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Coronavirus|

Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

Wishing you happiness during the holidays and throughout the New Year.
1)Thank You: Common courtesy? Sure. But tell me this: When was the last time you forgot (or rejected) gratitude? Whether given in private or public, a sincere ‘thanks’ creates goodwill. Don’t forget your mother’s advice: “Say please.” People are always happier doing a favor than taking an order.
The prize sold for a winning bid of $950,000 at auction, and an additional buyer's commission brought the final sale price to $1.16 million.
“Even if you have made your peace with a Fed rate rise there are other reasons to be nervous,” said David Hauner, head of emerging markets at Bank of America Merrill Lynch, who points to falling oil prices and the slowdown in China to illustrate why market volatility measured by the CBOE’s Vix index, a barometer of investor sentiment, has been elevated since August.
Much of the boost in exports came from shipments to the US, which grew for the first time since March at an annualised rate of 6.9 per cent to $36.8bn. Among other destinations that swung back to growth last month was the the EU, shipments to which rose 5.1 per cent to $29.9bn, as did those to Japan, by 3.2 per cent to $12.2bn.
Children show “Paper-cutting Flowers” (China Southern Dance School under the China Dancers Association)
问:你今年夏天去了美国,感觉怎样?
A hilarious video showed the swaying crowds singing Can’t Take My Eyes Off You and Hey Baby to the laughing young woman in Bordeaux.
4. "The Big Bang Theory" (3.4 million)
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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。
10月份,CPI环比下降了0.1%,9月份则环比上涨了0.7%。
As if 2016 hadn’t been hard enough for China’s workforce, an annual survey has revealed that more than half of the country’s white-collar employees got no year-end bonus ahead of the upcoming (and costly) lunar new year holiday.
The dollar value of outbound shipments from China rose 12.3 per cent year on year in November, lifting from a revised pace of 6.8 per cent in October, and smashing a median forecast of 5 per cent from economists polled by Reuters.
埃尔多安在国内也受益于与吕特的争执,他寻求将外交争端扩大至针对所有欧盟国家,尤其是德国,后者同样因土耳其在德国的大型土耳其社区拉票而与安卡拉发生争执。
There's a difference, though, in a team like Miami that's playing its young guys and trying to build a core while taking on losses, and, say, the Magic, who are trying to jump-start a stalled process.

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.

浅析|国内塑料门窗发展与德国的比较差距

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Enthusiastic supporters of the idea of a “universal basic income” for all citizens, meanwhile, will look to Finland where a trial is now well under way. In France, Emmanuel Macron will try to tread a delicate line in 2018 as he reforms the labour market, hoping to inject flexibility without increasing insecurity or incensing the unions.

皮卡大战:如果把得奖的问题抛在一边,福特的全铝皮卡生产起来很不容易,卖得也比较慢,这就为快速崛起的道奇公羊(Dodge Ram)1500提供了机会。同时,日产也试图忘掉该公司第一款全尺寸皮卡,也就是采用双拖斗造型的第二代Titan皮卡的失利。汽车业老将约翰o克拉福西克向《汽车新闻》透露了这个行业的最大秘密:在5万美元以上的市场区间,平价品牌的皮卡和SUV的销量要超过德系豪华品牌。
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While Jodie Foster used to opt for the bathroom – “they looked good with the faucets” – she has since moved the two she won for The Accused and Silence of the Lambs to a much more orthodox spot: a trophy case.
此类洞见尤其引起诉讼出资人的兴趣,后者支持原告以换取一定比例的损害赔偿金,并在出钱之前试图评估纠纷的可能结局。但是这种技术可能要到2019年乃至更遥远的未来才能突破。
根据全球最大航运公司马士基航运公司(Maersk Line)的数据,从汽车到集装箱运输的纺织品,1月中国对巴西出口同比下降60%,而通过集装箱进入拉美最大经济体的总进口量减半。
German Three:Mercedes-Benz begins to sag as new lower-priced Benz’s inevitably erode its once invincible “the best or nothing” status. At BMW, imminent arrival of a new 7-series cements its status as the preferred brand of Scarsdale, Shaker Heights, and Santa Monica. A new A3, starting at $30, 795, should nicely lift Audi’s sales beyond 2014’s 15% climb, and a new Q7 SUV should nicely lift profits.
Personal per capita disposable income increased by 6.3 percent in real terms.
声明中说:“我们真诚地向《月光男孩》剧组、《爱乐之城》剧组、沃伦?比蒂、费?唐纳薇和奥斯卡颁奖礼观众致歉,因为在宣布最佳影片环节中我们出了纰漏。”
DeMarcus Cousins, Serge Ibaka and Lou Williams were all dealt in advance of Thursday's 3 p.m. ET deadline, leaving role players like Taj Gibson and P.J. Tucker as the biggest names to move right before the buzzer.
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Opinion: China’s Commercial Aerospace Dream Edges Closer To Reality
今年最引人注目的化妆和发型设计几乎都源自角色的原型本身(其中有些无疑比银幕上的造型更有活力)。除了能让观众一眼看出角色的外貌特征,它们也能为演员的表演赋予整体感觉和微妙之感。有时,一个大鼻子就能加深观众的理解。