Quiet a Puzzle: A Case Report of 15 year Old Female with Severe Anemia Due To Scurvy

Scurvy is historically thought of a disease affecting sailors in the seventeenth century. Vitamin C deficiency is rare in the developed world. It is mainly found in patients with poor nutrition and specifically those with developmental delay. The spectrum of scurvy is varied and includes dermatological, dental, bone and systemic manifestations. We present to you a case of a 15 year old female with a history of trisomy 21 presenting with severe anemia as a direct cause of vitamin C deficiency. She presented with a one month history of progressive bilateral lower extremity bruising and inability to walk. Physical exam notable for trisomy 21 features. Bilateral swelling in lower extremities with the right calf more swollen than left. Perifollicular hyperkeratotic papules with surrounding pinpoint hemorrhage in upper extremities with coiled hair. Lower extremity had large areas of ecchymosis associated with significant tenderness. Reminder of the physical exam and review of the systems is unremarkable. Consent for photographs of exam findings were obtained from parents. She underwent extensive work up which showed normocytic anemia hgb 8.7 g/dL. Elevated D dimer. ANA +. Normal Iron studies, Comprehensive metabolic panel, coagulation studies. Autoimmune work was unremarkable. Hemolysis labs were grossly unremarkable. Hematological work up including ADAMTS12, Paroxysmal nocturnal hemoglobinuria , Factor deficiencies, platelet function assay, protein C , S were unremarkable. Duplex ultrasound , CT and CTA of lower extremities were unremarkable. Vitamin C levels were low and barely detectable at \u3c0.1mg/dl. Patient was started on Vitamin C supplementation of 250 mg twice a day and iron supplementation. She was found to have low B12 and vitamin D.. Significant improvement was notable in Three weeks of treatment as the patient was able to walk. In addition to near complete resolution of her ecchymosis and improvement in her anemia

Artificial Intelligence Techniques in E-Commerce: The Possibility of Exploiting them in Saudi Arabia

E-Commerce has transformed business as we know over the past few decades. The rapid increasing use of the Internet and the strong purchasing power in Saudi Arabia have had a strong impact on the evolution of E-Commerce in the country. Saudi Arabia is yet another country that will release artificial intelligence power to fuel its growth in the economic world.  Recently, artificial intelligence (AI) applications that can facilitate e-commerce processes have been widely used. The impact of using artificial intelligence (AI) concepts and techniques on the efficiency of e-commerce, particularly has been overlooked by many prior studies. In this paper, a literature review was conducted to explore and investigate possible applications of AI in E-Commerce that can help Saudi Arabian businesses

3D seismic geomorphology of fluvial systems

Fluvial sandstones constitute one of the major clastic petroleum reservoir types in many sedimentary basins around the world. This is especially true in the Tertiary basins of Southeast Asia, which display a wide range of fluvial channel reservoir types. This study is based on the analysis of high-resolution, shallow (seabed to ca. 500 m depth) 3D seismic data which provide exceptional imaging of the geometry, dimension and temporal and spatial distribution of fluvial channels. The Malay Basin comprises a thick (>8 km), rift to post-rift Oligo-Miocene to Pliocene basin-fill. The youngest (Miocene to Pliocene), post-rift succession is dominated by a thick (1-5 km), cyclic succession of coastal plain and coastal deposits, which accumulated in a humidtropical climatic setting. This study focuses on the Pleistocene to Recent (ca. 500 m thick) succession, which comprises a range of seismic facies, mainly reflecting changes in fluvial channel style and gross stratigraphic architecture. The succession has been divided into four seismic units (Unit 1-4), bounded by basin-wide stratal surfaces. Units 3 and 4 have been further divided into two sub-units. Two types of boundaries have been identified: 1) a boundary that is defined by a regionally-extensive erosion surface at the base of a prominent incised valley (e.g. Horizons C.1 and D.1); 2) a sequence boundary that is defined by more weakly-incised, straight and low-sinuosity channels which is interpreted as lowstand alluvial bypass channel systems (e.g. Horizons A, B, C, and D). Each unit displays a predictable vertical change of the channel pattern and scale, with wide low-sinuosity channels at the base passing gradationally upwards into narrow high-sinuosity channels at the top. The wide variation in channel style and size is interpreted to be controlled mainly by the sea-level fluctuations on the widely flat and tectonically-quiescent Sundaland Platform

The Extent of Comprehension and Knowledge with Respect to Digital Citizenship Among Middle Eastern and US students at UNC

Digital technologies have revolutionized the way people acquire information and gain new knowledge. With a click or touch on the screen, anybody who is online can sail in the digital world and accomplish many things.  As such, the optimal use of information and communication technology involves user comprehension, knowledge, and awareness of positive digital citizenship.  The purpose of this study was to examine the scope of knowledge and understanding about digital citizenship among Middle Eastern and US students at the University of Northern Colorado. It also examines the difference among Middle Eastern and US students at the University of Northern Colorado in three categories: respect, education and protection. The study was based on a questionnaire that was distributed to 51 students at the University of Northern Colorado. The result reveals that there was not a significant difference between Middle Eastern and US students at the University of Northern Colorado in term of digital citizenship awareness. This study recommends examining other variables that may affect on digital citizenship. Keywords: Digital citizenship, awareness, respect, educate, protect, Middle East.