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Covid-19 Nasal Swab Test Led To Cerebrospinal Fluid Leak

Nina Shapiro

贝尼托.墨索里尼(Benito Mussolini)和阿道夫.希特勒(Adolf Hitler)就是煽动家变身独裁者的经典例子。
But closing the deal on RCEP less than a year after Donald Trump pulled the US out of the TPP would be a big win for Beijing.
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According to a report by Beijing Statistics Bureau, retail sales of consumer goods in the Chinese capital surpassed 1 trillion yuan ($152 billion) in 2015, up 7.3 percent year on year.
But economists generally expect the momentum of the recent past to resume and continue once storm distortions abate. The 45 economists who responded to The Wall Street Journal's latest monthly forecasting survey saw the jobless rate falling to 7.8% by next June and 7.5% by the end of 2013. Some say job growth could accelerate from its slow pace. 'I think businesses are going to have to hire,' said Bob Baur, an economist with Principal Global Investors.[qh]
当然在接下来的一段时间中里还有很多事情要解决,还会有更多的推测,更多的享受。祝我们所有的读者度过一个安全愉快的假期,迎来一个崭新快乐的篮球之年。
"The Hunger Games" star ranks first on the 2012 edition of AskMen.com's "Top 99 Most Desirable Women" list. The poll, which collected more than 2.4 million votes, asked the website's readers to choose their favorite female celebrities based on their looks, personality, talent and other desirable characteristics.
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注:本文转载自前十网,译者:Carrie
另一种看法是,油价在过去三年中的变动,是长期结构性变化的开始,预示着下一个50年里,能源价格按实际值计算将显著低于上一个50年。简单地说,持这种看法的人认为,供给的增长潜力超过需求增长。

We will promote workmanship and foster a culture of workmanship where workers have a strong ethic and tirelessly seek improvement. We will see great numbers of Chinese workers exemplify workmanship and more Chinese brands enjoy international recognition. We will usher in an era of quality for economic development in China.
在3月2号,北韩政府网站我们民族之间警告北韩将对任何气球投放展开"炮弹和导弹的攻击,而不只是几下枪击"。
In truth, slower growth of about 8 per cent could be better for China and for the world. More environmentally sustainable and equitable outcomes would ease popular concerns and higher consumption would ease tensions over global trade.
A vibrant ETF market would depend on the evolution of fee-based distribution networks. Mark Talbot, managing director of Asia-Pacific at Fidelity International, says the distribution infrastructure is holding back retail demand.
沪深300指数(CSI 300)包含了沪深两市交易的300支主要A股,其于2016年交易首日下跌7%,根据新推行的市场熔断机制,意味着当日股市交易已结束。
扎实有效去产能。

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.

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Global gold production rose to 3,268.7 tonnes in 2017 from 3,263 tonnes a year earlier, according to the WGC. That was the smallest increase since 2008, when gold mined fell more than 2 per cent during the financial crisis.
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9. Investors brains are so distracted, in denial, they won't get out in time.
1.摄影:增长了22.3%
It's a bit of a lark organised by UK film critics – a gong for the top canine performance at the festival, handed out on the last Friday in the British pavilion. This year the Palm Dog went to Lucky, a Maltipoo – that's half Maltese terrier, half poodle – who plays Dixie in Miguel Gomes' six-hour epic, Arabian Nights. The prizewinner is presented with a toy bone and this year delivered a brief acceptance speech (“woof”) by video link. A jolly time was had by all but an unnamed French journalist felt that the award was “an unwanted intrusion of British silliness” in the glamorous proceedings, according to AFP. “From the French perspective, this is a bit bizarre,” he is reported to have said. “The British are weird.”
7. Get Comfortable
Mr Na said that although South Korea had signed a trade agreement with China, there were plenty of other ways in which Beijing could punish Seoul.
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For the dynasties that flourished in China around 1,700 years ago "the conquest and effective governance of Kucha would enable them to control all the oasis city-states in the Western Frontiers," the researchers said.
Mark Rutte, the Dutch prime minister whose People’s Party for Freedom and Democracy (VVD) is slightly ahead of the PVV, has seen his poll numbers rise in recent days because of his hardline stance with Ankara. On Tuesday he called Mr Erdogan’s comments “a disgusting distortion of history”, adding: “We will not lower ourselves to this level. It is totally unacceptable.”
No details have been given about the content of the leaflets, though propaganda sent in the past has denounced North Korea's ruling family.
Separate temperature measurements taken from satellites do not show 2014 as a record year, although it is close. Several scientists said the satellite readings reflected temperatures in the atmosphere, not at the earth’s surface, so it was not surprising that they would differ slightly from the ground and ocean-surface measurements that showed record warmth.
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The pear-shaped diamond named The Blue is 13.22 carats is estimated to be worth between $21-$25 million.
In the month since her death, police have not said whether she accidentally pulled the trigger or was shot by someone else in the room.