Artificial nutrition therapy is recognized as a key aspect in the management of critically sick patients, but there is still debate about the appropriate route and timing, particularly in the acute phase. It is a convenient, effective, safe, and well-tolerated method of clinical nutrition in the hospital and at home. When appropriate oral diet fails to supply the body with the required nutrients. EN is normally delivered by a nasogastric technique, whereas PN is usually administered through a central venous access, directly into the bloodstream. The injected nutrients can then be immediately absorbed by the various organs. Early mixed enteral nutrition (EN) and parenteral nutrition (PN) may be an appealing alternative in certain critically sick patients to meet recommended calorie and protein targets. PN is related with potentially serious or even deadly consequences when handled and administered incorrectly. Patient observation and treatment regimen adaptation are required.

In this third part, we present the English translation of the text ‘Bachofen and Nietzsche’, written by the philosopher Alfred Baeumler. Baeumler's text explores the relationship between Friedrich Nietzsche and Johann Jakob Bachofen, two influential figures in the fields of philosophy, anthropology, and history. Baeumler argues that Nietzsche's philosophy was deeply influenced by Bachofen's ideas on matriarchy, Antiquity, and the feminine. Baeumler suggests that Nietzsche's concept of the Dionysian was inspired by Bachofen's theory of the chthonic and the matriarchal. Baeumler also argues that Bachofen's ideas on matriarchy and the feminine challenged the traditional patriarchal order of Western civilization, and that Nietzsche's philosophy continued this challenge by advocating for a new, life-affirming culture based on the principles of the Dionysian. Finally, Baeumler suggests that Nietzsche's philosophy can be seen as a critical response to Bachofen's romanticism, and that it offers a more nuanced and complex understanding of the relationship between the past and the present.

This study aims at discussing how devolved governance system has an economic impact to rural counties in Kenya with Kakamega rural county as the case study. The Devolution is one of the most transformative changes to Kenya’s governance system brought about by the Kenya Constitution, 2010. Article 174 of the Constitution provides that one of the key objectives of devolution is to promote social and economic development and provide proximate, easily accessible services throughout Kenya. Many rural Counties including Kakamega County faced with a myriad of challenges such as poverty, unemployment, disease, low agricultural productivity among others. Kakamega County through its short, medium and long term plans came up with an Integrated Development Plan (CIDP). The CIDP helps the county in identification of the projects and programmes through various consultative forums at the sub-county level vide Focused Ward Groups, community dialogues, County Stakeholders, such as the County Budget and Economic Forum, Kenya National Chamber of Commerce, Public Benefit Organizations such as GROOTS Kenya, ADS, and International development partners such as UNICEF, UNDP and USAID. Kakamega county has achieved much in terms of developments in various sectors such as education, health, infrastructure and urbanization. This study contributes in highlighting how devolved governance system has a positive impact to rural areas in kenya. The study provides crucial insights on devolution as a tool to economic development changes in rural Kenya especially in Kakamega County.

This study examined managing school plant planning for climate change in the attainment of sustainable educational development for public secondary schools in Rivers State. Two research questions and two hypotheses guided the study. The descriptive design was adopted. The population of the study comprised all the 542 public junior and senior secondary schools in Rivers State. A sample of 304 principals representing 56% of the population served as the study respondents. This sample was selected using the stratified random sampling technique. A validated Likert-modified 4-scale 16 item instrument titled: ‘Managing School Plant Planning for Climate Change in Public Secondary Schools Questionnaire (MSPPCCPSSQ)’ was used for data collection and its reliability coefficient was established at 0.82 using the Cronbach Alpha Correlation coefficient. Mean and standard deviation were used to analyze the research questions while the z-test statistics was used to test the hypotheses at 0.05 level of significance. The findings of this study revealed that discouraging deforestation while encouraging afforestation where trees acting as wind breakers are planted; communicating effectively with students by promoting students’ engagements by means of enlightening students on the importance of respecting green spaces such as school gardens, parks are some of the ways of managing school plant planning for climate change in the attainment of sustainable educational development in public secondary schools in Rivers State, Nigeria. Based on these findings, the researcher recommended that Rivers State government should endeavor to champion the course of initiating proactive ways and policies in managing school plant planning for public secondary schools aimed at curbing the negative effects of climate change in Rivers State.

The study investigated the effect of item order on the reliability of mathematics test among secondary school students in Rivers State. One research question and one null hypothesis guided the study. Quasi – experimental research design was used and the study was carried out in nine public senior secondary schools in three local government areas in River State which was drawn using Simple Random Sampling Technique. A sample size of 507 students were drawn from the population of 904 through Stratified Random Sampling Technique and the application of Taro Yemen formula to determine the minimum sample size. The instrument used was Multiple Choice Format Mathematics Performance Test (MCFMPT) arranged in ascending, descending and inconsistent order of difficulty and students’ scores were used for data collection. The reliability of the instrument was 0.75 using split-half method of establishing reliability and Spearman Brown prophecy formula for internal consistency of the instrument. Mean and Standard deviation were used to answer research question while t-test and Analysis of variance (ANOVA) were used to test the null hypotheses at 0.05 alpha level. The results revealed that item order based of ascending, descending and inconsistent order do not have significant effect on the reliability of mathematics test among secondary school students. Based on the findings, it was recommended that all pattern of item order (ascending, descending and inconsistent order of difficulty) should be encouraged among secondary school students as it has no significant effect on reliability coefficient. Students should be motivated to improve their real abilities in mathematics related courses and not judging their underperformance in mathematics based on the arrangement of items.

Wheat (Triticum aestivum L.) widely grown in Pakistan during winter season. Aphid is one of the biological factors that inhibits seed germination and plant development. Methyl jasmonate is a plant growth regulator known to take part in defense responses against different types of stresses including Aphid attack. The current study was conducted to improve the growth of the wheat by the foliar application of Methyl jasmonate. Two wheat varieties (Shafaq and Gold) were be sown in plastic pots filled with 6 kg soil in each pot. After germination, wheat plants were treated with different Aphids. After three weeks of treatment data about survival percentage, root attributes, shoot attributes and nutrient analysis was be recorded using standard procedure. The experiment was be conducted under a complete randomized design (CRD) with three replicates and results was be deducted after statistical analysis. Different concentrations of methyl jasmonate (100 micromolar and 1mM) were applied to 20 days old wheat plant. Rhopalosiphum padi was allowed to infest the methyl jasmonate treated plants as well as non-treated plants. Control plants were covered with net and no concentration of methyl jasmonate were applied. Aphids were allowed to infest the plant for 48 hours, after that the plant from all treatments were sampled for all physiological studies. Methyl jasmonate treated plants as well as control plants were used for direct aphid population count after every week. Concluded results depicted that plants exposed to different concentrations of methyl jasmonate affected the root and shoot length, plant height which was further improved through MeJA supplementation.

Plexiform fibromyxoma (PFM) is a rare gastrointestinal tumor, primarily found in the stomach. Esophageal PFM is exceptionally rare. We describe a case of a mid-20s woman with respiratory and swallowing difficulties, revealing a 105x65 mm upper thoracic esophageal submucosal tumor during endoscopy. Biopsy lacked histological evidence of gastrointestinal stromal tumors (GISTs). Post-tumor removal histopathology showed a spindle tumor with plexiform architecture and myxoid-vascular stroma. Immunohistochemistry revealed vimentin and alpha-smooth muscle actin expression, while desmin, c-kit, DOG1, and CD34 were absent, confirming PFM. No recurrence or metastasis appeared during a 6-month follow-up. This case underscores the extreme rarity of esophageal PFM, emphasizing the need for precise diagnostic tools to navigate challenging differential diagnosis.

Previously, English major learning research and curriculum design were usually based on the perspective of teachers and educators, which were adjusted from top to bottom under the social needs. Although it is in view of social needs, it inevitably lacks the demands of English majors themselves. This research shifts the perspective to English majors, surveying the curriculum design from the perspective of English majors, collecting their career plans and demands through questionnaires, and using SPSS (Statistic Package for Social Science) to integrate and analyze the data, so as to take advantage of learners’ ideas to promote educational innovation. Different from the traditional top-down training scheme planning of discipline designers, it will be conducive to adding more practical effects to discipline design from bottom to top by exploring learners' cognitive degree of three factors— "New Liberal Arts", "English Major" and "Talent Training".

Background: Genomics is one of the disciplines of modern medicine that focuses on identifying causative genes and their related variations that may have an impact on complex disorders. Candidate gene association studies are critical for determining the genetic relationship of genomic variations with complicated illnesses. Aim: The goal of this study is to anticipate the likely relationship of PRDM16 gene variations with negative effects on structural and functional features using online computational tools. Methodology: An insilico approach was utilized to find out the rare variant in the PRDM16 gene. Result: We found eight missense variants including rs572205989, rs201814961, rs572178955, rs182452331, rs551202646, rs554705536, rs184929979 and rs573567598that could play a role in the development of disease. Discussion & conclusion: This methodology can be used in future genomes and association studies, but it must be tested in a model organism and cell culture. This research could be useful in personalized therapy and could lead to the discovery of new therapeutic markers for a variety of disorders.

Background: Diabetic foot ulcers (DFUs) are a serious complication of diabetes that can lead to amputation. Despite advances in prevention and treatment, early detection and intervention remain essential to improve outcomes. Objective: To review the latest evidence on the prevention and management of DFUs and wound care. Methods: A comprehensive literature search was conducted to identify relevant studies. Key findings were extracted and synthesized. Results: The best approach to preventing DFUs is one that is tailored to the patient's personal needs and risk factors. Comprehensive foot care is required, which includes regular examinations, education, and monitoring. Diabetes sufferers should also control their blood sugar levels, avoid smoking, and maintain a healthy weight. The best way to manage DFUs is likewise unique and relies on the degree and intricacy of the ulcer. Sharp debridement, unloading, dressings, antibiotics, and surgery are among treatment possibilities. Multidisciplinary care, comprising a number of healthcare providers, is frequently required to produce the best results. Treatment advances have resulted in considerable decreases in the risk of amputation and improved outcomes for DFU patients. Improved wound care treatments, new technologies, and a greater knowledge are among the advancements. Conclusion: DFUs are a serious complication of diabetes, but they are preventable and treatable. Early detection and intervention are essential to improve outcomes. By following the latest evidence-based guidelines, healthcare professionals and patients can work together to reduce the risk of amputation and improve outcomes for patients with diabetes.

Background: Ovarian cancer is the eighth most frequent cancer among women worldwide, accounting for 4% of all cancers in the female population. When compared to other reproductive system cancers, ovarian cancer has a high death and morbidity rate. Objectives: The aim of the study was to assess the clinical presentation and histological types of ovarian tumor in patients admitted in tertiary care center. Methods: A descriptive cross-sectional study was conducted to determine the clinical presentation and histopathological types of ovarian tumour diagnosed at Medical college for women, Uttara and Nightingale medical college, Ashulia. The study was approved by the Institutional Review Board (IRB) and 600 patients diagnosed with ovarian tumors were consecutively included in the study from July 2009 to August 2016. The cases were diagnosed and subclassified in accordance with the WHO Classification of Female Genital Tumours, Fourth Edition. Statistical Package for Social Sciences (SPSS) application, version 25, was used for data analysis. Results: Out of Total Gynaecological admission of 4800 patients during the study period, 600 patients were admitted with diagnosis of ovarian Tumor, So occurance was 12.5%. the mean age of the patients was 35 ± 2.09. About 8.6% of the patients had less than 20 years old. 56.6% were within the age group of 21-40, 29.8% were within the age group of 41-60 and only 5% had more than 60 years. The mean Menarche in years was 14.6 ± 1.02 and Menopause in years was 48.7 ± 2.46. Regarding clinical presentation 37.40% had abdominal pain, 55.50% had abdominal mass, 3% had abdominal distension,2% had ascites, 0.50% had menstrual irregularities and 2.50% were asymptomatic. Regarding surgical procedure, 35% undergone Total abdominal hysterectomy and bilateral salpingo-oophorectomy, 18.33% Bilateral salpingo-oophorectomy, 15% Right salpingo-oophorectomy and Left salpingo-oophorectomy recommendation, 13.33% Right cystectomy, 3.33% Left cystectomy. Regarding consistency of tumour 57.33% were cystic, 37% were solid, 5.33% were complex and 0.33% were Diffuse pattern (metastatic tumor). Benign tumors were 77%, borderline 16.67% and malignant 6.33% cases. Out of 462 benign tumors, Serous cystadenoma (230/49.78%), Mucinous cystadenoma (60/12.98%), benign Brenner tumor (10/2.16%), Mature cystic teratoma (110/23.80%), stroma ovarii (10/2.16%), Fibroma (10/2.16%), Fibro-thecoma (12/ 2.59%), leiomyoma (20/4.34%). Out of 38 malignant tumour, Serous cystadenocarcinoma (11/28.94%), mucinous cystadenocarcinoma (6/15.78%), clear cell carcinoma (1/2.63%), Malignant Brenner tumor (1/2.63%), endometroid adenocarcinoma (4/10.52%), squamous cell carcinoma arising in mature teratoma (1/2.63%), Dysgerminoma (7/18.4%), Immature teratoma (1/2.63%), malignant mixed germ cell tumor (1/2.63%), Adult granulosa cell tumor (4/10.52%), Krukenburg tumor (1/2.63%). Survival status was satisfactory; 99.67% patients was alive. Conclusion: The study found that ovarian neoplasms had ambiguous signs and symptoms, were mostly seen in reproductive age groups, and were mostly benign. The proportion of malignant ovarian neoplasms was significantly lower than that of benign ovarian neoplasms. Although incidence of malignant tumor is less common but gynocologists should be more careful in diagnosis of malignancy as ovaries are pelvic organs and definite screening methods are not available and malignancy can occur in any age.

Background: The World Health Organization recognizes the lack of public information about children and adolescents’ mental health (CAMH) disorders as a barrier to seeking help. This study assessed the current knowledge and attitudes of caregivers about CAMH problems in Egypt. Methods: A total of 1937 caregivers attending primary health care centers in Beni Suef, Egypt, were surveyed using the Arabic version of the University of Chicago Behavior Health Questionnaire (UCBHQ). Results: We found a statistical significance of positive attitude towards CAMH in parents’/caregivers’ who were females, relatively young, or had a higher educational degree. Due to the influence of media and negative publicity, caregivers were wary of the adverse effects of psychoactive medications and MH treatment. We also identified participants who had previously attended MH workshops or had a family member with mental illness were skeptical about existing MH services. Cultural background and spirituality were not a barrier to seeking MH care in this study. Conclusion: Findings highlight the need to utilize social media, television ad campaigns, and print fora to raise awareness about stigma, etiology of MH problems, and evidence-based treatments targeting gender and age-specific population.

This paper critically examines the emergence of sexual technologies in Nigeria's digital public sphere. In particular, it explores how the use of sexual technologies like vibrators and dildos in public spaces is viewed as transgressive, and how cultural, social, and religious factors shape Nigerians' perceptions. The paper adopts the concept of transgressive publics to describe how social media enables minoritized groups to challenge dominant norms around sexuality. Two recent cases are analyzed – one involving a Nollywood actress publicly distributing dildos at an event, and another with a blogger recording Nigerian women using vibrators. To examine public discourse around these events, social media comments on Facebook, Twitter and Instagram were collected and analyzed thematically. Key findings show sexual technologies are condemned as immoral, demonic, disrespectful to cultural values, and a threat to masculinity. Criticism relies heavily on moral and religious beliefs that cast non-normative sexual expressions as sinful. Reactions also expose gender anxieties related to female autonomy and shifting power relations. However, some pragmatic comments defend women's actions given Nigeria's difficult economic climate. While stigmatized, the public emergence of sexual technologies constitutes a transgressive public for asserting women's sexual agency and pushing boundaries. The study demonstrates how cultural narratives regulating sexuality are negotiated through technology, highlighting tensions between tradition and modernity.

High frequency modulation techniques play very important role in multilevel inverters MLIs. These techniques have several advantages over low frequency modulation methods where they provide lower harmonic contents and higher performance in real time adaptation. Multicarrier sinusoidal pulse width modulation MCSPWM is a common high frequency technique and control method for MLIs. The synchronization of carrier signals, complexity of hardware components and high cost are very important issues when implementing multicarrier MCSPWM in real time. This paper presents an efficient approach that can overcome the problems of multicarrier signals. The proposed approach combines the advantages of low and high frequency modulation techniques. Real time adaptation of modulation index can be achieved easily, and harmonics contents are reduced to very low levels as well. Simulation and comparison of the proposed approach with MCSPWM are presented. The proposed approach is applied and tested effectively with different topologies of MLIs.

Literary studies encourage students to inculcate reading culture which ultimately produces graduates with creative and critical mind-set that could analyse and interpret all aspects of human life. Considering the importance of this field of knowledge, the National University Commission and Joint Admission and Matriculation Board have made it mandatory for admitting students into Nigerian universities to study BA (Ed) English, BA English, Law, and a host of other related programs at both undergraduate and post graduate studies. This research investigates how social media hinders the academic performance of Literature-in-English students in Kano State. Much attention given to the social media platforms by the students plays a significant influence in taking them relatively far away from their studies, and consequently making them too reluctant towards their academic pursuit which results into a great number of failures. Therefore, this research investigates the influence of social media on the academic performance of Literature-in-English students in Kano State. The study adopts a survey design with questionnaire as data collection instrument. The population of the study is the students of Federal College of Education, Kano; Kano State College of Education and Preliminary Studies, Kano; and Aminuddeen College of Education, Kano. The research analyses its data using descriptive and inferential statistics to present its findings and recommendations.