4. Smart trashcan
I only want you for New year!我只要你作为我的新年礼物！
With best wishes for a happy New Year!
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.
Managers are able to reward their subordinates in unique, personalized ways thanks to the budget they receive from corporate. Two examples of past bonuses: free trail rides at an equestrian stadium and a barbeque with lassoing and horseshow throwing lessons.
People promoting driverless cars, the most hyped industry segment of the moment, became world leaders in verbiage. Elon Musk claimed to be “laser-focused on achieving full self-driving capability on one integrated platform with an order of magnitude greater safety than the average manually driven car” (ie Tesla cars must stop crashing).
The leadership changes across the industry will be of particular interest to female consulting professionals, given none of these firms have ever been run by a woman. Consulting firms are vocal proponents of the business case for improved gender diversity at the top of large companies. It will be interesting to see if any of them decide to practice what they preach.
The Female Warlord Who Had C.I.A. Connections and Opium Routes
如果有什么电影能够至少在两个小时里，为美国生活中深刻的种族、代际与阶层鸿沟架起桥梁，那可能就是这部古老的《洛基》(Rocky)系列的复活影片。西尔维斯特·史泰龙(Sylvester Stallone)拖着脚步，饰演这个聪明的老教练角色，给出了他演艺生涯中或许是最松弛、最温暖的表演。迈克尔·B·乔丹饰演洛基的被保护人阿多尼斯·约翰逊(Adonis Johnson)，他也是洛基一度的竞争对手和早已丧失的朋友阿波罗·奎迪(Apollo Creed)的私生子，他成了我们这个时代重要的影星。至于库格勒，这是他执导的第二部唱片，证明他是一个真正的斗士。
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.