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Aims: Large population-based studies have demonstrated increased prevalence of rotator cuff disease amongst diabetics. Recent studies have suggested comparable clinical outcomes from rotator cuff repair despite suggestions of increased complication rates amongst diabetics. However, there is a relative paucity of studies considering the effect of diabetes upon complication rate. We aim to report and quantify the effect of diabetes on complication rates following arthroscopic rotator cuff repair. Materials and methods: A retrospective review of a consecutive series of patients undergoing arthroscopic rotator cuff repair between January 2011 and December 2014 was performed. Diabetic status and complication data defined as infection, frozen shoulder, re-tear or re-operation were collected and interrogated. Results: A total of 462 patients were included at median follow-up of 5.6 years. Diabetics were significantly more likely to experience frozen shoulder (15.8% vs. 4.4%, p = 0.001), re-tear (26.3% vs. 15.6%, p = 0.042) or at least one complication following surgery (35.1% vs. 22.7%, p = 0.041) compared to non-diabetics. These equated to odds ratios of 4.03, 1.94 and 1.84, respectively. Conclusions: Diabetic patients are almost twice as likely to experience complications following arthroscopic rotator cuff repair, including double the risk of repair failure and more than four times the risk of frozen shoulder. [ABSTRACT FROM AUTHOR]

Radioactive 141 Ce in ionic (I-Ce), nano (N-Ce, 11 ± 9 nm mean primary particle size ± standard deviation) and micron-sized (M-Ce, 530 ± 440 µm) forms associated with natural and artificial diets in natural river water and synthetic freshwater were used to measure the real-time biokinetics of dietary 141 Ce assimilation in a freshwater food chain. The model food chain consisted of microalgae (Raphidocelis subcapitata), snails (Potamopyrgus antipodarum) and prawns (Macrobrachium australiense). Pulse-chase experiments showed that 91-100 % of all forms of cerium associated with all diets and water types were eliminated from the digestive system of the snail and prawn within 24 h, with no detectable cerium assimilation. The prawn and snail median elimination times (ET50) and elimination rates (Ke) for all cerium forms ranged from 0.05 to 1.7 d, and 30 to >100 % per d, respectively. The pulse-chase results were supported by the autoradiographic evidence for N-Ce and M-Ce that confirmed no detectable assimilation and translocation within the tissue of the prawn over time. In contrast, the more soluble I-Ce was found to be associated in low quantities with the hepatopancreas in the prawn confirming that the lack of dissolution by N-Ce and M-Ce in the digestive environment of these organisms makes these forms less bioavailable. In addition, hetero-agglomeration of N-Ce and M-Ce resulted in particles that did not dissociate in digestive fluids and were too large to be assimilated thereby making them non-bioavailable. Based on the results from this study and from the literature review, the risk of N-Ce biomagnification and chronic dietary toxicity in freshwater ecosystems is no greater than the risk associated with M-Ce or I-Ce., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Lisa Golding reports financial support was provided by Australian Institute of Nuclear Science and Engineering. Co-authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

Background: The Discovery Elbow System (DES) utilizes a polyethylene bearing within the ulnar component. An exchange bearing requires preoperative freezing and implantation within 2 minutes of freezer removal to allow insertion. We report our outcomes and experience using this technique., Methods: This was an analysis of a two-surgeon consecutive series of DES bearing exchange. Inclusion criteria included patients in which exchange was attempted with a minimum 1-year follow-up. Clinical and radiographic review was performed 1, 2, 3, 5, 8 and 10 years postoperative. Outcome measures included range of movement, Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPS), complications and requirement for revision surgery., Results: Eleven DESs in 10 patients were included. Indications were bearing wear encountered during humeral component revision (n=5); bearing failure (n=4); and infection treated with debridement, antibiotics and implant retention (DAIR; n=2). Bearing exchange was conducted on the first attempt in 10 cases. One case required a second attempt. One patient developed infection postoperatively managed with two-stage revision. Mean follow-up of the bearing exchange DES was 3 years. No further surgery was required, with no infection recurrence in DAIR cases. Mean elbow flexion-extension and pronosupination arcs were 107° (±22°) and 140° (±26°). Mean OES was 36/48 (±12) and MEPS was 83/100 (±19)., Conclusions: Our results support the use of DES bearing exchange in cases of bearing wear with well-fixed stems or acute infection. This series provides surgeons managing DES arthroplasty with management principles, successful and reproducible surgical techniques and expected clinical outcomes in performing DES polyethylene bearing exchange. Level of evidence: IV.

Naturally occurring radioactive materials (NORMs) can be found in decommissioned oil and gas infrastructure (e.g. pipelines), including scales. The effects of NORM contaminants from offshore infrastructure on benthic macroorganisms remain poorly understood. To test the potential ecological effects of NORM-contaminated scale, we exposed a marine amphipod, a clam and a polychaete to marine sediments spiked with low level concentrations of barium sulfate scale retrieved from a decommissioned subsea pipe. Only amphipods were included in further analysis due to treatment mortalities of the clam and polychaete. Barium (Ba) and copper (Cu) were elevated in the seawater overlying the spiked sediments, although no sediment metals exceeded guidelines. 210 Po was the only NORM detected in the overlying waters while both 210 Po and 226 Ra were significantly elevated in the scale-contaminated sediments when compared with the control sediments. The whole-body burden of Ba and 226 Ra were significantly higher in the scale-exposed amphipods. Using experiment- and scale-specific parameters in biota dose assessments suggested potential dose rates may elicit individual and population level effects. Future work is needed to assess the biological impacts and effects of NORM scale at elevated levels above background concentrations and the accumulation of NORM-associated contaminants by marine organisms., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Tom Cresswell reports financial support was provided by Undisclosed industry partner., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Agronomic biofortification of crops is a promising approach that can improve the nutritional value of staple foods by alleviating dietary micronutrient deficiencies. Iodine deficiency is prevalent in many countries, including Australia, but it is not clear what foliar application strategies will be effective for iodine fortification of grain. This study hypothesised that combining adjuvants with iodine in foliar sprays would improve iodine penetration in wheat, leading to more efficient biofortification of grains. The glasshouse experiment included a total of nine treatments, including three reference controls: 1) Water; 2) potassium iodate (KIO 3 ) and 3) potassium chloride (KCl); and a series of six different non-ionic surfactant or oil-based adjuvants: 4) KIO 3 + BS1000; 5) KIO 3 + Pulse ® Penetrant; 6) KIO 3 + Uptake ® ; 7) KIO 3 + Hot-Up ® ; 8) KIO 3 + Hasten ® and 9) KIO 3 + Synerterol ® Horti Oil. Wheat was treated at heading, and again during the early milk growth stage. Adding the organosilicon-based adjuvant (Pulse ® ) to the spray formulation resulted in a significant increase in grain loading of iodine to 1269 µg/kg compared to the non-adjuvant KIO 3 control at 231µg/kg, and the water and KCl controls (both 51µg/kg). The second most effective adjuvant was Synerterol ® Horti Oil, which increased grain iodine significantly to 450µg/kg. The Uptake ® , BS1000, Hasten ® , and Hot-Up ® adjuvants did not affect grain iodine concentrations relative to the KIO 3 control. Importantly, iodine application and the subsequent increase in grain iodine had no significant effects on biomass production and grain yield relative to the controls. These results indicate that adjuvants can play an important role in agronomic biofortification practices, and organosilicon-based products have a great potential to enhance foliar penetration resulting in a higher translocation rate of foliar-applied iodine to grains, which is required to increase the iodine density of staple grains effectively., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Magor, Wilson, Wong, Cresswell, Sánchez-Palacios, Bell and Penrose.)

This modelling study uses the ERICA Tool and Bateman's equation to derive sediment threshold values for radiation protection of the marine environment relevant to NORM-contaminated products (radium-contaminated scales, 210 Pb films and 210 Po films) found in subsea oil and gas infrastructure. Threshold values are calculated as the activity concentration of the NORM-contaminated products' head of chain radionuclide (i.e., 226 Ra + 228 Ra, 210 Pb, or 210 Po) that will increase radiation dose rates in sediments by 10 μGy/h to the most exposed organism at a given release time. The minimum threshold value (corresponding to peak radiation dose rates from the ingrowth of progeny) were for radium-contaminated scales, 0.009 Bq/g of 226 Ra, 0.029 Bq/g of 228 Ra (in the absence of 226 Ra) or 0.14 Bq/g of 228 Ra (in the presence of 226 Ra), followed by 0.015 Bq/g for 210 Pb films, and 1.6 Bq/g for 210 Po films. These may be used as default threshold values. Added activity concentrations of the NORM-contaminated products to marine sediments below these threshold values implies a low radiological risk to organisms while exceedances imply that further investigation is necessary. Using contaminated product specific parameterisations, such as K d values derived for Ra from a BaSO 4 matrix in seawater, could greatly affect threshold values. Strong consideration should be given to deriving such data as part of specific radiological risk assessments for these products., Competing Interests: Declaration of competing interest NERA, an independent scientific advisory board, and industry partners provided insights to the authors from their respective experience and provided comments to a report from which this manuscript was drafted. The NDRI project was funded by eight industry partners including Shell Australia, Esso Australia, Chevron Australia, BHP Petroleum, Woodside Energy, Santos Limited, ConocoPhillips Pipeline Australia, and Vermilion Oil and Gas Australia. This funding source has not influenced any of the authors objectivity. All views expressed within the paper are those of the authors., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aims: Multiple studies have shown excellent clinical results in primary rotator cuff repairs; however, not much evidence is available in the literature on the outcomes of arthroscopic revision rotator cuff repairs. The purpose of this study was to report a cohort of patients who underwent revision arthroscopic rotator cuff repair and identify factors that may influence its outcomes., Methods: We examined a cohort of 62 patients which underwent revision arthroscopic rotator cuff repair in a single UK institution with a minimum of 24 months follow-up. Active shoulder movements including forward flexion, abduction and external rotation were evaluated, as well as Oxford Shoulder Score (OSS). Further subgroup analysis was performed looking of the effects of age, size of tear, obesity and diabetes mellitus had on clinical outcomes., Results: 59 patients were available for final review. 39 male and 23 were female. The mean age was 64 years. Overall, significant improvements were seen in terms of OSS ( p  < 0.05), active forward flexion ( p  < 0.05), active abduction ( p  < 0.05) and active external rotation ( p  < 0.05). Our study showed that a significant proportion of patients undergoing arthroscopic revision rotator cuff repair achieve good outcomes. Repairing small- and medium-size tears was successful, diabetics had no post-operative improvements, obese patients achieved significant improvement in range of movement and age was not a predictor of surgical success., Conclusion: Overall, arthroscopic revision surgery is a successful option; however, appropriate patient selection and counselling is paramount., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Indian Orthopaedics Association 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Scale residues can accumulate on the interior surfaces of subsea petroleum pipes and may incorporate naturally occurring radioactive materials (NORM). The persistent nature of 'NORM scale' may result in a radiological dose to the organisms living on or near intact pipelines. Following a scenario of in-situ decommissioning of a subsea pipeline, marine organisms occupying the exteriors or interiors of petroleum structures may have close contact with the scale or other NORM-associated contaminated substances and suffer subsequent radiological effects. This case study used radiological dose modelling software, including the ERICA Tool (v2.0), MicroShield® Pro and mathematical equations, to estimate the likely radiological doses and risks of effects from NORM-contaminated scale to marine biota from a decommissioned offshore oil and gas pipeline. Using activity concentrations of NORM ( 226 Ra, 210 Po, 210 Pb, 228 Ra, 228 Th) from a subsea pipeline from Australia, environmental realistic exposure scenarios including radiological exposures from both an intact pipe (external only; accounting for radiation shielding by a cylindrical carbon steel pipe) and a decommissioned pipeline with corrosive breakthrough (resulting in both internal and external radiological exposure) were simulated to estimate doses to model marine organisms. Predicted dose rates for both the external only exposure (ranging from 26 μGy/h to 33 μGy/h) and a corroded pipeline (ranging from 300 μGy/h to 16,000 μGy/h) exceeded screening levels for radiological doses to environmental receptors. The study highlighted the importance of using scale-specific solubility data (i.e., K d ) values for individual NORM radionuclides for ERICA assessments. This study provides an approach for conducting marine organism dose assessments for NORM-contaminated subsea pipelines and highlights scientific gaps required to undertake risk assessments necessary to inform infrastructure decommissioning planning., (Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Thousands of offshore oil and gas facilities are coming to the end of their life in jurisdictions worldwide and will require decommissioning. In-situ decommissioning, where the subsea components of that infrastructure are left in the marine environment following the end of its productive life, has been proposed as an option that delivers net benefits, including from: ecological benefits from the establishment of artificial reefs, economic benefits from associated fisheries, reduced costs and improved human safety outcomes for operators. However, potential negative impacts, such as the ecological risk of residual contaminants, are not well understood. Naturally occurring radioactive materials (NORM) are a class of contaminants found in some oil and gas infrastructure (e.g. pipelines) and includes radionuclides of uranium, thorium, radium, radon, lead, and polonium. NORM are ubiquitous in oil and gas reservoirs around the world and may form contamination products including scales and sludges in subsea infrastructure due to their chemistries and the physical processes of oil and gas extraction. The risk that NORM from these sources pose to marine ecosystems is not yet understood meaning that decisions made about decommissioning may not deliver the best outcomes for environments. In this review, we consider the life of NORM-contamination products in oil and gas systems, their expected exposure pathways in the marine environment, and possible ecological impacts following release. These are accompanied by the key research priorities that need to better describe risk associated with decommissioning options., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Purpose: Stiffness is a sequelae of elbow trauma. Arthrolysis may be considered to increase range of movement (ROM). Little is published on the outcomes/complications of elbow arthrolysis. We present our series of primary open arthrolysis in posttraumatic elbow stiffness., Methods: A consecutive series of patients that underwent primary open arthrolysis for posttraumatic elbow stiffness in our unit (2011-2018) were analysed. All procedures were performed by an elbow surgeon. Postoperative rehabilitation followed protocol with early motion; continuous passive motion (CPM) was utilised if requested. Data collected included patient demographics, traumatic injury type, arthrolysis technique, preoperative, intraoperative and postoperative elbow ROM, complications and postoperative Oxford Elbow Score (OES)., Results: 41 patients were included. 59% were male. Mean age at time of arthrolysis was 43 years (range 12-79 years). Mean duration of follow-up was 53 months (range 8-100 months). Median duration from time of injury to arthrolysis was 11 months (range 2-553 months). Mean preoperative flexion-extension arc (FEA) was 70°, improving to 104° postoperatively (p < 0.001). Mean preoperative pronosupination arc (PSA) was 125°, improving to 165° postoperatively (p < 0.001). Mean postoperative OES was 37 (n = 28). Complication rate was 24% with 7 recurrence requiring surgery, 2 nerve injuries and 1 infection. CPM, 10 patients, saw mean FEA improvement of 56°. Mean PSA improvement was 36°. Complication rate for these patients was 40%. Severe traumatic injury was associated with increased preoperative stiffness (FEA 61° vs 84°, PSA 111° vs 149°) but larger improvements in ROM (postoperative FEA 98° [p < 0.001], PSA 165° [p < 0.001])., Conclusion: This series demonstrates improvement in elbow ROM following open arthrolysis with significantly higher gain in pronosupination for those withsevere injury. Moderate results were seen in a patient reported outcome measure. Patients considering arthrolysis should be counselled regarding expectations/complication rate., Competing Interests: The authors have no competing interests to declare., (Crown Copyright © 2020 All rights reserved.)

The potential impacts of mining activities on tropical coastal ecosystems are poorly understood. In particular, limited information is available on the effects of metals on scleractinian corals which are foundation species that form vital structural habitats supporting other biota. This study investigated the effects of dissolved nickel and copper on the coral Acropora muricata and its associated microbiota. Corals collected from the Great Barrier Reef were exposed to dissolved nickel (45, 90, 470, 900 and 9050 μg Ni/L) or copper (4, 11, 32 and 65 μg Cu/L) in flow through chambers at the National Sea Simulator, Townsville, Qld, Australia. After a 96-h exposure DNA metabarcoding (16S rDNA and 18S rDNA) was undertaken on all samples to detect changes in the structure of the coral microbiome. The controls remained healthy throughout the study period. After 36 h, bleaching was only observed in corals exposed to 32 and 65 μg Cu/L and very high nickel concentrations (9050 μg Ni/L). At 96 h, significant discolouration of corals was only observed in 470 and 900 μg Ni/L treatments, the highest concentrations tested. While high concentrations of nickel caused bleaching, no changes in the composition of their microbiome communities were observed. In contrast, exposure to copper not only resulted in bleaching, but altered the composition of both the eukaryote and bacterial communities of the coral's microbiomes. Our findings showed that these effects were only evident at relatively high concentrations of nickel and copper, reflecting concentrations observed only in extremely polluted environments. Elevated metal concentrations have the capacity to alter the microbiomes which are inherently linked to coral health., (Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.)

Plastic pollution is ubiquitous in aquatic environments and its potential impacts to wildlife and humans present a growing global concern. Despite recent efforts in understanding environmental impacts associated with plastic pollution, considerable uncertainties still exist regarding the true risks of nano- and micro-sized plastics (<5 mm). The challenges faced in this field largely relate to the methodological and analytical limitations associated with studying plastic debris at low (environmentally relevant) concentrations. The present paper highlights how radiotracing techniques that are commonly applied to trace the fate and behaviour of chemicals and particles in various systems, can contribute towards addressing several important and outstanding questions in environmental plastic pollution research. Specifically, we discuss the use of radiolabeled microplastics and/or chemicals for 1) determining sorption/desorption kinetics of a range of contaminants to different types of plastics under varying conditions, 2) understanding the influence of microplastics on contaminant and nutrient bioaccumulation in aquatic organisms, and 3) assessing biokinetics, biodistribution, trophic transfer and potential biological impacts of microplastic at realistic concentrations. Radiotracer techniques are uniquely suited for this research because of their sensitivity, accuracy and capacity to measure relevant parameters over time. Obtaining precise and timely information on the fate of plastic particles and co-contaminants in wildlife has widespread applications towards effective monitoring programmes and environmental management strategies., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

The adsorption of radiocesium and radiostrontium onto a range of natural materials has been well quantified, but not for the new media of environmental plastics, which may have enhanced adsorption due to surface-weathering and development of biofilms. Microplastic samples were deployed in freshwater, estuarine and marine conditions, then characterised using infrared spectroscopy to document changes to the plastic surface (vs interior). Synchrotron elemental mapping data revealed surfaces that were well-covered by accumulation of reactive water solutes and sulphur, but, in contrast, had highly discrete coverage of elements such as Fe and Ti, indicating adhered mineral/clay-associated agglomerates that may increase overall adsorption capacity. Plastics that had been deployed for nearly five months adsorbed radionuclides in both freshwater and estuarine conditions with the highest K d for cesium (Cs) in freshwater (80 ml g -1 ) and lowest for strontium (Sr) in estuarine conditions (5 ml g -1 ). The degree of Cs and Sr adsorption onto plastics appears to be approximately 2-3 orders of magnitude lower than for sediment reference values. While lower than for sediments, adsorption occurred on all samples and may indicate a significant radionuclide reservoir, given that plastics are relatively buoyant and mobile in water regimes, and are increasing in global aquatic systems., (Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.)

Multiple ectomycorrhizal fungi (EMF) compete to colonise the roots of a host plant, but it is not known whether their success is under plant or fungal control, or a combination of both. We assessed whether plants control EMF colonisation by preferentially allocating more carbon to more beneficial partners in terms of nitrogen supply or if other factors drive competitive success. We combined stable isotope labelling and RNA-sequencing approaches to characterise nutrient exchange between the plant host Eucalyptus grandis and three Pisolithus isolates when growing alone and when competing either indirectly (with a physical barrier) or directly. Overall, we found that nitrogen provision to the plant does not explain the amount of carbon that an isolate receives nor the number of roots that it colonises. Differences in nutrient exchange among isolates were related to differences in expression of key fungal and plant nitrogen and carbon transporter genes. When given a choice of partners, the plant was able to limit colonisation by the least cooperative isolate. This was not explained by a reduction in allocated carbon. Instead, our results suggest that partner choice in EMF could operate through the upregulation of defence-related genes against those fungi providing fewer nutrients.

The use of live animal gamma radioisotope tracer techniques in the field of ecotoxicology allows laboratory studies to accurately monitor contaminant biokinetics in real time for an individual organism. However, methods used in published studies for aquatic organisms are rarely described in sufficient detail to allow for study replication or an assessment of the errors associated with live animal radioanalysis to be identified. We evaluate the influence of some important methodological deficiencies through an overview of the literature on live aquatic animal radiotracer techniques and through the results obtained from our radiotracer studies on four aquatic invertebrate species. The main factors discussed are animal rinsing, radioanalysis and geometry corrections. We provide examples of three main techniques in live aquatic animal radiotracer studies to improve data quality control and demonstrate why each technique is crucial in interpreting the data from such studies. The animal rinsing technique is also relevant to non-radioisotope tracer studies, especially those involving nanoparticles. We present clear guidance on how to perform each technique and explain the importance of proper reporting of the validation of each technique for individual studies. In this paper we describe methods that are often used in lab-based radioecology studies but are rarely described in great detail. We hope that this paper will act as the basis for standard operating procedures for future radioecology studies to improve study replication and data quality control., (Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Metals and metalloids released through anthropogenic activities can accumulate in aquatic organisms, resulting in adverse effects in sensitive species. We investigated the influence of feeding regime and exposure complexity (i.e., mixture) on bioaccumulation kinetics and body distribution of common metal(loid) pollutants in Limnodynastes peronii during early post-embryonic development. Tadpoles were exposed to radiolabelled 109 Cd, 75 Se and 65 Zn alone and in a mixture for 4 days, followed by 3 days depuration in clean water. One group was fed directly in exposure aquaria, whereas a second group was transferred to clean water for feeding, to investigate the potential influence of sorption to food on uptake. Bioconcentration factor and retention was observed to be greatest for Se. Results demonstrate that tadpoles accumulated and retained half the amount of Cd when exposed in mixture, suggesting that Se and/or Zn may have antagonistic effects against Cd uptake. Additionally, tadpoles fed directly in exposure water accumulated 2-3-times more Cd and Zn compared to tadpoles fed in clean water, indicating that the presence of food particles is an important factor that may influence uptake. Interestingly, this had a negligible impact on Se uptake. The study reveals how exposure conditions can influence the bioaccumulation of metal(loid)s, highlighting experimental factors as important considerations for both controlled toxicity experiments and for understanding exposure risks for amphibian populations., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Background: Uptake of preschool vaccinations is less than optimal. Financial incentives and quasi-mandatory policies (restricting access to child care or educational settings to fully vaccinated children) have been used to increase uptake internationally, but not in the UK., Objective: To provide evidence on the effectiveness, acceptability and economic costs and consequences of parental financial incentives and quasi-mandatory schemes for increasing the uptake of preschool vaccinations., Design: Systematic review, qualitative study and discrete choice experiment (DCE) with questionnaire., Setting: Community, health and education settings in England., Participants: Qualitative study - parents and carers of preschool children, health and educational professionals. DCE - parents and carers of preschool children identified as 'at high risk' and 'not at high risk' of incompletely vaccinating their children., Data Sources: Qualitative study - focus groups and individual interviews. DCE - online questionnaire., Review Methods: The review included studies exploring the effectiveness, acceptability or economic costs and consequences of interventions that offered contingent rewards or penalties with real material value for preschool vaccinations, or quasi-mandatory schemes that restricted access to 'universal' services, compared with usual care or no intervention. Electronic database, reference and citation searches were conducted., Results: Systematic review - there was insufficient evidence to conclude that the interventions considered are effective. There was some evidence that the quasi-mandatory interventions were acceptable. There was insufficient evidence to draw conclusions on economic costs and consequences. Qualitative study - there was little appetite for parental financial incentives. Quasi-mandatory schemes were more acceptable. Optimising current services was consistently preferred to the interventions proposed. DCE and questionnaire - universal parental financial incentives were preferred to quasi-mandatory interventions, which were preferred to targeted incentives. Those reporting that they would need an incentive to vaccinate their children completely required around £110. Those who did not felt that the maximum acceptable incentive was around £70., Limitations: Systematic review - a number of relevant studies were excluded as they did not meet the study design inclusion criteria. Qualitative study - few partially and non-vaccinating parents were recruited. DCE and questionnaire - data were from a convenience sample., Conclusions: There is little current evidence on the effectiveness or economic costs and consequences of parental financial incentives and quasi-mandatory interventions for preschool vaccinations. Universal incentives are likely to be more acceptable than targeted ones. Preferences concerning incentives versus quasi-mandatory interventions may depend on the context in which these are elicited., Future Work: Further evidence is required on (i) the effectiveness and optimal configuration of parental financial incentive and quasi-mandatory interventions for preschool vaccinations - if effectiveness is confirmed, further evidence is required on how to communicate this to stakeholders and the impact on acceptability; and (ii) the acceptability of parental financial incentive and quasi-mandatory interventions for preschool vaccinations to members of the population who are not parents of preschool children or relevant health professionals. Further consideration should be given to (i) incorporating reasons for non-vaccination into new interventions for promoting vaccination uptake; and (ii) how existing services can be optimised., Study Registration: This study is registered as PROSPERO CRD42012003192., Funding: The National Institute for Health Research Health Technology Assessment programme.

Potential sources and kinetics of metal bioaccumulation by the three Macrobrachium prawn species M. australiense, M. rosenbergii and M. latidactylus were assessed in laboratory experiments. The prawns were exposed to two scenarios: cadmium in water only; and exposure to metal-rich mine tailings in the same water. The cadmium accumulation from the dissolved exposure during 7 days, followed by depuration in cadmium-free water for 7 days, was compared with predictions from a biokinetic model that had previously been developed for M. australiense. M. australiense and M. latidactylus accumulated significant tissue cadmium during the exposure phase, albeit with different uptake rates. All three species retained >95% of the bioaccumulated cadmium during the depuration phase, indicating very slow efflux rates. Following exposure to tailings, there were significant (p<0.05) differences in tissue arsenic, cadmium, lead and zinc concentrations among species. Cadmium and zinc concentrations were increased relative to controls for all three species but were not different between treatments (direct/indirect contact with tailings), suggesting these metals were primarily accumulated via the dissolved phase. All species bioaccumulated significantly greater arsenic and lead when in direct contact with mine tailings, demonstrating the importance of an ingestion pathway for these metals. Copper was not bioaccumulated above control concentrations for any species. The differences between the metal accumulation of the three prawns indicated that a biokinetic model of cadmium bioaccumulation for M. australiense could potentially be used to describe the metal bioaccumulation of the other two prawn species, albeit with an over-prediction of 3-9 times. Despite these being the same genus of decapod crustacean, the study highlights the issues with using surrogate species, even under controlled laboratory conditions. It is recommended that future studies using surrogate species quantify the metal bioaccumulation characteristics of each species in order to account for any differences between species., (Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.)

The potential sources and mechanisms of cadmium bioaccumulation by the native freshwater decapods Macrobrachium species in the waters of the highly turbid Strickland River in Papua New Guinea were examined using (109)Cd-labelled water and food sources and the Australian species Macrobrachium australiense as a surrogate. Synthetic river water was spiked with environmentally relevant concentrations of cadmium and animals were exposed for 7 days with daily renewal of test solutions. Dietary assimilation of cadmium was assessed through pulse-chase experiments where prawns were fed separately (109)Cd-labelled fine sediment, filamentous algae and carrion (represented by cephalothorax tissue of water-exposed prawns). M. australiense readily accumulated cadmium from the dissolved phase and the uptake rate increased linearly with increasing exposure concentration. A cadmium uptake rate constant of 0.10 ± 0.05 L/g/d was determined in synthetic river water. During depuration following exposure to dissolved cadmium, efflux rates were low (0.9 ± 5%/d) and were not dependent on exposure concentration. Assimilation efficiencies of dietary sources were comparable for sediment and algae (48-51%), but lower for carrion (28 ± 5%) and efflux rates were low (0.2-2.6%/d) demonstrating that cadmium was well retained by M. australiense. A biokinetic model of cadmium accumulation by M. australiense predicted that for exposures to environmentally relevant cadmium concentrations in the Strickland River, uptake from ingestion of fine sediment and carrion would be the predominant sources of cadmium to the organism. The model predicted the total dietary route would represent 70-80% of bioaccumulated cadmium., (Crown Copyright © 2014. Published by Elsevier B.V. All rights reserved.)