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Child maltreatment through physical abuse, sexual abuse, emotional abuse, neglect, and exposure to domestic violence, causes substantial adverse health, educational and behavioural consequences through the lifespan. The generation of reliable data on the prevalence and characteristics of child maltreatment in nationwide populations is essential to plan and evaluate public health interventions to reduce maltreatment. Measurement of child maltreatment must overcome numerous methodological challenges. Little is known to date about the extent, nature and methodological quality of these national studies. This study aimed to systematically review the most comprehensive national studies of the prevalence of child maltreatment, and critically appraise their methodologies to help inform the design of future studies. Guided by PRISMA and following a published protocol, we searched 22 databases from inception to 31 May 2019 to identify nationwide studies of the prevalence of either all five or at least four forms of child maltreatment. We conducted a formal quality assessment and critical analysis of study design. This review identified 30 national prevalence studies of all five or at least four forms of child maltreatment, in 22 countries. While sound approaches are available for different settings, methodologies varied widely in nature and robustness. Some instruments are more reliable and obtain more detailed and useful information about the characteristics of the maltreatment, including its nature, frequency, and the relationship between the child and the person who inflicted the maltreatment. Almost all studies had limitations, especially in the level of detail captured about maltreatment, and the adequacy of constructs of maltreatment types. Countries must invest in rigorous national studies of the prevalence of child maltreatment. Studies should use a sound instrument containing appropriate maltreatment constructs, and obtain nuanced information about its nature.

The physical climate formulation and simulation characteristics of two new global coupled carbon–climate Earth System Models, ESM2M and ESM2G, are described. These models demonstrate similar climate fidelity as the Geophysical Fluid Dynamics Laboratory’s previous Climate Model version 2.1 (CM2.1) while incorporating explicit and consistent carbon dynamics. The two models differ exclusively in the physical ocean component; ESM2M uses Modular Ocean Model version 4p1 with vertical pressure layers while ESM2G uses Generalized Ocean Layer Dynamics with a bulk mixed layer and interior isopycnal layers. Differences in the ocean mean state include the thermocline depth being relatively deep in ESM2M and relatively shallow in ESM2G compared to observations. The crucial role of ocean dynamics on climate variability is highlighted in El Niño–Southern Oscillation being overly strong in ESM2M and overly weak in ESM2G relative to observations. Thus, while ESM2G might better represent climate changes relating to total heat content variability given its lack of long-term drift, gyre circulation, and ventilation in the North Pacific, tropical Atlantic, and Indian Oceans, and depth structure in the overturning and abyssal flows, ESM2M might better represent climate changes relating to surface circulation given its superior surface temperature, salinity, and height patterns, tropical Pacific circulation and variability, and Southern Ocean dynamics. The overall assessment is that neither model is fundamentally superior to the other, and that both models achieve sufficient fidelity to allow meaningful climate and earth system modeling applications. This affords the ability to assess the role of ocean configuration on earth system interactions in the context of two state-of-the-art coupled carbon–climate models.

The authors describe carbon system formulation and simulation characteristics of two new global coupled carbon–climate Earth System Models (ESM), ESM2M and ESM2G. These models demonstrate good climate fidelity as described in part I of this study while incorporating explicit and consistent carbon dynamics. The two models differ almost exclusively in the physical ocean component; ESM2M uses the Modular Ocean Model version 4.1 with vertical pressure layers, whereas ESM2G uses generalized ocean layer dynamics with a bulk mixed layer and interior isopycnal layers. On land, both ESMs include a revised land model to simulate competitive vegetation distributions and functioning, including carbon cycling among vegetation, soil, and atmosphere. In the ocean, both models include new biogeochemical algorithms including phytoplankton functional group dynamics with flexible stoichiometry. Preindustrial simulations are spun up to give stable, realistic carbon cycle means and variability. Significant differences in simulation characteristics of these two models are described. Because of differences in oceanic ventilation rates, ESM2M has a stronger biological carbon pump but weaker northward implied atmospheric CO₂ transport than ESM2G. The major advantages of ESM2G over ESM2M are improved representation of surface chlorophyll in the Atlantic and Indian Oceans and thermocline nutrients and oxygen in the North Pacific. Improved tree mortality parameters in ESM2G produced more realistic carbon accumulation in vegetation pools. The major advantages of ESM2M over ESM2G are reduced nutrient and oxygen biases in the southern and tropical oceans.

Background Considerable emphasis is presently being placed on usage of generic medicines by governments focussed on the potential economic benefits associated with their use. Concurrently, there is increasing discussion in the lay media of perceived doubts regarding the quality and equivalence of generic medicines. The objective of this paper is to report the outcomes of a systematic search for peer-reviewed, published studies that focus on physician, pharmacist and patient/consumer perspectives of generic medicines. Methods Literature published between January 2003 and November 2014, which is indexed in PubMed and Scopus, on the topic of opinions of physicians, pharmacists and patients with respect to generic medicines was searched, and articles within the scope of this review were appraised. Search keywords used included perception, opinion, attitude and view, along with keywords specific to each cohort. Results Following review of titles and abstracts to identify publications relevant to the scope, 16 papers on physician opinions, 11 papers on pharmacist opinions and 31 papers on patient/consumer opinions were included in this review. Quantitative studies ( n  = 37) were the most common approach adopted by researchers, generally in the form of self-administered questionnaires/surveys. Qualitative methodologies ( n  = 15) were also reported, albeit in fewer cases. In all three cohorts, opinions of generic medicines have improved but some mistrust remains, most particularly in the patient group where there appears to be a strongly held belief that less expensive equals lower quality. Acceptance of generics appears to be higher in consumers with higher levels of education while patients from lower socioeconomic demographic groups, hence generally having lower levels of education, tend to have greater mistrust of generics. Conclusions A key factor in improving confidence in generic products is the provision of information and education, particularly in the areas of equivalency, regulation and dispelling myths about generic medicines (such as the belief that they are counterfeits). Further, as patient trust in their physician often overrules their personal mistrust of generic medicines, enhancing the opinions of physicians regarding generics may have particular importance in strategies to promote usage and acceptance of generic medicines in the future.

We describe the baseline coupled model configuration and simulation characteristics of GFDL's Earth System Model Version 4.1 (ESM4.1), which builds on component and coupled model developments at GFDL over 2013–2018 for coupled carbon‐chemistry‐climate simulation contributing to the sixth phase of the Coupled Model Intercomparison Project. In contrast with GFDL's CM4.0 development effort that focuses on ocean resolution for physical climate, ESM4.1 focuses on comprehensiveness of Earth system interactions. ESM4.1 features doubled horizontal resolution of both atmosphere (2° to 1°) and ocean (1° to 0.5°) relative to GFDL's previous‐generation coupled ESM2‐carbon and CM3‐chemistry models. ESM4.1 brings together key representational advances in CM4.0 dynamics and physics along with those in aerosols and their precursor emissions, land ecosystem vegetation and canopy competition, and multiday fire; ocean ecological and biogeochemical interactions, comprehensive land‐atmosphere‐ocean cycling of CO2, dust and iron, and interactive ocean‐atmosphere nitrogen cycling are described in detail across this volume of JAMES and presented here in terms of the overall coupling and resulting fidelity. ESM4.1 provides much improved fidelity in CO2 and chemistry over ESM2 and CM3, captures most of CM4.0's baseline simulations characteristics, and notably improves on CM4.0 in (1) Southern Ocean mode and intermediate water ventilation, (2) Southern Ocean aerosols, and (3) reduced spurious ocean heat uptake. ESM4.1 has reduced transient and equilibrium climate sensitivity compared to CM4.0. Fidelity concerns include (1) moderate degradation in sea surface temperature biases, (2) degradation in aerosols in some regions, and (3) strong centennial scale climate modulation by Southern Ocean convection. Plain Language Summary GFDL has developed a coupled chemistry‐carbon‐climate Earth System Model (ESM4.1) as part of its fourth‐generation coupled model development activities with model results contributed publicly to the sixth phase of the Coupled Model Intercomparison Project. With similar computational expense as GFDL's first coupled model CM4.0, ESM4.1 focuses on chemistry and ecosystem comprehensiveness rather than the ocean resolution‐focus of CM4.0. With fidelity near to that of CM4.0, ESM4.1 features much improved representation of climate mean patterns and variability from previous GFDL ESMs as well as comprehensive couplings for chemistry, carbon, and dust. Key Points A new coupled chemistry‐carbon‐climate Earth system model has been developed at the Geophysical Fluid Dynamics Laboratory This model unifies component advances in chemistry, carbon, and ecosystem comprehensiveness within a single coupled climate framework This model features much improved climate mean patterns and variability from previous chemistry and carbon coupled models

Several social theories have been proposed to explain the uneven distribution of vegetation in urban residential areas: population density, social stratification, luxury effect, and ecology of prestige. We evaluate these theories using a combination of demographic and socio-economic predictors of vegetative cover on all residential lands in New York City. We use diverse data sources including the City’s property database, time-series demographic and socio-economic data from the US Census, and land cover data from the University of Vermont’s Spatial Analysis Lab (SAL). These data are analyzed using a multi-model inferential, spatial econometrics approach. We also examine the distribution of vegetation within distinct market categories using Claritas’ Potential Rating Index for Zipcode Markets (PRIZM™) database. These categories can be disaggregated, corresponding to the four social theories. We compare the econometric and categorical results for validation. Models associated with ecology of prestige theory are more effective for predicting the distribution of vegetation. This suggests that private, residential patterns of vegetation, reflecting the consumption of environmentally relevant goods and services, are associated with different lifestyles and lifestages. Further, our spatial and temporal analyses suggest that there are significant spatial and temporal dependencies that have theoretical and methodological implications for understanding urban ecological systems. These findings may have policy implications. Decision makers may need to consider how to most effectively reach different social groups in terms of messages and messengers in order to advance land management practices and achieve urban sustainability.

Fatigue is a difficult multi-scale modelling problem nucleating from localised plasticity at the scale of dislocations and microstructure with significant engineering safety implications. Cold dwell fatigue is a phenomenon in titanium where stress holds at moderate temperatures lead to substantial reductions in cyclic life, and has been implicated in service failures. Using discrete dislocation plasticity modelling complemented by transmission electron microscopy, we successfully predict lifetimes for ‘worst case’ microstructures representative of jet engine spin tests. Fatigue loading above a threshold stress is found to produce slip in soft grains, leading to strong dislocation pile-ups at boundaries with hard grains. Pile-up stresses generated are high enough to nucleate hard grain basal dislocations, as observed experimentally. Reduction of applied cyclic load alongside a temperature excursion during the cycle lead to much lower densities of prism dislocations in soft grains and, sometimes, the elimination of basal dislocations in hard grains altogether. Material fatigue is the most common source behind failures of mechanical structures. Here the authors combine transmission electron microscopy, high-resolution electron backscatter diffraction and discrete dislocation plasticity modeling to study the underlying mechanism of dwell fatigue in titanium alloys.

Background E-learning is recognised as a useful educational tool and is becoming more common in undergraduate medical education. This review aims to examine the scope and impact of e-learning interventions on medical student learning in clinical medicine, in order to aid medical educators when implementing e-learning strategies in programme curricula. Methods A systematic review compliant with PRISMA guidelines that appraises study design, setting and population, context and type of evaluations. Specific search terms were used to locate articles across nine databases: MEDLINE/PubMed, ScienceDirect, EMBASE, Cochrane Library, ERIC, Academic Search Complete, CINAHL, Scopus and Google Scholar. Only studies evaluating e-learning interventions in undergraduate clinical medical education between January 1990 and August 2021 were selected. Of the 4,829 papers identified by the search, 42 studies met the inclusion criteria. Results The 42 studies included varied in scope, cognitive domain, subject matter, design, quality and evaluation. The most popular approaches involved multimedia platforms (33%) and case-based approaches (26%), were interactive (83%), asynchronous (71%) and accessible from home (83%). Twelve studies (29%) evaluated usability, all of which reported positive feedback. Competence in use of technology, high motivation and an open attitude were key characteristics of successful students and preceptors. Conclusions Medical education is evolving consistently to accommodate rapid changes in therapies and procedures. In today’s technologically adept world, e-learning is an effective and convenient pedagogical approach for the teaching of undergraduate clinical medicine.

Ocean ecosystems are increasingly stressed by human-induced changes of their physical, chemical and biological environment. Among these changes, warming, acidification, deoxygenation and changes in primary productivity by marine phytoplankton can be considered as four of the major stressors of open ocean ecosystems. Due to rising atmospheric CO2 in the coming decades, these changes will be amplified. Here, we use the most recent simulations performed in the framework of the Coupled Model Intercomparison Project 5 to assess how these stressors may evolve over the course of the 21st century. The 10 Earth system models used here project similar trends in ocean warming, acidification, deoxygenation and reduced primary productivity for each of the IPCC's representative concentration pathways (RCPs) over the 21st century. For the \"business-as-usual\" scenario RCP8.5, the model-mean changes in the 2090s (compared to the 1990s) for sea surface temperature, sea surface pH, global O2 content and integrated primary productivity amount to +2.73 (±0.72) °C, −0.33 (±0.003) pH unit, −3.45 (±0.44)% and −8.6 (±7.9)%, respectively. For the high mitigation scenario RCP2.6, corresponding changes are +0.71 (±0.45) °C, −0.07 (±0.001) pH unit, −1.81 (±0.31)% and −2.0 (±4.1)%, respectively, illustrating the effectiveness of extreme mitigation strategies. Although these stressors operate globally, they display distinct regional patterns and thus do not change coincidentally. Large decreases in O2 and in pH are simulated in global ocean intermediate and mode waters, whereas large reductions in primary production are simulated in the tropics and in the North Atlantic. Although temperature and pH projections are robust across models, the same does not hold for projections of subsurface O2 concentrations in the tropics and global and regional changes in net primary productivity. These high uncertainties in projections of primary productivity and subsurface oxygen prompt us to continue inter-model comparisons to understand these model differences, while calling for caution when using the CMIP5 models to force regional impact models.

Thermal fatigue is a common failure mode in electronic solder joints, yet the role of microstructure is incompletely understood. Here, we quantify the evolution of microstructure and damage in Sn-3Ag-0.5Cu joints throughout a ball grid array (BGA) package using EBSD mapping of localised subgrains, recrystallisation and heavily coarsened Ag 3 Sn. We then interpret the results with a multi-scale modelling approach that links from a continuum model at the package/board scale through to a crystal plasticity finite element model at the microstructure scale. We measure and explain the dependence of damage evolution on (i) the β-Sn crystal orientation(s) in single and multigrain joints, and (ii) the coefficient of thermal expansion (CTE) mismatch between tin grains in cyclic twinned multigrain joints. We further explore the relative importance of the solder microstructure versus the joint location in the array. The results provide a basis for designing optimum solder joint microstructures for thermal fatigue resistance. Thermal fatigue frequently leads to failure in electronic solder joints. Here, the authors measure and quantitatively explain how microstructure affects thermal fatigue in a ball grid array package and propose optimum microstructures for thermal fatigue resistance.