Journal articles on the topic 'Gentlemen specialists'

Finance Minister, Dr Abdul Hafeez Sheikh, Dr Nadeem VI Haque, Patron of the Pakistan Society of Development Economists and Deputy Chairman Planning Commission, Past Presidents and Distinguished Members of the Society, Excellencies, Ladies and Gentlemen: It is my pleasure to welcome you all to the 27th Annual General Meeting and Conference of the Pakistan Society of Development Economists. On behalf of the members of the PSDE, I would like to thank you, Finance Minister for having spared your precious time to open this important meeting. I would like also to especially thank our members and guests who have come from different parts of the country and from different continents to participate in the Conference. We are extremely pleased to see here today many young students of Economics and Development-Pakistan's future economists and development specialists-who I am sure are enthusiastic to learn from the many leading economists attending this Conference of the critical issues and economic challenges that we face at the national, regional and global levels.

Honourable Minister for Planning, Development and Reforms and Chancellor PIDE, Past Presidents and Distinguished Members of the Society, Excellencies, Ladies and Gentlemen, It is my pleasure to welcome you all to the 29th Annual General Meeting and Conference of the Pakistan Society of Development Economists. On behalf of the members of the PSDE, I would like to thank you, Honourable Prof. Ahsan Iqbal for having spared your precious time to open this important meeting. I would also like to especially thank our members and guests who have come from different parts of the country and from different continents to participate in the Conference. We are extremely pleased to see here today many young students— Pakistan’s future economists and business leaders—who I am sure are enthusiastic to learn from the many leading specialists attending this Conference on the critical issue of ‘Energy’ that we in Pakistan face today. Let me join Dr Durr-e-Nayab in especially welcoming Dr Ilhan Ozturk, Professor at the Çağ Üniversitesi in Turkey who will be delivering the The Mahbub Ul Haq Memorial Lecture. Dr Prof. Zhaoguang Hu, Vice-President and Chief Energy Specialist at the State Grid Energy Research Institute in Beijing who will deliver Gustav Ranis Lecture. Professor Mohan Munasinghe, Chairman of the Munasinghe Institute of Development, Sri Lanka who will be delivering The Allama Iqbal Lecture and Dr Rajendra K. Pachauri, Chief Executive of the Energy and Resources Institute, New Dehli who will deliver The Quaid-i-Azam Lecture this year

Paratesticular soft tissue tumours are remarkably rare entities, with malignant subtypes accounting for approximately 30%. Due to the paucity of cases, a consensus on the best treatment has not yet been reached, presenting a diagnostic and therapeutic challenge for clinicians. Although rare, three such cases presented to the care of our institution serving a population of approximately 400,000 in the space of 13 months. These were three gentlemen, aged 54, 82 and 86 years old, presenting with left sided testicular swellings. Ultrasound in each case confirmed an extratesticular mass. Only the second gentleman complained of associated pain, however he had experienced scrotal trauma in the preceding weeks. Only one patient had suspicions of metastatic disease, with a 9 mm pulmonary nodule on computed tomography. All patients underwent a radical inguinal orchidectomy with high ligation of the spermatic cord, in keeping with best accepted guidelines. Histology confirmed a well-differentiated liposarcoma, a dedifferentiated liposarcoma and a leiomyosarcoma respectively, all high grade. One gentleman returned to theatre for re-excision of margins. Our case series emphasises the need for full multidisciplinary team specialist sarcoma input, as well as radical resection with judicious margins in order to reduce the risk of local recurrence, in the treatment of these rare tumours.

Finance Minister, Dr Abdul Hafeez Sheikh, Dr Nadeem Ul Haque, Patron of the Pakistan Society of Development Economists, and Deputy Chairman Planning Commission, Past Presidents and Distinguished Members of the Society, Excellencies, Ladies and Gentlemen! It is my pleasure to welcome you all to the 28th Annual General Meeting and Conference of the Pakistan Society of Development Economists. On behalf of the members of the PSDE, I would like to thank you, Finance Minister for having spared your precious time to open this important meeting. I would also like to especially thank our members and guests who have come from different parts of the country and from different continents to participate in the Conference. We are extremely pleased to see here today many young students—Pakistan’s future economists and business leaders—who I am sure are enthusiastic to learn from the many leading specialists attending this Conference on the critical economic issues and challenges that we face at the global, regional and national levels. Let me join Dr Musleh ud Din in especially welcoming Professor L. Alan Winters, Professor of Economics, University of Sussex, United Kingdom, who will be delivering The Mahbub Ul Haq Memorial Lecture later today; Professor M. Ali Khan, Abram Hutzler Professor of Political Economy, Johns Hopkins University, USA who will be delivering the Gustav Ranis Lecture; Dr Yannos Papantoniou, Former Economy and Finance Minister of Greece, and currently President of the Centre for Progressive Policy Research, Athens, who will deliver The Allama Iqbal Lecture; and Dr Ishrat Husain, Dean and Director, Institute of Business Administration, Karachi, Former Governor, State Bank of Pakistan who will be delivering the Quaid-i-Azam Lecture this year. In continuation of the tradition started last year by the Pakistan Society of Development Economists (PSDE), the Society will this year be honouring Professor S. M. Naseem to acknowledge his outstanding contribution to the field of Economics and for his pioneering work on Pakistan.

Abstracttitle SUMMARY /title Henri Michel (1885-1981), collector and connoisseur maintained an extensive international correspondence concerning scientific instruments. His archive includes letters to and from all the leading specialists between c. 1933 and c. 1975. It is therefore an important source for a period that coincides with the formation of several major collections and the publication of important reference works. The archive of this pioneer student of instruments includes over 500 letters, four notebooks and a set of photographic plates.

This paper concentrates mainly on Professor A.E. Boycott and his contribution to malacology in Britain. This does not diminish in any way the contribution made by Dr H.E. Quick but merely reflects that his contribution was rather more restricted and specialised than Boycott's.

In Australia, high-dose sublingual buprenorphine and long-acting injectable buprenorphine are available. High-dose buprenorphine is used predominantly in the setting of opioid use disorder and has a role in chronic pain. Palliative care specialists are increasingly involved in pain management and end-of-life care for patients on these medications, yet there is a lack of education and training about high-dose buprenorphine for palliative care specialists. We describe our experience caring for John (fictional name), a gentleman with chronic pain and a new high-grade post-transplant lymphoproliferative disorder prescribed high-dose buprenorphine. We share the challenges and experience in caring for John as he deteriorated into the terminal phase and died of his illness. We include potential management options and the rationale for our decision to rotate John from high-dose sublingual buprenorphine to subcutaneous oxycodone. We conclude with practice implications and suggestions for improved patient care and clinician experience, including increased collaboration between palliative medicine, acute pain, and addiction medicine services, increased education and training for palliative care specialists about high-dose buprenorphine, and ultimately the development of consensus high-dose buprenorphine to oral morphine equivalence guidelines.

Norman Sims foi o primeiro palestrante principal das conferências da International Association for Literary Journalism Studies. Tido como um dos maiores especialistas sobre jornalismo literário, é um nome basilar no que toca esse gênero. Porém, é também um homem multifacetado com uma paixão pela canoagem e pela escrita sobre a história da canoa no continente norte-americano. O seu legado tem influenciado várias gerações de pesquisadores e acadêmicos que se dedicam ao jornalismo literário, também denominado jornalismo narrativo. PALAVRAS-CHAVE: Norman Sims; jornalismo literário, jornalismo, IALJS, Estados Unidos. ABSTRACT Norman Sims was the first keynote speaker of the conferences held by the International Association for Literary Journalism Studies. Renowned as one of the greatest specialists in literary journalism, his is an inescapable name when it comes to that journalistic genre. He is also a man of multiple interests with a passion for canoeing and a writer about the history of North-American canoes. His legacy has influenced many generations of researchers and academics dedicated to the study of literary journalism, also known as narrative journalism. KEYWORDS: Norman Sims; literary journalism; journalism; IALJS, United States of America. RESUMEN Norman Sims fue el primer orador principal de las conferencias celebradas por la Asociación Internacional de Estudios de Periodismo Literario. Reconocido como uno de los mejores especialistas en periodismo literario, el suyo es un nombre ineludible en lo que respecta a ese género periodístico. También es un hombre de múltiples intereses con una pasión por el piragüismo y un escritor sobre la historia de las canoas norteamericanas. Su legado ha influido en muchas generaciones de investigadores y académicos dedicados al estudio del periodismo literario, también conocido como periodismo narrativo. PALABRAS CLAVE: Norman Sims; periodismo literario; periodismo; IALJS, Estados Unidos.

Irreducible dorsal dislocation of the interphalangeal (IP) joint of the great toe is rare. We report a case of a 29-year-old gentleman who presented to the Orthopaedic Surgery Specialist Outpatient Clinic with an irreducible IP joint of the great toe that had been untreated for 4 weeks. The mechanism of injury is believed to be a combination of axial loading with a hyperdorsiflexion force when the patient fell foot first into a drain. As the patient did not report severe symptoms and a true lateral radiograph was not ordered, the dislocation was missed initially at the emergency department. The patient had continued to run and play field hockey prior to visiting us. Incarceration of the sesamoid became a block to manipulation and reduction at the specialist outpatient clinic 3 weeks later. The patient was treated with open surgical exploration, resection of the interposed sesamoid, and Kirschner-wire fixation of the IP joint followed by occupational therapy for mobilization exercises. The operative course was uneventful. At 6 months after surgery, the patient could walk, run, and return to sports.

Purpose: Brachial access is occasionally used for endovascular procedures when other more established or safer ones (eg, femoral or radial) are contraindicated. Although manual compression is the standard of care after brachial arteriotomy, suboptimal compression may lead to bleeding or thrombosis. Arteriotomy closure devices have thus been proposed as an alternative means to achieve hemostasis after brachial arteriotomy. Yet, there is a paucity of evidence and a limited spectrum of devices suitable for brachial arteriotomy closure. We present the use of the MynxGrip closure device after brachial arteriotomy. Case: A 70-year-old gentleman underwent brachial arteriotomy followed by iliac artery stenting with a 7F compatible device. Hemostasis was then achieved with the MynxGrip device, uneventfully. Conclusions: This clinical vignette highlights the feasibility and safety of brachial use of the MynxGrip device in experienced hands, suggesting that it can represent a useful adjunct to the armamentarium of the endovascular specialist.

Objective: Benign paroxysmal positional vertigo (BPPV) is one of common peripheral vestibular problem reported that head injury is one of common cause among young age. In current situation it only treated by medication or injection by medical officer and specialist. Medication is not an optimal treatment and it only symptomatic therapy and often need chronic prescriptions if not treated properly. There are an optimum specific manoeuvre offers curative therapy in majority of BPPV cases such as Epley’s manoeuvre, Gan Canal repositioning Manoeuvrer (CRM) and Semont manoeuvre. Semont manoeuvre is one of selected manoeuvre that recently done in posterior BBPV case if Epley’s and Gan CRM failed, but less practice among our clinician due to less exposure. Case Studies: A 22 -year-old gentleman, complain of imbalance, difficulty in walking and vertigo for the past few days. He history of moderate traumatic brain injury (left parietooccipital Epidural Haemorrhage) and surgical intervention done last 5 days ago. He also complained of reduced hearing and on off left tinnitus over left side. No prominent psychological involvement reported. Detail physical and balance assessment done using BAL EX Foam test Modified Dix Hallpike Test (DHT) done. During the left DHT there is rotatory up beating nystagmus then it proceeds with GRM three-time, 1 session on previous day and 2 session on the current day but it was failed. Then proceed with Semont manoeuvre by specialist in vestibular rehabilitation. After 10 minutes of manoeuvre, modified DHT done and show negative result found there is no nystagmus.

We describe the case report of an 86-year-old Afro-Caribbean parkinsonian gentleman with intermittent Mobitz II heart block and syncope who received a DDD pacemaker. Due to Parkinson’s syndrome, the patient rotated the atrial lead around the pacemaker, causing the famous "Twiddler’s syndrome", a rare clinical issue which can easily be diagnosed with a simple chest X-ray.

Background and Aims. This report demonstrates the utility of a pudendal nerve block by pulsed radiofrequency ablation (RFA) for the treatment of male pelvic pain and urinary urgency and hesitancy.Methods. The patient is an 86-year-old gentleman with a 30-year history of urinary hesitancy and urgency. The patient also had pain in the area of the perineum but considered it a secondary issue. The patient was seen by a number of specialists, tried various medications, and underwent a variety of procedures to no avail. Therefore, the patient underwent a pulsed RFA of the pudendal nerve.Results. The patient underwent a pulsed RFA of the pudendal nerve; the patient reported marked improvement in his pelvic pain as well as a drastic reduction in his urinary urgency and hesitancy.Conclusion. Urinary urgency and hesitancy and male pelvic pain are some of the most common symptoms affecting men. Pudendal nerve block by pulsed RFA is an effective treatment of pelvic pain. It may also hold some therapeutic value in the treatment of urinary urgency and hesitancy as our case demonstrated. Further studies are needed to help clarify both the anatomy of the pelvis as well as if pudendal blocks are effective in treating more than pelvic pain.

Abstract Background Constrictive pericarditis (CP), although an uncommon cause of heart failure, requires specialist multidisciplinary input and multi-modality imaging to identify the underlying aetiology and treat potentially reversible causes. Case summary We report the case of a 74-year-old gentleman referred for assessment of progressive exertional dyspnoea and peripheral oedema, 30 months following treatment of acute myeloid leukaemia with high-dose chemotherapy and allogeneic stem cell transplantation. Clinical examination and cardiac imaging revealed a small pericardial effusion and pericardial thickening with constrictive physiology; however, no aetiology was identified despite diagnostic pericardiocentesis. The patient required recurrent hospital admissions for intravenous diuresis, therefore, following multidisciplinary discussions, surgical partial pericardectomy was performed. Histology suggested graft-vs.-host disease (GvHD) and post-operatively, the patient improved clinically. Following immunomodulatory therapy with ruxolitinib for both pericardial and pulmonary GvHD, his functional status improved further with no subsequent hospital admissions. Discussion Although pericardial disease in cancer patients is common, CP is unusual. Determining the underlying aetiology is important for subsequent management, and here, we describe the use of multi-modality imaging to diagnose a rare cause, GvHD, which responded to surgical treatment and immunomodulatory therapy.

Neurofibroma is a slow growing benign tumour of the peripheral nerve sheath which is frequently associated with neurofibromatosis type 1 (Prakash et al., 2014). Isolated solitary occurrence of neurofibroma in the maxillary sinus is rare with only 29 reported cases in the literature. We present a rare case of a 70-year-old gentleman who was referred to ENT with a right maxillary sinus neurofibroma with extension into the right inferior orbit. He has significant proptosis, ptosis, and limitation in abduction of the right eye. He has a complicated past history of multiple neurofibromas which were completely excised. Craniofacial MRI shows a large mass filling the right maxillary antrum extending anteriorly into subcutaneous tissue towards nasal ala and posterolaterally into inferior temporal fossa and superiorly into orbit and cavernous sinus involvement. Biopsy of the right maxillary mass revealed cellular spindle cell tumour with wavy collagen bundles within myxoid stroma which is consistent with a neurofibroma. Patient’s case was discussed in the skull-base MDT and he has been referred to a specialist center for surgical removal of the neurofibroma with reconstructive surgery. Despite the rarity of this disease, otorhinolaryngologist should consider a possibility of neurofibroma of the paranasal sinuses.

Rationale: The recognition of calciphylaxis often eludes practitioners because of its multiple ambiguous presentations. It classically targets areas of the body dense with adipose tissue. A heightened suspicion for the disorder is therefore required in the case of penile calciphylaxis, given its unconventional location. The diagnosis of calciphylaxis is also challenging as the gold standard for diagnosis is biopsy which can often yield equivocal results. Unfortunately, in penile calciphylaxis, the utility of biopsies is further debated due to their potential to precipitate new lesions and their decreased sensitivity due to the limited depth of tissue that can be sampled. For these reasons, it is important that practitioners recognize other accessible and accurate investigative tools which can aid in their diagnosis. Presenting concerns of the patient: We present the case of a 49-year-old man who presented to the emergency room with penile pain in the context of known chronic kidney disease secondary to diabetic nephropathy. The pain had been present for about a week, was exquisitely tender, and was initially associated with a faint violaceous lesion. This gentleman had just recently initiated peritoneal dialysis and had no other lesions on his body. Diagnosis: His pain was determined by ultrasound and plain radiograph to be secondary to calciphylaxis after two biopsies were nondiagnostic. Interventions: The patient had already made changes to his diet to reduce phosphate and calcium intake, and had been on phosphate-lowering therapy with both calcium and phosphate being within their respective target range. Following his diagnosis, this patient was promptly converted from peritoneal dialysis to hemodialysis with sodium thiosulphate and initiated hyperbaric oxygen therapy. This patient continues to be followed by nephrology and urology specialists.

A 54-year-old gentleman presented with pulmonary oedema secondary to anterolateral papillary muscle (PPM) rupture and acute mitral regurgitation subsequent to myocardial ischaemia (MI). Angiography revealed complete occlusion of the first obtuse marginal (OM1) branch of the circumflex coronary artery and a 70% occlusion of the left anterior descending (LAD) coronary artery. Operatively, unusual anatomy was noted; an accessory head was attached superiorly to the anterior lateral PPM. This gave rise to chordae that were subsequently attached to the posterior second (P2) scallop. Additionally, the P2 scallop was deficient in chordae from the posteromedial PPM, thus, loss of this accessory head led to severe mitral regurgitation. We review the PPM anatomy and pathological context of PPM rupture and ischaemic mitral regurgitation.

IntroductionThe prevalence of dementia rises with the rapidly increasing elderly population in developed world. In Singapore, 10% of the elderly population is estimated to have dementia. Other than physical and psychological needs, social welfare should also be addressed with the support of specialised geriatric care sources to improve their quality of life.ObjectiveTo study a case of an elderly with dementia, who was identified and managed through a multi-agency approach and to describe different services involved for dementia care.AimTo highlight the various elderly care organizations available in Singapore to address healthcare and social needs in dementia.MethodThrough a case report of an elderly who presented to hospital for medical issues with dementia, the social needs were identified and multiple agencies were involved to provide holistic care in dementia.ResultA 77-year-old gentleman was brought by a community social worker to hospital as he was found ill during home visit. During admission, the concern for poor self-care and cognition decline was raised by his family. Mini-mental state examination was 16/30. He was diagnosed with vascular dementia with clinical and MRI Brain finding. With active multidisciplinary intervention, his medical issues were addressed, and family and social needs were attended by several voluntary welfare organizations. Access to memory clinic service was also arranged for. This intervention also provided opportunity for his long-term care and welfare.ConclusionMulti-agency approach is crucial in dementia care to identify their unmet needs and plan for long-term care in Singapore.Disclosure of interestThe authors have not supplied their declaration of competing interest.

AimsThe Royal College of Psychiatrists’ Fair Deal (RCPsych 2008) highlighted the far-reaching impact of stigma and discrimination on the lives of people with mental illness. The pervading nature of stigma has been acknowledged in recent national and international mental health policies (WHO). The World Health Organisation reiterates people affected by mental illness should not suffer social exclusion and marginalisation due to stigma.MethodsA sixty-year-old gentleman presented to the Emergency Department following self-inflicted stabbing to the neck resulting in pharyngeal tear and surgical repair. Previous psychiatric history included inpatient admission on Section 2 following a major depressive episode. On this admission, inpatient psychiatric review elicited three months of psychotropic medication non-adherence due to difficulties the patient had encountered in acquiring repeat medications from his GP. He had relapsed into alcohol misuse as a coping mechanism culminating in a suicide attempt at home with a knife. Upon recommencing of sertraline and risperidone during admission, he was assessed as euthymic with low risk to self. The patient had been previously abstinent from alcohol and described religion as a protective factor. Prior to discharge, the patient's GP stated he must present to the surgery in person with a form of identification. This is despite CQC guidance stipulating practices should not refuse patients registration if proof of identity cannot be produced.ResultsThis case illustrates the socioeconomic factors increasing likelihood of suicide including forensic history, low financial status, unstable housing and lack of social support. Substance dependence is a risk factor that can be reduced by supporting patients in accessing specialist misuse input from inpatient and community teams. The patient reported fear of stigmatisation and criminalisation which led to the avoidance of seeking treatment, deterioration in mental health and severe clinical consequences. It is imperative marginalised patients with mental illness can access quality health care and this starts with GP registration.ConclusionForensic mental health patients experience multiple stigmas impacting on well-being including social, institutional and media stigmatisation and high levels of internalised stigma. The Time to Change campaign focused on changing attitudes and behaviour however evaluation illustrated difficulties in tackling this issue. Healthcare professionals should be mindful to avoid stigmatising language and actions to ensure fairness in care. There is a need for the medical profession to continue striving for a tangible shift in attitudes. Advocating for those with mental illness can enhance quality of life for vulnerable patient groups.

Numerous papers have reported the presence of reactive but benign bony exostosis in the external auditory canal of swimmers; of both cold and warm water. This outgrowth may lead to stenosis of the canal with associated complications such as repeated cerumen impaction, infections and also hearing loss. In this case report, we will present the case of a 62-year-old gentleman who was referred for imaging by an ENT specialist following difficulty with visualisation of the tympanic membrane during otoscopy.

This short article was written in 1809 as an answer to Johann Gottlieb Fichte’s essay On Machiavelli as an Author (1807). Fichte was unsettled by the defeat of the Prussian army at Jena and Auerstedt and tried to find in Niccolò Machiavelli’s works a prescription for restoring national spirit and military victory. Carl von Clausewitz answers Fichte not only as a military specialist emphasizing the role of light infantry and artillery (the efficiency of which has “at the very least doubled” since Macchiavelli’s time) but also as a philosopher who delves into the problems in the modernity of war. He contrasts the revival of “true military spirit” with artificial forms (the phalanxes and legions that are seen by Machiavelli and subsequently by Fichte as the key to the victories of the ancient Greeks and Romans). Clausewitz does not accept the universality of ancient stratagems and instead historicizes war and draws a connection between the military and social orders. Clausewitz claims that efficiency of military means is determined by civil conditions. The latter were radically changed by the French Revolution, which produced a new politics that “proposed other means and other forces and therefore made it possible to conduct war with such energy that it could not be conceived in any other terms” as Clausewitz wrote afterwards (part VIII, chapter 6). Clausewitz’s answer to the threat from France appears therefore to be twofold: a sociopolitical transformation must first create the new forces that then permit the art of war to exploit them effectively. He eagerly agrees with Fichte’s call for rekindling German feelings of nationhood in order to unify the people and achieve revanche because those steps increase the enthusiasm and military spirit which are necessary in modern war — a war that, as it seemed at that time, the German nation had to wage “on its territory for freedom and independence.”

In an era dominated by high-yield technology and novel therapies, a clinician’s insight and mindful reasoning remain more powerful than fine point instruments. During the course of our medical training, we are taught to consider the most prevalent aetiologies upfront, since « frequent conditions are widespread ». Moreover, we are trained to develop a unicist vision in front of a clinical scenario, especially when young patients are concerned. However, we shall never forget that the exceptional case will eventually present to clinic. It is our responsibility to recognize the Red Flags. Every patient has only one life, and good clinical awareness protects those lives. The case discussed in this review is highly pertinent for numerous medical fields, mentioning: Neurology, Neurosurgery, Internal Medicine, Psychiatry, Emergency Medicine, Family Medicine, General Surgery and Endocrinology. Numerous specialists are involved in a single case. A gentleman in his early 30s presents is diagnosed with a low-grade oligodendroglioma involving unilaterally the basal ganglia, documented clinically and radiologically to be stable for years. While he recited his story, we listened carefully. This young man mentioned one sentence, which retrospectively saved his life.

Traumatic aortic injuries can be a lethal event. Almost 88% of patients with traumatic aortic injuries die within the first hour and only 2% survive long enough to develop a chronic aneurysm. Injury to the ascending aorta, whether acute or chronic, are typically managed with surgery, and those in the descending aorta, are managed conservatively or in some cases with stents. We present a rare case of a 53-year old gentleman with intra-aortic migration of a left clavicular prosthesis used for restoration of the left shoulder girdle.

Abstract Case report - Introduction In 2011 a gentleman in his 50s presented with nasal blockage and bloody discharge. He was diagnosed with sarcoidosis and after 9 years of failed strategies to control his disease, he developed dactylitis. X-ray of the hands showed severe arthropathy in the distal interphalangeal joints. This case demonstrates an uncommon extrapulmonary manifestation of sarcoidosis. Although most of his follow up was with a respiratory clinic, his main symptoms were not due to interstitial lung disease, highlighting the importance of a multidisciplinary approach. To reduce the need for steroids, several DMARDs were tried illustrating that there are limited treatment options. Case report - Case description This gentleman presented in June 2011 with left epiphora, bloody nasal discharge and fatigue. He had no family history of sarcoidosis and was of Caucasian ethnicity. He was referred by his GP to Ophthalmology and ENT. Septoplasty showed a 95% blockage at the lacrimal sac. A biopsy was performed, and histology showed a nasal sarcoid granuloma. He was referred to the respiratory team who requested a high-resolution CT scan showing sizeable lymph nodes. One inguinal node was biopsied confirming sarcoid granulomas before starting treatment. Calcium was briefly raised, and serum ACE was initially 123. He was started on 40mg of prednisolone for 6 weeks, which was tapered to 20/25mg on alternating days. There was a recurrence of his nasal discharge; steroids were increased again but he developed symptoms of muscle weakness from long term steroid use. He was referred to an interstitial lung disease clinic at a tertiary centre where he was investigated for cardiac sarcoidosis with MRI due to ventricular ectopics. Hydroxychloroquine was started to reduce the steroid use however he developed symptoms of tinnitus, so it was stopped. Methotrexate, Azathioprine and Leflunomide were all trialled to however they did not have any impact on controlling his disease. His Prednisolone was slowly reduced by 1mg a month. When he had recurrence of his symptoms, he was given IV methylprednisolone. Nine years after his first presentation he presented with stiffness of the right thumb base. This progressed to dactylitis and slight fixed flexion deformity of right index finger and left little finger. An x-ray of his hands showed disease in the distal interphalangeal joints bilaterally with severe changes in the left little finger. The effects of long-term steroids led him to request a letter to support early retirement. Case report - Discussion The main rationale for changing treatment options was to reduce the prednisolone dose. Steroids were the only treatment option that showed evidence of controlling his disease when the dose was between 25mg and 40mg a day. Each of the DMARDs that were trialled had a different side effect profile and did not show any evidence of suppressing disease as symptoms recurred. Dose changes later in treatment fluctuated, reflecting a balancing act between disease recurrence and side effects of long-term steroids. There are many extra pulmonary manifestations of sarcoidosis that were investigated in this case. The first being the nasal granuloma, which can occur in sarcoid patients with symptoms of epistaxis, crusting, congestion, and pain. There were granulomatous changes seen in the hila as well as other lymph nodes such as the inguinal region; inguinal lymphadenopathy can lead to pain in the groin area. In addition to this it was important to exclude uveitis with ophthalmology review as he had symptoms of epiphora. Uveitis can be diagnosed in ophthalmological assessment of sarcoid patients in the absence of ocular complaints. Cardiac sarcoidosis was excluded with an MRI at a specialist heart and lung centre due to ventricular ectopics. Cardiac sarcoidosis can lead to heart block, arrhythmias, and congestive cardiac failure. Finally, he developed sarcoid arthropathy, review of his radiological images over time showed extensive damage to the joints of the hand. This gentleman had poor outcomes due to limited treatment options for his disease. Being restricted to long term steroid as the mainstay of treatment led to early retirement due to fatigue and muscle weakness. Conversely, under dosing steroids led to recurrence in symptoms. His disease is still not controlled as shown by an evolving sarcoid arthropathy. Case report - Key learning points An illustration of sarcoid arthropathy is also shown in this case. Sarcoid arthropathy is an uncommon manifestation of the disease primarily affecting joints in the hands and feet. In this case the distal interphalangeal joints and proximal interphalangeal joints were affected. The first symptom of arthropathy was stiffness of the base of the right thumb in 2017, this could fit with an osteoarthritic picture and could be mistaken for it in undiagnosed sarcoidosis. The most severe disease was in the DIP of the left little finger, which is not commonly affected. An oligoarthritic pattern with involvement of the ankle is seen more often. This is also an unusual case of sarcoidosis as there was no family history of the disease and his ethnicity did not predispose him to the condition. He also had a few uncommon extra pulmonary manifestations of sarcoidosis. The importance of a multidisciplinary approach in managing sarcoidosis was demonstrated in this case. Most of his follow up was with a respiratory clinic. However, respiratory symptoms were not the main issue during the patient journey; early ENT and rheumatology input was significant in managing his disease. Although pulmonary lymph nodes were enlarged, they did not affect his lung function.

Abstract Case report - Introduction Granulomatous disorders are diverse in their aetiologies and presentations. We present an unusual case of severe psoriatic arthritis patient who subsequently developed multiple granulomatous diseases over time, granulomatous interstitial nephritis, granulomatous sarcoidosis with hilar lymphadenopathy and localised laryngeal granulomatous inflammation secondary to lambda type amyloidosis. Case report - Case description 52-year-old gentleman with arthritis mutilans secondary to severe poorly controlled psoriatic arthritis was followed up in Rheumatology clinic. Earlier therapy with leflunomide and methotrexate provided inadequate control. Golimumab, despite giving a good response, was stopped in 2013 after 5 months of treatment due to acute kidney injury. Renal biopsy revealed granulomatous interstitial nephritis, thought to be Golimumab-induced based on the timing of usage and reversibility with discontinuation. He was then trialled on Ustekinumab and Secukinumab in 2016 and 2017 respectively with variable response. He also had a few-years history of voice change (high pitched) and sore throat which he attributed to recurrent colds. He denied dysphagia or breathlessness, and he did not have stridor. He has never smoked and only drank alcohol occasionally. ENT team noted white deposits on erythematous and thickened false vocal cords and posterior glottis with a thin web on microlaryngoscopy, which histologically proved to show granulomatous inflammation, potentially consisting of amyloid, although congo red stain was negative. On further investigation, including SAP scan, he was diagnosed with localised lambda type amyloid. Increasing throat pain and worsening dysphonia prompted change of management from conservative to a surgery at a specialist centre and an input from speech and language therapy team. During this time, consideration for Etanercept for his joint and skin disease was put on hold, pending further management of laryngeal amyloidosis. Furthermore, he presented to hospital with breathlessness in 2019, where his chest X-ray showed bulky right hilum and a follow-up CT chest revealed calcified right hilar and mediastinal lymphadenopathy, ground glass opacification and consolidation. Histology from hilar node was suggestive of sarcoidosis, with stain negative for amyloid. He underwent removal of false vocal cords for his symptomatic laryngeal amyloidosis. He continues to be followed up at the local Rheumatology, Dermatology and ENT team. Case report - Discussion Granulomatous diseases have vast aetiologies, including infectious, immunological, neoplastic, and chemical-induced processes. The age at which they affect patients and tissue they involve also vary hugely. This is the first reported case of three seemingly unrelated granulomatous diseases occurring in a single patient with severe refractory psoriatic arthritis. Retrospective reassessment of the histology samples supported that these are three separate pathologies. It is very unusual for one patient to acquire multiple separate granulomatous diseases, which was why the diagnostic process of this patient was challenging. In this case, managing the original underlying psoriatic arthritis was particularly difficult due to interruptions of treatment for adverse drug effects and investigations and treatment of subsequent granulomatous diseases. The case also raises questions about possible currently unknown association between the pathologies. Case report - Key learning points Key points are the uniqueness of this case and that it highlighted the possibility of currently under-reported association between these three granulomatous conditions. As ever, a multidisciplinary approach to managing such a complex patient is important for the provision of good care.

Abstract Case report - Introduction Back pain is one of the common musculoskeletal presentations to GPs and rheumatologists. While common causes are frequent, our patient required extensive investigation to reach a clinical diagnosis. This case draws attention to complexities involved and aims to refresh knowledge of less common causes. Case report - Case description A 40-year-old man presented to the GP with a few months history of gradual onset worsening low back and buttock pain, which was non-radiating resulting in reduced mobility. There was no preceding illness, systemic symptoms, gross neurology or associated features. Bloods revealed raised inflammatory markers and XR-pelvis showed lytic lesion left ischium. MRI showed multiple destructive lesions in lumbar spine and sacrum, suggestive of malignancy. Gentleman was referred for ambulatory care assessment as unable to work, using a wheelchair and requiring significant analgesia. CT TAP indicated left hip synovial thickening possibly inflammatory arthritis, confirmed lytic bony lesions but found no primary. He was referred for CT-guided bone biopsy and cancer of unknown primary MDT. Tumour markers were tested and symptom management assistance was sought from pain team and palliative care. Orthopaedic colleagues reviewed and discharged for management by palliative care team. He was discussed with rheumatology. Detailed review revealed tuberculosis (TB)-related death in the family. His IGRA returned positive. There was vague history of fluctuating weight over the few months before presentation to GP. He was of Filipino origin settled in UK for over 10 years and no foreign travel for last few years. PET-CT showed active lytic bony lesions. MRI hip suggested likelihood of tuberculosis due to synovial thickening with septation. Hip aspiration for culture couldn’t be performed as effusion resolved by then. Bone biopsy showed granulomatous inflammation with plasma cells, staining and culture were negative for acid fast bacilli. Specialist opinion on biopsy specimen was sought which ruled out Langerhans cell histiocytosis and haematological malignancy including multiple myeloma. Serum ACE, ANCA, ANA were all negative and C4 mildly raised, C3 normal. Immunoglobulin electrophoresis didn't show monoclonal bands. Anti-TB chemotherapy was commenced based on probability and patient recovered almost back to baseline in 8 months. Repeat MRI after 4 months of treatment showed no interval change. Case report - Discussion Extrapulmonary TB accounts for 3% of all TB and skeletal TB 10% of extrapulmonary TB. Skeletal TB presents with minimal systemic symptoms. Drug resistance is emerging around the world due to incomplete treatment and migration from countries with high prevalence of MDR-TB. Common differentials for lytic bone lesion include secondary or primary malignancy and multiple myeloma/plasma cell tumours. Biopsy is gold standard for diagnosis. The differential diagnosis for bone marrow granuloma is wide but TB, sarcoid and malignancy remain common considerations. It is rare for sarcoidosis to present with isolated bone marrow granuloma and usually there are systemic symptoms. Infectious causes of bone marrow granuloma include brucellosis, typhoid, Q fever, histoplasmosis, Epstein Barr virus and cytomegalovirus but usually present with significant systemic symptoms. In addition to routine tests and biopsy for TB, adenosine deaminase assay from cerebrospinal fluid could be used to aid diagnosis in cases where it would alter management (as per NICE guidance). Challenges exist from the patient perspective. This young man had constantly changing diagnostic and prognostic considerations which he found confusing. Culture did not provide a confirmation of diagnosis so he found it hard to be sure. He was off work in a wheelchair on palliative care for suspected malignancy early in the year. In the mid part of year he was told it was bone TB and commenced treatment. In the later part of year he was walking unaided and able to reduce pain medication. Challenges also exist from the rheumatologist’s perspective. This was a young man with minimal systemic symptoms on a palliative care pathway. There was constantly evolving change in management and multispecialty involvement with no ownership. Locally TB is managed by the respiratory team; however, they felt it more appropriate to offer advice regarding treatment and for this to be managed by rheumatology. TB nurses for the region did provide assistance for contact tracing and notification to public health. Case report - Key learning points Consider TB as differential diagnosis of lytic bone lesion and/or bone marrow granuloma. Bone and spine TB present with no or minimal systemic symptoms. Family and immigration history may be important. TB blood tests (IGRA) preferred over skin tests in BCG vaccinated as per CDC, USA. Bone marrow granuloma in TB is noncaseating mainly and caseating in 29% as per a study. Presence of acid-fast bacilli in TB bone marrow granuloma is rare and culture is positive in only 15% of cases as per a case series. PET-CT cannot distinguish between TB, malignancy and inflammatory lesions but can be used to assess improvement after therapy. MRI may show resolution of bony changes in bone TB 9 months post treatment. This would be an appropriate time to consider repeat imaging. NICE recommends 12 months of treatment for disseminated TB or spine TB with central nervous system involvement but commonest duration in literature is 18 months for bone TB. NICE recommends 6 months anti-TB treatment for spinal tuberculosis without central nervous system involvement. There is no need to routinely extend treatment beyond these for people with HIV and active TB. Comorbidities that may need working with multidisciplinary specialist teams include HIV, severe liver disease, stage 4 or 5 chronic kidney disease, eye disease/impaired vision, pregnancy/breastfeeding, history of alcohol/substance misuse. Referral of patients with spinal TB for surgery to be considered as per NICE for patients with spine instability or cord compression. Future consideration for monitoring of anti-TB drug therapy – drug-induced liver injury from anti-TB therapy was found to be 8.3% in a north-west London study and authors suggested routine 2-week check of liver function after commencing treatment (>30 u/l rise in pretreatment ALT predicted risk of drug-induced liver injury).

Abstract Introduction/Background Psoriatic arthritis is a heterogenic, immune-mediated musculoskeletal disease that presents with inflammation of joints, enthesis, and axial skeleton, and is associated with cutaneous psoriasis. Anti-TNF therapy has been known to trigger autoantibody response. Several cases of Autoimmune Hepatitis (AIH) have been reported. Anti-TNFα therapy in AIH is mainly attributed to the disruption of the regulatory role of TNFα signalling on the immune system. Close monitoring is essential to identify any evolving autoimmune events while on TNF antagonists. Treatment requires discontinuing the agent in mild cases and in those with systemic involvement, treatment with steroids and specialist referral is warranted. Description/Method This 39-year-old South African origin gentleman was initially referred to the Rheumatology department in 2013 with throbbing pain in his hands and stiffness in heels associated with scalp and nail changes secondary to psoriasis. His past medical history included psoriasis and sports trauma related left anterior cruciate ligament (ACL) tear. He also had a strong family history of psoriasis. His initial autoimmune results were negative including a negative ANA. The Magnetic Resonance Imaging (MRI) of his right ankle at the time, revealed enthesopathy with surrounding oedema, consistent with psoriatic arthropathy. The patient was managed initially with methotrexate. Over following months, he experienced significant fatigue and hypersomnia, and stopped the medication. He re-presented one and half years later with a flare on his hands and feet. The clinical examination showed onycholysis, guttate pattern psoriasis and synovitis in his PIPJs. He was started on Leflunomide, and his symptoms improved, however he suffered loose stools. The drug frequency was tapered, but the efficacy was poor leading to recurrent flares. Subsequently, he was switched to Adalimumab in 2016 and his symptoms improved significantly. However, after a few months his monitoring bloods showed that abnormal Alanine Transaminase (ALT) levels soaring to 263 U/L, with normal albumin, bilirubin and alkaline phosphatase. A repeat autoimmune study showed strongly positive Anti-Nuclear Antibody (ANA) Hep2 cells (1:1280, mixed pattern homogenous and speckled). His Adalimumab was stopped and within 2 months his ANA became negative and ALT normalized. He was then switched to Ustekinumab. In 2018, he started to notice finger swellings especially on the left hand and ultrasound showed paratenonitis of the left third and fourth proximal interphalangeal joints and synovitis of the left 1st distal interphalangeal joint consistent with active psoriasis. He was then switched to Secukinumab which he has remained on with sustained remission and no adverse effects. Discussion/Results We present a rare case of adalimumab induced autoimmune hepatitis in a patient with psoriasis, who developed strongly positive ANA during the course of treatment. Following cessation of adalimumab, his liver profile returned to normal limits and ANA became negative. Autoimmune hepatitis (AIH) is a chronic inflammation of the liver caused by hepatocyte-specific autoantigens. Not all pathophysiologic mechanisms of AIH are fully understood however, there is emerging evidence that genetic predisposition, molecular mimicry, and an imbalance between effector and regulatory immunity are important factors for disease development and progession. Liver biopsy results for autoimmune hepatitis classically reveal interface hepatitis, focal necrosis, portal inflammation, and plasma cells. Hepatotoxicity is an expected adverse reaction of tumour necrosis factor-α (anti-TNF-α) blocking agents including, infliximab, etanercept and adalimumab. The majority of cases appeared between one month and one year after initiation of the biological agent and complete resolution was observed in nearly 75% of cases after cessation of therapy. Evidence suggests that patients with psoriasis have a higher risk of AIH. Drug induced AIH and drug induced liver injury (DILI) can be quite challenging to diagnose due to the similar presentations and a recent study also suggest that infliximab was associated with a higher risk of DILI than other agents like adalimumab and etanercept. Our literature search has shown, that TNF-alpha antagonists, especially adalimumab and infliximab are known to trigger many autoimmune conditions like Psoriasis, Inflammatory Bowel disease (IBD), Systemic Lupus Erythematosus (SLE), and vasculitis, with the majority of cases having good outcomes following cessation of drug. Drug induced demyelinating disease and interstitial lung disease is noted to have poor outcomes. Interestingly, biologic agent induced IBD is more common than AIH. Key learning points/Conclusion The number and complexity of drug-induced autoimmune syndromes with biologics has increased in the recent years. Anti-TNF-induced AIH has occurred most commonly with Infliximab and much less commonly with adalimumab or etanercept. Physicians dealing with patients treated with biological therapies should be aware of the possible development of several autoimmune phenomena, and close follow-up and monitoring is essential. Before commencing anti-TNF therapy in patients with any autoimmune conditions, it is imperative to have a baseline liver profile and autoimmune profile so as to differentiate between AIH and other causes of liver derangement including genetic predisposition. It is also crucial to rule out other potential causes of hepatitis including alcohol use, viral infection, and hepatotoxic medications. Clinical response is excellent in almost all cases following discontinuation of anti TNF therapy and in severe cases low or moderate steroid therapy and hepatologist input is needed. Close monitoring and regular follow-up with blood tests would help in minimising adverse drug reactions. Referral to hepatologist is recommended if ALT> 3 times the upper limit of normal or when there is an increase in bilirubin or onset of jaundice.

The ideas put forth here do not fit perfectly or entirely into the genre and form of what has established itself as the scholarly journal article. What is put forth, instead, is a juxtaposition of lines of thinking about the scholarly and popular in publishing, past, present and future. As such it may indeed be quite appropriate to the occasion and the questions raised in the call for papers for this special issue of M/C Journal. The ideas put forth here are intended as pieces of an ever-changing puzzle of the making public of scholarship, which, I hope, may in some way fit with both the work of others in this special issue and in the discourse more broadly. The first line of thinking presented takes the form of an historical overview of publishing as context to consider a second line of thinking about the current status and future of publishing. The historical context serves as reminder (and cause for celebration) that publishing has not yet perished, contrary to continued doomsday sooth-saying that has come with each new medium since the advent of print. Instead, publishing has continued to transform and it is precisely the transformation of print, print culture and reading publics that are the focus of this article, in particular, in relation to the question of the boundaries between the scholarly and the popular. What follows is a juxtaposition that is part of an investigation in progress. Presented first, therefore, is a mapping of shifts in print culture from the time of Gutenberg to the twentieth century; second, is a contemporary snapshot of the editorial mandates of more than one hundred member journals of the Canadian Association of Learned Journals (CALJ). What such juxtaposition is able to reveal is open to interpretation, of course. And indeed, as I proceed in my investigation of publishing past, present and future, my interpretations are many. The juxtaposition raises a number of issues: of communities of readers and the cultures of reading publics; of privileged and marginalised texts (as well as their authors and their readers); of access and reach (whether in terms of what is quantifiable or in a much more subtle but equally important sense). In Canada, at present, these issues are also intertwined with changes to research funding policies and some attention is given at the end of this article to the Social Sciences and Humanities Research Council (SSHRC) of Canada and its recent/current shift in funding policy. Curiously, current shifts in funding policies, considered alongside an historical overview of publishing, would suggest that although publishing continues to transform, at the same time, as they say, plus ça change, plus c’est la même chose. Republics of Letters and Ghosts in Machines Republics of Letters that formed after the advent of the printing press can be conjured up as distant and almost mythical communities of elite literates, ghosts almost lost in a Gutenberg galaxy that today encompasses (and is embodied in) schools, bookshelves, and digital archives in many places across the globe. Conjuring up ghosts of histories past seems always to reveal ironies, and indeed some of the most interesting ironies of the Gutenberg galaxy involve McLuhanesque reversals or, if not full reversals, then in the least some notably sharp turns. There is a need to define some boundaries (and terms) in the framing of the tracing that follows. Given that the time frame in question spans more than five hundred years (from the advent of Gutenberg’s printing press in the fifteenth century to the turn of the 21st century), the tracing must necessarily be done in broad strokes. With regard to what is meant by the “making public of scholarship” in this paper, by “making public” I refer to accounts historians have given in their attempts to reconstruct a history of what was published either in the periodical press or in books. With regard to scholarship (and the making public of it), as with many things in the history of publishing (or any history), this means different things in different times and in different places. The changing meanings of what can be termed “scholarship” and where and how it historically has been made public are the cornerstones on which this article (and a history of the making public of scholarship) turn. The structure of this paper is loosely chronological and is limited to the print cultures and reading publics in France, Britain, and what would eventually be called the US and Canada, and what follows here is an overview of changes in how scholarly and popular texts and publics are variously defined over the course of history. The Construction of Reading Publics and Print Culture In any consideration of “print culture” and reading publics, historical or contemporary, there are two guiding principles that historians suggest should be kept in mind, and, though these may seem self-evident, they are worth stating explicitly (perhaps precisely because they seem self-evident). The first is a reminder from Adrian Johns that “the very identity of print itself has had to be made” (2 italics in original). Just as the identity of print cultures are made, similarly, a history of reading publics and their identities are made, by looking to and interpreting such variables as numbers and genres of titles published and circulated, dates and locations of collections, and information on readers’ experiences of texts. Elizabeth Eisenstein offers a reminder of the “widely varying circumstances” (92) of the print revolution and an explicit acknowledgement of such circumstances provides the second, seemingly self-evident guiding principle: that the construction of reading publics and print culture must not only be understood as constructed, but also that such constructions ought not be understood as uniform. The purpose of the reconstructions of print cultures and reading publics presented here, therefore, is not to arrive at final conclusions, but rather to identify patterns that prove useful in better understanding the current status (and possible future) of publishing. The Fifteenth and Sixteenth Centuries—Boom, then Busted by State and Church In search of what could be termed “scholarship” following the mid-fifteenth century boom of the early days of print, given the ecclesiastical and state censorship in Britain and France and the popularity of religious texts of the 15th and 16th centuries, arguably the closest to “scholarship” that we can come is through the influence of the Italian Renaissance and the revival and translation (into Latin, and to a far lesser extent, vernacular languages) of the classics and indeed the influence of the Italian Renaissance on the “print revolution” is widely recognised by historians. Historians also recognise, however, that it was not long until “the supply of unpublished texts dried up…[yet for authors] to sell the fruits of their intellect—was not yet common practice before the late 16th century” (Febvre and Martin 160). Although this reference is to the book trade in France, in Britain, and in the regions to become the US and Canada, reading of “pious texts” was similarly predominant in the early days of print. Yet, the humanist shift throughout the 16th century is evidenced by titles produced in Paris in the first century of print: in 1501, in a total of 88 works, 53 can be categorised as religious, with 25 categorised as Latin, Greek, or Humanist authors; as compared to titles produced in 1549, in a total of 332 titles, 56 can be categorised as religious with 204 categorised as Latin, Greek, or Humanist authors (Febvre and Martin 264). The Seventeenth Century—Changes in the Political and Print Landscape In the 17th century, printers discovered that their chances of profitability (and survival) could be improved by targeting and developing a popular readership through the periodical press (its very periodicity and relative low cost both contributed to its accessibility by popular publics) in Europe as well as in North America. It is worthwhile to note, however, that “to the end of the seventeenth century, both literacy and leisure were virtually confined to scholars and ‘gentlemen’” (Steinberg 119) particularly where books were concerned and although literacy rates were still low, through the “exceptionally literate villager” there formed “hearing publics” who would have printed texts read to them (Eisenstein 93). For the literate members of the public interested not only in improving their social positions through learning, but also with intellectual (or spiritual or existential) curiosity piqued by forbidden books, it is not surprising that Descartes “wrote in French to a ‘lay audience … open to new ideas’” (Jacob 41). The 17th century also saw the publication of the first scholarly journals. There is a tension that becomes evident in the seventeenth century that can be seen as a tension characteristic of print culture, past and present: on the one hand, the housing of scholarship in scholarly journals as a genre distinct from the genre of the popular periodicals can be interpreted as a continued pattern of (elitist) divide in publics (as seen earlier between the oral and the written word, between Latin and the vernacular, between classic texts and popular texts); while, on the other hand, some thinkers/scholars of the day had an interest in reaching a wider audience, as printers always had, which led to the construction and fragmentation of audiences (whether the printer’s market for his goods or the scholar’s marketplace of ideas). The Eighteenth Century—Republics of Letters Become Concrete and Visible The 18th century saw ever-increasing literacy rates, early copyright legislation (Statute of Anne in 1709), improved printing technology, and ironically (or perhaps on the contrary, quite predictably) severe censorship that in effect led to an increased demand for forbidden books and a vibrant and international underground book trade (Darnton and Roche 138). Alongside a growing book trade, “the pulpit was ultimately displaced by the periodical press” (Eisenstein 94), which had become an “established institution” (Steinberg 125). One history of the periodical press in France finds that the number of periodicals (to remain in publication for three or more years) available to the reading public in 1745 numbered 15, whereas in 1785 this increased to 82 (Censer 7). With regard to scholarly periodicals, another study shows that between 1790 and 1800 there were 640 scientific-technological periodicals being published in Europe (Kronick 1961). Across the Atlantic, earlier difficulties in cultivating intellectual life—such as haphazard transatlantic exchange and limited institutions for learning—began to give way to a “republic of letters” that was “visible and concrete” (Hall 417). The Nineteenth Century—A Second Boom and the Rise of the Periodical Press By the turn of the 19th century, visible and concrete republics of letters become evident on both sides of the Atlantic in the boom in book publishing and in the periodical press, scholarly and popular. State and church controls on printing/publishing had given way to the press as the “fourth estate” or a free press as powerful force. The legislation of public education brought increased literacy rates among members of successive generations. One study of literacy rates in Britain, for example, shows that in the period from 1840–1870 literacy rates increased by 35–70 per cent; then from 1870–1900, literacy increased by 78–261 per cent (Mitch 76). Further, with the growth and changes in universities, “history, languages and literature and, above all, the sciences, became an established part of higher education for the first time,” which translated into growing markets for book publishers (Feather 117). Similarly the periodical press reached ever-increasing and numerous reading publics: one estimate of the increase finds the publication of nine hundred journals in 1800 jumping to almost sixty thousand in 1901 (Brodman, cited in Kronick 127). Further, the important role of the periodical press in developing communities of readers was recognised by publishers, editors and authors of the time, something equally recognised by present-day historians describing the “generic mélange of the periodical … [that] particularly lent itself to the interpenetration of language and ideas…[and] the verbal and conceptual interconnectedness of science, politics, theology, and literature” (Dawson, Noakes and Topham 30). Scientists recognised popular periodicals as “important platforms for addressing a non-specialist but culturally powerful public … [they were seen as public] performances [that] fulfilled important functions in making the claims of science heard among the ruling élite” (Dawson et al. 11). By contrast, however, the scholarly journals of the time, while also increasing in number, were becoming increasingly specialised along the same disciplinary boundaries being established in the universities, fulfilling a very different function of forming scholarly and discipline-specific discourse communities through public (published) performances of a very different nature. The Twentieth Century—The Tension Between Niche Publics and Mass Publics The long-existing tension in print culture between the differentiation of reading publics on the one hand, and the reach to ever-expanding reading publics on the other, in the twentieth century becomes a tension between what have been termed “niche-marketing” and “mass marketing,” between niche publics and mass publics. What this meant for the making public of scholarship was that the divides between discipline-specific discourse communities (and their corresponding genres) became more firmly established and yet, within each discipline, there was further fragmentation and specialisation. The niche-mass tension also meant that although in earlier print culture, “the lines of demarcation between men of science, men of letters, and scientific popularizers were far from clear, and were constantly being renegotiated” (Dawson et al 28), with the increasing professionalisation of academic work (and careers), lines of demarcation became firmly drawn between scholarly and popular titles and authors, as well as readers, who were described as “men of science,” as “educated men,” or as “casual observers” (Klancher 90). The question remains, however, as one historian of science asks, “To whom did the reading public go in order to learn about the ultimate meaning of modern science, the professionals or the popularizers?” (Lightman 191). By whom and for whom, where and how scholarship has historically been made public, are questions worthy of consideration if contemporary scholars are to better understand the current status (and possible future) for the making public of scholarship. A Snapshot of Scholarly Journals in Canada and Current Changes in Funding Policies The here and now of scholarly journal publishing in Canada (a growing, but relatively modest scholarly journal community, compared to the number of scholarly journals published in Europe and the US) serves as an interesting microcosm through which to consider how scholarly journal publishing has evolved since the early days of print. What follows here is an overview of the membership of the Canadian Association of Learned Journals (CALJ), in particular: (1) their target readers as identifiable from their editorial mandates; (2) their print/online/open-access policies; and (3) their publishers (all information gathered from the CALJ website, http://www.calj-acrs.ca/). Analysis of the collected data for the 100 member journals of CALJ (English, French and bilingual journals) with available information on the CALJ website is presented in Table 1 (below). A few observations are noteworthy: (1) in terms of readers, although all 100 journals identify a scholarly audience as their target readership, more than 40% of the journal also identify practitioners, policy-makers, or general readers as members of their target audience; (2) more than 25% of the journals publish online as well as or instead of print editions; and (3) almost all journals are published either by a Canadian university or, in one case, a college (60%) or a scholarly or professional society (31%). Table 1: Target Readership, Publishing Model and Publishers, CALJ Members (N=100) Journals with identifiable scholarly target readership 100 Journals with other identifiable target readership: practitioner 35 Journals with other identifiable target readership: general readers 18 Journals with other identifiable target readership: policy-makers/government 10 Total journals with identifiable target readership other than scholarly 43 Journals publishing in print only 56 Journals publishing in print and online 24 Journals publishing in print, online and open access 16 Journals publishing online only and open access 4 Journals published through a Canadian university press, faculty or department 60 Journals published by a scholarly or professional society 31 Journals published by a research institute 5 Journals published by the private sector 4 In the context of the historical overview presented earlier, this data raises a number of questions. The number of journals with target audiences either within or beyond the academy raises issues akin to the situation in the early days of print, when published works were primarily in Latin, with only 22 per cent in vernacular languages (Febvre and Martin 256), thereby strongly limiting access and reach to diverse audiences until the 17th century when Latin declined as the international language (Febvre and Martin 275) and there is a parallel to scholarly journal publishing and their changing readership(s). Diversity in audiences gradually developed in the early days of print, as Febvre and Martin (263) show by comparing the number of churchmen and lawyers with library collections in Paris: from 1480–1500 one lawyer and 24 churchmen had library collections, compared to 1551–1600, when 71 lawyers and 21 churchmen had library collections. Although the distinctions between present-day target audiences of Canadian scholarly journals (shown in Table 1, above) and 16th-century churchmen or lawyers no doubt are considerable, again there is a parallel with regard to changes in reading audiences. Similarly, the 18th-century increase in literacy rates, education, and technological advances finds a parallel in contemporary questions of computer literacy and access to scholarship (see Willinsky, “How,” Access, “Altering,” and If Only). Print culture historians and historians of science, as noted above, recognise that historically, while scholarly periodicals have increasingly specialised and popular periodicals have served as “important platforms for addressing a non-specialist but culturally powerful public…[and] fulfill[ing] important functions in making the claims of science heard among the ruling élite” (Dawson 11), there is adrift in current policies changes (and in the CALJ data above) a blurring of boundaries that harkens back to earlier days of print culture. As Adrian John reminded us earlier, “the very identity of print itself has had to be made” (2, italics in original) and the same applies to identities or cultures of print and the members of that culture: namely, the readers, the audience. The identities of the readers of scholarship are being made and re-made, as editorial mandates extend the scope of journals beyond strict, academic disciplinary boundaries and as increasing numbers of journals publish online (and open access). In Canada, changes in scholarly journal funding by the Social Sciences and Humanities Research Council (SSHRC) of Canada (as well as changes in SSHRC funding for research more generally) place increasing focus on impact factors (an international trend) as well as increased attention on the public benefits and value of social sciences and humanities research and scholarship (see SSHRC 2004, 2005, 2006). There is much debate in the scholarly community in Canada about the implications and possibilities of the direction of the changing funding policies, not least among members of the scholarly journal community. As noted in the table above, most scholarly journal publishers in Canada are independently published, which brings advantages of autonomy but also the disadvantage of very limited budgets and there is a great deal of concern about the future of the journals, about their survival amidst the current changes. Although the future is uncertain, it is perhaps worthwhile to be reminded once again that contrary to doomsday sooth-saying that has come time and time again, publishing has not perished, but rather it has continued to transform. I am inclined against making normative statements about what the future of publishing should be, but, looking at the accounts historians have given of the past and looking at the current publishing community I have come to know in my work in publishing, I am confident that the resourcefulness and commitment of the publishing community shall prevail and, indeed, there appears to be a good deal of promise in the transformation of scholarly journals in the ways they reach their audiences and in what reaches those audiences. Perhaps, as is suggested by the Canadian Centre for Studies in Publishing (CCSP), the future is one of “inventing publishing.” References Canadian Association of Learned Journals. Member Database. 10 June 2008 ‹http://www.calj-acrs.ca/>. Canadian Centre for Studies in Publishing. 10 June 2008. ‹http://www.ccsp.sfu.ca/>. Censer, Jack. The French Press in the Age of Enlightenment. London: Routledge, 1994. Darnton, Robert, Estienne Roche. 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“A bunch of faggots for watching men hug each other in tights.”For the past five Marches, World Wrestling Entertainment (WWE) has produced an awards show which honours its aged former performers, such as Jimmy “Superfly” Snuka and Ricky “The Dragon” Steamboat, as pro-wrestling Legends. This awards show, according to WWE, is ‘an elegant, emotional, star-studded event that recognizes the in-ring achievements of the inductees and offers historical insights into this century-old sports-entertainment attraction’ (WWE.com, n.p.). In an episodic storyline leading up to the 2009 awards, however, the real-life personal shortcomings of these Legends have been brought to light, and subsequently mocked in one-on-one interview segments with WWE’s Superstar of the Year 2008, the dastardly Chris Jericho. Jericho caps off these tirades by physically assaulting the Legends with handy stage props. Significantly, the performances of Jericho and his victims have garnered positive attention not only from mass audiences unaware of backstage happenings in WWE, but also from the informed community of pro-wrestling fans over at the nihilistic humour website SomethingAwful. During Jericho’s assault on the Legend Jimmy “Superfly” Snuka at the March 02 WWE Raw event, a WWE-themed forum thread on SomethingAwful logged over sixty posts all reiterating variations of ‘gently caress me Jericho is amazing’ (Jerusalem, n.p.). This is despite the community’s passive-aggressive and ironically jaded official line that they indeed are ‘a bunch of faggots for watching men hug each other in tights. Thank you for not telling us this several times’ (HulkaMatt, n.p.). Why were these normally cynical fans of WWE enthusiastically expressing their love for the Jericho-Legends feud? In order to answer this question, this paper argues that the feud articulates not only the ideal of the “giving wrestler”, but also Roland Barthes’s version of jouissance. Consuming and commenting on WWE texts within the SomethingAwful community is further argued to be a performative ritual in which informed wrestling fans distance themselves from audiences they perceive as uncritical and ill-informed cultural dupes. The feud, then, allows the SomethingAwful fans to perform enthusiasm on two interconnected levels: they are not only able to ironically cheer on Jericho’s morally reprehensible actions, but also to genuinely appreciate the present-day in-ring efforts of the Legends. The Passion of the SuperflyTo properly contextualise this paper, though, the fact that “pro wrestling is fake” needs to be reiterated. Each match is a choreographed sequence of moves. Victory does not result from landing more damaging bodyslams than one's opponent, but is instead predetermined by scriptwriters—among whom wrestlers are typically not numbered—backstage. In the 1950s, Roland Barthes thus commented that pro wrestling ‘is not a sport, it is a spectacle’ (Mythologies 13). Yet, pro wrestling remains popular because this theatricality allows for the display of spectacular excesses of passion—here Barthes not only means “an intensity of emotion”, but refers to the physically tortured heroes of medieval passion plays as well—giving it an advantage over the legitimate sport of amateur wrestling. ‘It is obvious that at such a pitch, it no longer matters whether the passion is genuine or not. What the public wants is the image of passion, not passion itself’ (Mythologies 16). This observation still holds true in today’s WWE. On one hand, the SomethingAwful fans go ‘gently caress Jericho, [Superfly] will MURDER you’ (Jerusalem, n.p.) in disapproval of Jericho’s on-screen actions. In the same thread, though, they simultaneously fret over him being slightly injured from an off-screen real life accident. ‘Jericho looks busted up on his forehead. Dang’ (Carney, n.p.).However, Barthes’s observations, while seminal, are not the be-all and end-all of pro wrestling scholarship. The industry has undergone a significant number of changes since the 1950s. Speeches and interview segments are now seen as essential tools for furthering storylines. Correspondingly, they are given ample TV time. At over ten minutes, the Jericho-“Superfly” confrontation from the March 02 Raw is longer than both the matches following it, and a fifteen minute conversation between two top wrestlers capstones these two matches. Henry Jenkins has thus argued that pro wrestling is a male-targeted melodrama. Its ‘writers emphasize many traits that [legitimate sports such as] football share with melodrama-the clear opposition between characters, the sharp alignment of audience identification, abrupt shifts in fortune, and an emotionally satisfying resolution’ (Jenkins, “Never Trust a Snake” 81). Unlike football, though, the predetermined nature of pro wrestling means that its events can be ‘staged to ensure maximum emotional impact and a satisfying climax’ (Jenkins, “Never Trust a Snake” 81). Further, Jenkins notes that shouting is preferred over tears as an outlet for male affect. It ‘embodies externalised emotion; it is aggressive and noisy. Women cry from a position of emotional (and often social) vulnerability; men shout from a position of physical and social strength (however illusory)’ (Jenkins, “Never Trust a Snake” 80). Pro wrestling is seen to encourage this outlet for affect by offering its viewers spectacles of male physical prowess to either castigate or cheer. Jericho’s assault of the Legends, coupled with his half-screaming, half-shouting taunts of “‘Hall of Famer’? ‘Hall of Famer’ of what? You’re a has-been! Just like all the rest!” could be read to fit within this paradigm as well. Smarts vs. MarksWWE has repeatedly highlighted its scripted nature in recent years. During a 2007 CNN interview, for instance, WWE Chairman Vince McMahon constantly refers to his product as “entertainment” and laughingly agrees that “it’s all story” when discussing his on-screen interactions with his long-lost midget “son” (Griffin, n.p.). These overt acknowledgments that WWE is a highly choreographed melodrama have boosted the growth of a fan demographic referred to the "smart" in pro-wrestling argot. This “smart” fan is a figure for whom the fabricated nature of pro-wrestling necessitates an engagement with the WWE spectacle at a different level from mass audiences. The “smart” not only ‘follow[s] the WWE not just to see the shows, but to keep track of what “the Fed[eration]” is doing’ (McBride and Bird 170) with regards to off-camera events, but also 'has knowledge of the inner-workings of the wrestling business’ (PWTorch, n.p.). One of the few “GOLD”-rated threads on the SomethingAwful smart forums, accordingly, is titled “WWE News and Other Top Stories, The Insider Thread”, and has nearly 400 000 views and over 1000 posts. As a result, the smarts are in a subject position of relative insider-ness. They consume the WWE spectacle at a deeper level—one which functions roughly like an apparatus of capture for the critical/cynical affect mobilised around the binary of ‘real’ and ‘fake’—yet ultimately remain captured by the spectacle through their autodidact enthusiasm for knowledge which uncovers its inner workings.By contrast, there is the category of the “mark” fan. These “marks” are individuals who remain credulous in their reception of WWE programming. As cuteygrl08 writes regarding a recent WWE storyline involving brotherly envy:I LOVE JEFF HARDY!!!! i cried when i heard his brother say all the crap about him!! kinda weird but i love him and this video is soooo good!! JEFF hardy loves his fans and his fans love him no matter what he does i'll always love JEFF HARDY!!!!!!!!!!! (n.p.)This unstinting faith in the on-screen spectacle is understandable insofar as WWE programming trades upon powerful visual markers of authenticity—nearly-bare bodies, sweat, pained facial expressions­—and complements them with the adrenaline-producing beats of thrash metal and hard rock. Yet, smarts look down upon marks like cuteygrl08, seeing them as Frankfurt School-era hypnotised sots for whom the WWE spectacle is ‘the common ground of the deceived gaze and of false consciousness’ (Debord 117), and additionally as victims of a larger media industry which specialises in mass deception (Horkheimer and Adorno 41). As Lawrence McBride and Elizabeth Bird observe:Marks appear to believe in the authenticity of the competition—Smarts see them as the stereotypical dupes imagined by wrestling critics. Smarts approach the genre of wrestling as would-be insiders, while Marks root unreflexively for the most popular faces. Smart fans possess truly incredible amounts of knowledge about the history of wrestling, including wrestler’s real names and career histories, how various promotions began and folded, who won every Wrestlemania ever. Smart fan informants defined a Mark specifically as someone who responds to wrestling in the way intended by the people who write the storylines (the bookers), describing Marks with statements such as “Kids are Marks.” or “We were all Marks when we were kids.” Smarts view Marks with scorn. (169)Perhaps feeding on the antagonistic binaries drawn by WWE programming, there exists an “us vs them” binary in smart fan communities. Previous research has shown that fan communities often rigidly police the boundaries of “good taste”, and use negatively constructed differences as a means of identity construction (Fiske 448; Jenkins, “Get a Life!” 432; Theodoropoulou 321). This ritual Othering is especially important when supporting the WWE. Smarts are aware that they are fans of a product denigrated by non-fans as ‘trash TV’ (McKinley, n.p.). As Matt Hills finds, fandom is a mode of performative consumption. It is ‘an identity which is (dis)claimed, and which performs cultural work’ (Hills xi). Belonging to the SomethingAwful smart community, thus, exerts its own pressures on the individual smart. There, the smart must perform ‘audiencehood, knowing that other fans will act as a readership for speculation, observation, and commentaries’ (Hills 177). Wrestling, then, is not just to be watched passively. It must be analysed, and critically dissected with reference to the encyclopaedic knowledge treasured by the smart community. Mark commentary has to be pilloried, for despite all the ironic disaffection characterising their posts, the smarts display mark-like behaviour by watching and purchasing WWE programming under their own volition. A near-existential dread is hence articulated when smarts become aware of points where the boundaries between smart and mark overlap, that ‘the creatures that lurk the internet ...carry some of the same interests that we do’ (rottingtrashcan, n.p.). Any commonalities between smarts and marks must thus be disavowed as a surface resemblance: afterall, creatures are simply unthinking appetites, not smart epicures. We’re better than those plebs; in fact, we’re nothing like them any more. Yet, in one of the few forms of direct address in the glossary of smart newsletter PWTorch, to “mark out” is ‘to enthusiastically be into [a storyline] or match as if you [emphasis added] were “a mark”; to suspend one's disbelief for the sake of enjoying to a greater extent a match or [a storyline]’ (PWTorch, n.p.). The existence of the term “marking out” in a smart glossary points to an enjoyably liminal privileged position between that of defensively ironic critic and that of credulous dupe, one where smarts can stop their performance of cooler-than-thou fatigue and enthusiastically believe that there is nothing more to WWE than spontaneous alarms and excursions. The bodily reactions of the Legends in response to Jericho's physical assault helps foster this willing naiveté. These reactions are a distressing break from the generic visual conventions set forth by preceding decades of professional wrestling. As Barthes argues, wrestling is as much concerned with images of spectacular suffering as with narratives of amazing triumphs:the wrestler who suffers in a hold which is reputedly cruel (an arm- lock, a twisted leg) offers an excessive portrayal of Suffering; like a primitive Pieta, he exhibits for all to see his face, exaggeratedly contorted by an intolerable affliction. It is obvious, of course, that in wrestling reserve would be out of place, since it is opposed to the voluntary ostentation of the spectacle, to this Exhibition of Suffering which is the very aim of the fight. (17)Barthes was writing of the primitively filmed wrestling matches of the 1950s notable for their static camera shots. However, WWE wrestlers yet follow this theatrical aesthetic. In the match immediately following Jericho’s bullying of Superfly, Kane considerately jumps the last two feet into a ringside turnbuckle after Mike Knox pushes him into its general vicinity. Kane grunts at the impact while the camera cuts to a low-angled shot of his back—all the better to magnify the visual of the 150 kg Knox now using his bulk to squash Kane. Whenever Jericho himself traps his opponent in his “Walls of Jericho” submission manoeuvre, both their faces are rictuses of passion. His opponent clutches for the safety of the ring ropes, shaking his head in heroic determination. Audiences see Jericho tighten his grip, his own head shaking in villainous purpose. But the Legends do not gyrate around the set when hit. Instead, they invariably slump to the ground, motionless except for weakly spasming to the rhythm of Jericho’s subsequent attacks. This atypical reaction forces audiences—smart and mark alike—to re-evaluate any assumptions that the event constitutes a typical WWE beatdown. Overblown theatricality gives way to a scene which seems more related to everyday experiences with pain: Here's an old man being beaten and whipped by a strong, young man. He's not moving. Not like other wrestlers do. I wonder... The battered bodies of these Legends are then framed in high angle camera shots, making them look ever so much more vulnerable than they were prior to Jericho’s assault. Hence the smart statements gushing that ‘gently caress me Jericho is amazing’ (Jerusalem, n.p.) and that Jericho’s actions have garnered a ‘rear end in a top hat chant [from the crowd]. It has been FOREVER since I heard one of those. I love Chris Jericho’ (Burrito, n.p.).Jouissance and “Marking Out”This uninhibited “marking out” by normally cynical smarts brings to mind Barthes's observation that texts are able to provoke two different kinds of enjoyment in their readers. On one hand, there is the text which provides pleasure born from familiarity. It ‘contents, fills, grants euphoria; [it is] the text that comes from culture and does not break with it, is linked to a comfortable practice of reading’ (Barthes, Image-Music-Text 14). The Knox-Kane match engendered such a been-there-done-that-it's-ok-I-guess overall reaction from smarts. For every ‘Mike Knox throwing Mysterio at Kane was fantastic’ (Burrito, n.p.), there is an ‘Ahahaha jesus Knox [sic] that was the shittiest Hurracanrana sell ever’ (Axisillian, n.p.), and a ‘Hit the beard [sic] it is Knox's weakpoint’ (Eurotrash, n.p.). The pleasant genericity of the match enables and necessitates that these smarts maintain their tactic of ironic posturing. They are able to armchair critique Knox for making his opponent's spinning Hurracanrana throw look painless. Yet they are also allowed to reiterate their camp affection for Knox's large and bushy beard, which remains grotesque even when divorced from a WWE universe that celebrates sculpted physiques.By contrast, Barthes praises the text of rapturous jouissance. It is one where an orgasmic intensity of pleasure is born from the unravelling of its audience’s assumptions, moving them away from their comfort zone. It is a text which ‘imposes a stage of loss, [a] text that discomforts (perhaps to the point of boredom), unsettles the reader's historical, cultural, psychological assumptions, the consistency of his tastes, values, memories, brings to crisis his relation with language’ (Barthes, Image-Music-Text 14). In addition to the atypical physical reactions of the Legends, WWE cynically positions the Jericho-Legends segments during Raw events which also feature slick video montages highlighting the accomplishments of individual Legends. These montages—complete with an erudite and enthusiastic Voice-of-God narrator— introduce the long-retired Legends to marks unfamiliar with WWE's narrative continuity: “Ladies and gentlemen! Rrriiiicky “The Draaagon” Steeeeamboat!”. At the same time, they serve as a visually and aurally impressive highlight-reel-cum-nostalgic-celebration of each Legend's career accomplishments. Their authoritative narration is spliced to clips of past matches, and informs audiences that, for instance, Steamboat was ‘one of the first Superstars to combine technical skills with astounding aerial agility ... in a match widely regarded as one of the best in history, he captured the Intercontinental title from Randy Savage in front of a record-breaking 93 173 fans’ (“Raw #636”, WWE). Following the unassailably authentic video footage of past matches, other retired wrestlers speak candidly in non-WWE stages such as outdoor parks and their own homes about the Legend's strengths and contributions to the industry.The interesting thing about these didactic montages is not so much what they show —Legends mythologised into triumphant Titans — but rather, what they elide. While the Steamboat-centred package does reflect the smart consensus that his Intercontinental bout ‘was a technical classic, and to this day, is still considered one of the greatest matches of all-time’ (NPP, n.p.), it does not mention how Steamboat was treated poorly in the WWE. Despite coming to it as the widely-known World Champion of [the NWA] rival promotion, WWE producers ‘dressed Steamboat up as a dragon and even made him blow fire. ...To boot, he was never acknowledged as a World Champion and [kept losing] to the stars’ (NPP, n.p.). The montages, overtly endorsed by the gigantic WWE logo as they are, are ultimately pleasant illusions which rewrite inconvenient truths while glamorising pleasant memories.Jericho’s speeches, however, sharply break from this celebratory mode. He references Steamboat’s previous success in the NWA, ‘an organisation that according to this company never even existed’(“Raw #636”, WWE). He then castigates Steamboat for being a real-life sellout and alludes to Steamboat having personal problems unmentioned in the montage:It wasn't until you came to the WWE that you sold your soul to all of these parasites [everyone watching] that you became “The Dragon”. A glorified Karate Kid selling headbands and making poses. Feeding into stereotypes. And then you eventually came to the ring with a Komodo Dragon. Literally spitting fire like the circus freak you'd become. It was pathetic. But hey, it's all right as long as you're making a paycheck, right Steamboat? And then when you decided to retire, you ended up like all the rest. Down and out. Broken. Beaten down. Dysfunctional family ...You applied for a job working for the WWE, you got one working backstage, and now here you are. You see, Steamboat, you are a life-long sellout. And now, with the Hall of Fame induction, the loyal dog gets his bone. (WWE)Here, Jericho demonstrates an apparent unwillingness to follow the company line by not only acknowledging the NWA, but also by disrespecting a current WWE backstage authority. Yet, wrestlers having onscreen tangles with their bosses is the norm for WWE. The most famous storyline of the 1990s had “Stone Cold” Steve Austin and the WWE Chairman brutalising each other for months on end, and the fifteen minute verbal exchange mentioned earlier concerns one wrestler previously attacking the Raw General Manager. Rather, it is Jericho’s reinterpretation of Steamboat’s career trajectory which gives the storyline the intensely pleasurable uncertainty of jouissance. His confrontational speeches rupture the celebratory nostalgia of the montages, forcing smarts to apply extra-textual knowledge to them. This is especially relevant in Steamboat’s case. His montage was shown just prior to his meeting with Jericho, ensuring that his iconic status was fresh in the audience’s memory. Vera Dika’s findings on the conflict between memory and history in revisionist nostalgia films are important to remember here. The tension ‘that comes from the juxtaposition of the coded material against the historical context of the film itself ...encourages a new set of meanings to arise’ (Dika 91). Jericho cynically views the seemingly virtuous and heroic Steamboat as a corporate sycophant preying on fan goodwill to enrich his own selfish ends. This viewpoint, troublingly enough for smarts, is supported by their non-WWE-produced extra-textual knowledge, allowing for a meta-level melodrama to be played out. The speeches thus speak directly to smarts, simultaneously confounding and exceeding their expectations. The comfortingly pleasant memories of Steamboat’s “amazing aerial prowess” are de-emphasised, and he is further linked to the stereotypical juvenilia of the once-popular The Karate Kid. They articulate and capitalise upon whatever misgivings smarts may have regarding Steamboat’s real-life actions. Thus, to paraphrase Dika, ‘seen in this clash, [the Jericho-Legends feud] has the structure of irony, producing a feeling of nostalgia, but also of pathos, and registering the historical events as the cause of an irretrievable loss [of a Legend’s dignity]’ (91). “C’mon Legend! Live in the past!” taunts Jericho as he stuffs Superfly’s mouth with bananas and beats him amidst the wreckage of the exactingly reproduced cheap wooden set in the same way that “Rowdy” Roddy Piper did years ago (“RAW #637”, WWE). This literal dismantling of cherished memories results from WWE producers second-guessing the smarts, and providing these fans with an enjoyably uncomfortable jouissance that cleverly confounds the performance of a smart disaffection. “Marking out” —or its performance at least—results.The Giving WrestlerLastly, the general physical passivity of the Legends also ties into the ethos of the “giving wrestler” when combined with the celebratory montages. In a business where performed passion is integral to fan enjoyment, the “giving wrestler” is an important figure who, when hit by a high-risk move, will make his co-worker’s offense look convincing (McBride and Bird 173). He ‘will give his all in a performance to ensure a dual outcome: the match will be spectacular, benefiting the fans, and each wrestler will make his “opponent” look good, helping him “get over with the fans” (McBride and Bird 172). Unsurprisingly, this figure is appreciated by smarts, who ‘often form strong emotional attachments to those wrestlers who go to the greatest lengths to bear the burden of the performance’ (McBride and Bird 173). As described earlier, the understated reactions of the Legends make Jericho’s attacks paradoxically look as though they cause extreme pain. Yet, when this pathetic image of the Legends is combined with the hypermasculine images of them in their heyday, a tragedy with real-life referents is played out on-stage. In one of Jenkins’s ‘abrupt shifts of fortune’ (“Never Trust a Snake” 81), age has grounded these Legends. They can now believably be assaulted with impunity by someone that Steamboat dismisses as ‘a snotty brat wrestler of a kid[sic] ...a hypocrite’ (“Raw #636”, WWE), and even in this, they apparently give their all to make Jericho look viciously “good”, thus exceeding the high expectations of smarts. As an appreciative thread title on SomethingAwful states, ‘WWE Discussion is the RICKY STEAMBOAT OWN [wins] ZONE for 02/23/09’ (HulkaMatt, n.p.) ConclusionThe Jericho-Legends feud culminated the day after the Hall of Fame ceremony, at the WWE’s flagship Wrestlemania event. Actor Mickey Rourke humiliated Jericho for the honour of the Legends, flattening the cocky braggart with a single punch. The maximum degree of moral order possible was thus temporarily restored to an episodic narrative centred around unprovoked acts of violence. Ultimately though, it is important to note the three strategies that WWE used The Legends were scripted to respond feebly to Jericho’s physical assault, slick recap montages were copiously deployed, and Jericho himself was allowed candid metatextual references to incidents that WWE producers normally like to pretend have “never even existed”. All these strategies were impressive in their own right, and they eventually served to reinforce each other. 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