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This first national descriptive study used an indicator, which comprehensively reflects incident all-type hospitalized cases coded endometriosis in the French territory up to the municipality scale. We observed an increase in the risk of being hospitalized from 2011 to 2017 and spatial heterogeneity with the identification of 20 scattered hotspots in Metropolitan France as well as in 2 overseas departments.Descriptive resultsThe annual incidence rate (12.9/10,000 PYs) of all-type hospitalized cases coded endometriosis in France in females aged 10–49 years was of the same order of magnitude as the rates observed in other countries (Italy, Iceland) using similar methods29,30. Moreover, a recent meta-analysis2 estimated the pooled incidence rate of endometriosis based on hospital data to be 13.6/10,000 PYs (95% CI: 10.9; 16.3), which situates the French estimation within the confidence interval and close to the pooled value.In our study, 68.3% of all-type cases and 83.2% of non-adenomyosis cases were aged 25–49 years, and only 3.6% (8.5% for non-adenomyosis cases) were under 24 years. In young females, this low percentage could reflect underdiagnosis or delayed diagnosis, because histologic evidence may occur after an interval of 5–10 years following the first signs of endometriosis31. Moreover, many cases are fortuitously diagnosed during fertility check-ups, which rarely take place before 25 years of age. This age distribution in France is close to the distribution observed in a recent Italian study (3.6%  50 years) carried out using similar methods in the population of the Friuli Venezia Giulia region from 2011 to 201330. The Italian authors remarked a noticeable percentage of incident cases over 50 years of age for non-adenomyosis cases (11.5%), close to our results (8.3%), even though endometriosis is expected to attenuate after menopause. They suggested that endometriosis deposits could still be potentially active in older patients and be reactivated in the presence of certain hormones30. This hypothesis seems quite relevant regarding the potential link with EDC exposure. Indeed, the developmental hypothesis supposes that reproductive disorders at adult age could result from early (i.e., prenatal, perinatal, or pubertal) exposure to EDCs in specific exposure windows. In males, this hypothesis has been especially developed according to the so-called “testicular dysgenesis syndrome (TDS)”32. The disruption of fetal androgen action with EDCs, specifically in the “masculinization programming window” (MPW), induces a shorter anogenital distance that is supposed to provide a life-long readout of the level of androgen exposure in the MPW33 and is consistently associated in animals and humans with TDS troubles (cryptorchidism, hypospadias, poor sperm quality)34.In females, the mirror concept of “ovarian dysgenesis syndrome” has been proposed, including a higher risk to develop endometriosis35. Interestingly, endometriosis has recently been associated with a shorter anogenital distance in women36, and this anthropological indicator, measurable using MRI, could be useful for a non-invasive diagnosis of the disease37.In addition, some authors suggest that endometriosis onset could occur in two steps: an early hormonal-developmental step and a second hormonal step at adult age38,39, or a first initiation step with a second promotion step based on experimental tumor production40. Overall, these hypotheses could contribute to the unexpected proportion of hospitalized endometriosis cases identified after menopause. Another explanation could be the large number of fortuitous diagnoses of endometriosis at the same time as hysterectomies performed for diverse indications in women at an older age.Temporal trendsStudies on the temporal trends of endometriosis incidence used diverse methods and delivered differing results according to the country as reviewed in a recent study1. Only three studies carried out with hospital data in the general population are available. A Finnish study showed a decrease in incidence from 1987 to 201241. An Icelandic study did not conclude to any trend from 1981 to 200029, and a recent Korean study only showed an incidence increase in young women aged 15–19 and 20–24 years, but not in other age groups42.In France, the increase in the risk of being hospitalized, observed for both adenomyosis and non-adenomyosis cases, could reflect a real increase in the incidence of endometriosis, consistent with the perception of numerous clinicians. We did not observe an upward trend in females under the age of 25 years, which could reflect the underdiagnosis of this population. The global increase could also relate to the increasing use of non-invasive examinations, like ultrasounds or pelvic MRI during the study period. Pelvic MRI was only recommended by the French Health Authority at the end of the study period43, although clinicians would have anticipated this recommendation, which is supported by the results of the additional analyses (Supplementary Material). In the study period, there was a 69% increase in cases who underwent this examination concurrently with hospitalization, which accounted for around a third of cases. The increasing use of MRI (or ultrasounds) would result in more and more cases treated without hospitalization and could explain the apparent increase of hospitalized incidence at later ages and less at younger ages.Regarding the secondary indicator, the incidence rate in the whole of France during the study period remained steady. However, the trends differed according to each type (Table 4). The risk did not increase for endometrioma, a type of endometriosis that is not expected to depend on the use of pelvic MRI, but it did increase for intestinal endometriosis, expected to be strongly influenced by pelvic MRI. Therefore, these results also support the role of pelvic MRI. As for the divergent evolution of specific types of endometriosis, experts believe that it could depend on shifting practice patterns such as the more frequent tendency to medically treat endometrioma.Table 4 Number of incident cases of hospitalized endometriosis and crude incident rate for specific types of endometriosis for the study period in the whole of France, in females aged 10 years and above.Full size tableAnother factor could also contribute to the global increase in hospitalized endometriosis. Several patient societies (EndoFrance, Endomind, Info-endometriose) have strongly advocated for better detection and care of this disease and provided targeted information, which may have resulted in increased awareness of patients and clinicians regarding the disease during the study period.These factors are likely interlinked with a possible real increase in endometriosis incidence, which could be confirmed by a longer monitoring period.Spatiotemporal and spatial trendsThe spatiotemporal and spatial heterogeneity of the risk of hospitalized endometriosis that we observed in France during the study period could be related to spatial disparities and different evolutions in terms of detection and hospital care. In half of the 20 hotspots in Metropolitan France, we identified a town where an expert clinic for endometriosis was operational during the study period (Fig. 4). In the overseas departments, we identified an expert clinic in the Reunion Island, where we also observed a high incidence. However, we identified expert clinics in areas with a low or moderate risk of hospitalized endometriosis, especially in Paris (four expert clinics), Lyon (two expert clinics), Rennes, Brest, and Angers. Adjusting the spatial model at the department scale with the density of gynecologists and obstetricians using the available data provided by the shared inventory of health professionals from 2011 to 2016 did not change the geographic distribution (data not shown). Adjusting for incident cases of non-endometriotic ovarian cysts only brought about some changes in several departments in the north where the risk attenuated, even though it stayed above 1 (data not shown).Taken together, these results indicate that the activity of local expert clinics could only partially explain the spatial and spatiotemporal heterogeneity of the risk of hospitalized endometriosis. The contribution of environmental factors remains possible and plausible, as we argued above.The results of the exploratory cluster detection performed in Metropolitan France showed a negative relation with the socioeconomic deprivation index. Indeed, a high socioeconomic status (SES) or education level has been associated with a higher frequency of endometriosis44,45, which probably reflects the better detection and patient care of women with high SES. However, this relation was inverted in a recent Swedish study, although the authors partly attribute this inconsistent finding to egalitarian health care in Sweden46.Among the 40 detected clusters (p  More

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Minimum distance to weak efficient frontierBriec and Charnes et al. first proposed the Minimum distance to weak efficient frontier (MinDW) model39,40, which can be expressed as (m + n) linear programming ((m) is the number of input indicators and (n) is the number of output indicators), assuming that the input variable is (x) and the output variable is (y). The specific formula is shown in Eq. (1):$$ begin{aligned} & max beta_{z} ,z = 1,2, ldots ,m + n \ & s.t.left{ begin{gathered} sumnolimits_{j = 1}^{q} {alpha_{j} x_{rj} + beta_{z} e_{r} le x_{rk} ,r = 1,2, ldots ,m} hfill \ sumnolimits_{j = 1}^{q} {alpha_{j} x_{ij} + beta_{z} e_{i} ge y_{ik} ,i = 1,2, ldots ,n} hfill \ alpha_{j} ge 0 hfill \ end{gathered} right. \ end{aligned} $$
(1)
(e_{r}) and (e_{i}) are constants. In the programming formula, only one (e) is equal to 1, and the others are 0, that is shown in Eq. (2):$$ begin{aligned} & e_{r} = 1;{text{ if}}; , r = z; , e_{r} = 0 , ;{text{if}}; , r ne z \ & e_{i} = 1 , ;{text{if}}; , i = z – m; , e_{r} = 0 , ;{text{if}}; , i ne z – m \ end{aligned} $$
(2)
The efficiency value of model is expressed as Eq. (3):$$ theta_{z}^{*} = frac{{1 – frac{1}{m}sumnolimits_{r = 1}^{m} {frac{{beta_{z}^{*} e_{r} }}{{x_{rk} }}} }}{{1 + frac{1}{n}sumnolimits_{i = 1}^{n} {frac{{beta_{z}^{*} e_{i} }}{{y_{ik} }}} }} $$
(3)
The efficiency value of MinDW model is expressed as (theta_{max }^{*} = max (theta_{z}^{*} ,z = 1,2, cdots ,m + n)), and the maximum efficiency value corresponds to the minimum (beta^{*}), that is the nearest distance to the frontier.This paper uses the MinDW model with negative output to conduct empirical analysis. The method can be expressed as (m + n + d) linear programming ((m) is the number of inputs, (n) is the number of desirable output, (d) is the number of unexpected output), assuming that the input variable is (x), the desirable output variable is (y), and the undesirable output variable is (f). The specific formula is shown in Eq. (4):$$ begin{aligned} & max beta_{z} ,z = 1,2, ldots ,m + n + d \ & s.t.left{ begin{gathered} sumnolimits_{j = 1}^{q} {alpha_{j} x_{rj} + beta_{z} e_{r} le x_{rk} ,r = 1,2, ldots ,m} hfill \ sumnolimits_{j = 1}^{q} {alpha_{j} x_{ij} – beta_{z} e_{i} ge y_{ik} ,i = 1,2, ldots ,n} hfill \ sumnolimits_{j = 1}^{q} {alpha_{j} x_{lj} + beta_{z} e_{l} le f_{lk} ,l = 1,2, ldots ,d} hfill \ alpha_{j} ge 0 hfill \ end{gathered} right. \ end{aligned} $$
(4)
(e_{r}), (e_{i}) and (e_{l}) are constants. In the programming formula, only one (e) is equal to 1, and the others are 0, that is shown in Eq. (5):$$ begin{aligned} & e_{r} = 1;{text{ if}}; , r = z; , e_{r} = 0 , ;{text{if}}; , r ne z \ & e_{i} = 1 , ;{text{if }};i = z – m; , e_{r} = 0 , ;{text{if}}; , i ne z – m \ & e_{l} = 1 , ;{text{if}}; , l = z – m – n; , e_{l} = 0 , ;{text{if}}; , l ne z – m – n \ end{aligned} $$
(5)
The efficiency value of model is expressed as Eq. (6):$$ theta_{z}^{*} = frac{{1 – frac{1}{m}sumnolimits_{r = 1}^{m} {frac{{beta_{z}^{*} e_{r} }}{{x_{rk} }}} }}{{1 + frac{1}{n + d}left( {sumnolimits_{i = 1}^{n} {frac{{beta_{z}^{*} e_{i} }}{{y_{ik} }}} + sumnolimits_{l = 1}^{d} {frac{{beta_{z}^{*} e_{l} }}{{f_{lk} }}} } right)}} $$
(6)
The efficiency value of MinDW model is expressed as (theta_{max }^{*} = max (theta_{z}^{*} ,z = 1,2, cdots ,m + n + d)), and the maximum efficiency value corresponds to the minimum (beta^{*}), which means the nearest distance to the frontier.The efficiency value of MinDW model will not be less than the efficiency value of directional distance function model with any direction vector or other distance types (such as radial model and SBM model). In other words, the efficiency value of MinDW model is the largest. Combined with the above process, we can define the common boundary ((beta^{meta*})) and the model is as Eq. (7):$$ begin{aligned} & beta^{meta*} = max frac{{1 – frac{1}{m}sumnolimits_{r = 1}^{m} {frac{{beta_{z} e_{r} }}{{x_{rk} }}} }}{{1 + frac{1}{n + d}left( {sumnolimits_{i = 1}^{n} {frac{{beta_{z} e_{i} }}{{y_{ik} }}} + sumnolimits_{l = 1}^{d} {frac{{beta_{z} e_{l} }}{{f_{lk} }}} } right)}} \ & s.t.left{ begin{gathered} sumnolimits_{j = 1}^{{q_{m} }} {alpha_{j} x_{rj} + beta_{z} e_{r} le x_{rk} ,r = 1,2, cdots ,m} hfill \ sumnolimits_{j = 1}^{{q_{m} }} {alpha_{j} x_{ij} – beta_{z} e_{i} ge y_{ik} ,i = 1,2, cdots ,n} hfill \ sumnolimits_{j = 1}^{{q_{m} }} {alpha_{j} x_{lj} + beta_{z} e_{l} le f_{lk} ,l = 1,2, cdots ,d} hfill \ alpha_{j} ge 0 hfill \ end{gathered} right. \ end{aligned} $$
(7)
Similarly, the efficiency value of DMU relative to the scale frontier ((beta^{scale*})) can be obtained by the Eq. (8):$$ begin{aligned} & beta^{scale*} = max frac{{1 – frac{1}{m}sumnolimits_{r = 1}^{m} {frac{{beta_{z} e_{r} }}{{x_{rk} }}} }}{{1 + frac{1}{n + d}left( {sumnolimits_{i = 1}^{n} {frac{{beta_{z} e_{i} }}{{y_{ik} }}} + sumnolimits_{l = 1}^{d} {frac{{beta_{z} e_{l} }}{{f_{lk} }}} } right)}} \ & s.t.left{ begin{gathered} sumnolimits_{j = 1}^{{q_{s} }} {alpha_{j} x_{rj} + beta_{z} e_{r} le x_{rk} ,r = 1,2, ldots ,m} hfill \ sumnolimits_{j = 1}^{{q_{s} }} {alpha_{j} x_{ij} – beta_{z} e_{i} ge y_{ik} ,i = 1,2, ldots ,n} hfill \ sumnolimits_{j = 1}^{{q_{s} }} {alpha_{j} x_{lj} + beta_{z} e_{l} le f_{lk} ,l = 1,2, ldots ,d} hfill \ alpha_{j} ge 0 hfill \ end{gathered} right. \ end{aligned} $$
(8)
Finally, in the common frontier model, the technology gap ratio (TGR) is equal to the ratio of the efficiency value of the common frontier to the scale frontier41. The formula is as Eq. (9):$$ TGR^{MinDW} = frac{{beta^{meta*} }}{{beta^{scale*} }} $$
(9)
(beta^{meta*}) and (beta^{scale*}) represent the optimal solution of formula (7) and formula (8), respectively. Obviously, (0 le TGR le 1). TGR is used to measure the distance between the optimal production technology and the potential optimal technology of a group, and identify whether there are any differences in LHG under different groups. The closer the TGR is to 1, the closer the technology level is to the optimal potential technology level. Conversely, it shows the larger gap between the technology level and the potential optimal technology level.Metafrontier-Malmquist–Luenberger indexMalmquist productivity index is widely used in the study of dynamic efficiency change trend, and has good adaptability to multiple input–output data and panel data analysis. The actual production process often contains unexpected output. After Chung et al. proposed Malmquist–Luenberger (ML) index, any Malmquist index with undesired output can be called ML index42. Oh constructed the Global-Malmquist–Luenberger index43. All the evaluated DMUs are included in the global reference set, which avoids the phenomenon of infeasible solution in VRS. The global reference set constructed in this paper is as Eqs. (10)–(11):$$ Q^{G} left( x right) = Q^{1} left( {x^{1} } right) cup Q^{2} left( {x^{2} } right) cup cdots cup Q^{T} left( {x^{T} } right) $$
(10)
$$ Q^{t} left( {x^{t} } right) = left{ {left( {y^{t} ,f^{t} } right)left| {x^{t} ;can;produce} right.;left( {y^{t} ,f^{t} } right)} right} $$
(11)
This paper takes MML index as the LHG.$$ begin{aligned} MML_{t – 1}^{t} & = sqrt {frac{{1 – D_{t – 1} left( {x^{t} ,y^{t} ,f^{t} ;y^{t} , – f^{t} } right)}}{{1 – D_{t – 1} left( {x^{t – 1} ,y^{t – 1} ,f^{t – 1} ;y^{t – 1} , – f^{t – 1} } right)}} times frac{{1 – D_{t} left( {x^{t} ,y^{t} ,f^{t} ;y^{t} , – f^{t} } right)}}{{1 – D_{t} left( {x^{t – 1} ,y^{t – 1} ,f^{t – 1} ;y^{t – 1} , – f^{t – 1} } right)}}} \ & = sqrt {frac{{1 – D_{t – 1} left( {x^{t – 1} ,y^{t – 1} ,f^{t – 1} ;y^{t – 1} , – f^{t – 1} } right)}}{{1 – D_{t} left( {x^{t – 1} ,y^{t – 1} ,f^{t – 1} ;y^{t – 1} , – f^{t – 1} } right)}} times frac{{1 – D_{t – 1} left( {x^{t} ,y^{t} ,f^{t} ;y^{t} , – f^{t} } right)}}{{1 – D_{t} left( {x^{t} ,y^{t} ,f^{t} ;y^{t} , – f^{t} } right)}}} \ & ;;;;; times frac{{1 – D_{t} left( {x^{t} ,y^{t} ,f^{t} ;y^{t} , – f^{t} } right)}}{{1 – D_{t – 1} left( {x^{t – 1} ,y^{t – 1} ,f^{t – 1} ;y^{t – 1} , – f^{t – 1} } right)}} \ end{aligned} $$
(12)
Next, it further decompose the MML index into efficiency change (EC) and technology change (TC). The specific formula is shown in Eqs. (13)–(14):$$ TC_{t – 1}^{t} = sqrt {frac{{1 – D_{t – 1} left( {x^{t – 1} ,y^{t – 1} ,f^{t – 1} ;y^{t – 1} , – f^{t – 1} } right)}}{{1 – D_{t} left( {x^{t – 1} ,y^{t – 1} ,f^{t – 1} ;y^{t – 1} , – f^{t – 1} } right)}} times frac{{1 – D_{t – 1} left( {x^{t} ,y^{t} ,f^{t} ;y^{t} , – f^{t} } right)}}{{1 – D_{t} left( {x^{t} ,y^{t} ,f^{t} ;y^{t} , – f^{t} } right)}}} $$
(13)
$$ EC_{t – 1}^{t} = frac{{1 – D_{t} left( {x^{t} ,y^{t} ,f^{t} ;y^{t} , – f^{t} } right)}}{{1 – D_{t – 1} left( {x^{t – 1} ,y^{t – 1} ,f^{t – 1} ;y^{t – 1} , – f^{t – 1} } right)}} $$
(14)
where (left( {x^{t – 1} ,y^{t – 1} ,f^{t – 1} } right)) and (left( {x^{t} ,y^{t} ,f^{t} } right)) represent the input, expected output and unexpected output of t-1 and t, respectively. (TC_{t – 1}^{t}) is the devotion to LHG raise of DMU’s technical progress from (t – 1) to (t). And (EC_{t – 1}^{t}) represents the devotion to LHG raise of DMU’s efficiency improvement from (t – 1) to (t). The higher the value is, the larger the devotion is. The (MML) index is recorded as (MI). The value of (MI) is the LHG. The green total factor productivity index of laying hens breeding under the common frontier and scale frontier are as Eqs. (15)–(16):$$ metaMI_{t – 1}^{t} = sqrt {frac{{1 – D_{{_{t – 1} }}^{m} left( {x^{t} ,y^{t} ,f^{t} ;y^{t} , – f^{t} } right)}}{{1 – D_{{_{t – 1} }}^{m} left( {x^{t – 1} ,y^{t – 1} ,f^{t – 1} ;y^{t – 1} , – f^{t – 1} } right)}} times frac{{1 – D_{{_{t} }}^{m} left( {x^{t} ,y^{t} ,f^{t} ;y^{t} , – f^{t} } right)}}{{1 – D_{{_{t} }}^{m} left( {x^{t – 1} ,y^{t – 1} ,f^{t – 1} ;y^{t – 1} , – f^{t – 1} } right)}}} $$
(15)
$$ groupMI_{t – 1}^{t} = sqrt {frac{{1 – D_{{_{t – 1} }}^{g} left( {x^{t} ,y^{t} ,f^{t} ;y^{t} , – f^{t} } right)}}{{1 – D_{{_{t – 1} }}^{g} left( {x^{t – 1} ,y^{t – 1} ,f^{t – 1} ;y^{t – 1} , – f^{t – 1} } right)}} times frac{{1 – D_{{_{t} }}^{g} left( {x^{t} ,y^{t} ,f^{t} ;y^{t} , – f^{t} } right)}}{{1 – D_{{_{t} }}^{g} left( {x^{t – 1} ,y^{t – 1} ,f^{t – 1} ;y^{t – 1} , – f^{t – 1} } right)}}} $$
(16)
For the DMUs with scale heterogeneity, we can measure the technology gap between the group frontier and the common frontier, which is caused by the specific group structure.Data and variablesBased on the research of the existing literature36, this paper selects five indexes to build the input–output indicator system. Details are as below:

1.

Input variables:

(1)

Quantity of concentrated forage. Mainly includes seeds of crops and their by-products.

(2)

Quantity of grain consumption. Quantity of grain consumed is the quantity of grain consumed by laying hens when they are raised. For example: corn, sorghum, broken rice, wheat, barley, wheat bran, etc.

(3)

Material expenses. The sum of water and fuel power costs, labor costs, and medical epidemic prevention fees. Water and fuel power costs include water, electricity, coal and other fuel power costs; labor costs mean the human management cost of each laying hen from the brood stage to the laying stage; medical and epidemic prevention costs include the cost of disease prevention and control.

2.

Positive output Main product production, which is the egg production per layer.

3.

Negative output Total discharge. According to the calculation method of The Manual of Pollutant Discharge Coefficient, Eq. (17) is used to calculate the COD, TN, and the TP of each layer. Then, according to the calculation method of class GB3838-2002 water quality standard in V, Eq. (18) is used to calculate the total discharge.

$$ POLLUTANTS = FP(FD) times Days $$
(17)
$$ TOTAL , POLLUTANTS = frac{COD}{{40}} + frac{TN}{2} + frac{TP}{{0.4}} $$
(18)
where, (FP(FD)) is the pollution discharge coefficient and the (Days) is the average raising days. Descriptive statistics of input and output indicators are shown in Table 1.Table 1 Descriptive statistics of input and output indicators.Full size tableThe quantity of concentrate, the quantity of food consumed, the cost of labor, the cost of medical treatment all come from “National Agricultural Product Cost and Benefit Data Compilation”. The pollutant discharge coefficient of laying hens is derived from “The Manual of Pollutant Discharge Coefficient”. According to the definition of scale in above two materials, a small scale 300–1000 laying hens, a medium scale 1000–10,000 laying hens, and a large scale greater than 10,000 laying hens are grouped to calculate cost efficiency.From 2004 to 2018, this paper selects 24 major egg-producing provinces (municipalities) in China as samples, after eliminating singular data in the three scales and averaging the missing data, the final small-scale group is left with 7 provinces including Liaoning, Shandong, Henan, Heilongjiang, Jilin, Shanxi, and Shaanxi; the medium-scale group is the remaining 21 provinces of Beijing, Hebei, Jiangsu, Liaoning, Shandong, Tianjin, Zhejiang, Anhui, Henan, Heilongjiang, Jilin, Hubei, Inner Mongolia, Shanxi, Yunnan, Gansu, Ningxia, Shaanxi, Sichuan, Xinjiang, Chongqing; the large-scale group has 18 provinces, including Beijing, Fujian, Guangdong, Henan, Jiangsu, Liaoning, Shandong, Tianjin, Anhui, Henan, Heilongjiang, Hubei, Jilin, Shanxi, Yunnan, Gansu, Sichuan and Chongqing.As is shown in Table 2, after dividing the provinces by region, the eastern region has 10 provinces (municipalities): Liaoning, Shandong, Beijing, Hebei, Jiangsu, Tianjin, Zhejiang, Fujian, Guangdong, Henan. The central region has 7 provinces (autonomous region): Henan, Heilongjiang, Jilin, Shanxi, Anhui, Hubei, Inner Mongolia. The western region has 7 provinces (municipalities): Shaanxi, Gansu, Ningxia, Sichuan, Xinjiang, Chongqing, Yunnan.Table 2 Samples selected from 2004–2018.Full size table More

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We used the IUCN Red List criteria34,35 and methods developed in other global status-assessment efforts36,37 to assess 10,078 reptile species for extinction risk. We additionally include recommended Red List categories for 118 turtle species38, for a total of 10,196 species covered, representing 89% of the 11,341 described reptile species as of August 202039.Data compilationWe compiled assessment data primarily through regional in-person and remote (that is, through phone and email) workshops with species experts (9,536 species) and consultation with IUCN Species Survival Commission Specialist Groups and stand-alone Red List Authorities (442 species, primarily marine turtles, terrestrial and freshwater turtles, iguanas, sea snakes, mainland African chameleons and crocodiles). We conducted 48 workshops between 2004 and 2019 (Supplementary Table 1). Workshop participants provided information to complete the required species assessment fields (geographical distribution, population abundance and trends, habitat and ecological requirements, threats, use and trade, literature) and draw a distribution map. We then applied the Red List criteria34 to this information to assign a Red List category: extinct, extinct in the wild, critically endangered, endangered, vulnerable, near threatened, least concern and data deficient. Threatened species are those categorized as critically endangered, endangered and vulnerable.TaxonomyWe used The Reptile Database39 as a taxonomic standard, diverging only to follow well-justified taxonomic standards from the IUCN Species Survival Commission40. We could not revisit new descriptions for most regions after the end of the original assessment, so the final species list is not fully consistent with any single release of The Reptile Database.Distribution mapsWhere data allowed, we developed distribution maps in Esri shapefile format using the IUCN mapping guidelines41 (1,003 species). These maps are typically broad polygons that encompass all known localities, with provisions made to show obvious discontinuity in areas of unsuitable habitat. Each polygon is coded according to species’ presence (extant, possibly extant or extinct) and origin (native, introduced or reintroduced)41. For some regions covered in workshops (Caucasus, Southeast Asia, much of Africa, Australia and western South America), we collaborated with the Global Assessment of Reptile Distributions (GARD) (http://www.gardinitiative.org/) to provide contributing experts with a baseline species distribution map for review. Although refined maps were returned to the GARD team, not all of these maps have been incorporated into the GARD.Habitat preferencesWhere known, species habitats were coded using the IUCN Habitat Classification Scheme (v.3.1) (https://www.iucnredlist.org/resources/habitat-classification-scheme). Species were assigned to all habitat classes in which they are known to occur. Where possible, habitat suitability (suitable, marginal or unknown) and major importance (yes or no) was recorded. Habitat data were available for 9,484 reptile species.ThreatsAll known historical, current and projected (within 10 years or 3 generations, whichever is the longest; generation time estimated, when not available, from related species for which it is known; generation time recorded for 76.3% of the 186 species categorized as threatened under Red List criteria A and C1, the only criteria using generation length) threats were coded using the IUCN Threats Classification Scheme v.3.2 (https://www.iucnredlist.org/resources/threat-classification-scheme), which follows a previously published study42. Where possible, the scope (whole ( >90%), majority (50–90%), minority (30%), rapid ( >20%), slow but notable ( More

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