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Peggy McIntosh's ("White privilege and male privilege: A personal account of coming to see correspondences through work in women's studies," Working Paper 189, Wellesley Center for Research on Women, 1988) list of 50 racial privileges, which purportedly benefit persons of white skin colour, has had enormous impact on social science research and educational curriculum and pedagogy. Surprisingly, to date, no attempt has been made to empirically explore the validity and reliability of her list of racial privileges. To address this issue, we conducted a psychometric analysis on McIntosh's list of racial privileges with 204 adult Australian university students. Using a combination of factor analyses and Rasch modelling on McIntosh's list of racial privileges we identified a 27-item multidimensional scale consisting of three well-functioning and reliable subscales (i.e. a 15-item Racial Representation, a six-item Social Interaction and a six-item Culture and Politics subscale). Moreover, the derived multi-dimensional white privilege instrument was found to have good criterion validity in that persons' experiences of racism significantly predicted white privilege (i.e. the more racism experienced the less white privilege experienced and vice versa). Finally, analysis of variance comparisons indicated that persons with white skin colour had significantly more white privilege than persons with black skin colour and Asians, while Asians had more white privilege than persons with black skin colour. Overall, this study presents evidence of a psychometrically valid and reliable 27-item multi-dimensional white privilege instrument and lends empirical support to the theoretical underpinnings of McIntosh's contentions.

Since its inception nearly a half century ago, CHARMM has been playing a central role in computational biochemistry and biophysics. Commensurate with the developments in experimental research and advances in computer hardware, the range of methods and applicability of CHARMM have also grown. This review summarizes major developments that occurred after 2009 when the last review of CHARMM was published. They include the following: new faster simulation engines, accessible user interfaces for convenient workflows, and a vast array of simulation and analysis methods that encompass quantum mechanical, atomistic, and coarse-grained levels, as well as extensive coverage of force fields. In addition to providing the current snapshot of the CHARMM development, this review may serve as a starting point for exploring relevant theories and computational methods for tackling contemporary and emerging problems in biomolecular systems. CHARMM is freely available for academic and nonprofit research at https://academiccharmm.org/program.

Abstract Background The value of patient and public involvement (PPI) during the earliest stages of clinical trial development, and prior to the award of substantive funding, is widely recognised. However, it is often under-resourced and PPI processes during this phase are rarely reported in detail. Having benefitted from seed funding to develop an international clinical trial proposal, we sought to describe and appraise PPI activities and processes that support pre-award co-development. Methods A 12-month “accelerator” award facilitated development of a substantive funding application to deliver the Rheumatoid Arthritis Prevention PlatfORm Trial (RAPPORT), conceived to prioritise preventative interventions for people at risk of RA. PPI partners, including individuals at risk of rheumatoid arthritis (RA), RA patients, relatives and members of the public, provided feedback on key trial design issues through online meetings, a feedback form and emails. PPI processes employed during the one-year accelerator project were thereafter evaluated by PPI partners using an anonymous online feedback form with reference to National Institute of Health and Care Research (NIHR) UK standards for public involvement in research. Results Sixteen out of the 25-strong PPI partner panel completed an online feedback form (64%). Respondents perceived PPI processes positively in relation to all NIHR standard domains. Several key facilitators and challenges were identified, including the need for adequate PPI funding during pre-award phases of research, strategies for creating an inclusive environment, flexibility around levels of involvement, and challenges in achieving representatively diverse participation, and the importance of communicating transparent processes for role-assignment and time-reimbursement. Conclusions In general, RAPPORT was considered an example of PPI well done, and in line with UK standards for public involvement in research. Facilitators and challenges of relevance for the development of future translational and clinical trial funding applications are highlighted.

This article draws upon a critical policy analysis approach to examine the state of inclusive education policy in Global North settings over the past decade. Building on an earlier paper on this topic ten years ago, this updated article seeks to explore whether and how inclusion and inclusive education have been understood in varied international, national and sub-national policy settings over time. While it might be anticipated that schooling systems should be more aware and proactive in supporting inclusion within their policies, our findings reveal mixed results. At times, there appears to have been regression in some settings, stagnation in others, as well as moderate progress in other settings in relation to support and advocacy for inclusion in educational policies. In an era of increased attention to a range of issues of inclusion more broadly over the past decade (e.g. marriage equality, gender fluidity, Black Lives Matter, #StopAsianHate), our article cautions against assuming that such movements have somehow led to a more 'inclusive' conception of students' identities and wellbeing in schooling policy. Whether and how teachers can be expected to be more inclusive in their practices in such a variegated policy environment is an area for continued inquiry.

In this paper, a group of nine international scholars reflect on the collective responsibilities of stakeholders within inclusive educational settings. This reflection was prompted by the need to identify specific elements which would support intentional, collective responsibility to support authentic inclusion for all students. In order to engender this collectivist mindset, mirroring the metaphor of the nurturing village, the group conducted a qualitative study based on structured and semi-structured dialogue, written reflections and previously constructed research to inform a framework to support inclusivity more collectively. Results suggest that nurturing spaces, empathetic relationships, supportive networks and targeted teaching, all contribute to bona fide inclusion, especially if this responsibility is shared and cohesive. Data further revealed that inclusivity is a values-driven process which flourishes when all stakeholders subscribe to common values and tenets regarding socially just educational provision. The authors inculcate the village-mindset, a now popularly received notion, reinforcing the need for active and deliberate dialogue focusing on shared responsibilities and vision. In this paper, we intend to reiterate the need for educational systems which foster more collective, compassionate and nurturing inclusive practice in educational settings.

This study investigated English first language (L1) speakers' motivation for learning Chinese as a second language (L2) in Australia and the links of underlying motivational components to learner sociobiographical (e.g. gender and reasons for learning) and language learning variables (i.e. experience abroad, hours of self-study, and speaking with Chinese L1 speakers). A total of 164 Australian university students participated in the study. The findings show that instrumentality (e.g. employment and travel) tops their orientations to learn L2 Chinese, followed by integrative orientations (e.g. interest in the Chinese language and culture and desire to communicate with the Chinese people), with mandatory requirements as the least agreed reason. Statistical analyses reveal that the underlying structure of their motivation consists of six components: intrinsic motivation, orientation, anxiety, integrativeness, instrumentality, and sociality. Some of them are linked to certain learner background variables. Females demonstrated stronger instrumental orientation than their male counterparts. Visiting China and self-study hours have positive connections with intrinsic motivation. The findings shed light on the complexities and multifaceted characteristics of motivation and their links with learner sociobiographical and learning variables by providing evidence for global language speakers' motivation to learn other languages.

This study compares the psychometric properties of two popular teacher self-efficacy scales, namely, Teachers' Sense of Efficacy Scale (TSES) and Teacher Efficacy Scale (TES). This study was quantitative in nature and distributed the two scales to 287 preservice teachers in the USA and in Australia. Findings indicate that the two scales function well and show linear measurement properties after Rasch optimization. However, the TES's factor of general teacher efficacy was found to have very low reliability. Regression analyses indicated a significant positive relationship between the Student Engagement subscale of TSES and TES. There is a limited relationship between the two popular scales that have been used for decades. Therefore, we argue for the need for a new scale that will reflect all components of Bandura's Triadic Reciprocal Determinism.

Inclusive education is a key goal of modern educational reforms, yet its implementation is complex. This study examines the roles of teacher attitudes and self-efficacy in predicting their intentions to use inclusive practices across five western countries: Canada, Germany, Greece, Italy, and Switzerland. The study identified both significant differences and commonalities in prediction patterns across these countries. For instance, beliefs about inclusion varied in their significance, being the most influential predictor among Italian teachers, while managing challenging behaviour was a key predictor for Swiss teachers only. For the other predictors, no significant differences were found, and self-efficacy in collaboration was the strongest predictor nominally. The study suggests that, while aspects such as collaboration seem generally important across countries, effective strategies for promoting inclusive education may also need to be tailored to each country's unique context, considering aspects of historical background of inclusive education, teacher training, and support. It also emphasizes the need to consider domain-specific aspects of teacher self-efficacy, as different facets differently affect teachers' intentions.

As newly qualified teachers begin their teaching career, the first year can be a challenging one where they need to learn new skills and handle many stresses, including classroom management. Managing the class in order to teach is a challenging skill for newly qualified teachers. This study investigated 156 primary school teachers who are based in New South Wales, Australia, in their first year of teaching and their classroom management strategies. The results showed that newly qualified teachers frequently employ rewards, preventative strategies, differentiated strategies, and low-level corrective approaches. They were most confident using rewards and preventative strategies. Furthermore, they found that low-level correction strategies were not as effective as other strategies, such as rewards, prevention, and differentiated approaches. As new teachers transition from pre-service into in-service teachers, it is important to support them and provide appropriate professional development opportunities.

Background: While dyadic faculty-mentored relationship research currently saturates the mentoring literature, recent developments suggest the need for a broader consideration of a student's mentor network. Research taking a network approach may provide deeper insights into the formation and benefits of mentorship for undergraduate students in science, technology, engineering, and mathematics (STEM) disciplines. Utilizing Developmental Mentor Network Theory and ego-centric social network analysis, this pre-registered study evaluates how the characteristics of mentees and mentors relate to both the content of support and structure of mentor networks in a large sample of White and Hispanic/Latino(a) STEM undergraduates across 12 universities. Results: Results were nuanced but showed that perceived psychological similarity with their mentor(s) predicted both dyadic and network average levels of mentor support (i.e., psychosocial, career, role modeling) and relational satisfaction. Furthermore, results point to homophily and engagement in undergraduate research effects on mentor network structures. Conclusions: These findings highlight the importance of using a network approach to deepen our understanding of the factors (e.g., psychological similarity) that may influence the formation and maintenance of robust and diverse supportive mentoring networks.

Previous research has identified the importance of teacher attitudes and self-efficacy in supporting inclusive education. This study involved a multi-national exploration of a further dimension of inclusive education, collective efficacy, through the testing of a new tool, the Teacher Efficacy for Inclusive Practice-Collective (TEIP-C) Scale. The study also aimed to investigate whether teacher attitudes, self-efficacy, collective efficacy and intention to teach in inclusive classrooms differ across countries. Participants included 1,523 teachers from Canada, Greece, Italy and Switzerland. Results suggested a two-factor structure for the TEIP-C, Engagement, and Inclusive Pedagogies, with strong internal consistency for the scale. Several differences across countries were identified, with teachers from Italy reporting more positive attitudes towards inclusion and a greater intention to teach in inclusive classrooms. Implications of the study in terms of further strengthening inclusive practice are discussed.

Abstract Background N6-methyladenosine (m6A) is the most common internal RNA modification and is involved in regulation of RNA and protein expression. AlkB family member 5 (ALKBH5) is a m6A demethylase. Given the important role of m6A in biological mechanisms, m6A and its regulators, have been implicated in many disease processes, including cancer. However, the contribution of ALKBH5 to invasive breast cancer (BC) remains poorly understood. The aim of this study was to evaluate the clinicopathological value of ALKBH5 in BC. Methods Publicly available data were used to investigate ALKBH5 mRNA alterations, prognostic significance, and association with clinical parameters at the genomic and transcriptomic level. Differentially expressed genes (DEGs) and enriched pathways with low or high ALKBH5 expression were investigated. Immunohistochemistry (IHC) was used to assess ALKBH5 protein expression in a large well-characterised BC series (n = 1327) to determine the clinical significance and association of ALKBH5 expression. Results Reduced ALKBH5 mRNA expression was significantly associated with poor prognosis and unfavourable clinical parameters. ALKBH5 gene harboured few mutations and/or copy number alternations, but low ALKBH5 mRNA expression was seen. Patients with low ALKBH5 mRNA expression had a number of differentially expressed genes and enriched pathways, including the cytokine-cytokine receptor interaction pathway. Low ALKBH5 protein expression was significantly associated with unfavourable clinical parameters associated with tumour progression including larger tumour size and worse Nottingham Prognostic Index group. Conclusion This study implicates ALKBH5 in BC and highlights the need for further functional studies to decipher the role of ALKBH5 and RNA m6A methylation in BC progression.

Abstract Background Rather than being perceived as merely ‘part of the problem’, the perspectives and experiences of young people play a pivotal role in devising effective solutions for mental health challenges. Two distinct methodologies that aid in this endeavour are ‘patient and public involvement’ (PPI) and ‘responsible research and innovation’ (RRI). However, there is a tendency to conflate PPI and RRI practices, leading to ambiguity in their application. Moreover, the extent and nature of young people’s involvement in mental health-related projects (namely: research, intervention, product development) employing these methodologies, and the subsequent implications thereof, remain unclear. Consequently, the proposed scoping review aims to identify and analyse literature pertaining to PPI and RRI approaches in mental health projects that engage young people in collaboration. Methods The selected databases will be MEDLINE, PsycINFO, PsycArticles, Scopus, Web of Science, IBBS, CINAHL (EBSCO) and ASSIA. Comprehensive searches will span from the inception of each database. A pilot test will be conducted to assess the screening criteria and data extraction form, with two authors independently reviewing titles and abstracts. Full-text articles meeting the inclusion criteria will undergo narrative syntheses, with results presented in tabular format. Feedback on the findings from a youth perspective will be sought from young people within our broader research network, namely Sprouting Minds. The review will adhere to the guidelines outlined by the Joanna Briggs Institute (JBI) and follow the PRISMA-ScR procedures. Inclusion criteria will comprise English-language, primary research peer-reviewed articles focused on Patient and Public Involvement (PPI) or Responsible Research and Innovation (RRI), examining mental health-related research processes, interventions, and products developed in collaboration with young people. Studies employing quantitative, qualitative, and mixed-methods approaches will be considered, while non-journal publications will be excluded. Discussion The intended scoping review aims to map the literature concerning mental health-related projects that engage with young people through PPI or RRI approaches. The outcomes hold promise for enriching the participatory research domain, particularly in studies centred on young people and their mental well-being. Furthermore, by delineating potential overlaps and distinctions between PPI and RRI, the findings stand to aid mental health researchers and practitioners in making informed decisions about the most suitable approach for their projects when partnering with young individuals. Systematic review registration Open Science Framework (registration: DOI https://doi.org/10.17605/OSF.IO/N4EDB ).

The causal relationship between emotional outbursts and emotion dysregulation is proposed to be heterogeneous, but cultural influences have not been considered despite established cultural differences in emotional processes (e.g., increased motivation to suppress emotions in interdependent cultures). Responses to the Brazilian Portuguese version of the Emotional Outburst Questionnaire were collected from 327 caregivers of young people (6-25 years) with autism spectrum disorder, Down's syndrome, or intellectual disability. Responses were compared to a previous sample of 268 responses from the English version of the questionnaire. The latent factor structure of the contextual items was measurement invariant across both versions. The Brazilian responses were classified into three distinct clusters (Sensory Sensitivity; Perceived Safety; Perceived Unsafety) which considerably overlapped with the English clusters.

Ecological theory posits that temporal stability patterns in plant populations are associated with differences in species ecological strategies. However, empirical evidence is lacking about which traits, or trade-offs, underlie species stability, especially across different biomes. We compiled a worldwide collection of long-term permanent vegetation records (greater than 7000 plots from 78 datasets) from a large range of habitats which we combined with existing trait databases. We tested whether the observed inter-annual variability in species abundance (coefficient of variation) was related to multiple individual traits. We found that populations with greater leaf dry matter content and seed mass were more stable over time. Despite the variability explained by these traits being low, their effect was consistent across different datasets. Other traits played a significant, albeit weaker, role in species stability, and the inclusion of multi-variate axes or phylogeny did not substantially modify nor improve predictions. These results provide empirical evidence and highlight the relevance of specific ecological trade-offs, i.e. in different resource-use and dispersal strategies, for plant populations stability across multiple biomes. Further research is, however, necessary to integrate and evaluate the role of other specific traits, often not available in databases, and intraspecific trait variability in modulating species stability.

In preclinical studies and our human laboratory, the α2-noradrenergic autoreceptor antagonist yohimbine was found to promote drug-seeking behavior. This study evaluated effects of dose-combinations of yohimbine and the glucocorticoid receptor agonist hydrocortisone to model intensity-dependent effects of stimulating each neurochemical system, alone and together, on stress-reactivity and opioid-seeking. Twelve regular heroin-using participants diagnosed with opioid use disorder (OUD) were stabilized on sublingual buprenorphine (8-mg/day), then passed a hydromorphone 18-mg vs. placebo intramuscular reinforcement screen. Across 9 experimental conditions (3 × 3 within-subject, randomized crossover, placebo-controlled, double-blind design) during inpatient buprenorphine maintenance, combinations of oral pretreatment doses of yohimbine (0, 27, 54-mg; t = 0 min) then hydrocortisone (0, 20, 40-mg; t = 45 min) were administered. In each condition, subjective drug and mood effects, cardiovascular responses, and saliva cortisol and α-amylase levels were assessed to evaluate stress-reactivity, and participants completed a 12-trial choice progressive ratio task during which they could earn units of hydromorphone (1.5-mg intramuscular) and/or money ($2.00). Yohimbine dose-dependently increased blood pressure, α-amylase, and anxiety scores, and decreased opioid agonist symptoms; hydrocortisone dose-dependently increased cortisol levels. Yohimbine/hydrocortisone dose-combinations significantly shifted within-session responding from money to opioid-seeking among participants with lower basal cortisol levels. These findings replicate yohimbine effects on stress biomarkers and demonstrate that noradrenergic/glucocorticoid-potentiated opioid-seeking is modulated by basal cortisol level. In persons with OUD stabilized on buprenorphine, basal HPA-axis activity and acute stressors can enhance opioid relative reinforcing efficacy. These factors may limit OUD treatment efficacy and highlight the need for novel interventions that prevent stress-induced opioid-seeking.

We present a genome assembly from an individual male Cheilosia grossa (a hoverfly; Arthropoda; Insecta; Diptera; Syrphidae). The genome sequence has a total length of 362.40 megabases. Most of the assembly is scaffolded into 6 chromosomal pseudomolecules, including the X sex chromosome. The mitochondrial genome has also been assembled and is 17.81 kilobases in length. Gene annotation of this assembly on Ensembl identified 20,196 protein-coding genes.

Background: Opioids are frequently prescribed for persistent non-cancer pain despite limited evidence of long-term effectiveness and risk of harm. Evidence-based interventions to address inappropriate opioid prescribing are lacking. Aim: To explore perspectives of people living with persistent pain to understand barriers and facilitators in reducing opioids in the context of a pharmacist-led primary care review, and identify review components and features for optimal delivery. Design & setting: A multi-method qualitative study undertaken in the primary care setting in the UK. Method: Adults with experience of persistent pain and taking opioids participated in semi-structured interviews (n = 15, 73% female) and an online discussion forum (n = 31). The Theoretical Domains Framework (TDF) provided a framework for data collection and thematic analysis, involving deductive analysis to TDF domains, inductive analysis within domains to generate sub-themes, and sub-theme comparison to form across-domain overarching themes. The behaviour change technique taxonomy (v1) and motivational behaviour change technique classification system were used to systematically map themes to behaviour change techniques to identify potential review components and delivery features. Results: Thirty-two facilitator and barrier sub-themes for patients reducing opioids were identified across 13 TDF domains. These combined into the following six overarching themes: learning to live with pain; opioid reduction expectations; assuming a medical model; pharmacist-delivered reviews; pharmacist–patient relationship; and patient engagement. Sub-themes mapped to 21 unique behaviour change techniques, yielding 17 components and five delivery features for the proposed PROMPPT review. Conclusion: This study generated theoretically informed evidence for design of a practice pharmacist-led PROMPPT review. Future research will test the feasibility and acceptability of the PROMPPT review and pharmacist training.

We present a genome assembly from an individual male Dasysyrphus tricinctus (the yellow-girdled Dasysyrphus; Arthropoda; Insecta; Diptera; Syrphidae). The genome sequence spans 1,054.90 megabases. Most of the assembly is scaffolded into 5 chromosomal pseudomolecules, including the X sex chromosome. The mitochondrial genome has also been assembled and is 18.39 kilobases in length.

ABSTRACT Gender Differences in Planned Retirement Age Among Medical Students: Are Changes On the Horizon? Purpose Planned age of retirement has an important effect on the physician workforce. Earlier studies of practicing physicians have reported that the planned as well as actual retirement age was significantly younger for women. Also, previous reports had shown that rural physicians tended to retire earlier. This paper offers a view earlier in the physician pipeline and reports surveys of medical students and pre-medical college students concerning their retirement plans. Methods During 2015-2019, 70 college students and 41 medical students at a regional rural medical campus completed a career eulogy that included their planned retirement age. Results Combining both groups of students, women planned to retire at a mean age of 61.9 and men at 59.1, P=0.048. A longitudinal comparison of just medical students showed that prematriculation students just before starting medical school had the oldest planned age of 66.9, compared to college students (57.4 to 58.9) and medical students (64.0 to 64.6), P=0.049. There was no difference in planned retirement age in rural vs urban upbringing. Conclusions In this group of pathways students, women planned to retire almost 3 years later than men, which differs from earlier reports of physicians in practice. The men planned retirement almost 5 years earlier than in previous reports of planned retirement age. There was no difference in rural vs urban upbringing. Whether this is a generalizable finding will require similar studies in different student populations on other campuses, and our survey instrument is available for others to look deeper into the process of professional identity formation that may explain any differences in planned retirement age.

Implementation of coral restoration practices within reef management strategies is accelerating globally to support reef resilience and recovery. However, full costs underpinning restoration project feasibility have historically been underreported yet are critical to informing restoration cost-benefit decision-making. Such knowledge is especially lacking for Australia’s Great Barrier Reef (GBR), where a coral restoration program led by reef tourism operators, Coral Nurture Program (CNP), was initiated in 2018 (northern GBR) and continues to scale. Here we describe the early outcomes and costs of implementing similar tourism-led asexual coral propagation and outplanting practices in a new region, the Whitsundays (central GBR) through the CNP. Specifically, we detail the local operational and environmental context of CNP Whitsundays, describe the costs of implementation and continuation of restoration activities, as well as evaluate survivorship of coral outplants across three restoration sites for nine months after project establishment (August 2022 to June 2023). Baseline benthic surveys revealed relatively low hard coral cover at restoration sites (ranging from 3.22-8.67%), which significantly differed in benthic composition from coral collection sites (ranging 16.67-38.06%), supporting strong motivation by tourism operators to undertake restoration activities. Mean coral survivorship of coral outplants in fate-tracked plots differed between the three restoration sites after 267 days (ranging 23.33-47.58%), with declines largely driven by coral detachment. Early-stage cost-effectiveness (costs relative to outplant survival) associated with implementation of restoration activity varied widely from US$33.04-178.55 per surviving coral (n = 4,425 outplants) depending on whether ‘in-kind’ costs, restoration activity (outplanting only vs. total costs encompassing planning through to monitoring), site-based survivorship, or a combination of these factors, were considered. As coral reef restoration projects continue to be established globally, our results highlight the need for ongoing, long-term monitoring that can inform adaptive practice, and fully transparent cost-reporting to understand and improve feasibility for any given project. We further highlight the inherent context-dependency of restoration costs, and the importance of considering local social-environmental contexts and their associated cost-benefits in economic rationale for reef restoration projects.

Prostate cancer (PCa) is the second most common cancer diagnosed in men. While radical prostatectomy and radiotherapy are often successful in treating localised disease, post-treatment recurrence is common. As the androgen receptor (AR) and androgen hormones play an essential role in prostate carcinogenesis and progression, androgen deprivation therapy (ADT) is often used to deprive PCa cells of the pro-proliferative effect of androgens. ADTs act by either blocking androgen biosynthesis (e.g. abiraterone) or blocking AR function (e.g. bicalutamide, enzalutamide, apalutamide, darolutamide). ADT is often effective in initially suppressing PCa growth and progression, yet emergence of castrate-resistant PCa and progression to neuroendocrine-like PCa following ADT are major clinical challenges. For this reason, there is an urgent need to identify novel approaches to modulate androgen signalling to impede PCa progression whilst also preventing or delaying therapy resistance.The mechanistic convergence of androgen and epitranscriptomic signalling offers a potential novel approach to treat PCa. The epitranscriptome involves covalent modifications of mRNA, notably, in the context of this review, the N(6)-methyladenosine (m6A) modification. m6A is involved in the regulation of mRNA splicing, stability, and translation, and has recently been shown to play a role in PCa and androgen signalling. The m6A modification is dynamically regulated by the METTL3-containing methyltransferase complex, and the FTO and ALKBH5 RNA demethylases.Given the need for novel approaches to treat PCa, there is significant interest in new therapies that target m6A that modulate AR expression and androgen signalling. This review critically summarises the potential benefit of such epitranscriptomic therapies for PCa patients.

Increasing population and the consequent rise in the demand for food and water resources pose significant challenges for the future of agriculture in Egypt. Rapid large-scale agricultural expansion has occurred in the country to meet the growing demand, but agricultural loss from urban infringement and field abandonment remains prevalent. Documenting the full spectrum of changes within Egypt’s agricultural systems is crucial for developing effective land-use policies that improve food security. Here we map and estimate the areal extent of multiple types of agricultural change in Egypt (i.e., agricultural gain, agricultural abandonment, and agricultural loss from urban growth) by applying the Landsat-based detection of trends in disturbance and recovery (LandTrendr) algorithm, a widely used time series temporal segmentation algorithm. First, we used LandTrendr to identify areas of agricultural gain and loss throughout Egypt from 1987 to 2019. Second, we combined land-cover maps and the LandTrendr results to create a comprehensive land-cover change map. Lastly, we evaluated the accuracy of our findings and estimated per-class areas with quantified uncertainty using high-quality reference data. Our results reveal a notable expansion in Egypt’s agricultural land area. However, this growth is accompanied by the widespread loss of prime agricultural land, a consequence of urban development and agricultural abandonment. This study emphasizes the pressing need for the implementation of sustainable land-use policies in Egypt, particularly as climate change will exacerbate pressures on the agricultural sector in the future.

Introduction Both physicians and patients are increasingly aware of the environmental impacts of medication. The shift of treatment paradigm towards MART-treatment (Maintenance and Reliever Therapy) in asthma affects the treatment-related emissions. The carbon footprint of inhaled medication is also tied to the type of the device used. Today the most commonly used propellant-containing pressurised metered-dose inhalers (pMDIs) have a carbon footprint typically 20–40-fold higher than propellant-free dry powder inhalers (DPIs) and soft mist inhalers.Methods We analysed the carbon footprint of inhaled medications in Europe using published life cycle analyses of marketed inhalers and comprehensive 2020 European sales data. In addition, we give an estimate on treatment-related emissions of different treatment regimens on Global Initiative for Asthma (GINA) step 2.Results There is potential to reduce the carbon footprint of inhaled medications by 85% if DPIs are preferred over pMDIs. Emissions from pMDIs in the EU were estimated to be 4.0 megatons of carbon dioxide equivalent (MT CO2e) and this could be reduced to 0.6 MT CO2e if DPIs were used instead. In the treatment of moderate asthma with DPI, an as-needed combination of inhaled corticosteroid and long-acting beta-agonist in a single inhaler had a substantially lower annual carbon footprint (0.8 kg CO2e) than the more traditional maintenance therapy with an inhaled corticosteroid alone with as-needed short-acting beta-agonist (2.9 kg CO2e).Discussion There has been an urgent call for healthcare to reduce its carbon footprint for appropriate patients with asthma and chronic obstructive pulmonary disease (COPD), changing to non-propellant inhalers can reduce the carbon footprint of their treatment by almost 20-fold.