replacement has been deemed unlikely, based on the lack of systematic increases in the prevalence of nonvaccine-type (NVT) infection in the first decade after vaccination, and on the presence of cross-protection for some NVTs.

Methods

To investigate whether type replacement can be inferred from early postvaccination surveillance, we constructed a transmission model in which a vaccine type and an NVT compete through infection-induced cross-immunity. We simulated scenarios of different levels of cross-immunity and vaccine-induced cross-protection to the NVT. We validated whether commonly used measures correctly indicate type replacement in the long run.

Results

Type replacement is a trade-off between cross-immunity and cross-protection; cross-immunity leads to type replacement unless cross-protection is strong enough. With weak cross-protection, NVT prevalence may initially decrease before rebounding into type replacement, exhibiting a honeymoon period. Importantly, vaccine effectiveness for NVTs is inadequate for indicating type replacement.

Conclusions

Although postvaccination surveillance thus far is reassuring, it is still too early to preclude type replacement. Monitoring of NVTs remains pivotal in gauging population-level impacts of HPV vaccination.
Reliability of the Service Trip Audit Tool to assess the quality of short-term medical missions
Authors: Dainton Christopher , Gorman Christina , Cherniak William , Lopez Lorena , Chu Charlene H
Published: January 2020

Background

We aimed to assess the adherence of short-term medical missions (STMMs) operating in Latin America and the Caribbean (LAC) to key best practices using the Service Trip Audit Tool (STAT) and to calculate the inter-rater reliability of the data points. This tool was based on a previously published inventory of 18 STMM best practices.

Methods

Programme administrators and recent volunteers from 335 North American organizations offering STMMs in LAC were invited to complete the STAT anonymously online. Adherence to each of 18 best practices was reported as either ‘yes’, ‘no’ or ‘not sure’. Fleiss’ κ was used to assess inter-rater agreement of the responses.

Results

A total of 194 individuals from 102 organizations completed the STAT (response rate 30.4%; 102/335 organizations) between 12 July and 7 August 2017. Reported adherence was >80% for 9 of 18 best practices. For 37 non-governmental organizations (NGOs) with multiple raters, inter-rater agreement was moderate to substantial (κ>0.4) for 12 of 18 best practices.

Conclusions

This is the first study to evaluate adherence to STMM best practices. Such an objective evaluation will be valuable to governments, volunteers and NGO donors who have an interest in identifying high-quality partners. Assessment and monitoring of STMMs through self-audit may be foundational steps towards quality improvement.
Toxicological and Demographic Profiles of Phencyclidine-Impaired Driving Cases in Houston
Authors: Lee Dayong , Stout Peter
Published: January 2020

Phencyclidine (PCP) was first synthesized in 1926 and originally developed in 1950s as a general anesthetic agent. Abuse of PCP declined at the national level since its first illicit use in 1960s, but it continues in certain areas including Houston. This research evaluates PCP-positive cases of driving while intoxicated (DWI) in 2013–2018. The blood samples were collected from drivers, submitted by the Houston Police Department and analyzed for alcohol and drugs. Toxicological findings and demographic information were evaluated for the impaired driving cases tested positive for PCP in blood. Additionally, the Drug Recognition Expert (DRE) findings were examined for 12 cases in 2018. A total of 615 DWI cases positive for PCP in blood were identified in which the traffic offense occurred between August 2013 and December 2018. The mean (median, range) PCP concentration was 47 (43, 7–180) ng/mL. A total of 23% of those cases were females, and 77% were males; 85% were blacks, 10% were whites and 5% were other races/ethnicities as identified by the arresting officer. The mean age was 37 years. No significant differences in median and distribution of PCP concentrations (P’s > 0.05) were observed across the offense years and among demographic cohorts. A total of 43% of the cases were positive for PCP only. Among the remaining 57%, cannabinoids are the most common concurrently detected analytes (35%), followed by cocaine/metabolite (14%) and ethanol (13%). The proportion of black male PCP-positive drivers decreased in younger age groups. Common indications observed by DRE officers included slurred speech, chemical breath odor, watery and/or bloodshot eyes, vertical/horizontal gaze nystagmus and impaired coordination/balance. This study provides valuable regional information to better understand the demographic patterns of PCP-impaired drivers in Houston, TX over 6 years. The findings may aid in designing and implementing regulations and prevention programs to reduce PCP-impaired driving.
Law’s boundaries: Connections in contemporary legal professionalism
Authors: Francis Andrew
Published: January 2020

Legal service markets and their professions are transforming through market liberalization, regulatory disruption, and a broader set of societal shifts. This article argues that the nature and scale of these changes require a re-evaluation of the role that rigid jurisdictional boundaries play within the system of the legal professions. Legal Professionalism developed on the basis of strong control over its professional boundaries. Recent discussion of the contemporary legal services market has focused on the competitive threat that new entrants bring to these established boundaries. This article argues that such a focus underplays the nature of the disruption across boundaries of expert knowledge. It focuses on legal services as an exemplar site of regulatory disruption to professional boundaries and draws on the analysis of two key sites (Alternative Business Structures and Wealth Management) to ask what is the nature of connected claims of expertise and what drivers for connectivity do they indicate? Through this analysis of connected professional claims within legal services, this article focuses attention on a new approach to professional work that is becoming more important. In doing so, it advances the research agenda on professions and organizations, not just within legal services in England and Wales, but for other professional sectors and other jurisdictions.
Asymptomatic cecal perforation and ileocecal fistula after intrauterine device migration: a case report
Authors: Almarhabi Yahya
Published: January 2020

Implantation of an intrauterine device (IUD) is a common method for long-term contraception. However, IUDs can cause colon perforation and fistula formation. We report a case of cecal perforation and ileocecal fistula secondary to IUD migration. The present study investigated incidental identification of a missing IUD after 9 years of deployment in a 35-year-old female with a three-year history of infertility. Abdominal imaging revealed a missing IUD. Intracecal perforation and ileocecal fistula consequent of IUD migration were identified during surgical exploration. Limited ileocecal resection was performed as an appropriate and safe surgical option. IUD migration can present with serious complications. Patients considering IUDs should be educated about the importance of regular check-ups to monitor the position of the IUD. Thorough examination should be carried out if a missing IUD string is reported.
French Slave Trade on Madagascar: A Quantitative Approach
Authors: Thiébaut Rafaël
Published: January 2020

This article provides a better understanding of the volume of the French slave trade on Madagascar. Indeed, while research on the European slave trade in the Atlantic has benefitted much from statistical data, the slave trade in the Indian Ocean still lags behind, despite new scholarship. Based on detailed archival research, this article systematically analyzes different aspects of this commerce, including the organization of the trade, the age-sex ratio of the enslaved, and their mortality during the middle passage. Taking the number of French expeditions as a basis, we are able to determine the number of slaves traded with greater accuracy than was previously possible. Through this calculation, this article will shed new light on the patterns of slave trade in the Indian Ocean.
Retos en construcción de traductores automáticos para lenguas indígenas de México
Authors: Mager Manuel , Meza Ivan
Published: January 2020

La traducción automática es una herramienta que aún con sus limitaciones permite el acceso a ideas e información entre lenguas. Su adopción para las lenguas indígenas de México podría revalorizarlas ante los hablantes que se enfrentan a la situación de qué sistemas digitales no las usan en sus interfaces. En este trabajo presentamos resultados de los primeros traductores de cinco lenguas indígenas: mexicanero, náhuatl, purépecha, wixarika y yorem nokki, con el español; pero más importante presentamos una reflexión sobre las lecciones aprendidas durante este esfuerzos y los retos para poder hacer sistemas de traducción automática funcionales para las lenguas indígenas de México.
Collisional formation of massive exomoons of superterrestrial exoplanets
Authors: Malamud Uri , Perets Hagai B , Schäfer Christoph , Burger Christoph
Published: January 2020

Exomoons orbiting terrestrial or superterrestrial exoplanets have not yet been discovered; their possible existence and properties are therefore still an unresolved question. Here, we explore the collisional formation of exomoons through giant planetary impacts. We make use of smooth particle hydrodynamical collision simulations and survey a large phase space of terrestrial/superterrestrial planetary collisions. We characterize the properties of such collisions, finding one rare case in which an exomoon forms through a graze and capture scenario, in addition to a few graze and merge or hit and run scenarios. Typically however, our collisions form massive circumplanetary discs, for which we use follow-up N-body simulations in order to derive lower limit mass estimates for the ensuing exomoons. We investigate the mass, long-term tidal-stability, composition and origin of material in both the discs and the exomoons. Our giant impact models often generate relatively iron-rich moons that form beyond the synchronous radius of the planet, and would thus tidally evolve outward with stable orbits, rather than be destroyed. Our results suggest that it is extremely difficult to collisionally form currently-detectable exomoons orbiting superterrestrial planets, through single giant impacts. It might be possible to form massive, detectable exomoons through several mergers of smaller exomoons, formed by multiple impacts, however more studies are required in order to reach a conclusion. Given the current observational initiatives, the search should focus primarily on more massive planet categories. However, about a quarter of the exomoons predicted by our models are approximately Mercury-mass or more, and are much more likely to be detectable given a factor 2 improvement in the detection capability of future instruments, providing further motivation for their development.
XMP gas-rich dwarfs in nearby voids: results of SALT spectroscopy
Authors: Pustilnik S A , Kniazev A Y , Perepelitsyna Y A , Egorova E S
Published: January 2020

In the framework of an ongoing project aimed at searching for and studying eXtremely Metal-Poor (XMP) very gas-rich blue dwarfs in nearby voids, we conducted spectroscopy with the 11-m Southern African Large Telescope (SALT) of 26 candidates, preselected in the first paper of this series (PEPK19). For 23 of them, we detected oxygen lines, allowing us to estimate the gas O/H ratio. For 10 of them, the oxygen abundance is found to be very low, in the range of 12 + log (O/H) = 6.95–7.30 dex. Of those, four void dwarfs have 12 + log (O/H) < 7.19, or Z < Z⊙/30. For the majority of observed galaxies, the faint line [O iii] λ4363 Å used to estimate O/H with the direct Te method appeared either too noisy or was not detected. We therefore use the semi-empirical method of Izotov & Thuan for these spectra, or, when applicable, the new ‘Strong line’ method of Izotov et al. We present and discuss the results for all void dwarfs observed in this work. We also compare their O/H values with O/H values of ∼140 void galaxies available from our recent papers. We address the properties of the newly found unusual void XMP dwarfs and compare them with those for 10 known prototype void XMP objects. The latter small group is outstanding based on their very small mass fraction of stars (only 0.01–0.02 of the baryonic mass), the blue colours of stars in the outer body indicating a non-cosmological age for the main star-forming episode), and the low gas metallicity (several times lower than expected for their luminosity).
Elucidation of leak-resistance DNA hybridization chain reaction with universality and extensibility
Authors: Li Shaofei , Li Pan , Ge Meihong , Wang Hongzhi , Cheng Yizhuang , Li Gan , Huang Qiang , He Huan , Cao Chentai , Lin Dongyue , Yang Liangbao
Published: January 2020

Hybridization chain reaction (HCR) was a significant discovery for the development of nanoscale materials and devices. One key challenge for HCR is the vulnerability to background leakage in the absence of the initiator. Here, we systematically analyze the sources of leakage and refine leak-resistant rule by using molecular thermodynamics and dynamics, biochemical and biophysical methods. Transient melting of DNA hairpin is revealed to be the underlying cause of leakage and that this can be mitigated through careful consideration of the sequence thermodynamics. The transition threshold of the energy barrier is proposed as a testing benchmark of leak-resistance DNA hairpins. The universal design of DNA hairpins is illustrated by the analysis of hsa-miR-21-5p as biomarker when used in conjunction with surface-enhanced Raman spectroscopy. We further extend the strategy for specific signal amplification of miRNA homologs. Significantly, it possibly provides a practical route to improve the accuracy of DNA self-assembly for signal amplification, and that could facilitate the development of sensors for the sensitive detection of interest molecules in biotechnology and clinical medicine.
What Went Wrong with the American Dream?
Authors: Eichner Maxine
Published: January 2020

This chapter considers a number of indicators relating to the well-being of American children and adults in order to examine the extent to which the American Dream is fulfilling its promise. For children, it considers levels of happiness, academic achievement, mental health, and economic mobility. For adults, it considers happiness, mental health, and life expectancy (including the rise of “deaths of despair”). All these indicators show that the United States is failing radically with respect to both children’s and adults’ well-being. These results are not surprising, the last section of the chapter shows, when we take into account the health of the nation’s families. Neither adults nor children can thrive without sound family ties. Yet indicators show that American families are in bad shape, and in considerably worse shape than families in other countries.
The First Four Elections
Authors: Foley Edward B.
Published: January 2020

By the time the Jeffersonians redesigned the Electoral College in 1803, they had the experience of four elections, the equivalent of experiencing the elections of 2004 through 2016. During these four elections, the states experimented with different methods for appointing electors. Most common was direct legislative appointment of electors. Some states used district-based systems in which the voters in a district chose an elector. Only a few states held statewide elections to choose all of a state’s electors. By 1796 two-party competition had developed between Federalists and Jeffersonians, and states used methods of appointing electors that would favor the majority party in each state. Massachusetts and New Hampshire explicitly required that an elector receive a majority of votes to be appointed; otherwise, a runoff was necessary for appointment. New Hampshire experimented with both popular and legislative runoffs, while Massachusetts only used legislative runoffs.
The Electoral College of 1803
Authors: Foley Edward B.
Published: January 2020

The congressional debates in 1803 that led to the adoption of the redesigned Electoral College in the Twelfth Amendment were far more extensive than the debates on the Electoral College in the Constitutional Convention of 1787. The 1803 debates were also deeply philosophical, rethinking the appropriate nature of republicanism and federalism in America after a dozen years of experience, including the development of intense two-party electoral competition. The debates unambiguously show that the Jeffersonians, who controlled both chambers of Congress with over two-thirds supermajorities, wanted the redesigned Electoral College to be premised on majority rule. The version of majority rule reflected in the redesigned Electoral College is a compound majority-of-majorities, the idea being that presidents would win a majority of Electoral College votes based on support from majorities within the states providing those electoral votes. Leading Jeffersonians participating in these debates included Senator John Taylor of Virginia.
The Jeffersonian Electoral College in the Twentieth Century
Authors: Foley Edward B.
Published: January 2020

For most of the twentieth century, including the 80-year period between 1912 and 1992, the existence of third-party or independent candidates did not prevent the Electoral College from producing majoritarian results consistent with the expectations of its Jeffersonian architects for how two-party competition was supposed to work. 1912 was anomalous for its three-way split among two Republican presidents, one incumbent and one former, running against the Democratic nominee; but its outcome was not clearly different from what the Jeffersonian system, operating properly, would have produced. 1992 involved another three-way split—among Bush, Clinton, and Perot—with a result that is uncertain from a Jeffersonian perspective, since it is debatable what the outcome would have been if there had been runoffs in the states to see which candidate was preferred by a majority. The century ended with an election, 2000, in which the system clearly malfunctioned; Nader’s presence masked Gore’s majority.
A Recommitment to Majority Rule
Authors: Foley Edward B.
Published: January 2020

States should adopt a majority-rule requirement for participating in the Electoral College, meaning specifically that no state should award all its Electoral College votes to any candidate who fails to receive a majority of the state’s popular vote. There are a variety of ways that states can satisfy this majority-rule requirement. One option is to hold a runoff after the November election if no candidate receives a majority of the popular vote. Another option is to hold a preliminary vote in advance of the November election, perhaps on or around Labor Day, so that only two candidates appear on the November ballot. A third option would be to adopt instant runoff voting, which is a species of ranked-choice balloting that permits a runoff to be conducted simultaneously with the initial vote. A proportional system, which divided a state’s electoral votes among candidates, would also comply with the majority-rule requirement.
A Feasible Reform
Authors: Foley Edward B.
Published: January 2020

Each state already has the constitutional power to require that candidates win a majority of the popular vote to receive all of the state’s electoral votes. Each state could adopt the kind of runoff that New Hampshire used in the past, or instant runoff voting. There is no need for a multistate compact. If only two or three states had used runoffs, or instant runoff voting, in 2016—for example, Florida and Michigan, or the three Rust Belt states of Michigan, Wisconsin, and Pennsylvania—and if Clinton had won those runoffs, then she would have been president. In the future, it might be a Republican candidate who prevails in runoffs in pivotal states but would lose using plurality winner-take-all. States with ballot initiatives can use them to require majority rule for appointing electors as long as they leave the specific details to legislation.
Hume's Epistemological Evolution
Authors: Qu Hsueh M.
Published: January 2020

Here is a central issue in Hume scholarship: What is the relationship between Hume’s early Treatise of Human Nature and his later Enquiry concerning Human Understanding? Is the Enquiry a mere simplified restatement of the contents of the Treatise, or do the two substantially differ? Here is another critical issue in Hume scholarship: What is the relationship between Hume’s scepticism and his naturalism? How can we reconcile Hume’s extreme brand of scepticism with his positive ambitions of providing an account of human nature? Hume’s Epistemological Evolution argues that these two issues are intimately related. In particular, this book argues that Hume’s Enquiry indeed differs from the Treatise, precisely because he changes his response to scepticism between the two works. Because the Treatise has as its primary focus the psychological naturalistic project, its treatment of epistemological issues arises unsystematically from the psychological investigation. Consequently, Hume finds himself forced into an unsatisfactory response to scepticism founded on the Title Principle . This response is, however, deeply problematic, as Hume himself seems to recognise. In contrast to the Treatise, the Enquiry emphasises the epistemological aspects of Hume’s project, and offers a radically different and more sophisticated epistemology. This framework addresses the weaknesses of the earlier one, and also constitutes a ‘compleat answer’ to two of his most prominent critics, Thomas Reid and James Beattie. Hume’s epistemology thus undergoes an evolution between these two works.
The Title Principle and THN 1.4.7
Authors: Qu Hsueh M.
Published: January 2020

This chapter studies Hume’s considered treatment of scepticism in the Treatise of Human Nature in THN1.4.7. It finds the Title Principle (THN 1.4.7.11) to be pivotal in resolving the dangerous dilemma (THN 1.4.7.6). In response to the question of when ought we to assent to reason, Hume’s answer is that we should do so when it is lively and mixes with some propensity. The chapter explores a number of interpretive alternatives and offers some preliminary reasons for resisting them. It ends by addressing a few objections to interpretations that are founded on the Title Principle, arguing that we have dialectical reason to read the Title Principle as crucial to Hume’s resolution to scepticism in THN 1.4.7, despite the position being philosophically problematic.
A Flawed Framework
Authors: Qu Hsueh M.
Published: January 2020

This chapter argues that the Title Principle (THN 1.4.7.11) that is pivotal to Hume’s response to scepticism in the Treatise of Human Nature is deeply flawed in a number of respects. First, Hume lacks any grounds for endorsing it; second, it is unable to dismiss superstition, forcing Hume to appeal to unsatisfactory grounds of dangerousness in order to reject such religious enquiries; finally, in founding epistemic justification on the passions, which are not sensitive to truth, Hume’s resulting epistemology seems somewhat divorced from truth. Thus, it is little surprise that Hume would have looked to offer a new epistemological framework in the Enquiry concerning Human Understanding that could rectify these problems.
Critical Self-Reflection
Authors: Qu Hsueh M.
Published: January 2020

This chapter argues that the Enquiry concerning Human Understanding expresses Hume’s own dissatisfaction with the treatment of scepticism found in the Treatise of Human Nature. EHU 1.12 argues that curiosity, so crucial in THN 1.4.7, can in fact lead one to false metaphysics. EHU 5.1 is striking insofar as it states that Hume’s preferred Academical philosophy does not mingle with the passions. This is antithetical to the Title Principle (THN 1.4.7.11), which recommends assenting to reason when it mixes with the passions. Thus, the Enquiry seems to distinctly reject the anti-sceptical framework of the Treatise, paving the way for a new epistemology in the later work.
A New Epistemology
Authors: Qu Hsueh M.
Published: January 2020

This chapter explores Hume’s considered treatment of scepticism in the Enquiry concerning Human Understanding in EHU 12. It finds a two-tiered epistemology in this section. First, Hume’s dismissal of antecedent scepticism suggests that he accords our faculties default authority (EHU 12.3). Having done so, we use these faculties to reflexively investigate themselves; those that are found wanting will be dismissed in line with Hume’s consequent scepticism (EHU 12.5). Pyrrhonian scepticism is founded on a problematic methodology: it either over-generalises discovered unreliability in our faculties, or ventures into enquiries for which our faculties are entirely unsuited. Thus, Hume rejects it in favour of his own mitigated scepticism, which recommends staying within the limits of our faculties. The chapter then argues against the sceptical interpretation of EHU 12, before pointing to various parallels between this account and EHU 1, EHU 5, and Part 1 of the Dialogues Concerning Natural Religion.
Epilogue
Authors: Johnson Julian
Published: January 2020

Grappling with music in language (music-ology) offers a critical reflection on both. It is here that a hundred years of the philosophical critique of language (from Mauthner, Wittgenstein, and Bergson through to Serres, Nancy, Derrida, and Wellmer) overlaps with a tradition of music after Debussy that, through a logic of the senses, resists the grammars of language. A key source here is Lyotard’s Discours/Figure. A recent convergence of work on the relation between music and language, across diverse scientific disciplines, suggests productive links with the kinds of ideas that emerge from the study of music ‘after Debussy’. The chapter concludes by considering how, at its boundaries, the range of practices we might call musical (playing, listening, composing) blur into something more broadly ecological and ethical.
Reckoning with the “View From Nowhere”
Authors: Callison Candis , Young Mary Lynn
Published: January 2020

Chapter 1 lays the conceptual groundwork for the book, bridging histories of journalism and science with particular attention to journalistic stance, objectivity, and representational critique. We start with why and how the tarnished ideal of objectivity—the view from nowhere—is still doing so much work, heavy lifting, and harm. We contend that journalism studies as a field has failed to address questions of power and decades of persistent criticism from media studies, critical race studies, science and technology studies, and feminist media studies. Instead, journalism scholarship has tended to focus on individual, ethical, and front-stage professional reputational concerns more than on journalism’s claims to speak truth to power—and its ability to talk about methods, expertise, and reliable knowledge claims. This focus has allowed journalists to deny their personal subjectivity and professional context as a white-dominated profession, which has left journalism open to yet more critique.
Introduction
Authors: Daneshgar Majid
Published: January 2020

The introduction deals with the format of the book as well as the overview of its four chapters. It shows how the book can provide a first-hand look into intra-Muslim critical scholarship. Through this introduction, readers may get familiar with the aim of the book, which is to shed light on relatively unexplored issues touching on the political, cultural, and intellectual contexts of the study of Islam in the Muslim academy. It explains how this book breaks taboos on internal self-criticism, highlights the influence of politics on Muslim approaches to the Qurʾān and Islam, and shows that the study of Islam (and “Qurʾanic sciences”) is far and away more political than is generally represented.
“Islamic Apologetics” and Islamic Studies
Authors: Daneshgar Majid
Published: January 2020

This chapter highlights the notion of “Islamic Apologetics” in the Muslim academy and Islamic studies in Western academia. The goal of the chapter is to prepare readers to see how topics discussed in the Western academy are understood differently in the Muslim academy. In it, the chapter tries to unpack the motives and intentions behind the development of Islamic Apologetics in the Muslim academy. This, as author hopes, will enable readers to understand what “Islamic Apologetics” both is and is not. This chapter also tries to outline the development of an academic approach to the pertinent issues in the Western academy.
The Sectarian Study of Islam
Authors: Daneshgar Majid
Published: January 2020

This chapter deals with the persistence of sectarian treatment of the Qurʾān and Qurʾanic studies. It shows how Muslim academics are, or are obliged to be, inattentive to the cultural and literary connections both between the Shiʿi and Sunni traditions and the different Muslim academies. These all combine to create a systemic ignorance of, and systematic disregard for, non-Middle Eastern sources and resources. It shows that Muslim academics too often do not appreciate the views of co-religionists of a different sect, especially in respect to the Sunni or Shiʿi traditions. This neglect of Islamic sources extends to other countries and cultures, even when these are of the same sect.
Introduction
Authors: Velmet Aro
Published: January 2020

The introduction outlines the contributions of the book to French history, the history of bacteriology, and the history of global health. It develops the use of “technopolitics,” particularly the use of the technopolitical strategy known as “pastorization,” and “politics of scale” for the argument advanced later in the book. It establishes the geographical and chronological boundaries of the inquiry (1890–1940) and surveys the history of laboratory medicine in France, particularly the role of Louis Pasteur. Finally, after noting that each chapter follows a particular scientific and political project, from its initial articulation through development, contestation, and praxis, it describes the focus of the individual chapters.
The Making of Imperial Tuberculosis
Authors: Velmet Aro
Published: January 2020

From 1880 to 1914, Pastorians reinterpreted tuberculosis in the French colonies as a central public health problem. The disease had been previously considered of marginal importance, compared with tropical diseases such as malaria or yellow fever. This chapter looks at the epidemiological studies, new disease ecologies, and technical innovations that made this reinterpretation possible. Armed with the tuberculin skin test, a conviction that contact with the tubercle microbe determined symptomatic illness, and a network of laboratories, Albert Calmette convinced colonial officials that Europeans were infecting a “virgin soil.” This idea echoed emerging anticolonial arguments that highlighted the health costs of “civilization” at events such as the Anti-colonial Exposition of 1931.
Citizen Activism and the Democratic Party
Authors: Skocpol Theda , Putnam Lara , Tervo Caroline
Published: January 2020

How will new grassroots resistance groups affect the electoral prospects and activities of the Democratic Party? This chapter draws evidence from groups in many states, but it principally analyzes changes in the large, variegated state of Pennsylvania—where more than two hundred grassroots anti-Trump groups emerged after 2016 in all but a dozen of sixty-seven counties. Drawing from answers to online questionnaires given by leaders of eighty-two groups, the chapter details group involvements in the 2018 election and analyzes the changing relationships between grassroots groups and Democratic candidates and local parties in five Pennsylvania settings: inner cities, metropolitan suburbs, upscale exurbs, declining rust belt areas, and rural counties.
Introduction
Authors: Gastil John , Knobloch Katherine R.
Published: January 2020

Citizens are often asked to make decisions about ballot measures, but they rarely have access to reliable information with which to make those decisions. This chapter tells the story of Seattle’s failed monorail project to explain the problems voters face when figuring out how to cast their vote. It introduces a new governing institution that could help solve that dilemma, the Citizens’ Initiative Review (CIR). The CIR gathers together a small group of citizens to deliberate about a ballot measure and then pass along their findings for voters to use when making their own decisions. The CIR continues the tradition of experimental democracy, which seeks to improve the ways that citizens govern themselves. The CIR, and deliberative institutions like it, attempt to empower the public by introducing reliable information into political decision making.
A Political Life Transformed
Authors: Gastil John , Knobloch Katherine R.
Published: January 2020

Democratic citizens often feel disempowered by contemporary politics, but deliberative democracy provides an antidote by creating opportunities for the public to engage in meaningful decision making. This chapter introduces readers to a few of those projects, including AmericaSpeaks, Participatory Budgeting, and the CIR and provides insight from one citizen who has engaged in two of those forums. These processes bring diverse citizens together to learn about and discuss public problems with the goal of creating better policy decisions. Initiatives and referenda were initially proposed with similar goals of empowering the public but have become beholden to the same problems that plague the rest of governance, namely the outsized influence of money and the proliferation of manipulative rhetoric. The CIR and processes like it attempt to bridge the decision-making power of initiative elections with the informed judgment gained in deliberative forums.
A Crucial Test
Authors: Gastil John , Knobloch Katherine R.
Published: January 2020

Chapter 5 tells the story of the first official Citizens’ Initiative Review (CIR) through the eyes of one of its participants, Marion Sharp. The CIR asked twenty-four demographically stratified voters to review an Oregon ballot measure that increased mandatory minimum sentencing for repeat sexual offenses and driving under the influence of intoxicants. Over five days, participants heard from expert witnesses and reviewed evidence related to the need for and potential impact of mandatory sentencing. Participants engaged in facilitated discussion aimed at gauging the credibility of that evidence and distilling it for voters. Despite flare-ups among participants and behind-the-scenes challenges, at the end of the review Marion and her fellow panelists drafted a Citizens’ Statement containing key facts about the measure and the best arguments favoring and opposing it. That statement appeared in the state Voters’ Pamphlet for the electorate to use before casting their ballots.