Implantable Phakic Contact Lens: vault evaluation five years after surgery.

PURPOSE: To evaluate the stability of the postoperative vault of the Intraocular Phakic Contact Lens (IPCL) five years after implantation. SETTING: Clínica de Ojos Dr. Nano, Olivos (Buenos Aires), Argentina. DESIGN: Retrospective case-series study. METHODS: Myopic patients operated with the IPCL lens for spherical correction in which preoperative data were compared with different scenarios of postoperative vault at 1, 3 and 5 years after surgery. The main parameter to be evaluated was the vault obtained 5 years after surgery. RESULTS: A total of 140 eyes of 72 patients, aged 31.9 ±2.8 years old (21-50) were included. Most of the eyes (78.6 %) obtained a vault between 250 to 750 µm, while in 15% of the eyes it was less than 250, and 6.4% were greater than 750 µm. The vault evaluated 1, 3 and 5 years after surgery remained stable. Sub-capsular cataracts were detected in two eyes, with vault < 250 µm. A total of 50 eyes (35.7 %) had cysts in the sulcus (5 cases in the group of eyes with vault > 750 µm). No changes were detected in relation to intraocular pressure or endothelial cell count. CONCLUSION: In eyes implanted with the IPCL lens over 5 years, it has been observed that the vault remained stable over time. The proportion of eyes with cysts was higher in eyes with vaults larger than 750 µm.

A step forward in fishway engineering: Validation and implementation of advanced algorithms for effective stepped fishway design, modeling, and retrofitting.

Stepped fishways are the main alternative to allow fish migration in river obstacles. Their design is a multidisciplinary process, where civil engineering meets biology. This can bias the fishway design towards one discipline, which may cause low efficiencies or inadequate solutions. Likewise, it is often challenging to incorporate new discoveries into well-established design principles. To solve these problems, we have developed a novel tool named "Escalas". Escalas is a multipurpose platform for the assisted design, 1D simulation, assessment, and correction of stepped fishways. Escalas architecture allows fishway assessment during different hydraulic scenarios in the river (i.e., different water levels and discharges in the river), automatic dimensioning considering fish's physical needs, the study of any type of stepped fishway, to test solutions for malfunctioning or to assess fishway retrofitting. This is achieved by a modular variable definition during fishway design or definition, which allows multiple combinations of connections within and/or between cross-walls and independent discharge equation definition. This work aims to introduce Escalas to the research and engineering community, describe its algorithms, and show and validate its performance by its use in real and practical cases. Among others, results demonstrate how the tool can reproduce uniform and non-uniform performances on stepped fishways and allows fishway retrofitting to make hydraulic conditions compatible with fish usage during different river scenarios. Therefore, this work represents a step forward in the fishway engineering discipline by applying methods of engineering informatics and providing a technical and scientific base to make engineering decision-making more reliable and accessible as well as to incorporate new advances in fishway research into the engineering design process.

High HIV and ulcerative sexually transmitted infection incidence estimates among men who have sex with men in Peru: awaiting for an effective preventive intervention.

BACKGROUND: In the Andean Region, HIV and sexually transmitted infections (STI) are most prevalent among men who have sex with men (MSM), but incidence estimates and associated factors have never been prospectively assessed. METHODS: A cohort of 1,056 high-risk HIV-negative MSM in Lima, Peru, were recruited during 1998-2000 (the ALASKA Cohort), and a nested case-control analysis was conducted between seroconverters and nonseroconverters, matched 1:3 by age and duration of follow-up for comparison of risk behaviors, acute retroviral symptoms, circumcision, and STI. RESULTS: During average follow-up of 335 days, 34 men seroconverted, providing a HIV incidence estimate of 3.5 per 100 person-years [95% confidence interval (CI): 2.3 to 4.7]. High syphilis (8.4 per 100 person-years, 95% CI: 6.7 to 10.1) and herpes simplex virus type 2 (HSV-2) infection (10.4 per 100 person-years, 95% CI: 8.6 to 11.9) incidence estimates were obtained. HIV seroconverters were more likely than men who remained seronegative to report fever >or=3 days (46% vs. 7%), to seek medical care (62% vs. 27%), and to have >or=1 casual partner (86.2% vs. 74.1%) since their last visit. HIV seroconverters also were more likely to have acquired syphilis or HSV-2 infection (31% vs. 8% among initially HSV-2-seronegative men) although they were less likely to be circumcised (4.2% vs. 20.6%, a nonsignificant difference). In multivariate analysis, incident syphilis or HSV-2 infection (odds ratio [OR]: 5.9, 95% CI: 1.5 to 22.7) and sex with any casual partner (OR: 4.8, 95% CI: 0.9 to 26.2) were associated with HIV seroconversion. CONCLUSIONS: STI that may cause anogenital ulcers are important risk factors for HIV acquisition among high-risk MSM in Lima, a population with a very high HIV incidence estimate. Synergistic interventions focusing in preventing both HIV and HSV-2, like male circumcision, are warranted to be assessed, especially in MSM populations with low levels of circumcision and high incidence estimates of ulcerative STI.