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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

Ms Xie estimates that around 40 per cent of the decline in November — about $35bn — is attributable to valuation effects related to the weakening of the euro and other currencies against the dollar in November, rather than outflows.
"I'm not really worried about it, honestly," Bryant said. "My shooting will be better."
Kunis was No. 9 on FHM's list last year.
IMD and Iese Business Schools have tightened their grip on the top spots of the twin FT executive education rankings, monopolising first and second places for both open-enrolment and customised programmes.
6.派对应有尽有——只要你有时间
If successful, Hurun estimates that Mr Wang’s net worth could soar past $50bn, making him one of the world’s 10 richest men.
Many believe the population is no longer a major threat to China's resources and environment. Instead, China's population challenges have shifted to low birth rates, an aging society and a widening gender imbalance. China has already experienced a shortage of skilled workers in places like the Pearl River Delta, so it might not be long before we see major reforms.
1. Buy expensive tailored clothing that only sort of fits so that most of the time your buttons appear to be just seconds from bursting.
n. 罪犯
自从2013年以来,前世界第一的泰格·伍兹没有赢过一次锦标赛,由于处于背部手术康复期,他也错过了去年的大部分比赛。但是,单单是泰格·伍兹的名号就能够使他赚得盆满钵满了。通过为耐克和泰特利斯等品牌代言,泰格·伍兹去年赚了3100万英镑,位居榜单第12位。

Amazon founder Jeff Bezos rose to No. 3 on the list for the first time, thanks to the jump in in Amazon shares, which boosted his net worth to $72.8 billion.
Just because the job market is tough doesn't mean it's impossible. "You have to work harder at the job search," Challenger said.
7. Flying Lotus “You’re Dead” (Warp) The new fusion makes no apologies for the old fusion, just a series of upgrades. As a producer, Flying Lotus values continuity as much as disruption, hazy beauty as well as jump-cut clamor. His suitelike reflection on death leaves room for irreverent wit — and, on “Never Catch Me,” one of the year’s best verses by Kendrick Lamar.
Will the AT&T/Time Warner merger go through without big remedies (such as the sale of CNN)
在过去三年里,夏威夷航空公司的航班延误率只有6.92%,几乎是排名第二的阿拉斯加航空公司的一半——这家公司的航班延误率达到11.27%。
Note that grosses are not the same thing as earnings. Downey outearned Johnson by $29 million with $75 million in estimated earnings between June 2012 and June 2013, the period we used for the latest edition of our Celebrity 100 list. The numbers we’re looking at here are how many dollars each star’s movies brought in at the box office worldwide this year.

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.

国税总局:从五个方面完善了个税专项附加扣除暂行办法

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This slide in the dollar value of exports has entirely been a price effect, driven by lower commodity prices. In volume terms, emerging market exports have continued to rise since 2014, even if volume growth in year-on-year terms has moderated to around 2 per cent, a fraction of the double-digit rates witnessed either side of the global financial crisis, as the second chart shows.
Build the armed forces through political work and reform, and run them by law

麦肯锡将于3月宣布当选者,预计此人将对麦肯锡的发展方向产生重大影响。一些内部人士倾向于那些在快速增长领域(比如数据分析)具备专长的候选人,而其他人想要一位可以维护公司品牌的传统主义者。
[ri'li:s]
3.卡夫品牌喜爱度:-10%/排名:11
n. 监牢,监狱,拘留所
Isolated in northern China, this virus was similar to the virus that spread before 1957. For this reason, individuals born before 1957 were generally protected, however children and young adults born after that year were not because they had no prior immunity. By January 1978, the virus had spread around the world, including the United States. Because illness occurred primarily in children, this event was not considered a true pandemic. Vaccine containing this virus was not produced in time for the 1977-78 season, but the virus was included in the 1978-79 vaccine.
飞速变化的效应
The total foreign trade volume between China and Germany reached 999.1 billion yuan (USD about 145.3 billion) in 2016, with a year-on-year growth of 2.6 percent, according to statistics released by China's General Administration of Customs.
泰勒斯威夫特被评为2012年最慈善明星。
国家统计局在发布最新数据的同时进行了解读,它将PPI连续上涨部分归因于煤炭开采和洗选业价格同比上涨15.4%,这一涨幅比上月扩大11.3个百分点。
对于美联储(Federal Reserve)预计本周宣布的加息已经产生了效应,还是会进一步加大负债企业和经济体所受的压力,投资者意见分歧。
“有个家伙请了一支军乐队来陪他宣布离职。”
The attitude of the founder will set the tone for the business. Negativity, laziness and entitlement waste time and money while they tarnish your reputation. Success largely depends on making mistakes and accepting blame in stride. Owning up to and facing challenges head-on is what makes a mere business owner a leader.
7. 举重训练可以帮助提高长期记忆力
还有些人直接就玩消失了: