"The pleasure of writing is inconceivable": William Hutton (1723-1815) as an Author

William Hutton started life as a child labourer, but rose to become a bookseller, stationer, and wealthy paper merchant. Like many autodidacts, he longed to be an author and published 15 popular books. This article examines Hutton’s remarks on ‘writing’, which reveal his motives, methods, and goals of authorship. It also gauges his impact on the literary marketplace by analysing 65 periodical reviews of his works. Hutton’s books were based on personal experience, and mixed memoir and biography with historical, topographical, and travel writing. They suited the nation’s thirst for entertaining formats and established him as a new kind of writer, who produced lively, unlearned books for a commercial age. Hutton’s breach of polite norms and opinionated style horrified the literary establishment. But they also attracted readers lower down the social scale, who enjoyed irreverent views on political, religious, economic, and social issues. Hutton thus had an impact on two contrasting groups of readers and put Birmingham and northern regions on the national literary map. Together this author and his critics offer a portrait of the evolution of authorship, the spread of knowledge and taste, and the creation of cultural identity in a time of literary change

The Signal of Regard: William Godwin’s Correspondence Networks

© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group. The letter is a gift of attention, in which the writer seeks to communicate regard by means of a signal crafted uniquely for the recipient. The concept of regard, as developed by the economic historian Avner Offer, indicates both attention and approbation. Adam Smith took it to be the driver of human exchange in emotions as much as in commerce. The exchange of regard captures the logic of a prodigious correspondent like William Godwin. The personalization of the gift signal is an attempt to convey an obligation to reciprocate. Godwin was attuned to this obligation and worked hard to fulfil it—with varying degrees of success. His correspondents encompassed almost every significant literary and political figure on the political left from the era of the French Revolution to the 1832 Reform Act. The children of the Godwin household were nourished by bonds of reciprocity, which they developed and extended when, in adulthood, they dispersed across Europe. The letters of Godwin and his correspondents embody a larger conversation, allowing intimacy to be preserved at a distance. The signals they once created for each other may now be received by us

Second asymptomatic carotid surgery trial (ACST-2) : a randomised comparison of carotid artery stenting versus carotid endarterectomy

Background: Among asymptomatic patients with severe carotid artery stenosis but no recent stroke or transient cerebral ischaemia, either carotid artery stenting (CAS) or carotid endarterectomy (CEA) can restore patency and reduce long-term stroke risks. However, from recent national registry data, each option causes about 1% procedural risk of disabling stroke or death. Comparison of their long-term protective effects requires large-scale randomised evidence. Methods: ACST-2 is an international multicentre randomised trial of CAS versus CEA among asymptomatic patients with severe stenosis thought to require intervention, interpreted with all other relevant trials. Patients were eligible if they had severe unilateral or bilateral carotid artery stenosis and both doctor and patient agreed that a carotid procedure should be undertaken, but they were substantially uncertain which one to choose. Patients were randomly allocated to CAS or CEA and followed up at 1 month and then annually, for a mean 5 years. Procedural events were those within 30 days of the intervention. Intention-to-treat analyses are provided. Analyses including procedural hazards use tabular methods. Analyses and meta-analyses of non-procedural strokes use Kaplan-Meier and log-rank methods. The trial is registered with the ISRCTN registry, ISRCTN21144362. Findings: Between Jan 15, 2008, and Dec 31, 2020, 3625 patients in 130 centres were randomly allocated, 1811 to CAS and 1814 to CEA, with good compliance, good medical therapy and a mean 5 years of follow-up. Overall, 1% had disabling stroke or death procedurally (15 allocated to CAS and 18 to CEA) and 2% had non-disabling procedural stroke (48 allocated to CAS and 29 to CEA). Kaplan-Meier estimates of 5-year non-procedural stroke were 2·5% in each group for fatal or disabling stroke, and 5·3% with CAS versus 4·5% with CEA for any stroke (rate ratio [RR] 1·16, 95% CI 0·86-1·57; p=0·33). Combining RRs for any non-procedural stroke in all CAS versus CEA trials, the RR was similar in symptomatic and asymptomatic patients (overall RR 1·11, 95% CI 0·91-1·32; p=0·21). Interpretation: Serious complications are similarly uncommon after competent CAS and CEA, and the long-term effects of these two carotid artery procedures on fatal or disabling stroke are comparable