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尚志市中医院在哪里黑龙江四院官方网Voice recognition technology is critically important, not just for mobile phones, but potentially for control of lots of other devices, particularly televisions. It is still early days, but if you#39;re thinking about which side will win in the battle between Apple#39;s Siri and Google Voice Search, consider the lesson of spell check.语音识别技术不仅对于手机产业来说至关重要,而且对很多其他设备,特别是电视机的控制来说,也十分关键。该技术目前尚处于初级阶段,但如果你在思考,到底“苹果语音助手”(Apple#39;s Siri)和“谷歌语音搜索”(Google Voice Search)谁会在这场竞争中取胜,那就想想拼写检查给我们的启示吧。When Eric Schmidt was still chief executive of Google, I asked him what the company owned that would make it particularly hard for any emerging search contender to wipe Google out. Spell check, he said. Google had observed the spelling mistakes and corrections typed into billions of queries, and had a vast understanding of what people really meant when they typed like thsi. Google was able to use this knowledge to offer a ;did you mean; function in search, eventually completing queries before people were finished typing.当埃里克·施密特(Eric Schmidt)还是谷歌首席执政官的时候,我问他,谷歌到底拥有什么,能让它不被任何新出现的搜索引擎打倒。拼写检查,他回答道。谷歌仔细研究了输入查询框的数十亿信息的拼写错误和修正,因此非常清楚用户出现像“thsi”这样的拼写错误时,他们实际想要表达的意思是什么。有了这种了解,谷歌在搜索中提供了“您是不是想找”的功能,最终做到了在人们完成输入之前,就将问题补充完整。Other companies would not be able to get that learning, he said, since people had come to expect search engines to fix their spelling. The customers would stay with Google, where that problem was solved. Microsoft Bing has proved Mr. Schmidt was not entirely correct in Google owning spell check, but it does take a company of Microsoft#39;s size to come at the problem.他表示,其他公司不会有这样的学习积累,因为人们已经开始指望搜索引擎来修正他们的拼写。客户仍会继续使用已经解决了这个问题的谷歌。微软必应(Microsoft Bing)明,施密特关于谷歌独有拼写检查功能的说法并不完全正确,但也只有微软这种规模的大公司才能应付这样的问题。It is common around the world to use Google to check one#39;s spelling now, and it#39;s common inside Google to use that same ancillary learning on new products.现在,使用谷歌来检查拼写在全世界都很普遍,而且在谷歌内部,同样的辅助性知识也经常应用于新产品。That is probably why Google Voice Search, in its Siri-like manifestation in the new Jelly Bean version of the Android operating system, appears to be winning the heart of my colleague Nick Bilton. Nick says Google Voice Search appears to have better understanding of what he#39;s talking about, and can answer questions better. There are also numerous s on the Web showing its prowess.这也许就是“谷歌语音搜索”似乎深受我同事尼克·比尔顿(Nick Bilton)追捧的原因。在安卓操作系统“软糖豆”(Jelly Bean)的升级版中,它看起来和Siri相似。尼克说,“谷歌语音搜索”对他所说的话识别能力似乎更强,而且回答问题也更出色。网上也有大量视频展示了这款产品的威力。If Google is better, it is most likely because it has roots in a product Google introduced in 2007, called Google-411, or Google Local Voice Search. Ostensibly a product that provided free directory assistance, Google was mostly interested in capturing the way different people pronounced words.如果说谷歌的表现更好,这极可能是因为谷歌2007年推出的一款产品为上述技术奠定了基础。这款产品名为“谷歌411“(Google-411),或称“谷歌本地语音搜索”(Google Local Voice Search)。这款产品表面上是为了提供免费信息查询,其实让谷歌最感兴趣的,是掌握不同人的发音方式。While the Jelly Bean version of Voice Search is new, Google#39;s linguists have five years of data on billions of pronunciations. A year ago, just for the English language, Google had a database of 230 billion word strings, and had worked on 23 other languages, based largely on 411 and related voice-based search products, including an earlier version of Voice Search. It#39;s another spell check.虽然语音搜索的“软糖豆”版本最近才推出,但谷歌语言学家已经有了5年数十亿不同发音的数据积累。一年前,谷歌就有一个包括2300亿词组的数据库,这还只是英语。谷歌还在致力于 23个其他语种的开发。这些开发很大程度上都以“411”及相关语音搜索产品为基础,其中还包括一个“语音搜索”的早期版本。这又是另一种拼写检查。Apple never worked on that kind of feature, which is one reason Siri is one of the few products Apple officially released in beta form. It is building up its database of speech during Siri#39;s early life. Some of the cute ways Siri talks when it does not understand a question, such as repeating back what you have said, may in fact be efforts to see if you will correct its understanding, somewhat in the way Google learned spell check. Google Voice Search on Jelly Bean is starting late, but its quality advantage from all that learning beforehand is what makes it better in the early days.苹果从来不曾进行类似功能的研发,这也是为什么Siri成为苹果官方以测试版形式发布的少数产品之一。在Siri的早期阶段,它的语音数据库逐渐建立。当Siri不明白一个问题的时候,它有一些可爱的表达方式,比如重复你刚才的话,也许实际上,这就是为了看你是否会纠正它的理解,这和谷歌掌握拼写检查的方法类似。虽然“谷歌语音搜索”的“软糖豆”版本出现较晚,但它建立在早期研究基础上的质量优势,正是它在初级阶段表现突出的原因。That is not the only area where Google develops one product for the sake of another. The Google Goggles application on Android, which uses computer-driven image recognition to help identify an object the customer photographs, is also a product for use in connection with Google Maps. You can take a picture of a street in Goggles, and if Google Maps has taken a picture of that place with its Street View cars, it can tell you where you are.开发一个产品是为了另一个产品,语音识别并不是谷歌这么做的唯一领域。安卓系统上的“谷歌眼镜”(Google Goggles)应用,使用电脑图像识别技术,能帮助确认用户所拍摄的物体,也是一款能与谷歌地图(Google Maps)联合使用的产品。你可以用“谷歌眼镜”拍一条街,如果谷歌地图也用“街景”(Street View)车拍过这个地点,它就能告诉你,你现在是在什么地方。 /201411/343215哈市九洲引产 The dependence on the Internet and mobile phones seems to have become profound. When cut off from these modern-day technological innovations, people tend to become anxious rather than feeling liberated, says a study.人们对互联网和移动电话的依赖似乎已经很深了。研究发现,当人们失去了这些现代技术创新时,不是感到“终于解放了”,而往往会变得焦虑不安。Researchers have found that staying in a place with no mobile phone coverage, or suffering from the Internet going down, is a cause of high stress and anxiety for an increasing number of people.研究人员发现,当呆在一个没有移动电话信号覆盖的地方,或互联网掉线时,越来越多的人会变得紧张和焦虑不安。The study, undertaken for Virgin Media by the analysts Future Laboratory, is based on a survey.这份基于调查的研究报告是由英国的《未来实验室》分析人员为《维京媒体》所作的。As many as 85 per cent of full-time mothers always have the Internet turned on at home, while a third of people said they no longer felt any sense of guilt about always being ;connected; either by having their mobile phone or computer turned on, the survey found.调查发现,在家里,有多达85%的全职母亲总是连上互联网的,而三分之一的人说,让手机和电脑总是处于“连网”状态时,已不再有任何的负罪感。The results indicated that 36 per cent of people were anxious about keeping in touch with their family if they were disconnected, compared with just 29 per cent who felt they#39;re liberated。调查显示,如果网络遭断开,就会有36%的人渴望与家人保持联系,而感到“解放了”的只有29%。When it came to work 29 per cent cent said they were anxious when cut off, compared with 28 per cent saying they felt liberated.当涉及到工作时,29%的人表示,网络切断时,他们会焦虑不安;而28%的说,他们可以轻松了。 /201507/385686黑龙江公立三甲医院处女膜修复

哈尔滨哪些医院可以做人流呼兰区妇女医院体检多少钱 It wasn’t his first broken condom, so Rafael didn’t worry. But three weeks later, the man he’d met in a bar called to say that he had “probably been exposed” to H.I.V.拉斐尔不是头一回碰上保险套破了这种事,所以一点儿也没放在心上。但三个礼拜后,他在酒吧遇到的那人打电话来说,他“可能接触到了”艾滋病病毒。Rafael, a muscular, affable 43-year-old, went to a clinic and within 45 minutes learned he was infected. Although it was aly closing time, a counselor saw him immediately and offered him a doctor’s appointment the next day.43岁的拉斐尔是为人友善的肌肉猛男。他去了一家诊所,过了45分钟得知自己确实被感染了。尽管当时已经是下班时间,一名顾问立即跟他碰面,并马上为其预约了第二天的医生看诊。At Ward 86, the famous H.I.V. unit at San Francisco General Hospital, the doctor handed him pills for five days and a prescription for more. Because he was between jobs, she introduced him to a counselor who helped him file for public health insurance covering his ,000-a-year treatment.在旧金山市综合医院(San Francisco General Hospital)著名的86号H.I.V.病区(Ward 86),医生给了他五天的药量,又为他开了处方好让他可以买到更多药。因为他暂时赋闲在家,这名大夫将他介绍给了一名顾问,后者帮助他申请了一份公共医疗保险,每年报销3万美元的治疗费。“They were very reassuring and very helpful,” said Rafael, who, like several other men interviewed for this article, spoke on condition that only his first name be used to protect his privacy. “They gave me the beautiful opportunity to just concentrate on my health.”“他们很帮忙,这让我感到宽慰,”拉斐尔说。出于隐私考量,他与本文其他几位接受采访的男性都坚持仅以姓氏相称。“他们提供给我一个很好的机会,让我能够全心专注于自己的健康。”Despite bad luck in sex-with-strangers roulette, Rafael did have some good fortune: He lives in San Francisco, which is turning the tide against H.I.V. and serving as a model for other cities. The city that was once the epidemic’s ground zero now has only a few hundred new cases a year, the result of a raft of creative programs that have sent infection rates plummeting.尽管在一夜情的轮盘赌中撞上霉运,但拉斐尔也有幸运之处:他住在旧金山,这是一座扭转了防治艾滋病颓势、堪为其他城市效仿的楷模城市。这里曾经是艾滋病的重灾区,多亏实施了一系列富有创意的方案,感染率急剧降低,现在这里每年只有几百例新病例。“I love the San Francisco model,” said Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases. “If it keeps doing what it is doing, I have a strong feeling that they will be successful at ending the epidemic as we know it. Not every last case — we’ll never get there — but the overall epidemic. And then there’s no excuse for everyone not doing it.”“我大爱旧金山市的这个模式,”美国国家过敏症及传染病研究所(National Institute of Allergy and Infectious Diseases)所长安东尼·S·福西(Anthony S. Fauci)士说。“如果坚持目前的做法,我坚信他们一定能成功地终结现在的疫情。我不是说这样就能消除所有的病例——恐怕我们永远也做不到这一点,但大体上消灭疫情是完全可能做到的。没有理由不这么做。”Last week, the World Health Organization essentially agreed. Issuing new guidelines for the treatment and prevention of H.I.V., the agency called on the rest of the world to do much of what San Francisco is aly doing: Every H.I.V. patient should start antiretroviral drugs as soon as they test positive rather than waiting for measures of immune system strength to drop, the agency said, and everyone at risk of infection should be offered preventive drugs. San Francisco adopted the first practice — “test and treat” — five years ago and the second in 2013. It has bolstered those efforts with others, like the rapid-doctor’s-appointment program that swept Rafael in, and another to track difficult patients.上周,世界卫生组织(World Health Organization, W.H.O.)对旧金山模式表示了基本的赞同。该机构印发了新的H.I.V.防治指南,呼吁世界其他地区以旧金山为榜样:一旦H.I.V.检测呈阳性,患者就应该尽快开始用抗逆转录病毒药物,而不是等到免疫系统功能指标衰退后再治疗;此外,该机构还指出,应该向所有高危人群提供预防性药物。5年前,旧金山市已经率先实践了上面的第一条——“检测即治疗”,2013年又实施了第二条。这又带动了其他的一些措施,比如预约医生的快速通道、跟踪比较麻烦的患者等,拉斐尔正是受益于前者。The results have been striking. Last year, San Francisco had only 302 new H.I.V. diagnoses, the lowest recorded number. In 1992, at the epidemic’s peak, there were 2,332.这些举措成效惊人。去年,旧金山市仅新增了302例H.I.V.确诊病历,创历史新低。而在疫情最严重的1992年,曾达2332例。In 1992, the city had 1,641 deaths from AIDS. Last year, just 177 San Franciscans with H.I.V. died, and most of them actually succumbed to heart disease, cancer or other old-age ills, said Dr. Susan Buchbinder, the head of H.I.V. prevention research for the city health department.1992年,该市有1641人死于艾滋病。到了去年,只有177名艾滋病病毒感染者死亡,而且其中大多数实际上是死于心脏病、癌症或其他老年病,旧金山市卫生部H.I.V.预防研究的负责人苏珊·布赫宾德(Susan Buchbinder)士如是说。By other measures, too, San Francisco is ahead. According to a 2012 estimate by the Centers for Disease Control and Prevention, only 39 percent of all infected Americans had seen an H.I.V. doctor, and only 30 percent were taking their pills consistently enough to be “virally suppressed,” meaning they were not infectious. By contrast, in San Francisco, 82 percent of residents with H.I.V. were in care, and 72 percent were suppressed. In Ward 86 — all of whose patients are uninsured or on public assistance — suppression has reached 84 percent.用其他指标衡量,旧金山市同样居于领先地位。美国疾病控制和预防中心(Centers for Disease Control and Prevention, C.D.C.)2012年估计,在所有受到H.I.V.感染的美国人中,只有39%曾到专科医生处就诊,只有30%能坚持药直至达到“病毒抑制”(此时他们不再具有传染性)。相比之下,在旧金山的居民中,82%的H.I.V.感染者都接受了治疗,72%达到了“病毒抑制”状态。86号病区中的患者要么没有医疗保险,要么依靠公共救济过活,但他们中的抑制率也已达到了84%。San Francisco has some natural advantages: wealth, political leaders who consistently back the fight — in part because the gay vote is so big — and a close-knit medical community in which many of the top officials in the fight against H.I.V. have studied together, trained each other and done research projects together through the University of California, San Francisco.旧金山市具备一些天然的优势:有钱、一贯力挺抗H.I.V.斗争的政治领导人(他们这么做的部分原因是因为同性恋人群是一大票仓)、密切合作的医学界。许多抗艾领域的高官都曾在加州大学旧金山分校(University of California, San Francisco)一起学习、培训,并共同完成研究项目。Because of the tech boom, City Hall’s budget grew from billion to nearly billion in 10 years. For patients not eligible for federal or state aid, the city has its own health insurance: Healthy San Francisco. And it has been able to counter every cut in federal AIDS funds.借助科技繁荣的东风,10年之内,市政厅的财政预算从50亿美元增长到了近90亿美元。对于无法获得联邦或州府医保救助的患者,该市提供了自己的医保计划:健康旧金山(Healthy San Francisco)计划。目前它已足以应对联邦政府AIDS基金的削减。“One of my first budget questions is always, ‘Are they cutting our Ryan White money again?’ ” Mayor Edwin M. Lee said in an interview, referring to the 1990 law that pays for AIDS drugs. “Since 2011, we’ve backfilled more than million — with very little debate.”“我面临的最重要的预算问题始终是:‘按照瑞安·怀特法案(Ryan White,瑞安·怀特是美国抗击艾滋病和消除艾滋病歧视的标志性人物,1990年他去世之后,美国国会通过了美国最大的针对艾滋病患者及携带者的免费治疗法案——译注)我们应该得到的拨款是不是又被砍了?’ ”市长李孟贤(Edwin M. Lee)在接受采访时说。“2011年以来,我们补上了2000多万美元的资金空缺——几乎没有引发什么争议。”Wealth also eases the burden in a harsher way: Soaring rents have driven out many poor residents. Two-thirds of San Francisco’s infected are white or Asian; nationally, 63 percent are black or Hispanic. Older, wealthier, openly gay white men are more likely to be insured and well-informed about risks than young black and Hispanic men, the epidemic’s fastest-growing subgroup.与此同时,金钱也在以一种更为残酷的方式减轻该市的负担:飙升的房租令许多贫困居民不得不离开此地。旧金山三分之二的H.I.V.感染者是白人或亚洲人。而纵观整个美国,63%的感染者是黑人或西裔美国人。与年轻黑人和西裔男性这个疫情增长最快的人口亚群相比,年龄较大、较为富裕、且已经出柜的白人同性恋男性拥有保险的可能性更高,对各种风险了解得也更加充分。But the city’s chief strength has been a willingness to go first, to rapidly adopt tactics that work in pilot projects or clinical trials, before they are endorsed by public health organizations like the C.D.C. and the W.H.O.但该市最大的优势之源是愿意先行一步,在C.D.C.和W.H.O.这样的公共卫生机构认可之前,就迅速应用那些在试点项目或临床试验中有效的策略。In 1983, the city opened the first dedicated AIDS ward. In 1987, it tested the first antiretroviral drug, AZT. In 1992, it began distributing clean needles to drug addicts.1983年,该市开设了第一个艾滋病专用病房。1987年,它试用了第一种抗逆转录病毒药物AZT(叠氮胸苷)。1992年,它开始向瘾君子们分发洁净的针头。In 2010, it adopted “test-and-treat” — antiretroviral drugs given as soon as a patient tested positive. In 2013, it started the preventive drug program, PrEP — pre-exposure prophylaxis with Truvada, a two-drug pill — at no charge to the uninsured. By some estimates, 15 percent of the city’s gay men are now taking Truvada.2010年,该市推行了“检测即治疗(test-and-treat)”策略,只要患者的检测呈阳性即尽快给予抗逆转录病毒药物治疗。2013年,它开始实施预防用药方案,即使用特鲁瓦达(Truvada,一种抗逆转录病毒药物,主要成分为恩去他滨和提诺福韦——译注)为无医保人群免费提供暴露前预防(PrEP)。据估计,该市的男同性恋中有15%正在用特鲁瓦达。Numerous recent studies have shown that people taking antiretroviral therapy every day not only live longer, but also have so little circulating virus that they are highly unlikely to infect others even through unprotected sex.近期的众多研究显示,每天接受抗逆转录病毒治疗者不仅寿命更长,其循环系统中的病毒也极少,即使发生了无保护的性行为,传染他人的可能性也很小。But the shift to immediate drug treatment was a struggle. Dr. Grant Colfax, who was then the city’s director of H.I.V. prevention, met resistance from doctors arguing that drug side effects were too harsh to begin immediately and that patients not yet motivated by brushes with death might take medicines carelessly and develop resistant strains.然而,将防治策略转变为立即上药仍然困难重重。该市H.I.V.预防部门的负责人格兰特·科尔法克斯(Grant Colfax)士遇到了来自医生们的阻力,他们反对的理由是:药物的副作用太厉害,不适合推行发现后立即治疗的原则;一部分未感到死亡威胁的患者治疗的积极性不高,很可能不好好药,以致因此产生耐药性病毒株。Community groups were also angry. Many had lucrative city contracts to hand out condoms and advice, which the city rewrote to require they do tests and provide medical care.社区团体也不高兴。之前许多社团都跟市政签订了利润丰厚的合同,负责分发安全套和宣传抗艾指南。根据该市重新起草的新指南,他们还需要协助进行检测,并提供医疗务。“We were accused of ‘medicalizing H.I.V.,’ ” Dr. Colfax said. “Which I found ironic.” But the new-infection rate had not budged for 11 years. “We couldn’t keep doing the same old thing,” he said.“别人指责我们‘对H.I.V.过度医疗化’,#39;“科尔法克斯士说。“这让我觉得很有讽刺意味。”新发感染率11年未变过。“我们不能再继续过去的做法了,”他说。He persisted, and won.他坚持了下来,并取得了胜利。To identify infected people, the city increased testing and created a program called Rapid, the one that helped Rafael: It guarantees a quick doctor’s visit, with cab fare to get there if necessary, and help finding insurance.为了甄别感染者,该市增强了检测力度,并创建了快速通道(Rapid program),确保受感染者可以尽快得到医生的看诊(如有必要,甚至还报销去医院的出租车费),并帮助他们获得医疗保险。拉斐尔就是该方案的受益者之一。The Magnet Clinic, where Rafael was diagnosed, did 9,600 H.I.V. tests last year. It lies in the heart of the Castro, the city’s rainbow-flag-bedecked gay mecca, and resembles a cheery cellphone store: The waiting room has couches, flowers, disco music and photographs of the Sisters of Perpetual Indulgence, a campy drag troupe. A mobile of smiling penis toys dangled over one examination table.为拉斐尔诊断的磁铁诊所(Magnet Clinic)去年进行了9600例H.I.V.检测。这家诊所坐落在旧金山市挂满了虹旗的同性恋者圣地——卡斯特罗街区(Castro)的中心地带,外观就像一个明快的手机店:候诊区里设有沙发、鲜花、迪斯科音乐和“无尽耽溺”(Sisters of Perpetual Indulgence,一个男扮女装的同性恋者剧团——译注)的照片。在检查台上方,还悬挂着一些带有微笑表情的阴茎玩具。“We didn’t want it to feel like a jail cell,” said the nursing director, Pierre-Cedric Crouch, wearing the clinic’s signature “No Blame/No Shame” T-shirt. “And we have no stigma. You can come in saying you just slept with 20 guys and don’t know what a condom is, and we don’t criticize you. We help you out.”“我们不想让人觉得这里像是牢房,”护理部主任皮埃尔-塞德里克·克劳奇(Pierre-Cedric Crouch)身着诊所标志性的“不责备/不羞愧(No Blame/No Shame)”T恤说道。“我们这里不做评判。你走进来说你跟20个男人上过床,而且从不知安全套为何物,我们也不会责难你。我们只提供帮助。”Magnet’s social workers will enroll patients in insurance or, if they have coverage, fight to make sure it covers what they need.磁铁诊所的社工会动员患者参加保险,如果他们已经参保,则会争取确保它可以报销他们的所需开销。Jayne Gagliano, the benefits manager, said she regularly had to explain to out-of-state insurers that using Truvada to prevent infection was, in fact, F.D.A.-approved.福利经理杰恩·加利亚诺(Jayne Gagliano)说自己经常需要向外州的保险公司解释使用特鲁瓦达预防H.I.V.感染实际上已经经过了美国食品和药品监督(Food and Drug Administration, F.D.A.)的审批。“The fragmented American insurance system is one of our biggest obstacles,” said Dr. Diane V. Havlir, the chief of the H.I.V. division at San Francisco General, who has seen patients stop taking their pills because of coverage lapses.“离破碎的美国保险体制是我们最大的障碍之一,”旧金山市综合医院H.I.V.部门的负责人黛安娜·V·哈夫利尔(Diane V. Havlir)士说道,她曾目睹一些患者因为医保报销问题而被迫停药。East of the Castro is the Tenderloin — a grim neighborhood peppered with single-room-occupancy hotels, homeless shelters and liquor stores. More than a quarter of the city’s homeless are gay or transgender, and many are found here. Some trade sex for drugs or a place to sleep, and end up infected.卡斯特罗区的东面是田德隆,一个充斥着单身公寓旅馆、无家可归者收容所和酒类专卖店的可怕街区。这个城市中超过四分之一的无家可归者是同性恋者或变性人,其中许多人都生活在这里。有的人用性来交换毒品或落脚地,结果感染了H.I.V.。Four years ago, San Francisco created Linkage into Care teams — Lincs for short — to track such patients.四年前,旧金山市创建了联动护理团队(Linkage into Care teams,简称Lincs)来追踪这类患者。In 2012-13, Lincs “navigators” searched for 315 missing H.I.V. patients and enrolled 116 of them — the rest were not found, or were jailed, dead or refused help. Navigators call and text patients, visit them and even escort them to doctors.2012-13年间,Lincs的“领航员”对315名失踪的H.I.V.患者展开了搜寻,并将其中116人纳入了医护项目,其余的人要么是没找到,要么是已经死亡或被关进了监狱,也有的拒绝接受帮助。“领航员”们给患者们打电话、发短信、看望他们,甚至陪他们去看医生。Some 73 percent of the Lincs patients stayed in care, and they were twice as likely to be virally suppressed as similar patients who were not in Lincs.在Lincs的患者中有约73%坚持了治疗,且达到病毒抑制状态的可能性是出于类似状况的非Lincs患者的两倍。Recently, Erin Antunez, a Lincs navigator, spent her day focused on three: a young man released from jail that morning, a drug injector living in a Market Street hotel, and a 36-year-old mother staying in a former AIDS hospice.不久前的一天,Lincs的一名“领航员”埃琳·安图内斯(Erin Antunez)在当天的工作主要围绕着三个人展开:一名当天上午刚从监狱释放出来的年轻男子,一个住在市场街旅馆里的瘾君子,还有一个是生活在曾经的AIDS安养院的一位36岁母亲。The former prisoner “was not a big red flag,” she said. He usually took his pills and had a clinic appointment that afternoon.那个刑满释放人员“不是什么大问题”,安图内斯女士说。他经常领取药物,而且还预约在当天下午接受诊疗。The drug user often disappeared. He recently had texted her: “Where can I get an abscess drained without all the red tape?” but then had not answered several messages.瘾君子经常玩失踪。前一阵子他还发短信问她:“在哪儿做脓肿引流可以不用忍受那些麻烦的繁文缛节?”她给他发了若干消息,但之后就杳无回音了。“A lot of this work is ‘Where’s Waldo?’ ” Ms. Antunez said.安图内斯女士说:“我的工作有很多时候都像是在玩《沃尔多在哪里?》(‘Where’s Waldo?’,由英国插画家Martin Handford创作的一套儿童书籍,读者需要在人山人海的图片中找出沃尔多——译注)”Her first visit was to the Maitri Hospice, a haven on a residential block. Founded, according to its website, by a “drug-addled drag queen turned Zen master,” it has a Buddha and origami cranes for décor, and separate smoking porches for tobacco and medical marijuana.这一天,她首先前往某住宅区一家名为Maitri 临终关怀中心(Maitri Hospice)的安养院。网站介绍其创办者“原先是个吸毒成瘾的男扮女装者,后来成为禅宗大师”。安养院里装饰着佛像和纸鹤,还设有独立的吸烟门廊以供吸烟和医用大麻。The young mother was not dying, although she had survived two types of AIDS-related pneumonia.她要探视的这位年轻母亲并无性命之忧,不过之前熬过了两种不同的AIDS相关肺炎。Rather, she “just needed a break,” Ms. Antunez said, from methamphetamine binges in her housing project, during which she slept on any free couch and neglected her pills.更确切地说,她“只是需要从她住处的甲基苯丙胺狂欢节中脱身,好好休息一下”,因为她只能随便找张空沙发睡觉,完全忽略了吃药这件事。Today, she was waiting in a turquoise tank top, floral shorts and a white Tilley hat, y to ride a city bus to Ward 86.她今天穿上了绿松石色的背心和印花短裤,还戴了一顶白色的Tilley帽子,正等着乘坐城市公交车前往86号病区。Ms. Antunez asked about her new tattoos. Deeply shy, the woman focused on her phone and mumbled childlike answers — until she mistakenly thought a reporter was a supervisor assessing Ms. Antunez, and leapt to her defense: “Erin is great! You can tell some people don’t want much to do with you, but she knocks on doors, she calls me, we play phone tag.”安图内斯女士问起她的新纹身。她很害羞,一直看着手机,喃喃地述说着孩子般天真的,直到她误以为记者是来评估安图内斯女士工作的主管,一下子跳了起来,为她辩护道:“埃琳很棒!你看得出来有些人其实并不心甘情愿想跟你扯上关系。但她来敲我的门,打电话给我,我们还一起玩电话捉迷藏的游戏。”Ms. Antunez’s afternoon client was not in his room at the Donnelly Hotel although she knocked loudly in case he was in a stupor.然而,安图内斯女士下午要拜访的客户却没待在唐纳利酒店(Donnelly Hotel)他的房间里。她大声地敲他的房门,怕他是昏过去了。A manager said he had “shown everyone his abscess” and then left.酒店经理说他“向所有人展示他身上的脓肿”,然后就走了。Worried that he would lance his own abscess, she checked restricted databases that Lincs has access to, including all public clinic visitors and all H.I.V. tests ordered.安图内斯女士很担心他会自己去挑脓肿,于是她利用Lincs的权限访问了数个数据库,查看了公共门诊的所有就诊者和已安排好的所有H.I.V.检测。They revealed that her ex-prisoner and the drug user had seen doctors that afternoon. “Yeah!” she cried, waving her fists and doing a dance in her chair. “That’s a good navigation day.”结果显示,她负责的那个刑满释放者和瘾君子在那天下午都接受过医生诊查。“好极了!”她挥舞着拳头喊道,在椅子上手舞足蹈。“真是顺利的一天”。In 2013, shortly after the Food and Drug Administration approved the use of Truvada to prevent H.I.V. infection San Francisco started offering it to everyone at risk. Some gay men called others “Truvada whores” for avoiding condoms.2013年,就在F.D.A.批准使用特鲁瓦达预防H.I.V.感染后不久,旧金山市开始向整个高危人群提供这种药物。有些男同性恋者管用了特鲁瓦达就不使用安全套的人叫“特鲁瓦达男娼(Truvada whores)”。The backlash has mostly faded, said Dr. Bradley C. Hare, the director of H.I.V. for Kaiser, which also offered PrEP early. The first adopters, he said, “were the equivalent of the people who camp outside the Apple store for the latest iPhones.” Now a “second wave” has emerged, he said. “It’s people who needed a little more education but now say, ‘My friend is using it, and I’m doing the same things he’s doing, so ...’ ”凯萨医疗机构(Kaiser)也是最早提供预防药物的组织之一,其H.I.V.部门的负责人布拉德利·C·黑尔(Bradley C. Hare)士说:抵触情绪基本已经消退了。他将首先尝试预防药物者“比作在苹果零售店外面彻夜排队等着买最新款iPhone手机的人”。如今,“第二次浪潮”已经出现,他说。“这些人需要更多的教育,现在他们终于意识到:‘我的朋友正在使用它,既然我们总是在做同样的事情,那么……’ ”Dr. Lisa Capaldini, a popular doctor in the Castro, said she was “still ambivalent” about PrEP. Avoiding condoms, she said “makes it a Trojan horse for syphilis and gonorrhea, so if I had an 18-year-old gay son, I’d say, ‘I’d rather you used condoms.’ ”在卡斯特罗区颇受欢迎的医生莉莎·卡帕尔迪尼(Lisa Capaldini)士说自己对预防药的态度“仍摇摆不定”。因为很多人用预防药后就不使用安全套了,她认为“这就像特洛伊木马一样给了梅毒和淋病可趁之机。所以如果我有一个18岁的同性恋儿子,我会对他说:‘我宁愿你使用安全套’。”Dr. Buchbinder, of the health department, disagreed, saying, “Denying PrEP to patients because they might have unsafe sex makes about as much sense as our colleagues who treat high cholesterol denying statins to theirs because they might eat more ice cream.”卫生部的布赫宾德士表示了不同意见,她说:“因为担心患者会发生不安全的性行为就拒绝对其应用预防药,就像治疗高胆固醇症的同行因为怕患者有了他汀类药物后会使劲吃冰淇淋而不肯给他们开药一样。”A recent study of the first 657 Kaiser patients on PrEP found that their condom use had indeed gone down and more had caught venereal diseases — but in two years, not one had caught H.I.V.最近的一项研究考察了Kaiser的前657名接受预防药物的患者,发现他们的安全套使用率确有下降,且更容易患上性病——但两年内这些人中无一感染H.I.V.。Stephen, a slim, soft-spoken 24-year-old Chicago native, just got on Truvada. He delayed for a year, he said, until he found a job with health insurance. He had been on his parents’ policy and feared their seeing the prescription. They are conservative Roman Catholics who know he is gay but dislike it. “My father offered to buy me hookers,” he said, shaking his head.斯蒂芬(Stephen)是一个24岁的芝加哥小伙子,身型单薄,说话轻声细语,他刚刚开始用特鲁瓦达。他不得不推迟一年用药是因为他需要先找到一份带医疗保险的工作。之前,他的保险附带在他父母的保单上,他生怕他们会发现特鲁瓦达的处方。他的父母都是保守的天主教徒,知道他是同性恋后非常不满。“我的父亲甚至给我钱让我去招妓,”他摇着头说。Stephen first heard of the drug through a gay student group at his Catholic college. “But my friend said it means you’re super-slutty, that it’s for people who bareback, or go into dark rooms for sex,” he said. “I didn’t want to associate with it.”斯蒂芬第一次听说这种药是在他所在的天主教学院的同性恋学生社团里。“我的朋友说,这种药是给那些超级放荡、做爱不戴套或者一有机会就钻进小黑屋做爱的人用的,”他说。“我一点儿也不想跟它扯上关系。”Now, he said, he considers it another form of protection, “something I definitely want to add to my bag of goods.”但现在他知道这是另一种形式的保护,“是应该毫不犹豫照单全收的东西。”If he had grown up in San Francisco, he probably would have learned of it earlier. Discussion of PrEP is now mandatory in public school ninth-grade sex-ed classes.如果他从小在旧金山长大,很可能早就明白了这一点。如今,围绕预防药物的讨论是公立学校九年级性教育课程的必修内容。The city’s success is not only shrinking the epidemic. It is changing the psychology of gay sex here in unexpected ways. The fear of death — so long a part of being gay in America — appears to be receding.旧金山的成功不仅在于它控制并缩小了疫情,还在于它以一种出人意料的方式改变着这里的同性恋者对性行为的心态。长期以来,美国的同性恋者已经习惯于生活在死亡的阴影之下,如今,这种恐惧正在逐渐消散。Take Bradley and Paul, a couple visiting the Magnet clinic for gonorrhea tests. Paul, 53, a ruddy and weather-beaten Hawaii resident who called himself “one of the dinosaurs,” said he had probably been infected with H.I.V. as a teenager. Many friends died decades ago. “It’s crazy I’m still alive,” he said.就拿布拉德利和保罗(Paul)这一对前往磁铁诊所接受淋病检测的恋人来说吧。保罗现年53岁,是个面色红润、皮肤黝黑的夏威夷人,自称“大恐龙”。他说自己大概在十几岁时就感染了H.I.V.。很多朋友在数十年前就已经去世了。“我居然还活着,这简直太好了,”他说。Bradley, who resembled a prep-school athlete about 20 years younger, was from Atlanta and uninfected. They felt safe together, Paul explained, because he takes Complera, a triple-therapy pill, while Bradley takes Truvada.布拉德利来自亚特兰大,他看起来就像是一名年轻20来岁的在读预科学校的运动员;他未受感染。保罗解释道,因为他自己在用三联制剂Complera,而布拉德利在接受特鲁瓦达,所以他们在一起感觉很安全。“PrEP has really changed the game,” he said. “Bradley was the first guy I knew who was on it. He’d prefer to be with someone with an undetectable viral load than with someone who says, ‘Well, I assume I’m still negative.’ It blows my mind to be positive and not feel like a pariah.”“是预防药改变了一切,”他说。“布拉德利是我认识的第一个在使用它的人。他说自己宁愿选择一个检测不出病毒载量的人,也不要跟一个自称‘哦,我猜我应该还没被感染’的人在一起。这让我心态积极,不会感觉自己像一个社会弃儿。”“It’s really nice to still be around now and see a younger generation go through what we did,” he added. “I grew up in the ’70s with no fear. The guys in the ’90s were full of fear. Now guys are growing up with no fear at all.”“现在还能活蹦乱跳地看着年轻一辈重温我们的经历,感觉真不赖,”他补充道。“我成长于20世纪70年代,当时人们并不知道有什么需要害怕。到了90年代,人们满心恐惧。现在,年轻人又可以无所畏惧地安心长大了。” /201510/405823阿城区妇女儿童医院治疗效果

哈尔滨第七人民医院在线医生咨询Apple’s iPhone juggernaut is showing no signs of slowing down — at least where first-weekend sales are concerned.苹果(Apple)惊人的iPhone销售没有呈现放缓迹象——至少从首个周末的销量来看是这样。On Monday, Apple said it had sold more than 13 million new iPhone 6s and 6s Plus devices since they became available for sale on Friday, a record for first-weekend sales. That was up from the 10 million iPhones sold last year during the first weekend that the iPhone 6 and 6 Plus were sold.本周一,苹果公司表示,新的iPhone 6s和6s Plus从上周五开始发售以来共卖出了逾1300万部,创下了首个周末的销售记录。去年iPhone 6和6 Plus的首个周末销量为1000万部。Any increase in sales was most likely helped by the geography of the markets where the new iPhones became available. This year, the iPhones went on sale in a dozen countries and territories, including China, which is one of Apple’s biggest markets. Last year, China was not among the countries that sold the iPhone on the first weekend, apparently because the devices had not received approval from Chinese regulators.新iPhone销量增长的重要原因,可能是其首发市场的变化。iPhone今年的首发市场包括十几个国家和地区,其中就有苹果最大的市场之一中国。去年,中国不在iPhone的首发地区名单中,似乎是因为设备当时没有获得中国监管机构的批准。Adding China to the product introduction more than doubled the initial market size, according to Walter Piecyk, an analyst at BTIG Research. Jan Dawson, the chief analyst at Jackdaw Research, said he also expected first-weekend sales to be higher than last year because the period for ordering the new iPhones before their sale date was longer than that for the previous generation of the device.BTIG研究公司(BTIG Research)分析师沃尔特·皮西科(Walter Piecyk)表示,将中国加入首发地区名单使得初始市场规模增加了一倍多。穴鸟研究公司(Jackdaw Research)的首席分析师简·道森(Jan Dawson)表示,他也认为首个周末的销量会超过去年,因为与前一代产品相比,新iPhone从预定到销售相隔的时间要长一些。The sales numbers slightly outpaced some Wall Street estimates. Daniel Ives, an analyst at FBR Capital, projected that Apple would sell 13 million phones on the opening weekend, and he said that Wall Street had expected that Apple would sell about 12 million. Gene Munster of Piper Jaffray had predicted sales of 12 million to 13 million.这一销售数据略微超过了华尔街的一些预测。FBR资本市场公司(FBR Capital Markets)分析师丹尼尔·艾夫斯(Daniel Ives)预计苹果在开售周末会卖出1300万部手机,他表示,华尔街认为苹果会售出大约1200万部。派杰投资研究公司(Piper Jaffray)分析师基尼·蒙斯特(Gene Munster)预计销量在1200万至1300万之间。First-weekend sales help indicate overall iPhone demand, an important measure given that the device accounts for the majority of Apple’s revenue. The initial sales also are a marker for how well the new smartphones may do during the end-of-year holiday season, which is typically the most significant sales period for consumer product companies.首个周末的销售数字在一定程度上反映了对iPhone的总体需求,是一个重要的衡量标准,因为iPhone为苹果带来了大部分收入。最初的销售状况也预示着新款iPhone智能手机在年终假日季的表现会有多好。对于个人消费品公司而言,年终假日季通常是最重要的销售时段。This year, UBS estimates that Apple will sell 78.4 million iPhones in the December quarter, up four million from last year, while FBR predicts the sale of 77 million iPhones.瑞银(UBS)预计,苹果在今年第四季度将会售出7840万部iPhone,比去年增加400万,而FBR资本市场预测,iPhone的销量将会达到7700万部。Over the weekend, people camped out in front of some Apple stores to buy the new iPhones, a trend that has become something of a tradition. To cut down on long wait times in line, Apple let people sign up online for time slots during which to pick up their phones in stores.周末期间,人们在一些苹果商店前露营,以便买到新款iPhone。这一潮流已经变成了某种传统。为了减少漫长的排队等候时间,苹果让顾客在网上预约,选好前往商店拿手机的时间段。Mr. Ives said he was at the Apple store on Fifth Avenue in Manhattan on Friday, where he saw about 1,100 customers in line for the 8 a.m. appointment slot and 500 more people walking in without appointments, which is more than he saw last year.艾夫斯表示,他周五去了位于曼哈顿第五大道的苹果商店,看到大约1100名顾客排队等待在上午8点的预约时段,还有500多名未经预约而来的顾客,这比他去年见到的人多。At the Apple store in the Grove mall in Los Angeles, customers stood in the 90-degree heat to collect their new phones. Store employees handed out free bottled water, packs of Capri Sun, fruit and granola bars and provided large umbrellas for shade.在位于洛杉矶格鲁夫购物中心的苹果商店,顾客们在华氏90度(约合32摄氏度)的高温下排队等候获取自己的新手机。商店员工分发了免费的瓶装水、可沛利(Capri Sun)饮料、水果燕麦棒,并提供大型遮阳伞。Late in the afternoon, the “Glee” TV star Lea Michele stopped by the Grove to pick up her phone: the iPhone 6s Plus in Apple’s new rose-gold color.接近傍晚时分,主演《欢乐合唱团》(Glee)的电视明星莱亚·米歇尔(Lea Michele)来到格鲁夫取走自己的手机:苹果新推出的玫瑰金iPhone 6s Plus。 /201510/401927 黑龙江省哈尔滨市第四人民医院看产科需要多少钱延寿县妇女儿童医院专业的医生

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