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- Alami, Jones, et al.
(författare)
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High-power impulse magnetron sputtering of Ti-Si-C thin films from a Ti3SiC2 compound target
- 2006
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Ingår i: Thin Solid Films. - : Institutionen för fysik, kemi och biologi. - 0040-6090 .- 1879-2731. ; 515:4, s. 1731-1736
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Tidskriftsartikel (refereegranskat)abstract
- We have deposited Ti-Si-C thin films using high-power impulse magnetron sputtering (HIPIMS) from a Ti3SiC2 compound target. The as-deposited films were composite materials with TiC as the main crystalline constituent. X-ray diffraction and photoelectron spectroscopy indicated that they also contained amorphous SiC, and for films deposited on inclined substrates, crystalline Ti5Si3Cx. The film morphology was dense and flat, while films deposited with dc magnetron sputtering under comparable conditions were rough and porous. Due to the high degree of ionization of the sputtered species obtained in HIPIMS, it is possible to control the film composition, in particular the C content, by tuning the substrate inclination angle, the Ar process pressure, and the bias voltage.
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| 2. |
- Högberg, Mona N, et al.
(författare)
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Does ectomycorrhiza have a universal key role in the formation of soil organic matter in boreal forests?
- 2020
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Ingår i: Soil Biology and Biochemistry. - : Elsevier BV. - 0038-0717 .- 1879-3428. ; 140
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Tidskriftsartikel (refereegranskat)abstract
- Forest soil organic matter (SOM) is an important dynamic store of C and N, which releases plant available N and the greenhouse gases CO2 and N2O. Early stages of decomposition of recent plant litters are better known than the formation of older and more stable soil pools of N and C, in which case classic theory stated that selective preservation of more resistant plant compounds was important. Recent insights heighten that all plant matter becomes degraded and that older SOM consists of compounds proximally of microbial origin. It has been proposed that in boreal forests, ectomycorrhizal fungi (ECMF), symbionts of trees, are actively involved in the formation of slowly-degrading SOM.We characterized SOM in the mor-layer along a local soil N supply gradient in a boreal forest, a gradient with large variations in chemical and biological characteristics, notably a decline in the biomass of ECMF in response to increasing soil N supply.We found contrasting and regular patterns in carbohydrates, lignin, aromatic carbon, and in N-containing compounds estimated by solid-state C-13 and N-15 nuclear magnetic resonance (NMR) spectroscopy. These occurred along with parallel changes in the natural abundances of the stable isotopes C-13 and N-15 in both bulk SOM and extracted fractions of the SOM. The modelled "bomb-C-14" age of the lower layers studied ranged between 15 years at the N-poor end, to 70 years at the N-rich end of the gradient. On average half the increase in delta C-13 with soil depth (and hence age) of the mor-layer can be attributed to soil processes and the other half to changes in the isotopic composition of the plant C inputs. There was a decrease in carbohydrates (O-alkyl C) with increasing depth. This supports the classical hypothesis of declining availability of easily decomposable substrates to microorganisms with increasing soil depth and age. The observed increase in delta C-13 with depth, however, speaks against the idea of selective preservation of more resistant plant compounds like lignin. Furthermore, from the N-poor to the N-rich end the difference between N-15 in plant litter N and N in the deeper part of the mor-layer, the H-layer, decreased in parallel with a decline in ECMF.The latter provides evidence that the role of ECMF as major sink for N diminishes, and hence their potential role in SOM stabilization, when the soil N supply increases. At the N-rich end, where bacteria dominate over fungi, other agents than ECMF must be involved in the large build-up of the H-layer with the slowest turnover rate found along the gradient.
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| 5. |
- Högberg, Ulf, 1949-, et al.
(författare)
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Infant abuse diagnosis associated with abusive head trauma criteria : incidence increase due to overdiagnosis?
- 2018
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Ingår i: European Journal of Public Health. - : OXFORD UNIV PRESS. - 1101-1262 .- 1464-360X. ; 28:4, s. 641-646
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Tidskriftsartikel (refereegranskat)abstract
- Background: The hypothesis of this study is that the diagnosis of infant abuse is associated with criteria for shaken baby syndrome (SBS)/abusive head trauma (AHT), and that that changes in incidence of abuse diagnosis in infants may be due to increased awareness of SBS/AHT criteria.Methods: This was a population-based register study. Setting: Register study using the Swedish Patient Register, Medical Birth Register, and Cause of Death Register. The diagnosis of infant abuse was based on the International Classification of Diseases, 9th and 10th revision. Participants: All children born in Sweden during 1987-2014 with a follow-up until 1 year of age (N = 2 868 933). SBS/AHT criteria: subdural haemorrhage, cerebral contusion, skull fracture, convulsions, retinal haemorrhage, fractures rib and long bones. Outcomes: Incidence, rate ratios, aetiologic fractions and Probit regression analysis.Results: Diagnosis of infant abuse was strongly associated with SBS/AHT criteria, but not risk exposure as region, foreign-born mother, being born preterm, multiple birth and small for gestational age. The incidence of infant abuse has increased tenfold in Sweden since the 1990s and has doubled since 2008, from 12.0 per 100 000 infants during 1997-2007 to 26.5/100 000 during 2008-2014, with pronounced regional disparities.Conclusions: Diagnosis of infant abuse is related to SBS/AHT criteria. The increase in incidence coincides with increased medical preparedness to make a diagnosis of SBS/AHT. Hidden statistics and a real increase in abuse are less plausible. Whether the increase is due to overdiagnosis cannot be answered with certainty, but the possibility raises ethical and medico-legal concerns.
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| 6. |
- Högberg, Ulf, 1949-, et al.
(författare)
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Medical diagnoses among infants at entry in out-of-home care : A Swedish population-register study
- 2019
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Ingår i: Health Science Reports. - : Wiley. - 2398-8835. ; 2:8
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Tidskriftsartikel (refereegranskat)abstract
- Background and aims: Identification of child abuse involves a medical investigation and assessment of problems related to social environment and upbringing and might necessitate out-of-home care. The objective of this study was to analyse infants placed in out-of-home care in Sweden by incidence, medical diagnoses, and perinatal factors.Methods: This was a population-based register study of infants born in Sweden 1997 to 2014. Data were retrieved from registers at the Swedish National Board of Health and Welfare and Statistics Sweden. Outcome measures were out-of-home care categories: (a) "Problems Related to Social Environment/Upbringing", (b) "Abuse diagnoses without SDH (subdural haemorrhage), RH (retinal haemorrhage), rib fracture, or long bone fracture", and (c) "SDH, RH, rib fracture, or long bone fracture." As a reference population, we randomly selected infants without medical diagnoses born the same year.Results: Overall incidence of out-of-home care was 402 per 100 000. For subcategories (a), (b), and (c), the incidences were 14.8 (n = 273), 3.77 (n = 70), and 9.83 (n = 182) per 100 000, respectively. During the study period, the first remained unchanged; the latter two have been increasing. Compared with other reasons for out-of-home care, children in category (c), "SDH, RH, rib fracture, or long bone fracture", had increased odds of being boys (adjusted odds ratio [aOR] 1.60; 95% confidence interval [CI], 1.08-2.38) and decreased odds of having a mother being single (aOR 0.49; 95% CI, 0.32-0.75) and a smoker (aOR 0.60; 95% CI, 0.37-0.96). Compared with the reference population, children in this category were more often twin born (7.7% versus 2.8%), preterm (18.5% versus 5.5%), and small-for-gestational age (5.2% versus 2.1%).Conclusion: SDH, RH, rib fracture, or long bone fracture constitute a minor part of medical diagnoses for infants entered in out-of-home care, but have been increasing, both in numbers and proportion. Overdiagnosis of abuse might be a possible reason but cannot be ascertained by this study design.
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| 7. |
- Högberg, Ulf, 1949-, et al.
(författare)
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Metabolic bone disease risk factors strongly contributing to long bone and rib fractures during early infancy : A population register study
- 2018
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Ingår i: PLOS ONE. - : PUBLIC LIBRARY SCIENCE. - 1932-6203. ; 13:12
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to assess the incidence of fractures in infancy, overall and by type of fracture, its association with accidents, metabolic bone disease risk factors, and abuse diagnosis.Methods: The design was a population-based register study in Sweden. Participants: Children born 1997-2014,0-1 years of age diagnosed with fracture-diagnosis according to International Classification of Diseases (ICD10) were retrieved from the National Patient Register and linked to the Swedish Medical Birth Register and the Death Cause Register. Main outcome measures were fractures of the skull, long bone, clavicle and ribs, categorized by age (younger or older than 6 months), and accident or not.Findings: The incidence of fractures during infancy was 251 per 100 000 infants (n = 4663). Major fracture localisations were long bone (44.9%), skull (31.7%), and clavicle (18.6%), while rib fractures were few (1.4%). Fall accidents were reported among 71-4%. One-third occurred during the first 6 months. Metabolic bone disease risk factors, such as maternal obesity, pre-term birth, vitamin D deficiency, rickets, and calcium metabolic disturbances, had increased odds of fractures of long bones and ribs in early infancy (0-6 months): birth 32-36 weeks and long bone fracture [AOR 2.13 (95%CI 1.67-2.93)] and rib fracture [AOR 4.24 (95%Cl 1.40-12.8)]. Diagnosis of vitamin D deficiency/rickets/disorders of calcium metabolism had increased odds of long bone fracture [AOR 49.5 (95%CI 18.3-134)] and rib fracture [AOR 617 (95%CI 162-2506)]. Fractures without a reported accident had higher odds of metabolic risk factors than those with reported accidents. Abuse diagnosis was registered in 105 infants, with overrepresentation of preterm births, multiple births and small-for-gestational age.Interpretation: Metabolic bone disease risk factors are strongly associated with fractures of long bone and ribs in early infancy. Fracture cases with abuse diagnosis had a metabolic bone risk factor profile.
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| 8. |
- Högberg, Ulf, et al.
(författare)
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Parents' experiences of seeking health care and encountering allegations of shaken baby syndrome : A qualitative study.
- 2020
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Ingår i: PLOS ONE. - : Public Library of Science (PLOS). - 1932-6203. ; 15:2
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To explore parents' experiences of seeking health care for their children and instead being accused by healthcare professionals of Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT), being reported to Social Services, undergoing judiciary processing, and the impact of these events on family (dis)integration.METHODS: Design: A qualitative study based on qualitative content analysis. Participants: Twelve parents in Sweden, mothers and fathers, seeking health care for their infants, encountering allegations of SBS/AHT, losing custody of their infants, and being subjected to a judiciary process, and finally regaining custody of their children. Data collection: In-depth interviews.RESULTS: An overarching theme 'Fighting for protection of their child after being trapped by doctors' and four sub-themes were developed to reflect the parents' experiences, reactions and interpretations. The first sub-theme, 'Being accused of injuring the child', illuminated the shock experienced when seeking care and instead being accused of being a perpetrator. The second, 'Chaos and powerlessness', refers to the emotions experienced when losing custody of the child and being caught in the enforcement of legislation by the authorities. The third, ´The unified fight against the doctors' verdict´, illustrates the parents' fight for innocence, their worry for the lost child, and their support and resistance. The fourth, 'The wounded posttraumatic growth', describes the emotions, grief, panic, anxiety, and challenges in reuniting the family, but also the parents' reflections on personal growth. Unanimously, they had experienced the authorities' inability to reconsider, and expressed a deep mistrust of paediatric care.CONCLUSIONS: Being wrongly accused of child abuse and alleged SBS/AHT evoked emotions of intense stress, but parents endured because of a successful fight to regain custody of their child. However, the trauma had a long-term impact on their lives with residual posttraumatic stress symptoms and mistrust towards healthcare services and the authorities. The results provide important inferences for restoring system failures within child protection services.
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| 9. |
- Högberg, Ulf, 1949-, et al.
(författare)
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Preventable harm and child maltreatment diagnosis (eLetter)
- 2019
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Ingår i: The BMJ. - : BMJ Publishing Group Ltd. - 1756-1833. ; 366
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To systematically quantify the prevalence, severity, and nature of preventable patient harm across a range of medical settings globally.Design: Systematic review and meta-analysis.Data sources: Medline, PubMed, PsycINFO, Cinahl and Embase, WHOLIS, Google Scholar, and SIGLE from January 2000 to January 2019. The reference lists of eligible studies and other relevant systematic reviews were also searched.Review methods: Observational studies reporting preventable patient harm in medical care. The core outcomes were the prevalence, severity, and types of preventable patient harm reported as percentages and their 95% confidence intervals. Data extraction and critical appraisal were undertaken by two reviewers working independently. Random effects meta-analysis was employed followed by univariable and multivariable meta regression. Heterogeneity was quantified by using the I2 statistic, and publication bias was evaluated.Results: Of the 7313 records identified, 70 studies involving 337 025 patients were included in the meta-analysis. The pooled prevalence for preventable patient harm was 6% (95% confidence interval 5% to 7%). A pooled proportion of 12% (9% to 15%) of preventable patient harm was severe or led to death. Incidents related to drugs (25%, 95% confidence interval 16% to 34%) and other treatments (24%, 21% to 30%) accounted for the largest proportion of preventable patient harm. Compared with general hospitals (where most evidence originated), preventable patient harm was more prevalent in advanced specialties (intensive care or surgery; regression coefficient b=0.07, 95% confidence interval 0.04 to 0.10).Conclusions: Around one in 20 patients are exposed to preventable harm in medical care. Although a focus on preventable patient harm has been encouraged by the international patient safety policy agenda, there are limited quality improvement practices specifically targeting incidents of preventable patient harm rather than overall patient harm (preventable and non-preventable). Developing and implementing evidence-based mitigation strategies specifically targeting preventable patient harm could lead to major service quality improvements in medical care which could also be more cost effective.
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