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The article presents a case study of a 57-year-old male with uncontrolled diabetes mellitus who developed central pontine myelinolysis (CPM) despite the absence of significant electrolyte disturbances. It states that the patient's condition, characterized by ataxia and dysarthria, improved significantly with proper glycemic control, highlighting the rare association between chronic hyperglycemia and CPM.

Background: Artificial intelligence is touted as the future of medicine. Classical algorithms for the detection of common bile duct stones (CBD) have had poor clinical uptake due to low accuracy. This study explores the challenges of developing and implementing a machine-learning model for the prediction of CBD stones in patients presenting with acute biliary disease (ABD). Methods: All patients presenting acutely to Christchurch Hospital over a two-year period with ABD were retrospectively identified. Clinical data points including lab test results, demographics and ethnicity were recorded. Several statistical techniques were utilised to develop a machine-learning model. Issues with data collection, quality, interpretation and barriers to implementation were identified and highlighted. Results: Issues with patient identification, coding accuracy, and implementation were encountered. In total, 1315 patients met inclusion criteria. Incorrect international classification of disease 10 (ICD-10) coding was noted in 36% (137/382) of patients recorded as having CBD stones. Patients with CBD stones were significantly older and had higher aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin and gamma-glutamyl transferase (GGT) levels (p < 0.001). The no information rate was 81% (1070/1315 patients). The optimum model developed was the gradient boosted model with a PPV of 67%, NPV of 87%, sensitivity of 37% and a specificity of 96% for common bile duct stones. Conclusion: This paper highlights the utility of machine learning in predicting CBD stones. Accuracy is limited by current data and issues do exist around both the ethics and practicality of implementation. Regardless, machine learning represents a promising new paradigm for surgical practice. [ABSTRACT FROM AUTHOR]

Introduction and Aim Heroin dependence is a serious health burden in Australia. Opioid substitution treatment ( OST) has been delivered in Australian community pharmacies since 1985. The effectiveness of pharmacy-based OST is evident and the demand is increasing; however, the participation rate of community pharmacies is low, with over 60% non-providers. While previous Australian studies have focused on perspectives of community pharmacists providing the service, the views of non-providers have not yet been explored. This study aimed to further investigate factors influencing pharmacists' participation in provision of OST in the community pharmacy setting in New South Wales, Australia. Design and Methods Semi-structured interviews were conducted with 35 NSW community pharmacists (20 providers, 15 non-providers). Transcripts of interviews were thematically analysed. Results Factors influencing non-providers were mainly stigma and fear, the nature of an opt-in scheme, professionals' moral responsibilities, lack of awareness and knowledge, disproportionate distribution of clients and lack of financial support for OST clients. Providers were motivated by positive attitudes, functional relationships with OST clients/stakeholders, professional satisfaction and financial rewards. Recommendations to improve participation in OST services were offered by both groups. Discussion and Conclusion This study explored views from both OST providers and non-providers, revealing a number of previously undocumented barriers that affect the uptake of OST provision in New South Wales community pharmacies. There were also profound ethical issues raised for consideration. These findings may help inform future policies aimed at encouraging pharmacists' provision of OST, to address the unmet needs of the ever-increasing number of heroin-dependent clients in the community. [Chaar BB, Wang H, Day CA, Hanrahan JR, Winstock AR, Fois R. Factors influencing pharmacy services in opioid substitution treatment. Drug Alcohol Rev 2013;32:426-434] [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented wherein the editor discusses various reports published within the issue including a perspective of China's corn import, a discussion on the market potential for U.S. meat in China and another on China's worldwide investment in agricultural resource.

Investigates the differences between farmers who adopt multiple conservation practices when wind erosion occurs from those who do not adopt such practices. Background on wind erosion and its effects on agriculture; Determinants of conservation practices adoption; Comparison of farm and farmer characteristics between adopters and non-adopters.

“All natural” food labels have become increasingly popular in recent decades. Labels may communicate to consumers a level of food quality above that of unlabeled products. In April 2011, a nationally representative survey was conducted asking respondents to estimate the likelihood that they will increase purchasing in response to an “all natural” label on food products. The sample totaled 1,000 respondents, with 49% being male and 35% between the ages of 45 and 64. Demographic information includes gender, age, income, region, and education. Ordered logit models were used to estimate the likelihood of changes in purchasing based on the “all natural” label. This stated that intended behavior change was evaluated using the ordered logit estimates for nine products: beef, pork, poultry, ice cream, yogurt, cheese, milk, soft dairy products, and bread and bakery products. For all products, being male and having too little information at grocery stores decreased the likelihood of purchase. Conversely, those respondents, who associate the “all natural” label with no preservatives, perceived such products to have improved taste, improved nutritional value, and improved food safety increased the likelihood of purchase. [ABSTRACT FROM AUTHOR]