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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

n. 妥协,折衷,折衷案
This whole week was a train wreck: the unconvincing denials, the timing of the Cousins trade on All-Star Sunday, the pathetic return value,
我原以为胡扯是失败与庸俗的产物——它的存在是因为真相往往太伤人,或者高管们懒得弄明原委。
这两部极具娱乐性,追求整体效果,建立在事实基础上的程序剧(procedural)都是关于惊人的犯罪与腐败滋生的大型机构的故事——一个是关于罗马天主教会,一个是关于华尔街银行。除了激发起正直的愤怒,麦卡锡与麦凯以不同的方式,把悬疑、情感和道德的分量融入到接电话、敲键盘、读报表等现代日常工作中去。
公民价值观是民主政体最重要的资产。
2月CPI同比上涨2.3%,高于预期的1.8%,为2014年7月以来最大涨幅。1月CPI同比上涨1.8%。
People on both sides of the Taiwan Strait are brothers and sisters, and no matter how the situation on the island evolves, the mainland is determined to maintain Cross-Strait stability.
Lopez Short is the name of the game, judging from the red carpet looks of Beyoncé and Jennifer Lopez. Both divas went for thigh-high dresses to show off their gams4, with strategically cut out neck and shoulder detail, but where Beyoncé opted to stand out in fire engine red, J. Lo went for soft and satiny earth tones.
Big and brassy! Paul McCartney (yes, yes, and also Wings) ushered in a new era of James Bond movies with the theme to Live and Let Die, sending the series careening into a 1970s musical sound as the franchise rebranded itself with a new leading man, Roger Moore. This is an almost maniacally excited song. The melody shifts and spirals and builds and sinks and hardly gives the listener a chance to get their bearings. It's a thrill.
汇丰的报告表示:“总的新业务在以温和的幅度增长,这与10月份没什么不同。然而,11月的数据显示外国需求继续疲软,新增出口业务的扩张幅度是6月份以来最低的。”

马纳尔·阿尔-谢里夫最有名的,是挑战她的祖国压制女性的法律和习俗。
赫梅尔说,“如果发达经济体的原油需求增加,再加上新兴经济体需求的增多,我认为市场供应将趋紧。”这意味着油价走势图上可能会再度出现多个高峰。
9月28日
要让产品显得很“酷”并不是唯一的目的。科技行业如果想让我们身体的更多部位连上网络,那么安全问题和隐私问题,尤其是顾客数据管理问题,依旧需要慎重考虑。正如《经济学人》(The Economist)所说,蓬勃发展的传感器的魅力,以及可穿戴设备的算法,分散了人们对于其他要素的关注。这些关键的其它要素包括:“标准、互通性、一体化、数据管理”,以及“知识产权、执行标准”。对国家安全局(National Security Administration)而言,这些技术发展都必须以网络安全为前提。
2.Batman vs Superman: Dawn of Justice
The Handmaid's Tale

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.

地产大热定制门窗刚需增大,企业要如何走才正确?

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The Pelicans have struggle to attract and keep free agents, they must retain Jrue Holiday this summer, Cousins is from nearby Alabama and enjoys a close friendship with Anthony Davis, and years of disappointing and injury-plagued seasons put the franchise in a position where it seemed to be teetering on perennial also-ran status.
Rio - home to the 2016 Olympics and a host city for the 2014 football World Cup - beat Greece as the most searched-for destination.

然而,在开始攻读EMBA课程之前,男女学员之间已然存在巨大的薪资差距,女性平均薪资较男性低15%,女性和男性的这个数字分别为11.1万美元和12.8万美元。
该网站声称,“越喝,你(和酒瓶)就越聪明,但实际上你喝得越多,你就越醉,脑海中保留的信息也更少。
自工业革命以来,全球气温已经上升了0.8摄氏度。虽然去年1摄氏度的升温不太可能在今后每年都出现,但科学家表示由于厄尔尼诺事件的持续,2016年可能又将是一个极端炎热的年份。
John Williams's classic score still raises goosebumps over 40 years after this summer blockbuster hit theaters. Jaws preys on our primal fear of the unknown in deep waters, showing a small beach town ravaged by a series of attacks from a single killer shark. In recent years, environmentalists have stressed the generally nonthreatening nature of sharks, which kill an average of just eight swimmers each year.
A disturbing and often bleak analysis of the automated future of work has been named 2015’s business book of the year.
The Chinese mainland had a population of 1.37 billion, an increase of 33.77 million people over the census taken in 2010, meaning the annual growth rate was 0.5 percent.
在过去的一年中,20多个省推出鼓励学生创业的政策,在创业期间,允许学生休学2至8年,并保留其学籍。然而,很多行业内部坚持学生应该首先完成学业,并先工作几年。
6. 现在,就像瘾君子戒不了毒一样,格罗斯在其博客“Tipping Point”中写道,QE将维持到2015年。“暂时没有名字的泡沫”早前似乎应该改名叫“贝南克泡沫”。但现在事关格罗斯及其太平洋投资管理公司(Pimco)的二万亿美元,或许我们应该称之为“格罗斯泡沫”。
awkward
与此同时,国内互联网用户已经养成了手机支付的习惯,去年用手机支付的用户数量飙升到了4.69亿,同比前一年增长了31.2%。
5. 弗莱德·赫什三人组(Fred Hersch Trio),《漂浮》(Floating), Palmetto。赫什目前的钢琴三人组由约翰·艾伯特(John Hébert)担任贝斯,埃里克·麦克菲森(Eric McPherson)担任鼓手,他们有着精确的优雅。这张专辑的结构如同一场夜间俱乐部演出,包括若干重新编配的标准曲,以及几首强劲而充满情感的原创曲,有着强大的表现力。
receptive
保障房倡导者们则担心,如果重新区划做得不认真,那么居民社区或将迅速士绅化。“看看威廉斯堡(Williamsburg)发生了什么吧,”城市正义中心(Urban Justice Center)的社区开发项目负责人哈维·艾普斯坦(Harvey Epstein)说,他指的是房价上涨,“我不明白,它怎么就不可能发生在东纽约、布朗克斯或者法拉盛呢。”
7. “The Kindergarten Teacher” In his tough, weird knockout, the Israeli director Nadav Lapid spins the story of a teacher’s obsession with a child poet to create a savage portrait of fanaticism and its costs.