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Mountain moves: spatial interaction modelling of Bulgaria’s internal migration (1934-1992)
Full text linkBulgaria experienced dramatic rural decline alongside rapid urban growth during the 20th century, shaped by both demographic pressures and socioeconomic change. Today, it remains one of Europe’s fastest-declining populations, underlining the importance of understanding long-term migration dynamics. Understanding these migration dynamics is essential for interpreting the country’s broader population shifts. This study provides a spatial analysis of internal migration in Bulgaria from 1934 to 1992. We construct a harmonised geocoded census settlement dataset, combining historical population records with geospatial settlement boundaries, road network data, and terrain ruggedness measures. Distances between settlements are calculated using both Euclidean and road-network measures, and terrain effects are quantified through terrain ruggedness indices. Migration flows are estimated using spatial interaction models (SIMs), parameterised by population scaling and distance decay functions. Model outputs are validated against historical benchmarks and aggregated regional flows, as well as on the settlement level, by intercensal period variability, ensuring robustness between the intercensal periods. Our analysis investigates the role of challenging topography in shaping migration flows, showing how mountainous landscapes constrained movement while facilitating concentrated urban growth. By integrating historical census records with spatial modelling and geospatial analysis, we uncover local migration dynamics that remain invisible at larger scales. Although our study does not offer direct policy advice, it provides a quantified geospatial perspective on historical context for contemporary policy debates and urban planning initiatives in a country that has experienced both significant rural decline and rapid urbanisation. The findings shed new light on Bulgaria’s population history and provide a framework for understanding the interplay between landscape features and migration dynamics
De-escalation of axillary surgery and targeted axillary dissection following neoadjuvant chemotherapy: multicentre prospective regional audit
Full text linkBackground:
Emerging evidence supports axillary de-escalation in patients with clinically node-positive breast cancer with low-volume residual disease following neoadjuvant chemotherapy, avoiding axillary node clearance in selected patients. Targeted axillary dissection, which retrieves a known metastatic, clipped node alongside standard sentinel node biopsy aims to reduce false-negative rates. This study evaluated axillary surgery after neoadjuvant chemotherapy across NHS Greater Glasgow and Clyde, and examined 10-year trends.
Methods:
Patients with node-positive breast cancer receiving neoadjuvant chemotherapy between 2017 and 2024 were identified from multidisciplinary team records. Clinicopathological and surgical data were collected. Outcomes were compared using χ2 tests and logistic regression. Additional data from 2015–2016 were extracted from the Regional Cancer Registry.
Results:
Of 498 patients, primary axillary surgery included Magseed®-localized targeted axillary dissection (27.5%), wire-localized targeted axillary dissection (0.4%), non-localized targeted axillary dissection (7.0%), sentinel node biopsy (14.3%), and axillary node clearance (50.8%). The clipped node retrieval rate was 100% with Magseed®-localized and 91.4% with non-localized targeted axillary dissection; sentinel node concordance rates were 85.8 and 66.7%, respectively. Completion axillary node clearance was undertaken in 27 patients (11.0%) and was associated with an increased risk of complications including seroma, restricted shoulder movement, and wound infection, compared with de-escalated surgery (odds ratio (OR) 2.88, 95% confidence interval (CI) 1.28 to 6.49; P = 0.011) and upfront axillary node clearance (OR 1.86, 95% CI 1.27 to 2.72; P = 0.001). Use of axillary de-escalation increased over 10 years, surpassing 50% recently (χ²(4) = 25.3, P < 0.001).
Conclusion:
Targeted axillary dissection enables safe de-escalation of axillary surgery in patients with low-volume residual disease. Localization enhances clipped node retrieval. Completion axillary node clearance carries higher morbidity, reinforcing the need for careful patient selection
Socioeconomic disparities in e-cigarette use: patterns, mechanisms, and equity implications
No full textPurpose of Review:
This critical review examines the complex relationship between socioeconomic status (SES) and electronic cigarette (e-cigarette) use, addressing how SES influences patterns of e-cigarette use. It explores whether e-cigarettes serve as a harm reduction tool for disadvantaged populations or exacerbate existing tobacco-related disparities. The review also highlights key mediating mechanisms and policy implications of SES-related differences in e-cigarette use.
Recent Findings:
Evidence points to divergent trends in e-cigarette use across SES groups. Initially, higher-SES adults who smoke were more likely to adopt e-cigarettes for smoking cessation, reflecting greater health awareness and access. However, recent data in several high-income countries show increasing uptake among lower-SES groups, driven by affordability, targeted marketing, and limited access to conventional smoking cessation support. Adolescents in disadvantaged settings may face higher exposure to pro-vaping cues across retail, peer networks, and social media, alongside weaker access to high-quality health information. Dual use (concurrent smoking and vaping) appears more prevalent in low-SES populations, raising concerns about sustained nicotine dependence and limited support for a complete switch from smoking to exclusive vaping. Structural factors such as income, education, occupation, and neighborhood/area-level deprivation, along with health literacy, shape vaping behaviors and help explain observed SES gaps. Regulatory measures such as flavour restrictions and taxation may have uneven effects across socioeconomic groups: they can help prevent youth uptake but may also create barriers for low-income adults who smoke and are trying to switch, with a risk of widening health inequalities.
Summary:
The findings underline the dual role of e-cigarettes: while they may offer harm reduction opportunity for some people who smoke, their full benefits are not yet evenly distributed, with lower-SES groups facing barriers to complete smoking cessation. Equity-focused interventions, including tailored smoking cessation programs, accessible harm reduction pathways, improved health literacy, and balanced regulations, are critical to ensuring e-cigarettes reduce rather than reinforce socioeconomic disparities in smoking-related health outcomes. Future research should prioritise longitudinal and intersectional studies, particularly in low- and middle-income countries, to address existing gaps in understanding
Educating for academic integrity: effectiveness of a digital resource on plagiarism awareness among postgraduate bioscience students
No full textPlagiarism remains an ongoing and complex challenge in higher education, particularly among postgraduate taught (PGT) students who comprise great diversity of academic and cultural backgrounds. This study evaluates the effectiveness of a bespoke Moodle-based academic integrity training resource developed to enhance plagiarism literacy among life sciences PGT students at our UK-based institution. An online survey, combining quantitative and qualitative elements from closed and open-ended questions respectively, was conducted among life sciences PGT students (n = 139). Quantitative data analysis of closed question responses revealed that students with prior degrees from elsewhere (PDE) reported significantly lower confidence in their knowledge of plagiarism, the use and integration of source material and using Turnitin but more favourable perceptions with regards to enhancing their knowledge and understanding of plagiarism compared to those with prior degrees from the UK (PDUK) (p < 0.05). Qualitative, thematic analyses of open-ended responses indicated positive perceptions surrounding the clarity, accessibility, and interactivity of the resource but also demonstrated a need for additional inclusive design features and optional face-to-face support. Students highlighted confusion regarding what constitutes plagiarism, difficulty with referencing and uncertainty surrounding institutional policy and use of digital tools. These results underscore the need for a more inclusive and accessible approach towards academic integrity training for diverse PGT cohorts, with wider implications for institutional strategies to mitigate academic misconduct. Our key recommendation is for academic integrity training resources to be culturally sensitive, equitable and learner-friendly through the incorporation of varied and blended learning resources and opportunities
Exploring the intensity and continuity of hospital care for patients with Long Covid: evidence from an English urban healthcare system
No full textBackground:
Long Covid (LC) is a multisystem condition leading to a wide range of symptoms and often requiring treatment by several different clinical specialties. Patients with LC have reported difficulties in accessing care and a lack of coordination of their care, particularly in a hospital setting.
Objective:
To determine the extent to which the intensity and continuity of hospital care changes for patients after they receive an LC diagnosis.
Design:
Retrospective observational cohort study using a linked primary and secondary care dataset.
Setting and Participants:
Routine healthcare data from North West London Integrated Care System of patients with a recorded diagnosis of LC who had attended a secondary care hospital Trust from 1 January 2019 to 30 September 2023.
Main Variables Studied:
The intensity of utilisation of secondary care was calculated, and the continuity of care with respect to hospitals and specialties was computed using the sequential continuity score (SeCon) before the Covid-19 pandemic, before and after an LC diagnosis.
Results:
5611 out of 6270 (90.1%) patients diagnosed with LC had a recorded secondary care interaction in the study period. Intensity of secondary care utilisation increased markedly in outpatient, inpatient and Emergency Department pathways after a diagnosis of LC but peaked in the week of diagnosis. Average hospital SeCon fell significantly after an LC diagnosis from 1.00 to 0.83, while specialty SeCon remained unchanged from after diagnosis (0.40) and before the pandemic (0.44). A notable shift in specialty activity was observed with a focus on respiratory medicine as a major hub in a densely connected patient-sharing network with cardiology and other medical and surgical specialties.
Discussion:
A recorded LC diagnosis was associated with increases in the intensity of hospital activity and a reduction in hospital-level care continuity, but no change in specialty continuity, which remains low.
Conclusion:
Collectively, this indicates a significant need to support LC patients as they navigate fragmented secondary care pathways.
Patient and Public Contribution:
This study was co-designed with, conducted with and written in conjunction with people with long Covid
Staying with the waste: litter, learning, and slow violence in wasted-edgelands
Full text linkPost-industrial landscapes, often dismissed as wastelands, are increasingly recognised as important sites for rethinking environmental education. This paper conceptualises wasted-edgelands, landscapes shaped by industrial legacies and capitalist disposability, as pedagogical sites that work on children's attention, ethics and relations, rather than as spaces requiring repair or restoration. Drawing on a 10-week John Muir Award project with primary school children in a working-class Scottish community, it examines how children encounter waste as a pedagogical force. Grounded in scholarship on slow violence, ecological entanglement and more-than-human relations, the paper reframes litter picking not as stewardship or environmental action, but as sustained attentiveness to waste's persistence. Children's engagements foreground ethical witnessing, speculation and relational thinking, emphasising endurance rather than erasure. The Wasted-Edgelands Learning Labyrinth conceptualises learning as recursive and non-linear, privileging return, uncertainty and lingering over behaviour change. The paper contributes to radical geographical debates on environmental justice, disposability and pedagogy in damaged landscapes
Approximable triangulated categories and reflexive DG-categories
Full text linkWe use the theory of approximable triangulated categories to give a condition for a proper DG-category to be reflexive in the sense of Kuznetsov and Shinder. To do this we provide another description of the completion of an approximable triangulated category under a properness assumption. We apply our results to proper schemes, proper connective DG-algebras and Azumaya algebras over proper schemes. We include an appendix by Raedschelders and Stevenson showing that proper connective DG-algebras admit finite dimensional models over any field
Modeling framework for solid-phase peptide synthesis on SiO2
Full text linkSolid-phase peptide synthesis (SPPS) allows for the sequential assembly of diverse peptide sequences. Alongside its scalability and capacity for automation, this makes it the method of choice for the synthesis of peptide-based pharmaceuticals. SPPS reaction pathways, however, suffer from a negative environmental footprint due to the super-stoichiometric quantities of reagents and high solvent use required to ensure reaction completion. In this paper, we propose the use of charge-based measurements as a complement to optical methods for measuring reaction completion. We extend the capabilities of our hybrid modeling framework to a representative four-step SPPS pathway on SiO2, showing each reaction intermediate, its molecular encoding, and the resulting modeled surface potential (ψ0). We show that the simulated ψ0(pH) plots are separable for three of the four key reaction steps in the representative pathway, indicating that charge-based measurements mayhelp verify protection/deprotection steps
Organophosphonate ligation approach for the controlled assembly of gigantic polyoxometalate clusters
Full text linkThe controlled assembly of gigantic polyoxometalate (POM) clusters remains one of the most formidable challenges in molecular self-assembly, as it is highly dependent on delicate synthesis parameters that can yield a wide variety of products. In this study, we report the synthesis of a series of unprecedented wheel-shaped molybdenum-blue (MB) clusters directed by organophosphonate (L) and acetate ligands, resulting in a new range of giant MB-type POMs: {Mo136Na4}, {Mo120}, {Mo118Na2}, {Mo118}, and {Mo157}. These structures, constructed from fundamental {Mo1}, {Mo2}, and {Mo8} building blocks, exhibit new features of organic ligand coordination on their exterior surfaces. Notably, the {Mo157} framework acts as a host capable of capturing the fully reduced ε-Keggin-based {Mo16} guest. It represents the first pure dodecameric Mo wheel reported to date. Systematic variation of reaction parameters─including ligand type, concentration, solvent composition, and precursor identity─enabled precise control over cluster topology, revealing competitive coordination between organophosphonate and acetate ligands. Structural analyses unveiled new connection modes involving reduced edge-sharing {e-Mo2} units and their derivative {Mo3L2} motifs, which reinforce the overall cage architecture. Mass spectrometry and NMR spectroscopy confirmed the structural integrity of these assemblies in solution. This work not only expands the library of gigantic MB clusters but also establishes a new strategy for their controlled construction using anchored organophosphonate ligands. The resulting clusters exhibit significantly enhanced solubility in organic solvents compared with traditional MB species, offering new opportunities for postsynthetic modification, improved interactions with biomolecules, and diverse applications
Simulation and modelling techniques for multi-objective optimization of hybrid fast EV charging station
Full text linkIn this era, electric vehicles (EVs) have become widely popular in the transportation sector because of their smaller carbon footprint and less noise. The charging stations for EVs are rapidly increasing to meet their charging demands in a shorter time. The hybrid charging stations, combined with renewable sources like solar and wind energy, offer an environmentally friendly solution for the massive adoption of EVs. However, the additional load of EV charging stresses the utility grid, and the intermittency of these renewable sources adds uncertainty to the performance of charging stations. The load management of the EVCS faces challenges during the unavailability of renewable energy and peak demand hours. This research focuses on the demand side management of the EV load through a coordinated demand response strategy that effectively schedules the EVs and employs a multi-objective optimization technique to balance operational cost and Loss of Power Supply Probability (LPSP) of the charging station. Three commonly used optimization algorithms, namely Multi-Objective Particle Swarm Optimization (MOPSO), Multi-Objective Evolutionary Algorithm Based on Decomposition (MOEA/D) and Non-dominated Sorting Genetic Algorithm (NSGA-II), are analyzed for a hybrid fast EVCS to determine an optimal trade-off solution that can improve economic feasibility and reliability. Sensitivity analysis of these techniques is performed to analyse the solution of each algorithm under perturbations
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