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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

9. 设身处地也能提高记忆力
有些热门剧已经走得太远,应该降降温了,却仍在大张旗鼓,比如《唐顿庄园》(Downton Abbey)、《丑闻》(Scandal)和《复仇》(Revenge)。ABC频道的新剧《逍遥法外》(How to Get Away With Murder)是一部有趣的替代品,它是一部耸人听闻的夜间肥皂剧,讲述不法辩护律师的故事,简直可以称为“法律与无序”。
The report also found that the top cities in intellectual capital and innovation and technological readiness also achieved high scores in the overall ranking, a clear indication that technologically advanced cities were more likely to earn the title of "cities of opportunity".
一些最近发表的科学论文说,高空急流中这种持续较长的怪现象,由于全球变暖正在导致北极地区海洋中的冰迅速融化而变得更可能发生,但许多主要的科学家还没有被这种观点说服。
The dollar value of China’s exports fell markedly more than expected last month and import growth more than halved, while revisions to November data erased what had appeared to be a long-hoped-for return to growth for outbound shipments.
Topped with golden leaves and flavored with champagne, the confection was sold for $100 a pop.
“The First Amendment’s Free Speech protections apply only to violations by public entities, and since Harvard is a private university the First Amendment does not apply,” she said.
GDP reached 74.4 trillion yuan, representing 6.7-percent growth.
去年我国内地人口总数达13.7亿,与2010年进行人口普查时相比,人口数量增加了3377万,这意味着人口年增长率为0.5%。
Her mother Stephanie Boyden, 32, says Bobbi is a 'diva' who runs to the stage when her name is called - and screams when she has to leave.

The US box office, which includes totals from Canada, hit $11.1 billion, an 8 percent increase year-over-year, and was credited to several smash hits, including Jurassic World ($652 million domestically), Avengers: Age of Ultron ($459 million) and Inside Out ($356 million).
3月5日,第十二届全国人民代表大会第四次会议在人民大会堂举行开幕会,国务院总理李克强作政府工作报告。
10.《萤火虫》灵感来自葛底斯堡战役
这使得“教育科技”初创公司(比如硅谷的Coursera和伦敦的FutureLearn)在市场上有了立足点。预计它们在2018年将继续这种模式,或许会与某个实体高等教育机构合并。
James Bond Themes 6. "A View to a Kill" by Duran Duran
10月份,美国联邦政府停止运转。星巴克CEO霍华德舒尔茨拒绝在所有公司都受到不利影响时袖手旁观。他写了一封请愿书,号召各公司CEO上街游行,给国会施加压力,迫使后者通过预算案。

In 2010, a 14-month-old child accidentally fell on a chopstick he had playfully placed into his nose. It did, indeed, puncture the roof of his nose and lodge into his brain. Neurosurgeons did successfully remove the chopstick, with little internal damage long term.

The nasal, or nasopharyngeal, swab for Covid-19 is a PCR (polymerase chain reaction) test looking for active infection, and remains the most accurate to date to assess for acutely infected individuals. This in contrast to the antigen, or rapid test, also performed as a nasopharyngeal swab, which is much less accurate, especially if the test result is negative (it has a very high false-negative rate). The antibody test, which is a blood test, is performed to detect evidence of prior infection, not active illness.

A 40-year-old woman in Iowa underwent a nasopharyngeal Covid-19 swab test as part of her preoperative clearance for an elective hernia repair. Soon after, she developed headache, nausea, vomiting, and clear watery drainage from the side of her nose where the swab had been placed. This was not the type of drainage one would get from allergies, a cold, or even a sinus infection. Picture your kitchen sink trickling out water if it’s not fully turned off. That’s what a spinal fluid leak can look like, which is what she had. In addition, the fact that a runny nose is just on one side is often a tip-off of something unusual. As published in the October issue of JAMA Otolaryngology, it turned out that she had had prior nasal polyp surgery two decades ago, as well as a history of disorder called intracranial hypertension, or increased pressure of the fluid surrounding the brain. The combination of these two entities led to a small defect in the bone between the roof of the nose and the brain, and she had developed a pocket of the brain’s lining prolapsing into the nose, known as an encephalocele. The sack of the encephalocele got nicked by the Covid-19 swab.

Radiologic imaging of her brain and sinuses demonstrated a one-inch area where there was no bony roof of her nose. Instead, there was an out-pouching of the brain’s lining, known as an encephalocele, filled with spinal fluid. The pouch got pierced by the swab, and just like piercing a water balloon that’s attached to a faucet, it immediately started leaking clear cerebrospinal fluid. Once this was identified, she underwent surgical repair of the defect in the bone, and the spinal fluid leak was controlled and repaired.

According to Dr. Jarrett Walsh, Assistant Professor of Otolaryngology-Head and Neck Surgery at the University of Iowa, and senior author of this report, “If the swab is introduced at an angle toward the skull base, then any defect in the skull base is potentially put at risk. Correct technique, following the floor of the nose, is exceptionally safe and will not cause skull base trauma.” When asked if he would recommend avoiding nasopharyngeal testing swabs in general, he thinks not: “Nasopharynx swabs, performed correctly, are safe...I think the group of patients that needs to exercise caution in testing are those who have had anterior (nasal) skull base surgery – specifically those who have had reconstruction of the anterior skull base. With missing bone between the nose and the brain, an errant swab could have significant consequences. This is the group that I would encourage considering an alternative testing technique, if it is available.”

When it comes to Covid-19 diagnostic testing, nasopharyngeal swab approach has been shown to be more accurate than oropharyngeal (oral) swab. However, in some cases, especially where a patient has had prior surgeries in the area between the nose and the brain, or prior injuries in that region, physicians will accept oropharyngeal testing for pre-procedure screening.

扩进口政策密集出台释红利 跨境电商迎新一轮爆发期

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该王储称,当局可通过和解收回多达1000亿美元。
D'Aloisio's parents came to England from Australia. His father, Lou, has worked in commodities for BP and Morgan Stanley, while his mother, Diana, is a corporate lawyer who also serves as her son's contractual representative. They always knew D'Aloisio was an extremely inquisitive child. 'But he was our first, so we didn't think it was anything out of the ordinary,' says Diana. (D'Aloisio's brother, Matthew, is 14.) They stress that despite his impressive accomplishments, he remains a normal kid. Or at least as normal as a kid can be when he's making offhand references to Markov models and stochastic processes. 'He still goes out on weekends, still goes to parties,' says Diana. 'He's got a girlfriend. All the things you do at 17.'

The appointment of Inga Beale to run Lloyds of London and of Mary Barra to run General Motors marked an encouraging end to 2013. Progress for women in the coming year will continue to be too little and too slow, but you should expect to see women in positions of power and influence everywhere. Even Japan is starting to try to get women into work.
公司:在线票务平台Eventbrite
n. 妥协,折衷,折衷案
2014年最佳引擎榜单的其他入选者还包括宝马5系豪华轿车和紧凑型雪佛兰科鲁兹(Cruze)所使用的涡轮增压柴油发动机,保时捷Cayman双座运动跑车的水平对置2.7升6缸发动机以及大众汽车捷达紧凑车的1.8升4缸涡轮增压发动机。
This list is composed of—The strongest, intelligent, desirable, popular, attractive, beautiful, successful women in 2015.
This includes McKinsey, the consultancy that kick-started its secretive leadership election process in October with a gathering of more than 500 senior partners at the Grosvenor House Hotel in London. The next stage involves the firm’s 550 senior partners voting on a shortlist of candidates to replace Dominic Barton — the incumbent since 2009 — in January, followed by a run-off between the two most popular candidates in February.
We learned that you can never turn a wolf into a pet dog.
The wealth and depth of knowledge from around the world adds tremendous value to the course, wrote another graduate from the US, adding that “with so many cultures and experiences represented, a classroom ethics discussion about bribery is not your typical boring USA version”.
有时,它是英语中最可怕的字眼之一。但是当机会在你的职业生涯中出现时,你应该准备好说出这个字眼:Yes。
Foreign robot makers sold 103,191 robots to China in 2017, up 71.9% from a year earlier.
Unlicensed drivers who engage in the services will face a fine ranging from 10 thousand yuan ($1,500) to 30 thousand yuan ($4,500).
['w?:θ'wail]
Subdivided flats smaller than 100 square feet (9 square meters) can rent for $385 in the Asian city.
国内生产总值达到74.4万亿元,增长6.7%;