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Forecasting emergent pest spread is paramount to mitigating their impacts. For host-specialized pests, epidemiological models of spread through a single host population are well developed. However, most pests attack multiple host species; the challenge is predicting which communities are most vulnerable to infestation.

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Background: Gender identity services for children and young people are currently being reorganised in England and Wales. Provision is required to negotiate clinical uncertainty and a public debate that cannot agree on what care should look like.

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