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Up to four years of gas production from Permian coals in the South Australian (SA) sector of the Cooper Basin illustrates their potential value as a sustainable unconventional gas resource. The success of this play is a result of many years of research, laboratory measurements and field trials designed to de-risk the play, following a well-defined road map. Since 2012, production variability has been tested in over 50 wells across the SA Cooper Basin. As an add-on frac stage in conventional gas development wells, coal targets regularly yield incremental reserve that provides an uplift in production and the opportunity to access a new tranche of gas. Production from the coal reservoirs is now accepted as “base business” for the Cooper Basin Joint Venture partners. The key to progressing the play from its earliest inception as a candidate Source Rock Reservoir to a productive reservoir, lies in in a focussed approach to de-risking each economic barrier. These risk factors include frac containment, formation water production, gas composition, permeability, deliverability, completion design and cost. The next steps are to improve the economic viability of deep coal as a stand-alone development. In these first projects, planned for late 2017 - early 2018, both vertical and horizontal well- completions specifically targeting deep coal will be tested for commercial flow rates in an existing productive field

Objective To study the visual and anatomic outcomes of serial anti–vascular endothelial growth factor (anti-VEGF) therapy for severe macular hemorrhage in eyes with exudative age-related macular degeneration (AMD). Design Consecutive retrospective analysis. Participants Twenty eyes from 20 patients with severe macular hemorrhage (greater than 50% blockage with formal fluorescein angiography [FA]) secondary to wet AMD were studied. Methods We performed a chart review of patients at a single centre from May 2006 to September 2009. Presenting visual acuity and diameter of hemorrhage were recorded as well as number of injections, time by which no hemorrhage was remaining, and final anatomic outcome. Cardiovascular risk factors and use of antiplatelet medication or anticoagulation were noted. Results Average presenting visual acuity was 1.55 (20/710), and number of injections needed for resolution of hemorrhage was 4. Visual acuity significantly improved from 1.55 (20/710) to 0.70 (20/100) after injections. Thirty-five percent of eyes were found to have an associated retinal pigment epithelial (RPE) tear, and these eyes were found to have received more injections. Final visual acuity was not significantly different in eyes with RPE tears compared with nontear eyes. Eighty-one percent of patients had associated cardiovascular risk factors; antiplatelet therapy and anticoagulation were not found to play a role in hemorrhage size. Conclusions RPE tears are found in a significant number of individuals with large macular hemorrhages secondary to exudative macular degeneration, but with continued treatment with anti-VEGF therapy, visual acuity can significantly improve even in the presence of these tears. Eyes with severe macular hemorrhage thus should be considered candidates for anti-VEGF therapy.

To study willingness to pay for cataract surgery, and its associations, in Southern China.Cross-sectional willingness-to-pay interview incorporating elements of the open-ended and bidding formats.Three-hundred thirty-nine persons presenting for cataract screening in Yangjiang, China, with presenting visual acuity (VA)or = 6/60 in either eye due to cataract.Subjects underwent measurement of their VA and a willingness-to-pay interview. Age, gender, literacy, education, and annual income also were recorded.Maximum amount that the subjects would be willing to pay for cataract surgery.Among 325 (95.9%) subjects completing the interview, 169 (52.0%) were 70 years or older, 213 (65.5%) were women, and 217 (66.8%) had an annual income of5000 renminbi (5000 = US 625 dollars). Eighty percent (n = 257) of participants were willing to pay something for surgery (mean, 442+/-444 renminbi [US 55 dollars+/-55]). In regression models, older subjects were willing to pay less (8 renminbi [US 1 dollar] per year of age; P = 0.01). Blind subjects were significantly more likely (odds ratio, 5.7; 95% confidence interval, 1.7-19.3) to pay anything for surgery, but would pay on average 255 renminbi (US 32 dollars) less (P = 0.004). Persons at the highest annual income level (10,000 renminbi [US 1250 dollars]) would pay 50 dollars more for surgery than those at the lowest level (5000 renminbi) (P = 0.0003). The current cost of surgery in this program is 500 renminbi (US 63 dollars).Sustainable programs will need to attract younger, more well-to-do persons with better vision, while still providing access to the neediest patients.

With rising obesity, despite low-fat diet recommendations, there is an increased interest in weight loss and alternative dietary approaches for cardiovascular health. Physicians must have an understanding of the literature to better counsel their patients about diets and cardiovascular disease. This review examines several dietary approaches to cardiovascular health and evaluates the available scientific evidence regarding these diets.

Objectives To examine the relationship between patent foramen ovale (PFO) or atrial septal defect (ASD) with the incidence of migraine headache (MHA) and assess whether closure of the interatrial shunt in patients with MHA would result in improvement of MHA. Background Migraine headache is present in 12% of adults and has been associated with interatrial communications. This study examined the relationship between PFO or ASD with the incidence of MHA and assessed whether closure of the interatrial shunt in patients with MHA would result in improvement of MHA. Methods A sample of 89 (66 PFO/23 ASD) adult patients underwent transcatheter closure of an interatrial communication using the CardioSEAL (n = 22), Amplatzer PFO (n = 43), or the Amplatzer ASD (n = 24) device. Results Before the procedure, MHA was present in 42% of patients (45% of patients with PFO and 30% of patients with ASD). At three months after the procedure, MHA disappeared completely in 75% of patients with MHA and aura and in 31% of patients with MHA without aura. Of the remaining patients, 40% had significant improvement (≥2 grades by the Migraine Disability Assessment Questionnaire) of MHA. Conclusions Transcatheter closure of PFO or ASD results in complete resolution of MHA in 60% of patients (75% of patients with migraine and aura) and improvement in symptoms in 40% of the remaining patients. Interatrial communications may play a role in the etiology of MHA either through paradoxic embolism or humoral factors that escape degradation in bypassing the pulmonary circulation. A randomized trial is needed to determine whether transcatheter closure of interatrial shunts is an effective treatment for MHA.

Metabolic syndrome is a cluster of risk factors for cardiovascular disease that include obesity, atherogenic dyslipidemia, raised blood pressure, and insulin resistance. The growing trend of obesity is associated with increased prevalence of metabolic syndrome. Optimizing diet and exercise are still the leading therapy for controlling the metabolic syndrome. Based on the current evidence, further emphasis should be placed on aggressive management of other metabolic risk factors such as high blood pressure and dyslipidemia.

Purpose: To estimate the prevalence of glaucomatous disease in a pilot study of young adults with Chinese ancestry.Methods: 164 adults residing in the United States (US) between 20 and 40 years of age inclusively, who selfidentified as being born to two ethnically Chinese parents, were prospectively recruited at nine university and medical center campuses in the US without disclosing the study's purpose. All subjects completed a standardized, closed-ended questionnaire detailing their genealogy and ocular history, followed by a comprehensive ophthalmic examination, including measurement of intraocular pressure (IOP), central corneal thickness (CCT), and axial length. Participants suspected of having glaucoma based on family history, optic nerve appearance, or IOP also underwent static automated white on white threshold perimetry. Main outcome measures included the prevalence of glaucomatous appearing optic nerves and visual fields as well as associated clinical parameters, including myopia, tilted optic nerves, and peripapillary atrophy. All comparisons were performed using the Student's T, Mann-Whitney U, Pearson's χ2, and Fisher's exact tests.Results: Nine subjects (5.5%) were observed to have optic nerve appearance and visual field defects suggestive of glaucomatous disease. There was no statistically significant association between this cluster of findings and any other measured clinical parameter.Conclusions: Young adult individuals of Chinese ancestry may be at substantial risk for glaucomatous disease. Given the cross sectional nature of this study, longitudinal follow-up of participants deemed to be suspicious for glaucoma will be necessary to ascertain whether or not they demonstrate a progressive course consistent with glaucomatous disease.

Background: This paper describes the design and preliminary testing of FINGER (Finger Individuating Grasp Exercise Robot), a device for assisting in finger rehabilitation after neurologic injury. We developed FINGER to assist stroke patients in moving their fingers individually in a naturalistic curling motion while playing a game similar to Guitar Hero® a . The goal was to make FINGER capable of assisting with motions where precise timing is important. Methods: FINGER consists of a pair of stacked single degree-of-freedom 8-bar mechanisms, one for the index and one for the middle finger. Each 8-bar mechanism was designed to control the angle and position of the proximal phalanx and the position of the middle phalanx. Target positions for the mechanism optimization were determined from trajectory data collected from 7 healthy subjects using color-based motion capture. The resulting robotic device was built to accommodate multiple finger sizes and finger-to-finger widths. For initial evaluation, we asked individuals with a stroke (n = 16) and without impairment (n = 4) to play a game similar to Guitar Hero® while connected to FINGER. Results: Precision design, low friction bearings, and separate high speed linear actuators allowed FINGER to individually actuate the fingers with a high bandwidth of control (�3 dB at approximately 8 Hz). During the tests, we were able to modulate the subject’s success rate at the game by automatically adjusting the controller gains of FINGER. We also used FINGER to measure subjects’ effort and finger individuation while playing the game. Conclusions: Test results demonstrate the ability of FINGER to motivate subjects with an engaging game environment that challenges individuated control of the fingers, automatically control assistance levels, and quantify finger individuation after stroke.

With rising obesity, despite low-fat diet recommendations, there is an increased interest in weight loss and alternative dietary approaches for cardiovascular health. Physicians must have an understanding of the literature to better counsel their patients about diets and cardiovascular disease. This review examines several dietary approaches to cardiovascular health and evaluates the available scientific evidence regarding these diets.

To examine the relationship between patent foramen ovale (PFO) or atrial septal defect (ASD) with the incidence of migraine headache (MHA) and assess whether closure of the interatrial shunt in patients with MHA would result in improvement of MHA.Migraine headache is present in 12% of adults and has been associated with interatrial communications. This study examined the relationship between PFO or ASD with the incidence of MHA and assessed whether closure of the interatrial shunt in patients with MHA would result in improvement of MHA.A sample of 89 (66 PFO/23 ASD) adult patients underwent transcatheter closure of an interatrial communication using the CardioSEAL (n = 22), Amplatzer PFO (n = 43), or the Amplatzer ASD (n = 24) device.Before the procedure, MHA was present in 42% of patients (45% of patients with PFO and 30% of patients with ASD). At three months after the procedure, MHA disappeared completely in 75% of patients with MHA and aura and in 31% of patients with MHA without aura. Of the remaining patients, 40% had significant improvement (or=2 grades by the Migraine Disability Assessment Questionnaire) of MHA.Transcatheter closure of PFO or ASD results in complete resolution of MHA in 60% of patients (75% of patients with migraine and aura) and improvement in symptoms in 40% of the remaining patients. Interatrial communications may play a role in the etiology of MHA either through paradoxic embolism or humoral factors that escape degradation in bypassing the pulmonary circulation. A randomized trial is needed to determine whether transcatheter closure of interatrial shunts is an effective treatment for MHA.

Transcatheter closure for atrial septal defect (ASD) and patent foramen ovale (PFO) is a promising alternative to surgical closure or anticoagulant therapy. A potential complication is thrombus formation on the device after implantation. From February 2001 to June 2003, 66 patients with atrial communication were treated successfully with the Amplatzer device (16 septal and 20 PFO occluders) or the CardioSEAL device (30). Patients were discharged on antiplatelet medication (aspirin and clopidogrel) and/or anticoagulation. Fifty patients (76%) had transesophageal echocardiography (TEE) 1 month after device implantation (28 +/- 10 days). No patient experienced a thromboembolic episode during follow-up. TEE revealed that thrombus formation occurred more frequently on the CardioSEAL device (5 of 23 patients; 22%) than on the Amplatzer device (0 of 27 patients; 0%) (p = 0.02). Although thrombus disappeared or markedly diminished after additional anticoagulation therapy in 3 patients, 1 patient had surgical explantation of the device due to progressive increase in the size of thrombus with hypermobility despite intensive anticoagulation therapy. There was no variable associated with the presence of thrombus formation on the occluder other than the use of the CardioSEAL device. One month after insertion, the CardioSEAL device is more likely to have thrombus present than the Amplatzer device.

Women die daily giving birth. However, we as midwives commit our lives to making a difference for childbearing women. We want women to be safe, we want them to feel valued, we want them to feel empowered and most importantly we want them to live. In tiny little areas of the world there are people making differences for childbearing women. A small birth centre called FreMo Medical and Maternity Centre in the slums of Nairobi is doing just this. In 2014, I spent 5 days documenting the faces of staff, women and children who work/attend this clinic. These people are savingwomen’s lives and treating themwith the utmost of respect at the same time. Each image has a story. Every woman’s story is important. This piece of work is a series of photographs celebrating the contribution the staff (midwives and clinicians) make to their community. Women are empowered and believe in normal birth. It is also a celebration of the women in their community, making daily decisions for themselves and their family in harsh conditions.