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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

Autonomous cars: Researchers are working on devices that will automatically park your car in a parking lot without you being in, or near, the car. It will also slip a note under the wipers of the car next to it with your phone number and insurance carrier in case of any scratches.
虽然汉德曾在英国石油公司(British Petroleum)担任过多年全球品牌、营销与创新高级副总裁,但她现在却在从事更加环保的事业。Project Frog的使命是希望通过易于建造的空间(通常几天或者几个月便可完成),彻底改造建筑行业。相比教育与医疗等行业的传统建筑,Project Frog的建筑可以节省约50%的能源。汉德的计划似乎已经奏效:公司今年的收入预计将增加一倍以上。
Morocco is a gateway to Africa. Major tourism cities in the North African kingdom include the capital of Rabat, Casablanca – the country's largest city - Marrakesh and Agadir.
A report from the ministry showed that employers recruited 5.2 million workers through public employment service agencies in the first quarter, dropping 229,000, or 4.5 percent, from the previous year.
荷兰合作银行认为,外汇市场波动性也可能会成为影响未来12个月大宗农产品价格的因素,法国、荷兰和德国大选可能会导致欧元贬值。
尽管随着2014年末几项官司尘埃落定,手机专利战争似乎已经降温,但新年伊始,苹果与爱立信就又在无线通讯的专利费率上爆发冲突。黑莓过去就是一家热爱诉讼的公司:他们甚至因为名人瑞安o西克雷斯特设计的手机键盘而起诉他。但近些日子以来,公司更多地把工作重心放在了让智能手机消费者相信他们的技术依旧很棒,或至少很有意义上。
An American actress, author, fashion designer, dancer, producer, and singer Jennifer Lopez hold the second place in the list of 10 most beautiful women of 2015. Lopez's personal relationships have attracted worldwide media attention; she has been married three times. Beside entertainment world, J. Lo enjoyed a highly successful business career, consisting of various clothing lines, accessories, fragrances, a production company, television shows and a charitable foundation among other business interests.
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由于电影业采取了更为市场化的改革措施,中国的票房总额在过去几十年里从10亿元人民币增长到了400亿元人民币。
China's consumer price inflation decelerated to just 1.3 per cent year-on-year last month, the slowest rate since May. On a month-to-month basis inflation fell by 0.3 per cent, the first negative reading since May.
Taken together, these events and strategic initiatives highlight the Chinese aerospace industry’s realization that, in order to become a globally competitive player, it will need depth as much as breadth. After getting their hands on both ends of the value chain—aircraft design and final assembly—the Chinese now understand that what will make or break their industry over the long term is what happens in the middle of the value chain, at the component and subsystem levels. And that is why China’s ambition to compete with Boeing and Airbus, as well as with GE and Rolls-Royce for aircraft engines, is now more credible than ever.
“Airbnb is here to stay,” Mr. Gottsegen said. “Instead of fighting it, we should wrap our arms around it and make it better.”
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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.

地产调控 是否是家居企业上市的最好良机?

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这是中国首次占据榜单前三甲以及在前10强中占了5名。中国工商银行连续两年占据第1名的宝座,中国建设银行次之,而且中国农业银行向上移动了5名成为第3名。这三大银行与排在第9名的中国银行一起跻身前10强,中国银行是“四大国有银行”中的另一个成员。
根据弗雷斯特研究公司(Forrester Research)的预测,今年美国网络商店的销售额将达到2,940亿美元,约为全国零售总额的9%。据弗雷斯特预计,到2018年,电子商务将占到全美零售总额的11%,约4,140亿美元,其中通过平板电脑和智能手机进行的交易约占线上销售额的20%。

Temperatures in 2015 also shattered the previous record set in 2014 by 0.13C, according to Nasa.
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福布斯杂志称,26岁的劳伦斯能排名榜首,大部分得益于从《饥饿游戏》系列影片的最后一部中分得的收入,以及从她参与拍摄的即将上映的太空探险影片《乘客》中所得的一大笔预付费。
测试采用闭卷形式,长达两个半小时。理论上说,妮诗的测试成绩以及由此推算出的162分智商比大名鼎鼎的物理学家爱因斯坦还要高2分。
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In this Sept. 18, 1990, file photo, Steve Jobs, president and CEO of NeXT Computer Inc., shows off his company's new NeXTstation after an introduction to the public in San Francisco
威廉凯特夫妇多次让加拿大人等候多时,例如,抵达加拿大时,两人花了20分钟时间才从飞机上下来接受加方欢迎团队的问候。
At the time of the third presidential debate in October both candidates churlishly refused to greet or bid farewell to the other in the custom of the handshake.
Plastic surgery has long been big business in the US, but now the trend is sweeping across Asia.
尽管每轮市场反弹最终都呈V形,每次连续的涨势中,个股的参与越来越少。今年春夏两季的绝大部分时间里,时事分析评论员们都专注于赢家与输家、大盘股和小盘股之间的明显差异。欧洲的通缩担忧以及日本的技术性衰退,使得分析师们愈加困惑,尽管美国经济正在好转,美国国库券收益率和通胀指标却双双下行。
Phil Baty, editor of THE rankings, said: "China has introduced powerful policy drives, backed with serious funding, to produce world-class universities. In 2015, the country announced its excellence initiative, which aims to establish six of its universities in the leading group of global institutions by 2020."