SAN JUAN, Puerto Rico (AP) — Puerto Rico’s new governor was sworn in Monday as the U.S. territory prepares for what many believe will be new austerity measures and a renewed push for statehood to haul the island out of a deep economic crisis.
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Developer activity is also at a fever pitch. According to the contributor graph at GitHub, the total number of contributions to bitcoin’s master code in November was the highest it had been since spring 2012. Bitcoin is also the 31st “most forked repository” on GitHub—”forks” are basically proposed or in-progress alterations to core code—out of more than 900,000. In other words, for developers, bitcoin is trending. The number of open jobs currently posted at bitcoin companies also underscores developer interest: it’s at 105, which is close to the all-time high in September of 137, according to Bitcoin Pulse, which monitors such trends.
These artificial ears will be a huge benefit to those who suffer injuries or who have microtia, a condition that keeps the ears from ever developing.
Hillary stays on: Clinton’s CV is chock full of firsts: The only first lady to become a U.S. senator turned viable presidential candidate turned secretary of state. Now a private citizen, she continues to be one of the most watched and listened-to women on the planet. All bets on that she will be the 2016 Democratic presidential candidate and the free world’s presumptive next leader. She’s done little to quiet the chatter, including hitting the speaking circuit last month at an estimated $200,000 fee per event and inking a reported $14 million book deal.
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Inventors Bryan Carpenter and Bland Hoke were inspired by their passion for the outdoors, and decided to come up with a creative way to bring their hammocks everywhere they go.
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.