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Coronavirus|

Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

[p?'tenl]
My arms are wide open for you this New Year.我张开双臂,盼与你共度新春佳节。
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.
自高中以后,科比就没怎么变过,即便他已经离开劳尔梅里恩高中16年了。
这位无懈可击的歌手用吉他和铜管乐器合成的节拍和强节奏的音乐效果展现了更为广阔的情感和音乐世界。它会使你回想起艺术摇滚乐教母凯特·布什(你可以去听一下《Green Light》(《绿灯》)这首歌)。
New year’s events can be anticlimactic. Not so in China where stock markets began 2016 with enough excitement to make traders choke on their bubbles: Shanghai stocks dropped 7 per cent on Monday, Shenzhen more than 8 per cent. It could have been worse. A new mechanism that suspends trading after a drop of 7 per cent halted play early — in this instance, by an hour and a half.
championship
China had a full-year GDP target of “around 6.5 per cent” for 2017.
pandemic
不过在这一通胡闹之余(主持人蒂娜?费举杯道:致这个美好的混乱之夜),本届金球奖(Golden Globes)颁奖典礼还是清醒地把多项重要大奖颁给了各个夺奖热门。戴维?罗素(David O. Russell)电影作品《美国骗局》(American Hustle) 揽入包括最佳喜剧片在内的三项金球奖,成为当晚最大赢家。历史剧情片《为奴十二年》(12 Years a Slave)虽在另外六个竞赛单元中失利,但最终斩获了最佳剧情片奖。

Everyone else is trying to win. The Mavericks, all of 3-13, proudly announced that they won't tank. Yet, this is expected to be one of the best NBA drafts in years, with Markelle Fultz, Jayson Tatum, Lonzo Ball, Josh Jackson, Harry Giles, OG Anunoby, Ivan Rabb ... the list goes on!
2016年国家公务员考试报名人数已经超过去年,仅周二一天,符合考试条件的报考人员就达到13.2万人以上,这是单日报考人数最高的一天。
清华大学是国内表现最好的大学,有三项学科的排名进入全球前10。北京大学则是有两项学科排名挤入前十。就清华大学而言,建筑/建成环境和土木/结构工程学均排名第8,材料科学排名第10。
But as Western manufacturing and industry have declined, taking many working-class towns with them, parents and grandparents have found that the opportunities they once had are unavailable to the next generation.
British statisticians’ unwillingness to correct known errors in the clothing price component of the RPI redistributes many billions every year from students, recent graduates, taxpayers and rail commuters to index-linked UK government bondholders, wealthy pensioners with RPI-linked pensions and rail companies.
8. Sturgill Simpson “Metamodern Sounds in Country Music” (High Top Mountain) A throwback progressive hunkered down with a whip-smart band: country music has seen this before. But on his breakthrough second album, Sturgill Simpson made it a pliable trademark, grounded at every turn by his winning, seen-it-all baritone.

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.

银行坏账处置加速 “不良”房产拍卖量价齐升

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Until Dawn
值得一提的是,优步和特斯拉也未能上榜。“优步和特斯拉都在创新,但用专利数量、成功、全球化和影响力进行衡量,都不足以上榜,”Stembridge说道。“还有,这两家公司在2010-2014年这段时间也没有获得超过100项的专利技术,从而达到该榜单要求。”

Part of the appeal of online programmes lies in their flexibility, reach and slower pace of delivery than cam-pus-based MBAs. Apart from IE, which imposes an 18-month time limit, participants have on average about five years to complete their degrees.
遇到别人我能很轻松地和他/她交谈
Zhu Yongxin, a member of the CPPCC National Committee, full-time vice-chairman of the Central Committee of the China Association for Promoting Democracy and vice-president of the Chinese Society of Education, talking about an NPC deputy representing 670,000 electorates.
brace原指双臂,用双臂支撑-使稳固用两个brace embrace(v 拥抱)
在中国永久居留的外国人在投资、购房、受教育等方面享受中国公民同等待遇。
Two bedrooms are on the second floor, including the master, which is part of a suite with a fireplace, a walk-in closet and a balcony overlooking the bay. An office down the hall also opens to the balcony. The other bedrooms are on the third floor. One overlooks the bay through the pediment’s fan window.
Microsoft Corp., Toyota Motor Corp., IBM Corp., Samsung Electronics Co. Ltd., Amazon.com Inc., Mercedes-Benz and General Electric Co. were also on the Top 10 list, according to Interbrand's 2016 Best Global Brands report.
It scares/intimidates people and they don't know better anyway.
第一次出现在人体内。禽类可能是病毒来源。Appeared for the first time in humans. It caused illness in two children in Hong Kong, with poultry being the probable source.
After weeks of nail-biting auditions and five days of tense semi-finals, Britain’s Got Talent picked one of the 11 acts to be the 2014 champion.
Experts waited until dark had fallen before detonating demolition charges which brought down 150000 square metres of concrete glass and steel in 10 seconds.
桑尼伯恩说他不仅对特朗普的错误决定和无知时期感到失望,同时也因为总统对8月在弗吉尼亚州夏洛茨维尔举行的白人种族主义集会上反抗者被杀害后做出的回应感到失望——这也更加坚定了桑尼伯恩竞选州长的决心。
《中国日报》(China Daily)援引中国旅游研究院(China Tourism Academy)和北京市旅游发展委员会(Beijing Commission of Tourism Development)的一篇报告称,污染状况加剧以及人民币升值,使得北京去年1月至11月间的外国游客数量从2012年同期的501万人下降至420万人。此前一份基于对国内旅行社的调查的报告显示,去年前三个季度赴北京旅游的游客数量较上年同期下降约50%。
adj. 人口统计学的