"Unpredictable symmetries": the discursive functions of early seventeenth-century Scottish romance

This thesis addresses the enduring critical neglect of seventeenth-century Scottish romance. In order to do so, it analyses four texts, namely Patrick Gordon’s Penardo and Laissa (1615), Patrick Hannay’s Sheretine and Mariana (1622), John Kennedy’s Calanthrop and Lucilla (1626) and George Mackenzie’s Aretina; or, the Serious Romance (1661). This study will evidence how Scottish romance pits itself against conventional motifs of the genre, indeed against its own more popular romantic features, and that it arguably instances a male resistance ─ prompted by a particularly Christian bias against sublimating love ─ against what was perceived to be the dangerously ‘feminised’ context of romance. It will indicate how Scottish romance thus sits apart from its contemporary equivalents with their more amatory accents, and how it is instead a canon of disparities, rather than of uniformity. Over and above this, the present study shall address the deliberate use of the genre’s inherently idiosyncratic nature to articulate cultural, literary and political aspects of what it means to be a Scottish seventeenth-century work of fiction, transitional between nations, classes and cultural periods, between local and British politico-cultural paradigms, essences and discontinuities. This study thus foregrounds the deliberate polyvalence of these texts, and identifies those particular aspects of seventeenth-century socio-political history that have rendered these texts so disparate not just from one another, but from the British and Continental romance tradition more generally. It will indicate how a significant shift of address to an implied audience ─ royal to noble ─ as well as the pursuit of appropriate patronage was of particular import for Scottish romancers, for whom the turbulent cultural shifts of the early seventeenth century symptomised in their respective texts a striking level of disunity, fracture, and a series of perplexing multiples

Rhetorics of martial virtue: mapping Scottish heroic literature c.1600-1660

This thesis investigates textual cultures of heroism in Scottish literature c. 1600-1660 as evidenced in a corpus of texts engaged with evolving concepts of martial virtue, honour and masculinity. It provides the first sustained analyses of four seventeenth-century romances – Penardo and Laissa (1615) and Prince Robert (1615), both by Patrick Gordon, Sheretine and Mariana (1622) by Patrick Hannay and Calanthrop and Lucilla (1626) by John Kennedy – and their trajectory within a Scottish tradition of writing that was engaged in a fundamental search for its ideal national hero. Over the course of this research, a series of intriguing connections and networks began to emerge which illuminated an active and diverse community of ‘martial writers’ from whom this corpus of texts were conceived. From these pockets of creativity, there emerged a small but significant body of writers who shared not just a military career but often patronage, experience of service in Europe and a literary interest in what I will define in this thesis as the search for post-Union (1603) Scottish male identity. What began as a study of romance texts was prompted to seek new lines of enquiry across a wide and varied body of texts as it sought to engage with a changeable but distinctive thematic discourse of martial heroism, conduct literature for young men disguised as romance. Its findings are by no means always finite; a partly speculative attempt is made to illuminate the path of one particularly pervasive thread of literary discourse – martial virtue – rather than to lay false claims to homogeneity. The nature of this enquiry means that the thesis examines a vast array of texts, including the fictional romances mentioned above and others such as Sir George Mackenzie’s Aretina; Or, the Serious Romance (1660) and John Barclay’s Argenis (1621), non-fictional texts such as Robert Munro’s The Expedition (1638), George Lauder’s The Scottish Soldier (1629) and James Hume’s Pantaleonis Vaticinia Satyra (1633), and their engagement with issues of martial service. It is, in essence, a study of the seventeenth-century Scottish literary hero, sought naturally at first among the epic and fantastical landscapes of fictional romance, but pursued further into the martial world inhabited by its authors, patrons, and, as will be argued, its readers. In mapping this hitherto neglected topic and its related corpus of texts, the thesis identifies a number of potentially characteristic emphases which evince the development of a specifically martial conversation in seventeenth-century Scotland. It foregrounds the re-emergence of feudal narratives of male identity in the wake of the 1603 Union of the Crowns and after the outbreak of Civil and European war, in which the martial warrior of Brucian romance emerges once again as an ideal model of heroism – the natural antithesis to the more (self-evidently) courtly romance narratives produced at the Stuart court in London. Coupled with the inheritance of a late-fifteenth and sixteenth-century poetics which foregrounds reading as an act of moral investment (from which later writers appear to select the specifically reader-focused aspects of Christian Humanism), the erudite soldier and his corresponding literary protagonist begin to emerge as the foremost Scottish hero in a selection of both fictive and non-fictive texts, from vernacular romance to memoirs and chronicles, and in prose fiction. Across this diverse corpus of texts, collective emphases upon the moral investment of reading, exemplar-based use of historical materials and Scotland’s martial past emerge as a shared advisory paradigm, a conduct book of behaviours for the young Scottish male

Clinical and Prognostic Differences in Oropharyngeal Squamous Cell Carcinoma in USA and Denmark, Two HPV High-Prevalence Areas

BACKGROUND: Uncertainty persists regarding clinical and treatment variations crucial to consider when comparing high human papillomavirus (HPV)-prevalence oropharyngeal squamous cell carcinoma (OPSCC) cohorts for accurate patient stratification and replicability of clinical trials across different geographical areas. METHODS: OPSCC patients were included from The University of Texas MD Anderson Cancer Center (UTMDACC), USA and from The University Hospital of Copenhagen, Denmark from 2015-2020, (n = 2484). Outcomes were 3-year overall survival (OS) and recurrence-free interval (RFI). Subgroup analyses were made for low-risk OPSCC patients (T1-2N0M0) and high-risk patients (UICC8 III-IV). RESULTS: There were significantly more HPV-positive (88.2 % vs. 63.1 %), males (89.4 % vs. 74.1 %), never-smokers (52.1 % vs. 23.7 %), lower UICC8-stage (I/II: 79.3 % vs. 68 %), and fewer patients treated with radiotherapy (RT) alone (14.8 % vs. 30.3 %) in the UTMDACC cohort. No difference in the adjusted OS was observed (hazard ratio [HR] 1.21, p = 0.23), but a significantly increased RFI HR was observed for the Copenhagen cohort (HR: 1.74, p = 0.003). Subgroup analyses of low- and high-risk patients revealed significant clinical and treatment differences. No difference in prognosis was observed for low-risk patients, but the prognosis for high-risk patients in the Copenhagen cohort was worse (OS HR 2.20, p = 0.004, RFI HR 2.80, p = 0.002). CONCLUSIONS: We identified significant differences in clinical characteristics, treatment modalities, and prognosis between a Northern European and Northern American OPSCC population. These differences are important to consider when comparing outcomes and for patient stratification in clinical trials, as reproducibility might be challenging

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)