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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

China's movie box office revenue grew 9 percent to $8.9 billion (RMB 60.98 billion) in 2018.
Agents and investment institutions are now flooding the sector, causing additional changes to content and platforms in the world's second-largest economy, the report said. A number of Internet gurus, including Lei Jun, investor and founder of tech firm Xiaomi, Zhou Hongyi, CEO of Qihoo 360 Technology, and China's richest man Wang Jianlin have all directly supported live video-streaming websites, a strong indication of the growing interest from capital investment.
得克萨斯州成为首批摆脱经济衰退的州之一,该州凭借低税收负担、监管环境可预见性和熟练劳动力不断吸引企业投资。根据穆迪分析公司的统计,得克萨斯州的就业人数到2017年将以每年3%的速度增长。(亚利桑那州的预计就业增长速度仅高出0.04%)。得克萨斯州吸引了众多加利福尼亚州企业的关注,得州州长里克?佩里(Rick Perry)毫不顾忌地把两个州的商业环境相对比。最近几年来,加州企业电子港湾(EBay)和电子艺界(Electronic Arts)都选择在得克萨斯州大举扩张。奥斯汀一直是商业活动的温床,今年埃森哲咨询公司(Accenture)、AT&T公司、国家仪器公司(National Instruments)和时代华纳有线(Time Warner Cable)都宣布计划在该地区大幅增加就业岗位。
3.体操类比赛项目
[s?:'vei]
The US has overtaken India as the leading user of anti-dumping and other trade defence cases, with China and its steel sector the biggest target, according to research.
国家统计局最近开始跟踪研究的大城市的房价数据就支持这种可能性。
麻省理工学院(MIT)最近发表了一份白皮书。虽然该报告的题目听起来不免有些不吉利——《你是否已为供应链人才危机做好准备?》(Are You Prepared for the Supply Chain Talent Crisis?),却一语中的。这项研究表明,供应链经理需要掌握先进的技术技能,同时还得具备“高度的外交手腕”,精通总体业务战略,能娴熟地解决各类问题,要能在混沌状态中求生存。
这些排行榜是基于某个特定学科的研究能力而做出评价,与综合榜单评价方式不同。
n. 精华,精锐,中坚份子

Yet the pizza is far from the first recipe to incorporate a bit of the precious metal. Earlier this year, Bj?rn DelaCruz, the owner of Filipino restaurant the Manila Social Club, in Williamsburg, New York, created the pricey Golden Cristal Ube Donut.
可穿戴设备公司Atlas Wearables创始人彼得o李表示,电池技术和用户的保守是可穿戴市场面临的两大障碍。他说,在一些情况下,电池技术需要有足够大的改进才能实现足以激发用户兴趣的体验,而在穿戴时间、充电时间、处理能力和产品特点上,各家公司也需要做出平衡。
We will weave a strong safety net to ensure people's wellbeing.
This post is in partnership with Time. The article below was originally published at Time.com
On our increasingly human-dominated planet we can still learn much from the lives of other species. The discovery this year that the Greenland shark lives for 400 years, making it the longest-living vertebrate, puts our hectic lives into perspective.
Work that requires German language skills also grew significantly during the third quarter of 2016. Those who wish to work as German translators might be in luck these days.

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.

白领妈妈移居乡村 “离线奋斗”成热词

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"The scenes in the TV adaptation are beautiful, and also consistent with the original work," a Douban user Banchengyansha said.
Under the Skin is just so visually free and uninhibited that there is an intense dark, destructive sexiness in everything about it – quite apart from the hilarious, bizarre, mesmeric eroticism of the film itself. It is a work of subcutaneous potency. It gets under your skin.

5.Britons love bleak humour: that's why all the hire bikes are branded with the name of a bank currently being investigated for fixing interest rates. It's supposed to be funny.
没戏。这家受到热捧的美国电动车制造商曾经承诺在2018年生产40万辆新款Model 3s。该公司最新的产量目标暗示20万-30万辆。但是电池生产中出现的严重问题意味着一开始就慢了,而且特斯拉的记录不佳。对尚未证明自己离了华尔街不断输入的资金也能活的特斯拉而言,2018年可能会是不成功便成仁的一年。
美国银行集团
Additional reporting by Ma Nan
3. Poverty
“现在,我只给她稍微擦了点唇膏,涂了点指甲油。”
胡润主席鲁伯特·霍格沃尔夫表示:“这些企业家应该被称为‘超级财富创造者’,而不是简简单单的富豪。他们会对中国社会和经济带来突出的贡献 。”
We began the year worried that the US was poised to withdraw from the World Trade Organisation. That hasn’t happened. And it’s now unlikely to any time soon.
当城市规划部门明年初(2015年——译注)提出初步的建议方案时,布鲁克林的东纽约(East New York)地区将被列为试点。随后,重新区划进程就将在该处全市最穷社区之一内展开。而紧随其后的,将是针对皇后区的西法拉盛(Flushing)的提案。
鉴于这些公司都从未有过女性掌门人,整个咨询行业的领导层变动将尤其引起女性咨询专业人员的兴趣。咨询公司在口头上支持大企业改善领导层性别多元化的商业理由。让我们拭目以待,看看这些公司会不会践行自己推崇的观念。
The next step? Jalava plans to upgrade the finger with an RFID tag and add wireless support. He also wants to add more memory, which seems pointless to us. If he needs more storage, he has nine other fingers he can chop off and replace with flash drives.
幸好这类单曲只是《名誉》这张专辑的一部分。在《Dress》(《连衣裙》)这首歌中,她沉醉于令人激动的新恋情里;在《New Year’s Day》(《新年》)这首歌中,她试着弄明白聚会结束后她还拥有什么。
Bringing harmony to Apple’s internal fiefdoms has not been easy. There is still “huge tension” inside Apple, according to one person who has worked with the company for many years. “That tension is something he uses to run the company but it can be dangerous.”
是否有什么事情我一直放不下?我们不会总是能意识到我们在何时抓住有害但感觉安全熟悉的事情不放手,不论是一份不称心的工作,还是一段不健康的关系或者一种停滞不前的生活方式。看看你是否执着于对你没用的事情,想出小措施来改变和解脱吧。