Background:Large Language Models(LLMs)have gained much attention and,in part,have replaced common search engines as a popular channel for obtaining information due to their contextually relevant responses.Osteoarthrit...Background:Large Language Models(LLMs)have gained much attention and,in part,have replaced common search engines as a popular channel for obtaining information due to their contextually relevant responses.Osteoarthritis(OA)is a common topic in skeletal muscle disor-ders,and patients often seek information about it online.Our study evaluated the ability of 3 LLMs(ChatGPT-3.5,ChatGPT-4.0,and Perplexity)to accurately answer common OA-related queries.Methods:We defined 6 themes(pathogenesis,risk factors,clinical presentation,diagnosis,treatment and prevention,and prognosis)based on a generalization of 25 frequently asked questions about OA.Three consultant-level orthopedic specialists independently rated the LLMs’replies on a 4-point accuracy scale.Thefinal ratings for each response were determined using a majority consensus approach.Responses classified as“satisfactory”were evaluated for comprehensiveness on a 5-point scale.Results:ChatGPT-4.0 demonstrated superior accuracy,with 64%of responses rated as“excellent”,compared to 40%for ChatGPT-3.5 and 28%for Perplexity(Pearson’s x2 test with Fisher’s exact test,all p<0.001).All 3 LLM-chatbots had high mean comprehensiveness ratings(Perplexity=3.88;ChatGPT-4.0=4.56;ChatGPT-3.5=3.96,out of a maximum score of 5).The LLM-chatbots performed reliably across domains,except for“treatment and prevention”However,ChatGPT-4.0 still outperformed ChatGPT-3.5 and Perplexity,garnering 53.8%“excellent”ratings(Pearson’s x2 test with Fisher’s exact test,all p<0.001).Conclusion:Ourfindings underscore the potential of LLMs,specifically ChatGPT-4.0 and Perplexity,to deliver accurate and thorough responses to OA-related queries.Targeted correction of specific misconceptions to improve the accuracy of LLMs remains crucial.展开更多
Adverse consequences to the ecological system and human health caused by impacts potentially attributable to climate change have already drawn great and widespread concern of many scientists and international organiza...Adverse consequences to the ecological system and human health caused by impacts potentially attributable to climate change have already drawn great and widespread concern of many scientists and international organizations.However,we still have a hard time determining exactly the impact of climate change on the environment or the damage that climate change inflicts on countries comprising small islands or low-lying lands in light of today's science and technology.The progress for dealing with the issue of loss and damage has been struggling for a long time from the beginning to the present.In this paper,the author begins by summarizing talks on the concept and the positions of commentators.The author is proposing that the development of future climate negotiations and rule-making process be based on global climate justice as a standard for measuring value.Also,the author proposes that a holistic view of climate justice be established.Generally,three aspects of climate justice can be derived.First,the dimension of human rights protection shows that protection of fundamental human rights is a logical precondition if small-island and low-lying countries are able to achieve climate justice.Second,the definite and traditional concepts of distributive justice and corrective justice hold the view that the principle of common but differentiated responsibilities should be upheld as a basic standard of allocating rights and duties associated with climate change.Third,climate justice requires that any state follow the "no-harm principle," which is regarded as an international customary rule.According to the principle,the obligation of states to prevent the use of their territory for causing trans-boundary harm to the environment shall be a violation of state responsibility,which incurs international punishment.Then we put forward three remedial approaches in light of climate justice,including the approach of State Responsibility(SR) based on the principles and rules of international human rights law and international environmental law.Based on clear rules,the judge can determine whether the damaging behavior or the damage perpetrated by a state party constitutes a state responsibility.The International Environmental Regulation(IEB),which means solving the problems within the framework established by the Conventions on Climate Change,takes advantage of the market mechanisms and incentives such as fund and insurance support system to relieve or compensate the loss and damage.International Environmental Dispute Settlement Mechanism(IEDSM),which includes the means such as consultations,negotiations,nonmandatory ways and international arbitration,international judicial ways to solve these disputes,functions as a procedural safeguard.As an active promoter of global climate governance,China should no doubt stand by the principle of Common But Differentiated Responsibility(CBDR) and take it as a basis for negotiations,actively strengthen the work of South-South cooperation,fulfill her international climate commitments without reservation,vigorously develop a low-carbon economy,and actively promote international negotiations on the subject of loss and damage.展开更多
Osteoarthritis(OA)is a major clinical challenge,and effective disease-modifying drugs for OA are still lacking due to the complicated pathology and scattered treatment targets.Effective early treatments are urgently n...Osteoarthritis(OA)is a major clinical challenge,and effective disease-modifying drugs for OA are still lacking due to the complicated pathology and scattered treatment targets.Effective early treatments are urgently needed to prevent OA progression.The excessive amount of transforming growth factorβ(TGFβ)is one of the major causes of synovial fibrosis and subchondral bone sclerosis,and such pathogenic changes in early OA precede cartilage damage.Herein we report a novel strategy of intra-articular sustained-release of pirfenidone(PFD),a clinically-approved TGFβinhibitor,to achieve disease-modifying effects on early OA joints.We found that PFD effectively restored the mineralization in the presence of excessive amount of TGFβ1(as those levels found in patients’synovial fluid).A monthly injection strategy was then designed of using poly lactic-co-glycolic acid(PLGA)microparticles and hyaluronic acid(HA)solution to enable a sustained release of PFD(the“PLGA-PFD+HA”strategy).This strategy effectively regulated OA progression in destabilization of the medial meniscus(DMM)-induced OA mice model,including preventing subchondral bone loss in early OA and subchondral bone sclerosis in late OA,and reduced synovitis and pain with cartilage preservation effects.This finding suggests the promising clinical application of PFD as a novel disease-modifying OA drug.展开更多
Copenhagen Climate Change Conference began with high expectation but ended in despair. It reached the so-called Copenhagen Accord with some dissenters. The Copenhagen Accord calls for deep cuts in global emissions, bu...Copenhagen Climate Change Conference began with high expectation but ended in despair. It reached the so-called Copenhagen Accord with some dissenters. The Copenhagen Accord calls for deep cuts in global emissions, but it has not reached a binding goal of greenhouse gas emission reduction commitment and is not a legal effective agreement. EU played a limited role in Copenhagen Climate Change Conference, while the US and China were crucial to achieve the Copenhagen Accord. The subsequent Cancun negotiation reached the Cancun Agreements, but many substantial issues remained unsolved, such as the second commitment period of the Kyoto Protocol and other core issues. Durban Climate Summit successfully managed to include the main polluters of the globe, especially the US and the main emerging economies （including India and China）, to commit their obligations for the first time to reduce greenhouse gas emission reduction under the international framework, and all the parties of the conference agreed that they would negotiate new mechanisms of greenhouse gas reduction which will be implemented by 2020 before 2015. Durban Climate Summit has also reached a package of agreements on climate change. Among them, an important one is about the Global Climate Fund. But some key issues including quantified GHGs emission reduction goals among countries have not been solved.展开更多
基金supported by the Health and Medical Research Fund of the Food and Health Bureau of the Government of the Hong Kong Special Administrative Region(HMRF/19202461)by a direct grant(2022/044)from the Chinese University of Hong Kong.
文摘Background:Large Language Models(LLMs)have gained much attention and,in part,have replaced common search engines as a popular channel for obtaining information due to their contextually relevant responses.Osteoarthritis(OA)is a common topic in skeletal muscle disor-ders,and patients often seek information about it online.Our study evaluated the ability of 3 LLMs(ChatGPT-3.5,ChatGPT-4.0,and Perplexity)to accurately answer common OA-related queries.Methods:We defined 6 themes(pathogenesis,risk factors,clinical presentation,diagnosis,treatment and prevention,and prognosis)based on a generalization of 25 frequently asked questions about OA.Three consultant-level orthopedic specialists independently rated the LLMs’replies on a 4-point accuracy scale.Thefinal ratings for each response were determined using a majority consensus approach.Responses classified as“satisfactory”were evaluated for comprehensiveness on a 5-point scale.Results:ChatGPT-4.0 demonstrated superior accuracy,with 64%of responses rated as“excellent”,compared to 40%for ChatGPT-3.5 and 28%for Perplexity(Pearson’s x2 test with Fisher’s exact test,all p<0.001).All 3 LLM-chatbots had high mean comprehensiveness ratings(Perplexity=3.88;ChatGPT-4.0=4.56;ChatGPT-3.5=3.96,out of a maximum score of 5).The LLM-chatbots performed reliably across domains,except for“treatment and prevention”However,ChatGPT-4.0 still outperformed ChatGPT-3.5 and Perplexity,garnering 53.8%“excellent”ratings(Pearson’s x2 test with Fisher’s exact test,all p<0.001).Conclusion:Ourfindings underscore the potential of LLMs,specifically ChatGPT-4.0 and Perplexity,to deliver accurate and thorough responses to OA-related queries.Targeted correction of specific misconceptions to improve the accuracy of LLMs remains crucial.
文摘Adverse consequences to the ecological system and human health caused by impacts potentially attributable to climate change have already drawn great and widespread concern of many scientists and international organizations.However,we still have a hard time determining exactly the impact of climate change on the environment or the damage that climate change inflicts on countries comprising small islands or low-lying lands in light of today's science and technology.The progress for dealing with the issue of loss and damage has been struggling for a long time from the beginning to the present.In this paper,the author begins by summarizing talks on the concept and the positions of commentators.The author is proposing that the development of future climate negotiations and rule-making process be based on global climate justice as a standard for measuring value.Also,the author proposes that a holistic view of climate justice be established.Generally,three aspects of climate justice can be derived.First,the dimension of human rights protection shows that protection of fundamental human rights is a logical precondition if small-island and low-lying countries are able to achieve climate justice.Second,the definite and traditional concepts of distributive justice and corrective justice hold the view that the principle of common but differentiated responsibilities should be upheld as a basic standard of allocating rights and duties associated with climate change.Third,climate justice requires that any state follow the "no-harm principle," which is regarded as an international customary rule.According to the principle,the obligation of states to prevent the use of their territory for causing trans-boundary harm to the environment shall be a violation of state responsibility,which incurs international punishment.Then we put forward three remedial approaches in light of climate justice,including the approach of State Responsibility(SR) based on the principles and rules of international human rights law and international environmental law.Based on clear rules,the judge can determine whether the damaging behavior or the damage perpetrated by a state party constitutes a state responsibility.The International Environmental Regulation(IEB),which means solving the problems within the framework established by the Conventions on Climate Change,takes advantage of the market mechanisms and incentives such as fund and insurance support system to relieve or compensate the loss and damage.International Environmental Dispute Settlement Mechanism(IEDSM),which includes the means such as consultations,negotiations,nonmandatory ways and international arbitration,international judicial ways to solve these disputes,functions as a procedural safeguard.As an active promoter of global climate governance,China should no doubt stand by the principle of Common But Differentiated Responsibility(CBDR) and take it as a basis for negotiations,actively strengthen the work of South-South cooperation,fulfill her international climate commitments without reservation,vigorously develop a low-carbon economy,and actively promote international negotiations on the subject of loss and damage.
基金supports from all parties during the Covid-19 pandemicsupported by(1)the National Key R&D Program of China(Project No.2019YFA0111900 to YJ),which is financed by the Ministry of Science and Technology of the People’s Republic of China(MOST,China)+3 种基金supported by a grant from the NSFC/RGC Joint Research Scheme sponsored by the Research Grants Council of the Hong Kong Special Administrative Region,China and the National Natural Science Foundation of China(Project No.N_CUHK483/22 to YJ)the Center for Neuromusculoskeletal Restorative Medicine[CNRM at InnoHK,to YJ,HC,PY]by Innovation and Technology Commission(ITC)of Hong Kong SAR,Chinathe Natural Science Foundation of China(Project No 82302728 to XZ)The Chinese University of Hong Kong.
文摘Osteoarthritis(OA)is a major clinical challenge,and effective disease-modifying drugs for OA are still lacking due to the complicated pathology and scattered treatment targets.Effective early treatments are urgently needed to prevent OA progression.The excessive amount of transforming growth factorβ(TGFβ)is one of the major causes of synovial fibrosis and subchondral bone sclerosis,and such pathogenic changes in early OA precede cartilage damage.Herein we report a novel strategy of intra-articular sustained-release of pirfenidone(PFD),a clinically-approved TGFβinhibitor,to achieve disease-modifying effects on early OA joints.We found that PFD effectively restored the mineralization in the presence of excessive amount of TGFβ1(as those levels found in patients’synovial fluid).A monthly injection strategy was then designed of using poly lactic-co-glycolic acid(PLGA)microparticles and hyaluronic acid(HA)solution to enable a sustained release of PFD(the“PLGA-PFD+HA”strategy).This strategy effectively regulated OA progression in destabilization of the medial meniscus(DMM)-induced OA mice model,including preventing subchondral bone loss in early OA and subchondral bone sclerosis in late OA,and reduced synovitis and pain with cartilage preservation effects.This finding suggests the promising clinical application of PFD as a novel disease-modifying OA drug.
文摘Copenhagen Climate Change Conference began with high expectation but ended in despair. It reached the so-called Copenhagen Accord with some dissenters. The Copenhagen Accord calls for deep cuts in global emissions, but it has not reached a binding goal of greenhouse gas emission reduction commitment and is not a legal effective agreement. EU played a limited role in Copenhagen Climate Change Conference, while the US and China were crucial to achieve the Copenhagen Accord. The subsequent Cancun negotiation reached the Cancun Agreements, but many substantial issues remained unsolved, such as the second commitment period of the Kyoto Protocol and other core issues. Durban Climate Summit successfully managed to include the main polluters of the globe, especially the US and the main emerging economies （including India and China）, to commit their obligations for the first time to reduce greenhouse gas emission reduction under the international framework, and all the parties of the conference agreed that they would negotiate new mechanisms of greenhouse gas reduction which will be implemented by 2020 before 2015. Durban Climate Summit has also reached a package of agreements on climate change. Among them, an important one is about the Global Climate Fund. But some key issues including quantified GHGs emission reduction goals among countries have not been solved.
