Large-scale land acquisitions exacerbate local farmland inequalities in Tanzania.

Land inequality stalls economic development, entrenches poverty, and is associated with environmental degradation. Yet, rigorous assessments of land-use interventions attend to inequality only rarely. A land inequality lens is especially important to understand how recent large-scale land acquisitions (LSLAs) affect smallholder and indigenous communities across as much as 100 million hectares around the world. This paper studies inequalities in land assets, specifically landholdings and farm size, to derive insights into the distributional outcomes of LSLAs. Using a household survey covering four pairs of land acquisition and control sites in Tanzania, we use a quasi-experimental design to characterize changes in land inequality and subsequent impacts on well-being. We find convincing evidence that LSLAs in Tanzania lead to both reduced landholdings and greater farmland inequality among smallholders. Households in proximity to LSLAs are associated with 21.1% (P = 0.02) smaller landholdings while evidence, although insignificant, is suggestive that farm sizes are also declining. Aggregate estimates, however, hide that households in the bottom quartiles of farm size suffer the brunt of landlessness and land loss induced by LSLAs that combine to generate greater farmland inequality. Additional analyses find that land inequality is not offset by improvements in other livelihood dimensions, rather farm size decreases among households near LSLAs are associated with no income improvements, lower wealth, increased poverty, and higher food insecurity. The results demonstrate that without explicit consideration of distributional outcomes, land-use policies can systematically reinforce existing inequalities.

Clarifying the landscape approach: A Letter to the Editor on "Integrated landscape approaches to managing social and environmental issues in the tropics".

Objectives, assumptions, and methods for landscape restoration and the landscape approach. World leaders have pledged 350 Mha for restoration using a landscape approach. The landscape approach is thus poised to become one of the most influential methods for multi-functional land management. Reed et al (2016) meaningfully advance scholarship on the landscape approach, but they incorrectly define the approach as it exists within their text. This Letter to the Editor clarifies the landscape approach as an ethic for land management, demonstrates how it relates to landscape restoration, and motivates continued theoretical development and empirical assessment of the landscape approach.

The data not collected on community forestry.

Conservation and development practitioners increasingly promote community forestry as a way to conserve ecosystem services, consolidate resource rights, and reduce poverty. However, outcomes of community forestry have been mixed; many initiatives failed to achieve intended objectives. There is a rich literature on institutional arrangements of community forestry, but there has been little effort to examine the role of socioeconomic, market, and biophysical factors in shaping both land-cover change dynamics and individual and collective livelihood outcomes. We systematically reviewed the peer-reviewed literature on community forestry to examine and quantify existing knowledge gaps in the community-forestry literature relative to these factors. In examining 697 cases of community forest management (CFM), extracted from 267 peer-reviewed publications, we found 3 key trends that limit understanding of community forestry. First, we found substantial data gaps linking population dynamics, market forces, and biophysical characteristics to both environmental and livelihood outcomes. Second, most studies focused on environmental outcomes, and the majority of studies that assessed socioeconomic outcomes relied on qualitative data, making comparisons across cases difficult. Finally, there was a heavy bias toward studies on South Asian forests, indicating that the literature on community forestry may not be representative of decentralization policies and CFM globally.

Governance regime and location influence avoided deforestation success of protected areas in the Brazilian Amazon.

Protected areas in tropical countries are managed under different governance regimes, the relative effectiveness of which in avoiding deforestation has been the subject of recent debates. Participants in these debates answer appeals for more strict protection with the argument that sustainable use areas and indigenous lands can balance deforestation pressures by leveraging local support to create and enforce protective regulations. Which protection strategy is more effective can also depend on (i) the level of deforestation pressures to which an area is exposed and (ii) the intensity of government enforcement. We examine this relationship empirically, using data from 292 protected areas in the Brazilian Amazon. We show that, for any given level of deforestation pressure, strictly protected areas consistently avoided more deforestation than sustainable use areas. Indigenous lands were particularly effective at avoiding deforestation in locations with high deforestation pressure. Findings were stable across two time periods featuring major shifts in the intensity of government enforcement. We also observed shifting trends in the location of protected areas, documenting that between 2000 and 2005 strictly protected areas were more likely to be established in high-pressure locations than in sustainable use areas and indigenous lands. Our findings confirm that all protection regimes helped reduce deforestation in the Brazilian Amazon.

MetaV: A Pioneer in feature Augmented Meta-Learning Based Vision Transformer for Medical Image Classification.

Image classification, a fundamental task in computer vision, faces challenges concerning limited data handling, interpretability, improved feature representation, efficiency across diverse image types, and processing noisy data. Conventional architectural approaches have made insufficient progress in addressing these challenges, necessitating architectures capable of fine-grained classification, enhanced accuracy, and superior generalization. Among these, the vision transformer emerges as a noteworthy computer vision architecture. However, its reliance on substantial data for training poses a drawback due to its complexity and high data requirements. To surmount these challenges, this paper proposes an innovative approach, MetaV, integrating meta-learning into a vision transformer for medical image classification. N-way K-shot learning is employed to train the model, drawing inspiration from human learning mechanisms utilizing past knowledge. Additionally, deformational convolution and patch merging techniques are incorporated into the vision transformer model to mitigate complexity and overfitting while enhancing feature representation. Augmentation methods such as perturbation and Grid Mask are introduced to address the scarcity and noise in medical images, particularly for rare diseases. The proposed model is evaluated using diverse datasets including Break His, ISIC 2019, SIPaKMed, and STARE. The achieved performance accuracies of 89.89%, 87.33%, 94.55%, and 80.22% for Break His, ISIC 2019, SIPaKMed, and STARE, respectively, present evidence validating the superior performance of the proposed model in comparison to conventional models, setting a new benchmark for meta-vision image classification models.

Linking management effectiveness indicators to observed effects of protected areas on fire occurrence in the Amazon rainforest.

Management-effectiveness scores are used widely by donors and implementers of conservation projects to prioritize, track, and evaluate investments in protected areas. However, there is little evidence that these scores actually reflect the capacity of protected areas to deliver conservation outcomes. We examined the relation between indicators of management effectiveness in protected areas and the effectiveness of protected areas in reducing fire occurrence in the Amazon rainforest. We used data collected with the Management Effectiveness Tracking Tool (METT) scorecard, adopted by some of the world's largest conservation organizations to track management characteristics believed to be crucial for protected-area effectiveness. We used the occurrence of forest fires from 2000 through 2010 as a measure of the effect of protected areas on undesired land-cover change in the Amazon basin. We used matching to compare the estimated effect of protected areas with low versus high METT scores on fire occurrence. We also estimated effects of individual protected areas on fire occurrence and explored the relation between these effects and METT scores. The relations between METT scores and effects of protected areas on fire occurrence were weak. Protected areas with higher METT scores in 2005 did not seem to have performed better than protected areas with lower METT scores at reducing fire occurrence over the last 10 years. Further research into the relations between management-effectiveness indicators and conservation outcomes in protected areas seems necessary, and our results show that the careful application of matching methods can be a suitable method for that purpose.

Postoperative Evaluation of Pain and Disability in Patients Undergoing Spinal Discectomy.

BACKGROUND: A spinal discectomy surgery (SDS) is a common surgical procedure performed to treat lumbosacral radiculopathy. AIM: To evaluate postoperative patterns of pain and disability in patients undergoing spinal discectomy. METHODS AND MATERIALS: This investigation was a retrospective longitudinal review of prospective information gathered from 543 enrolled patients for lumbar radiculoplasty. The study participants were divided into two categories: Category 1 (SDS) comprising patients of lumbar radiculoplasty managed with SDS (n=270) and Category 2 (non-SDS) comprising patients of lumbar radiculoplasty managed with therapy other than SDS (n=273). It included study participants taking medication for pain control including opioids and non-opioids and physiotherapy for strengthening lower back muscles. At baseline, three months, 12 months, and 24 months after surgery, patient-reported information was gathered. Leg pain magnitude, back pain magnitude, and pain-related impairment were the key outcome metrics of interest. RESULTS: The mean postoperative visual analog scale (VAS) score for leg pain at three-month follow-up was 4.3±1.2 in study participants in SDS and 8.1±1.3 in the non-SDS category. The VAS score was lower in the SDS category showing greater reduction in postoperative pain with statistically meaningful results (p<0.001). The mean postoperative VAS score at 12-month follow-up was 2.8±1.1 in study participants in SDS and 7.9±1.5 in the non-SDS category. The VAS score was lower in the SDS category showing greater reduction in postoperative pain with statistically meaningful results (p<0.001). The mean postoperative VAS score at 24-month follow-up was 1.7±1.2 in study participants in SDS and 7.1±1.1 in the non-SDS category. The VAS score was lower in the SDS category showing greater reduction in postoperative pain with statistically meaningful results (p<0.001). CONCLUSION:  It was observed that after discectomy, patients suffering from lumbar radiculopathy have significant pain and disability recovery. According to these results, only a small percentage of individuals exhibit negative results at the level of impairment.

Low-cost informational intervention reduced drinking water arsenic exposure in Bangladesh.

Thirty million Bangladeshis continue to drink water with unacceptable levels of arsenic (>10 µg/L), resulting in a large public health burden. The vast majority of the Bangladeshi population relies on private wells, and less than 12% use piped water, increasing the complexity of mitigation efforts. While mass testing and informational campaigns were successful in the early 2,000 s, they have received little attention in recent years, even though the number of wells in the country has likely more than doubled. We investigated the effect of a low-cost (

Trade-offs and synergies between carbon storage and livelihood benefits from forest commons.

Forests provide multiple benefits at local to global scales. These include the global public good of carbon sequestration and local and national level contributions to livelihoods for more than half a billion users. Forest commons are a particularly important class of forests generating these multiple benefits. Institutional arrangements to govern forest commons are believed to substantially influence carbon storage and livelihood contributions, especially when they incorporate local knowledge and decentralized decision making. However, hypothesized relationships between institutional factors and multiple benefits have never been tested on data from multiple countries. By using original data on 80 forest commons in 10 countries across Asia, Africa, and Latin America, we show that larger forest size and greater rule-making autonomy at the local level are associated with high carbon storage and livelihood benefits; differences in ownership of forest commons are associated with trade-offs between livelihood benefits and carbon storage. We argue that local communities restrict their consumption of forest products when they own forest commons, thereby increasing carbon storage. In showing rule-making autonomy and ownership as distinct and important institutional influences on forest outcomes, our results are directly relevant to international climate change mitigation initiatives such as Reduced Emissions from Deforestation and Forest Degradation (REDD) and avoided deforestation. Transfer of ownership over larger forest commons patches to local communities, coupled with payments for improved carbon storage can contribute to climate change mitigation without adversely affecting local livelihoods.

Forest commons and local enforcement.

This article examines the relationship between local enforcement and forests used as commons. It uses a unique multicountry dataset, created over the past 15 years by the International Forestry Resources and Institutions Research Program. Drawing on original enforcement and forest commons data from 9 countries, we find that higher levels of local enforcement have a strong and positive but complex relationship to the probability of forest regeneration. This relationship holds even when the influence of a number of other factors such as user group size, subsistence, and commercial importance of forests, size of forest, and collective action for forest improvement activities is taken into account. Although several of the above factors have a statistically significant relationship to changes in the condition of forest commons, differences in levels of local enforcement strongly moderate their link with forest commons outcomes. The research, using data from diverse political, social, and ecological contexts, shows both the importance of enforcement to forest commons and some of the limits of forest governance through commons arrangements.

Predictors of Pain Severity and its Impact on Quality of Life in Patients with Parkinson's Disease.

BACKGROUND: Pain is a common and distressing symptom of Parkinson's disease (PD). The relation of pain, its predictors, and its impact on quality of life (QoL) in PD has not been studied in Indian PD patients. OBJECTIVE: To assess the predictors of pain and investigate its impact on QoL among Indian PD patients. METHODOLOGY: We conducted a cross-sectional study on 100 PD patients. The cases were diagnosed according to the UK brain bank criteria. Unified PD Rating Scale (UPDRS) parts III, V, and VI were employed to assess the severity of the disease. King's Parkinson Disease Pain Scale (KPPS) and PD questionnaire-8 (PDQ-8) were used to evaluate pain and QoL, respectively. RESULTS: Prevalence of different pain types in patients with PD was 70%, mainly including musculoskeletal (53%), fluctuation-related (35%), and nocturnal pain (27%). Subjects with pain developed PD symptoms at a younger age and had a longer duration of the disease. A positive correlation was found between KPPS scores and UPDRS parts III and V, while a negative correlation was observed with UPDRS part VI. Pain in PD subjects had a significant impact on the QoL. CONCLUSIONS: Most of the PD patients suffered some form of pain with significant correlations with motor disability and poor QoL. Predictors of pain severity among PD patients included a longer disease duration, younger age of disease onset, and a higher levodopa equivalent daily dose (LEDD).

Carbon emissions from the global land rush and potential mitigation.

Global drivers and carbon emissions associated with large-scale land transactions have been poorly investigated. Here we examine major factors behind such transactions (income, agricultural productivity, availability of arable land and water scarcity) and estimate potential carbon emissions under different levels of deforestation. We find that clearing lands transacted between 2000 and 2016 (36.7 Mha) could have emitted ~2.26 GtC, but constraining land clearing to historical deforestation rates would reduce emissions related to large-scale land transactions to ~0.81 GtC.

Harnessing employment-based social assistance programmes to scale up nature-based climate action.

As the severity of the triple challenges of global inequality, climate change and biodiversity loss becomes clearer, governments and international development institutions must find effective policy instruments to respond. We examine the potential of social assistance policies in this context. Social assistance refers to transfers to poor, vulnerable and marginalized groups to reduce their vulnerability and livelihood risks, and to enhance their rights and status. Substantial public funds support social assistance programmes globally. Collectively, lower- and middle-income countries spend approximately 1.5% of their GDP on social assistance annually. We focus on the potential of paid employment schemes to promote effective ecosystem stewardship. Available evidence suggests such programmes can offer multiple benefits in terms of improvements in local ecosystems and natural capital, carbon sequestration and local biodiversity conservation. We review evidence from three key case studies: in India (the Mahatma Gandhi National Rural Employment Guarantee Scheme), Ethiopia (the Productive Safety Nets Programme) and Mexico (the Temporary Employment Programme). We conclude that, to realize the potential of employment-based social assistance for ecosystem benefits it will be necessary to address two challenges: first, the weak design and maintenance of local public works outputs in many schemes, and second, the concern that social protection schemes may become less effective if they are overburdened with additional objectives. Overcoming these challenges requires an evolution of institutional systems for delivering social assistance to enable a more effective combination of social and environmental objectives. This article is part of the theme issue 'Climate change and ecosystems: threats, opportunities and solutions'.

A Pregnant Woman Presenting With Progressively Worsening Dyspnea and Pneumothorax.

CASE PRESENTATION: A 29-year-old Ukrainian woman presented to the obstetric clinic at 28 weeks' gestation with pregnancy complicated by intrauterine growth restriction. She reported progressively worsening dyspnea during her pregnancy and was found to have significant hypoxia with an oxygen saturation of 84% on room air prompting admission for further evaluation. Oxygen saturation improved to 92% on 10 L of supplemental oxygen. On further questioning, she was found to have a history significant for pleurodesis as a treatment for recurrent pneumothoraces and nephrectomy for a benign renal mass several years prior while living in Ukraine.

Preparing interdisciplinary leadership for a sustainable future.

Urgent sustainability challenges require effective leadership for inter- and trans-disciplinary (ITD) institutions. Based on the diverse experiences of 20 ITD institutional leaders and specific case studies, this article distills key lessons learned from multiple pathways to building successful programs. The lessons reflect both the successes and failures our group has experienced, to suggest how to cultivate appropriate and effective leadership, and generate the resources necessary for leading ITD programs. We present two contrasting pathways toward ITD organizations: one is to establish a new organization and the other is to merge existing organizations. We illustrate how both benefit from a real-world focus, with multiple examples of trajectories of ITD organizations. Our diverse international experiences demonstrate ways to cultivate appropriate leadership qualities and skills, especially the ability to create and foster vision beyond the status quo; collaborative leadership and partnerships; shared culture; communications to multiple audiences; appropriate monitoring and evaluation; and perseverance. We identified five kinds of resources for success: (1) intellectual resources; (2) institutional policies; (3) financial resources; (4) physical infrastructure; and (5) governing boards. We provide illustrations based on our extensive experience in supporting success and learning from failure, and provide a framework that articulates the major facets of leadership in inter- and trans-disciplinary organizations: learning, supporting, sharing, and training.

Forest-linked livelihoods in a globalized world.

Forests have re-taken centre stage in global conversations about sustainability, climate and biodiversity. Here, we use a horizon scanning approach to identify five large-scale trends that are likely to have substantial medium- and long-term effects on forests and forest livelihoods: forest megadisturbances; changing rural demographics; the rise of the middle-class in low- and middle-income countries; increased availability, access and use of digital technologies; and large-scale infrastructure development. These trends represent human and environmental processes that are exceptionally large in geographical extent and magnitude, and difficult to reverse. They are creating new agricultural and urban frontiers, changing existing rural landscapes and practices, opening spaces for novel conservation priorities and facilitating an unprecedented development of monitoring and evaluation platforms that can be used by local communities, civil society organizations, governments and international donors. Understanding these larger-scale dynamics is key to support not only the critical role of forests in meeting livelihood aspirations locally, but also a range of other sustainability challenges more globally. We argue that a better understanding of these trends and the identification of levers for change requires that the research community not only continue to build on case studies that have dominated research efforts so far, but place a greater emphasis on causality and causal mechanisms, and generate a deeper understanding of how local, national and international geographical scales interact.

Assessment of the renal toxicity of novel anti-inflammatory compounds using cynomolgus monkey and human kidney cells.

PF1, an anti-inflammatory drug candidate, was nephrotoxic in cynomolgus monkeys in a manner that was qualitatively comparable to that observed with the two previous exploratory drug candidates (PF2and PF3). Based on the severity of nephrotoxicity, PF1 ranked between the other two compounds, withPF2 inducing mortality at all doses and PF3 eliciting only mild nephrotoxicity. To further characterize nephrotoxicity in monkeys and enable direct comparisons with humans, primary cultures of proximal tubular (PT) cells from monkey and human kidneys were used as in vitro tools, using lactate dehydrogenase release as the biomarker of cytotoxicity. In both human and monkey PT cells, PF2was by far the most cytotoxic compound of the three drugs. PF1 exhibited modest cytotoxicity at the highest concentration tested in human PT cells but none in monkey kidney cells whereas PF3 exhibited the reverse pattern.Because these drugs are organic anions, mechanistic studies using human organic anion transporters 1 and 3 (hOAT1 andhOAT3) transfected cell lines were pursued to evaluate the potential of these compounds to interact with these transporters. All three drugs exhibited high affinity for hOAT3 (PF1 exhibited the lowest IC50 of 6M) but only weakly interacted with hOAT1 (with no interaction found for PF2). PF2 was a strong hOAT3 (not hOAT1) substrate, whereas PF1 and PF3 were substrates for both hOAT1 and hOAT3.Upon pretreatment of monkeys with the OAT substrate probenecid, PF3 systemic exposure (AUC) and half-life (t1/2) increased approximately 2-fold whereas clearance (CL) and volume of distribution (Vdss) decreased, as compared to naïve monkeys. This indicated that PF3 competed with probenecid for hOAT1 and/or hOAT3mediated elimination of PF3. Thus, hOAT1 and/or hOAT3 may be responsible for the uptake of this series of drugs in renal PT cells, which may directly or indirectly lead to the observed nephrotoxicity in vivo.