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Even after two hereditary successions of power and what would appear to be preparations for a third, the question of whether North Korea should be considered a monarchy is yet to be recognized as an important one. Taking both North Korean realities and relevant political-scientific discussions of the institution of monarchy into account, this paper argues that North Korea should indeed be considered a monarchy. The monarchical model, if properly understood, may afford insight into the stability and longevity of the regime, suggest a different approach to nuclear negotiations, and produce less alarming assessments of the risk of conflict than those currently informed by the perception of a conventional personalist dictatorship.

Even after two hereditary successions of power and what would appear to be preparations for a third, the question of whether North Korea should be considered a monarchy is yet to be recognized as an important one. Taking both North Korean realities and relevant political-scientific discussions of the institution of monarchy into account, this paper argues that North Korea should indeed be considered a monarchy. The monarchical model, if properly understood, may afford insight into the stability and longevity of the regime, suggest a different approach to nuclear negotiations, and produce less alarming assessments of the risk of conflict than those currently informed by the perception of a conventional personalist dictatorship.

FKBP12-rapamycin associated protein (FRAP, also known as mTOR or RAFT) is the founding member of the phosphatidylinositol kinase-related kinase family and functions as a sensor of physiological signals that regulate cell growth. Signals integrated by FRAP include nutrients, cAMP levels, and osmotic stress, and cellular processes affected by FRAP include transcription, translation, and autophagy. The mechanisms underlying the integration of such diverse signals by FRAP are largely unknown. Recently, FRAP has been reported to be regulated by mitochondrial dysfunction and depletion of ATP levels. Here we show that exposure of cells to hyperosmotic conditions (and to glucose-deficient growth medium) results in rapid and reversible dissipation of the mitochondrial proton gradient. These results suggest that the ability of FRAP to mediate osmotic stress response (and glucose deprivation response) is by means of an intermediate mitochondrial dysfunction. We also show that in addition to cytosolic FRAP a large portion of FRAP associates with the mitochondrial outer membrane. The results support the existence of a stress-sensing module consisting of mitochondria and mitochondrial outer membrane-associated FRAP. This module allows the cell to integrate a variety of stress signals that affect mitochondrial function and regulate a growth checkpoint involving p70 S6 kinase.

A former chestnut stand on the Cumberland Plateau of Tennessee was sampled in 1952/53, 1979, and 2000. The site was clear-cut in 1921/22, and has remained unburnt and relatively undisturbed. Chestnut stumps are present, but sprouts are not. Liriodendron tulipifera remained important in the canopy since 1952/53. Acer rubrum and A. saccharum increased in the canopy, but only A. rubrum did so in the subcanopy. Quercus rubra/velutina increased in the canopy, and decreased in the subcanopy. Shade-intolerant (Juglans nigra, Liquidambar styraciflua, Ulmus rubra, Fraxinus americana) and shade-tolerant (Tilia americana, Aesculus flava) species declined, perhaps due to absence of large-scale disturbance needed for regeneration. Juglans cinerea and Cornus florida were impacted by fungal pathogens. Although J. cinerea was an important replacement species, no individuals are currently present. Cornus florida is present in the canopy, but not in the subcanopy. Lindera benzoin and Viburnum acerifolium increased, apparently in response to C. florida's decline.

Techniques for enumerating the spanning trees of graphs and multigraphs are presented which involve weighted sums of the spanning forests of certain subgraphs and which both borrow from and contribute to the theories of weighted compositions and Fibonacci numbers, which supplemental reference to electrical resistor network concepts.

Commemorative medal presentations marking the 75th anniversary were made by [Lloyd Lohnes] to past presidents: Armand Fournier, Pat Gatenby, Willem Groeneveld, Winnie Koal, Robert Oldale, Howard Ostrander, Larry Salyn, Ron Stein, Joe Trail and Harry Weeks. Associate members presented with the 75th anniversary medal were: Jean Ford, Anita Fournier, Margaret Groeneveld, Eileen McIntosh, Dale McKean, Robert Moore, Donna Myers, Trudy Powelson, Karen Salyn, Louise Soulliere, Margaret Stein, Evelyn Theriault and Dorothy Trail. Photo: Submitted photo / Cutting the 75th anniversary cake at Legion Branch 55, left to right, Wilma Stevens, Yukon/Pacific command representative, Lloyd Lohnes, zone commander, [Ken McRae], mayor, and Ton Jackson, branch president. ;

Introduction and Hypothesis The objective was to assess long-term mesh complications following total hysterectomy and sacrocolpopexy. Methods In this second extension study, women from a multicenter randomized trial were followed for more than 36 months after surgery. Owing to COVID-19, participants were assessed through either in-person visits or telephone questionnaires. The primary outcome was the incidence of permanent suture or mesh exposure. Secondary outcomes included surgical success and late adverse outcomes. Results Out of the 200 initially enrolled participants, 82 women took part in this second extension study. Among them, 46 were in the permanent suture group, and 36 in the delayed absorbable group. The mean follow-up duration was 5.3 years, with the cumulative mesh or suture exposure of 9.9%, involving 18 cases, of which 4 were incident cases. Surgical success after more than 5 years stood at 95%, with few experiencing bothersome bulge symptoms or requiring retreatment. No serious adverse events occurred, including mesh erosion into the bladder or bowel. The most common adverse events were vaginal pain, bleeding, dyspareunia, and stress urinary incontinence, with no significant differences between suture types. Conclusion The study found that mesh exposure risk gradually increased over time, reaching nearly 10% after more than 5 years post-surgery, regardless of suture type. However, surgical success remained high, and no delayed serious adverse events were reported.

This multicenter, randomized trial compared the effects of clomiphene citrate plus placebo, metformin plus placebo, and combination therapy in infertile women with the polycystic ovary syndrome. The rate of live birth was significantly higher with clomiphene than with metformin; there was no significant difference between the rates with combination therapy and with clomiphene alone. Multiple birth was a complication associated with clomiphene but was infrequent. These data support the use of clomiphene over metformin for the treatment of infertility in women with the polycystic ovary syndrome. In infertile women with the polycystic ovary syndrome, the rate of live birth was significantly higher with clomiphene than with metformin. The polycystic ovary syndrome affects 7 to 8% of women 1 and may be the most common cause of female infertility. 2 Anovulation, 2 early pregnancy loss, 3 and later pregnancy complications 4 have all been implicated in the low fecundity of women with this disorder. Obesity is also common in such women, 5 and this condition alone appears to have an adverse effect on reproduction. 6 , 7 The cause of the polycystic ovary syndrome is poorly understood, and both the diagnosis and treatment of the disorder are controversial. 5 , 8 , 9 Women with this syndrome have hyperandrogenism, 10 morphologic changes in the ovary (polycystic), 10 inappropriate gonadotropin secretion (elevated . . .

Introduction and hypothesis The objective was to evaluate total and incident mesh exposure rates at least 2 years after minimally invasive total hysterectomy and sacrocolpopexy. Secondary aims were to evaluate surgical success and late adverse events. Methods This extension study included women previously enrolled in the multicenter randomized trial of permanent vs delayed-absorbable suture with lightweight mesh for > stage II uterovaginal prolapse. Owing to COVID-19, women were given the option of an in-person (questionnaires and examination) or telephone visit (questionnaires only). The primary outcome was total and incident suture or mesh exposure, or symptoms suggestive of mesh exposure in women without an examination. Secondary outcomes were surgical success, which was defined as no subjective bulge, no prolapse beyond the hymen, and no pelvic organ prolapse retreatment, and adverse events. Results A total of 182 out of 200 previously randomized participants were eligible for inclusion, of whom 106 (58%) women (78 in-person and 28 via questionnaire only) agreed to the extension study. At a mean of 3.9 years post-surgery, the rate of mesh or suture exposure was 7.7% (14 out of 182) of whom only 2 were incident cases reported after 1-year follow-up. None reported vaginal bleeding or discharge, dyspareunia, or penile dyspareunia. Surgical success was 93 out of 106 (87.7%): 13 out of 94 (13.8%) failed by bulge symptoms, 2 out of 78 (2.6%) by prolapse beyond the hymen, 1 out of 85 (1.2%) by retreatment with pessary, and 0 by retreatment with surgery. There were no serious adverse events. Conclusions The rate of incident mesh exposure between 1 and 3.9 years post-surgery was low, success rates remained high, and there were no delayed serious adverse events.

This multicenter trial showed no significant differences in the composite outcome of death or neurodevelopmental impairment among extremely preterm infants randomly assigned to early CPAP or early surfactant and to lower or higher oxygen saturation. Extremely premature infants are at high risk for death and neurosensory or developmental impairment in early childhood. 1 – 3 The risk of neurodevelopmental impairment increases with decreasing gestational age and greater severity of illness. Neurodevelopmental impairment is often a consequence of neonatal complications. 4 – 12 Although surfactant administration decreases the risk of death and bronchopulmonary dysplasia, randomized, controlled trials of various respiratory interventions have not shown significant reductions in mortality and morbidity or improvement in developmental outcomes. 13 – 17 We previously reported results of the multicenter, randomized, controlled Surfactant, Positive Pressure, and Pulse Oximetry Randomized Trial (SUPPORT), which involved extremely premature infants (from . . .