Aproximació al paisatge del riu Serpis o riu Alcoi en la partida de la Rambla (N- NW de Alacant, Espanya)

L’itinerari es localitza a la partida de la Rambla del riu Serpis, ubicada a l’est de la ciutat d’Alcoi. En aquesta ruta destaquen els elements paisatgístics següents: geomorfologia del riu Serpis, evolució geològica, lliscaments de vessant, establiments fabrils dels inicis de la industrialització, paleoclimatologia, etc.El itinerario se localiza en la partida de la Rambla del río Serpis, ubicada al este de la ciudad de Alcoi. En esta ruta destacan los siguientes elementos paisajísticos: geomorfología del río Serpis, evolución geológica, deslizamientos de ladera, establecimientos fabriles de los inicios de la industrialización, paleoclimatología, etc.The itinerary describes the zone called The Rambla of Serpis River, located to the east of Alcoy’s city. In that place, the following landscape elements in this itinerary are: Serpis river geomorphology, geological evolution, archaelogy industrial of beginnings of industrialization, paleoclimatology, etc

Coupled Folding and Specific Binding: Fishing for Amphiphilicity

Proteins are uniquely capable of identifying targets with unparalleled selectivity, but, in addition to the precision of the binding phenomenon, nature has the ability to find its targets exceptionally quickly. Transcription factors for instance can bind to a specific sequence of nucleic acids from a soup of similar, but not identical DNA strands, on a timescale of seconds. This is only possible with the enhanced kinetics provided for by a natively disordered structure, where protein folding and binding are cooperative processes. The secondary structures of many proteins are disordered under physiological conditions. Subsequently, the disordered structures fold into ordered structures only when they bind to their specific targets. Induced folding of the protein has two key biological advantages. First, flexible unstructured domains can result in an intrinsic plasticity that allows them to accommodate targets of various size and shape. And, second, the dynamics of this folding process can result in enhanced binding kinetics. Several groups have hypothesized the acceleration of binding kinetics is due to induced folding where a “fly-casting” effect has been shown to break the diffusion-limited rate of binding. This review describes experimental results in rationally designed peptide systems where the folding is coupled to amphiphilicity and biomolecular activity

De la Iltiŕta prerromana a la Ilerda tardorromana. Nuevos datos tras dos décadas de investigación continuada en Lérida

Ancient Ilerda (Hispania Citerior) is a well known site thanks to written and numismatic sources, both Republican and Imperial. Howewer, archaeological research has been almost neglected as a source for the historical development of the city. Systematic archaeological excavations, carried out in last two decades, has change radically our knowledge of the extension, evolution and main features of the site from the pre-roman period until the late antique.La antigua Ilerda (Hispania Citerior) , bien conocida por las fuentes escritas y numismáticas republicanas e imperiales, no contaba con un conocimiento arqueológico paralelo. Las excavaciones continuas de los últimos años han variado sustancialmente este panorama (sobre todo las más recientes) y hoy podemos aventurar su evolución histórica con unos datos más fiables, así como su extensión y principales características por etapas

Applicability of information and communication technologies in a secondary hospital pelvic floor service

Information and Communication Technologies increase healthcare education. Since the COVID-19 pandemic outbreak, they have been gaining importance. Our aim was to assess the effects of a web-based questionnaire used in a pelvic floor consultation. We performed a prospective intervention study analysing the use of a web-based questionnaire prior to a first appointment. Fifty-two women used the questionnaire and 52 did not. All patients filled in a paper-based survey relating to satisfaction and pelvic floor knowledge after the appointment. Women in the intervention group showed better knowledge. They had 11% more correct answers for organ prolapse definition [CI 95% (−0.30 to 0.07)], 25% more correct answers for incontinence definition [CI 95% (−0.41 to −0.08)] and 23% better incontinence classification [CI 95% (−0.34 to 0.09]. More patients in the web-questionnaire group started primary therapy in the first consultation (38% versus 16%). Measurements of the total mean time in the consultation room revealed no statistically significant differences [19.36 (SD 4.96) and 21.19 (SD 4.62) minutes, respectively; p = .05] and satisfaction levels were similar. After using our web-based questionnaire, the time for medical histories reduced and patient knowledge increased without changing satisfaction levels. Impact statement Web-based questionnaires (WBQ) and information web links may help to reduce time of history taking while time for physical examination, counselling and treatment discussion increases. Also, patient knowledge improves. What is already known on this subject? There are reviews showing how Information and Communication Technologies (ICT) can improve health quality and sanitary education. Since the Covid-19 pandemic started, ICT use has been accelerated and traineeship and learning has been enforced. However, there is not extensive research on its use in gynaecological consultations. What do the results of this study add? We have proved that the use of a WBQ and information web links before face-to-face first visit in a pelvic floor service improves patient knowledge. We have also worked to provide scientific evidence to an ICT tool. What are the implications of these findings for clinical practice and/or further research? The most important implications for clinical practice are the improvement of patient–provider communication, the time reduction for history taking in contrast to time increase for physical examination, counselling and treatment discussion. Apart from that, WBQ may help to measure qualitative information, because it is registered and can be used as patient reported outcomes (PRO) to increase quality of care. Further research should focus on other benefits of WBQ such as achieving better patient satisfaction

Inadequate visits to the emergency department by pregnant women

Inadequate emergency visits, which could be resolved in primary care, are an unnecessary expense for the healthcare service. We did a review of all gynaecology and obstetrics emergency visits by pregnant or postpartum women during 2010 and 2011 in order to describe the adequacy of the visits by pregnant women to the emergency service. We defined three levels of adequacy: adequate, moderately adequate, and inadequate. One thousand seven hundred and forty-three visits to the emergency room of gynaecology and obstetrics were studied. These consultation motivations were adequate in 38.9%, moderately adequate in 46.7% and inadequate in 14.4%. This shows that the amount of inadequate and moderately adequate visits to the emergency department could be reduced by 61% by implementing different interventions, and also reducing health spending for emergencies.Impact statement What is already known on this subject: Visits to the emergency room constitute a basic pillar in the hospital structure, and it generates great health expense. Other authors have reported high rates of inadequacy of these visits to the emergency services. They find inadequate visits are associated with young age and female gender among other factors. What the results of this study add: Knowing the adequacy of the visits generated by pregnant young women is a starting point for implementing health policies that could reduce these inadequate visits and consequently health expenditure could be reduced. What the implications are of these findings for clinical practice and/or further research: These health policies could consequently reduce health expenditure

Comportamiento de los lípidos durante la gestación y su relación con acontecimientos obstétricos desfavorables

Lipids play an important role during pregnancy, and in this period major changes occur in lipoprotein metabolism. During the third trimester plasma cholesterol and triglyceride levels are substantially increased, returning to normal after delivery. Described associations between increased morbidity during pregnancy and excessive increases in plasma cholesterol and triglycerides. For this reason we have reviewed the relationship between lipid alterations, preeclampsia, gestational diabetes and preterm birth. The overall metabolic control can improve pregnancy outcomes, and the assessment of supraphysiological changes in lipid profile will classify pregnancy risk at a higher level, which would entail a stricter control