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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

调查指出,关键的是,世界的不稳定性和冲突可能继续推动通货膨胀并影响某些城市的生活成本。
The Disaster Artist is part buddy movie, part show-business fable, and part behind-the-scenes DVD featurette.
可口可乐首席运营官詹姆斯?昆西(James Quincey)表示:“我们并未真的假设今年余下时期中国的形势会好转。”他表示,今年第二季度该公司在华果汁销售额降幅达到两位数,可口可乐饮料销售额降幅为个位数。
“今年榜单有趣的地方之一是,尽管网站都开始实行更严的密码设定政策,位数少的密码仍出现在今年的榜单上。”
Recipient: Canadian Prime Minister Justin Trudeau
如果一个“推文幼稚的像个幼儿园小朋友”一样最年长的人,都可以当选总统,那为什么反过来不试一下,看看年轻人能否当选并明智地执政?
issue
Epic is not OK with ongoing cheating or copyright infringement from anyone at any age, it said.
“We sincerely apologize to Moonlight, La La Land, Warren Beatty, Faye Dunaway, and Oscar viewers for the error that was made during the award announcement for Best Picture. The presenters had mistakenly been given the wrong category envelope and when discovered, was immediately corrected.”
我知道你们中很多人在公司里曾经找到过自己的前任。但是,这不是放之四海皆准的规律。搞办公室恋情可能会对你产生不好的影响。

Winners: Thunder
都柏林大学学院(UCD)迈克尔?斯墨菲特商业研究生院(Michael Smurfit Graduate School of Business)的总体进步最大,排名攀升21位至第48名。北京大学(Peking University)光华管理学院(Guanghua School of Management)重回排行榜第38名,去年该院因学员调查反馈率低而未上榜。
希拉里的回应则迎来了掌声:"我认为我是个女权主义者,因为我相信在我们经济和社会的方方面面,女性都应该获得跟男性同样的权利,不管是在我们国内,还是在整个世界上。你们知道,我在公共生活中将大量精力投入到了为女性倡权上,通过法律、规定、文化等途径做一切力所能及的事情,改变依旧存在的、让女性退缩的那些成见。"
9. The 2012 Ig Nobel Anatomy Prize
Among the amenities spread through its three terminals are two 24-hour movie theaters screening the latest blockbusters for free, a rooftop swimming pool and a butterfly garden.
欧洲工商管理学院(Insead)领衔2017年英国《金融时报》全球MBA百强榜。这是这所拥有多个校区的国际商学院连续第二年高居榜首,去年该学院首次摘得桂冠。

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.

中国首个绿色建材基金正式运营

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尽管中国国内经济放缓,中国对欧洲和美国的投资却达到创纪录高位。
该学校在这个指标上位列全球第三,排在位于艾哈迈德巴德和班加罗尔的两所印度管理学院之后,这两所学校校友的平均薪资分别为10.9万美元和10.6万美元。

52% of the world lived in extreme poverty in 1981. This number dropped down by 21% in 2010, as 721 million fewer people no longer live in absolute poverty.
与此同时,有一首非常有意思的歌曲来自我们的读者Libby Russell,是她为所有世界杯期间的足球寡妇所作。非常感谢Libby的分享,太棒了!
But what about the tens of thousands of Irish fans? They're out of control.
Hailed as one of the greatest films of all time, Taxi Driver tells the story of a depressed ex-Marine who attempts to assassinate a senator after being rejected by a woman he admires. While the titular taxi driver, Travis Bickle, lives a chaotic life filled with drug dealers and prostitutes, his story was never meant to be an unrealistic fantasy. Rather, it meant to expose the very real warning signs of a would-be gunman.
When M·A·S·H first aired, the characters of Hawkeye and Trapper were meant to be equally sized roles. It was with that understanding that Wayne Rogers agreed to take the role of Trapper John. However, as Alan Alda began to make changes to the characters and have more influence on the direction of the show, Hawkeye began to seriously eclipse Trapper.
Warriors winning title was inevitable
Disparity between the 34 cities surveyed was still greater, as the the average bonus of over Rmb15,800 in Beijing was more than triple the lowest-paying city of Shenyang, the provincial capital Liaoning located in China’s northeastern rust belt.
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7.戛纳的“女性之年”并走运
Meanwhile, villages within the city's boundaries will be overhauled and low-end manufacturers and logistics companies removed.
但是,我们也许终于走到了终点。也许只有在该剧落幕之后,它对成衣秀的影响力才会终结。也许我们对历史无休止的模仿(是的,我们曾模仿70年代的风格以及80年代的大波浪头和高垫肩)才会最终停止。
Read about successful businesses. Take in the wealth of knowledge that’s been provided by successful entrepreneurs such as Steve Jobs and the personalities from Shark Tank. A successful business plan does not have to be a book. A 10-page plan is digestible yet long enough to include everything you need to start.
But with Jrue Holiday back and Anthony Davis putting up historic numbers, they aren't going to be bad enough to get a Fultz or Jackson. Why couldn't last year's draft class be this good?
该研究基于数亿个安全问题的答案以及数百万条恢复账号登录的请求。