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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

根据2016年胡润百富榜,中国房地产大亨王健林击败了阿里巴巴集团创始人马云以及异军突起的宝能投资集团董事长姚振华,再度蝉联中国首富。
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尽管购汇限制并未调整,但监管部门现在要求个人详细披露到底要用购得的外汇去做什么。购得的外汇只能用于旅游和购物、留学、境外求医以及咨询服务等经常项目支出。房地产和其他投资性支出属明确禁止之列。
High and rising US rates may quickly become drivers of EM crises: such conditions may lead to higher borrowing costs in EMs, along with capital outflows and an unwillingness by the financial sector to take risks.
Ashley Graham, 30, is the first ever curve model to make the highest-paid list, coming in at 10th place after banking $5.5 million from her lingerie and swimsuit lines contracts.
It was the best of times, it was the worst of times…
badminton;basketball;fencing;Judo;Ping Pang;taekwondo;Tennis;weightlifting;Wrestling;Volleyball;Boxing;Hocky.
n. 粉底霜,基
7. Big anti-corruptionprograms will be accelerated. We expect to see increased prosecutions,from approximately 140,000 per annum today to more than 200,000 in 2014. Thisaggressive push for integrity and accountability will set the country on astrong new course. Success will become much more about what you know ratherthan who you know.
President Xi Jinping is also a well-known football fan, who has repeatedly voiced his support for the sport's development in China.

The pear-shaped diamond named The Blue is 13.22 carats is estimated to be worth between $21-$25 million.
根据普京最近的一次收入申报,2015年他总计收入大约为890万卢布(约合13.7万美元)。
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在最近一连串的几场比赛之前,史蒂芬·库里真的没有想到能够创造这么多的NBA历史纪录。
魔术队是所有队伍中最迷的哪一个。不论从纸面上看还是从球场表现来看,他们这样的队伍都毫无意义。
James Bond Themes 2. "GoldenEye" by Tina Turner

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.

聚焦“十三五”规划:LED行业发展方向的六大建议

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经济学人智库全球生活成本指数发现,亚洲和澳大利亚共有11个城市跻身全球最贵20城市之列,其余有8个是欧洲城市,一个为南美城市。北美没有一个城市进入前20名。
At least 10 students lost their chance to attend Harvard College after posting "obscene memes" to a private Facebook chat, the main Harvard student newspaper reported.

由于本月初谷歌人工智能程序AlphaGo对弈韩国围棋大师李世石取得历史性的胜利,互联网巨头们就人工智能的前景展开了热烈讨论。
DNA from the bones matched that of descendants of the king's sister, while the skeleton had the twisted spine and battle injuries consistent with contemporary accounts, said researchers from the University of Leicester.
“然而,考虑到政策紧缩的延迟影响,以及房地产市场降温将在未来数个季度压制中国对大宗商品的需求,我们怀疑出口的增长势头是否还能维持下去。”
Kellogg/HKUST dominated this ranking from 2009 to 2014 but lost out to Trium in 2014 and to Tsinghua University/Insead in 2015.
尽管有少数人坚持这种说法,但绝大多数研究气候的科学家表示,地球正在经历一个长期变暖的趋势,这种趋势给人类带来深刻的威胁,而且几乎完全是由人类活动造成的。
Andersl?v, Sweden was plagued by residents with green hair. Johan Pettersson discovered that there was too much copper in their water.
经济学人智库表示,尽管没有一个北美城市进入前20名,但是纽约的生活成本相对于其他美国城市有所上升。纽约与洛杉矶并列第27位成为美国最贵城市。
Immigrant populations in Arkansas, North Carolina and Tennessee have more than tripled since 1990, noted Lee Drutman, a senior fellow at the New America Foundation, in an analysis for Vox. Anxiety over those changes may explain why the Republican Party became so much more focused on limiting immigration over that period — and why white voters in those states overwhelmingly support Mr. Trump.
“纽约人正逐渐意识到,这一漫长的繁荣期已对我们眼中的经典纽约市容造成了破坏,”历史街区保护委员会(Historic Districts Council)的执行董事西蒙·班考夫(Simon Bankoff)说,他同时指出,2015年将是纽约市通过《地标建筑保护法》的50周年。“环顾左右,那些总被我们认为是一成不变的东西,却都在纷纷关门闭户。”
那么2015年最好的职业是什么?保险精算师高居榜首,他们是分析财务风险方面的专业人员。
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与此同时,预计出口将继续下降,原因是全球需求疲软而价格上涨,以及中国实际上决定让人民币汇率再度盯住正在走强的美元。
A recent example: When Gwen Stefani launched her new album Spark the Fire, Swyft created a free sticker pack and distributed it on several of its messaging apps. It was downloaded almost a million times and sent between users seven million times, resulting in 41 million impressions in 10 days. Such campaigns cost anywhere from $50,000 to $250,000 for brands, Wray says.
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