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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

上周四公布的一项数据显示,两所中国顶尖大学跻身今年《泰晤士报高等教育专刊世界大学声誉排行榜》的前20名。
爆发冲突的潜在可能性,将迫使中国和美国在不断变幻的环境中重新定义各自的角色,双方都对这种环境感到不安。美国大选期间的反华情绪将使紧张气氛加剧。亚洲国家将勾勒出这两个大国的影响力范围,但考虑到各国的利益各有不同,取决于各自的具体关切,联盟的构成也将变化。
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Graham Allison, the famous Harvard professor, also warned that east Asia was headed towards the “Thucydides Trap”, adding: “When a rapidly rising power rivals an established ruling power, trouble ensues.” In early 2013, the then prime minister of Luxembourg, Jean-Claude Juncker, warned that 2013 was looking dangerously like 1913. The Economist also warned at the end of 2013, “A century on, there are uncomfortable parallels with the era that led to the outbreak of the first world war.”
Cambridge Judge Business School also ends the year on a high, appearing for the first time in the rankings for both open and custom executive education, and climbing three places in the MBA ranking and 12 places in the Executive MBA table.
通过比较不同地区指定类别的生活成本,《经济学人智库》指出,亚洲城市在食品上的购买成本最高,其中韩国首尔的食品价格最高。欧洲城市则是在休闲娱乐用品上的成本最高。
"Metro-Goldwyn-Mayer Inc. ('MGM') today announced that the secured lenders voting in the Company's solicitation process have overwhelmingly approved its proposed plan of reorganization ('Plan'). MGM will now move expeditiously to implement that Plan, which will dramatically reduce its debt load and put the Company in a strong position to execute its business strategy. MGM is appreciative of the lenders' support."
When did winter become the season of television’s most distinguished content? The fall season, with its organized and heavily publicized broadcast-network premieres, still gets the attention, but a greater number of interesting shows now arrive on cable, broadcast and online in the first quarter of the year.
Trium在三个指标上名列第一:攻读课程前学员的工作经历、实现的目标,以及国际课程经历。该课程学员在毕业3年后的平均薪资排名第二(30.7003万美元),仅次于Kellogg/HKUST联合推出的课程。
With interest rates expected to rise only slowly, commodities are likely to attract hedge funds and other speculative investors looking for juicier returns, said the bank.

这种情况下,湖人从他们的头等交易品那里获得了足够的回报,让他们的年轻球员诸如丹吉洛-拉塞尔和布兰登-英格拉姆准备好在比赛关键时刻承担更重的责任,同时铁了心摆滥准备迎接UCLA新星朗佐-鲍尔的到来。
With the compliments of the season.
为提高中国足球在国际赛场上的竞争力,中国政府日前公布了最新的足球发展计划,将在2017年开设20000所足球专业学校,用于训练年轻球员、培养人才。
adj. 易坏的,脆弱的,浅薄的 n. 复写纸,薄纸副本
中国一群现代汽车经销商要求韩国现代汽车赔偿8-9亿元(1.2-1.35亿美元),称现代汽车削减了向他们出口的车型,导致经销商亏损严重。
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。

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.

谁推高了三四线城市的房价?

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Belgium
n. 硅

这位微软公司创始人的净资产是860亿美元,而一年前则是750亿美元。
5. 杜克大学福库商学院
The nearest star, Proxima Centauri, has a planet orbiting it not much bigger than Earth. Its "year" is only 11 days. But it's in the habitable zone because Proxima Centauri is a red dwarf star about 100 times fainter than the sun. And there's hot news that a similar star, 40 light years away, may have three planets in its habitable zone.
作为过去二十五年来的常胜将军、福特的F系列皮卡一直成功地抵挡住了雪佛兰重新设计的西尔维拉多(Silverado)的挑战,盘踞着美国最畅销皮卡的宝座。而全是日本品牌角逐的最畅销汽车决赛,丰田(Toyota)凯美瑞(Camry)再次成功击败本田(Honda)雅阁(Accord),摘得冠军头衔。
An odd assortment of S&P sectors led the market higher this year, with some strange bedfellows atop the leaderboard. Even if a manager had foreseen that the healthcare sector would gain 27% this year, would they have guessed that utilities would be in the No. 2 slot, with gains of 23%? Unlikely.
Rio - home to the 2016 Olympics and a host city for the 2014 football World Cup - beat Greece as the most searched-for destination.
To Rouslan Krechetnikov and Hans Mayer for studying the dynamics of liquid-sloshing, to learn what happens when a person walks while carrying a cup of coffee. I`ll give you a hint: it happens between step 7 and 10.
Another slowdown in food prices pulled Chinese inflation lower in October, according to the National Bureau of Statistics.
4) I often feel inhibited in social interactions 0 1 2 3 4
据张晓光表示,怀旧部分将包括出自上海文华电影制作工作室的电影,该公司成立于1946年、引领了中国文艺电影的新时代,将会让观众“一睹中国的电影文化和历史”。
《性别之战》
Chinese consumer prices rose in January, an encouraging sign for the world’s second largest economy in a month characterised by turbulence in its financial markets.
节目20 小品《今天的幸福2》,沈腾 马丽 杜晓宇 王琦
考察指标包括“智力资本和创新”、“技术成熟度”、“区域重要城市”、“健康、安全与治安”、“交通和城市规划”、“可持续发展与自然环境”、“文化与居民生活”、“经济影响力”、“成本”和“宜商环境”。