Although it is considered to have fewer relapses and better prognosis than NMOSD, the clinical course and outcome of MOGAD has not been fully characterized.
  To evaluate the impact of a care bundle (antenatal information to women, manual perineal protection and mediolateral episiotomy when indicated) on obstetric anal sphincter injury (OASI) rates.
 
  Multicentre stepped-wedge cluster design.
 
  Sixteen maternity units located in four regions across England, Scotland and Wales.
 
  Women with singleton live births between October 2016 and March 2018.
 
  Stepwise region by region roll-out every 3months starting January 2017. The four maternity units in a region started at the same time. Multi-level logistic regression was used to estimate the impact of the care bundle, adjusting for time trend and case-mix factors (age, ethnicity, body mass index, parity, birthweight and mode of birth).
 
  Obstetric anal sphincter injury in singleton live vaginal births.
 
  A total of 55060 singleton live vaginal births were included (79% spontaneous and 21% operative). Median maternal age was 30years (interquartile range 26-34years) and 46% of women were primiparous. The OASI rate decreased from 3.3% before to 3.0% after care bundle implementation (adjusted odds ratio 0.80, 95% CI 0.65-0.98, P=0.03). There was no evidence that the effect of the care bundle differed according to parity (P=0.77) or mode of birth (P=0.31). There were no significant changes in caesarean section (P=0.19) or episiotomy rates (P=0.16) during the study period.
 
  The implementation of this care bundle reduced OASI rates without affecting caesarean section rates or episiotomy use. These findings demonstrate its potential for reducing perineal trauma during childbirth.
 
  OASI Care Bundle reduced severe perineal tear rates without affecting caesarean section rates or episiotomy use.
 OASI Care Bundle reduced severe perineal tear rates without affecting caesarean section rates or episiotomy use.Resourcefulness, a collection of problem-solving, coping, self-control and emotion regulation skills, has been shown to moderate health outcomes in various caregiver populations. Caregivers of children with neurodevelopmental disorders, such as autism spectrum disorder (ASD), report higher levels of stress, anxiety and depressive symptoms with poorer health-related quality of life. The current study replicated and extended psychometric research on the Resourcefulness Scale (RS) among caregivers of children with ASD (n = 287) and a comparison group of caregivers of non-affected children (n = 207). Results suggest acceptable internal consistency and construct validity when using the RS among caregivers of children with and without ASD. The RS demonstrated poor temporal stability over an average of 4 weeks (r = 0.087, p = 0.434). Caregivers of children with ASD report higher levels of general, social, and personal resourcefulness than non-affected caregivers. Findings validate the use of the RS within caregiving populations with implications for clinical use and future research in the development of interventions to enhance caregiver QoL.Secondary ocular malignancies most commonly spread to the choroid. Previously, the prognosis was poor however, with newer treatments including immunotherapy, patient's life expectancy have increased. It is therefore, important that ophthalmologists diagnose this condition in a timely manner and offer treatment to maximize visual potential and refer them on to oncology colleagues in order to optimize their systemic treatment for their primary cancer.
  Glaucoma filtration surgery (GFS) is limited by subconjunctival, episcleral and scleral fibrosis sealing the trabeculectomy and scarring the filtering bleb. Mitomycin-C (MMC) is commonly applied intraoperatively to the subconjunctival and/or intrascleral space to reduce scarring and promotes GFS success but is associated with postoperative scleral melting and bleb leaks. IP-10 peptide (IP-10p), an ELR-negative CXC chemokine mimetic and inhibitor of fibroblast function, may be an alternative or adjunct to current postoperative GFS treatments. This study sought to determine if IP-10p produces histological changes in tissue remodelling, vascularity and fibrosis that enhance bleb survival after GFS.
 
  Rabbits underwent tube-assisted filtration surgery on the right eye with either (a) IP-10p injected into bleb at time of surgery and postoperative days 2, 4 and 7, (b) intraoperative MMC or (c) intraoperative MMC plus IP-10p injected into bleb at time of surgery and postoperative days 2, 4 and 7. Left contralateral eyes were treated with balanced salt solution (BSS).
 
  IP-10p-treated blebs demonstrated reduced collagen deposition, cellularity and overall reduction of scar formation compared to BSS-control. Bleb vascularity was reduced compared to BSS-control and MMC treatment groups. Additionally, IP-10p/MMC treated eyes demonstrated an increased number of conjunctival goblet cells in bleb histology compared to the dramatic loss seen with MMC treatment alone.
 
  This study demonstrates that IP-10p significantly reduces histological scarring compared to BSS or MMC alone, does not damage the conjunctiva to the extent of current standards, and may be an alternative or adjunct to MMC for those undergoing GFS.
 This study demonstrates that IP-10p significantly reduces histological scarring compared to BSS or MMC alone, does not damage the conjunctiva to the extent of current standards, and may be an alternative or adjunct to MMC for those undergoing GFS.Inflammasomes are cytosolic innate immune complexes, which assemble in mammalian cells in response to microbial components and endogenous danger signals. A major family of inflammasome activators is bacterial toxins.  https://www.selleckchem.com/products/Sunitinib-Malate-(Sutent).html  Inflammasome sensor proteins, such as the nucleotide-binding oligomerisation domain-like receptor (NLR) family members NLRP1b and NLRP3, and the tripartite motif family member Pyrin+ efflux triggered by pore-forming toxins or by other toxin-induced homeostasis-altering events such as lysosomal rupture. Pyrin senses perturbation of host cell functions induced by certain enzymatic toxins resulting in impairment of RhoA GTPase activity. Assembly of the inflammasome complex activates the cysteine protease caspase-1, leading to the proteolytic cleavage of the proinflammatory cytokines IL-1β and IL-18, and the pore-forming protein gasdermin D causing pyroptosis. In this review, we discuss the latest progress in our understanding on the activation mechanisms of inflammasome complexes by bacterial toxins and effector proteins and explore avenues for future research into the relationships between inflammasomes and bacterial toxins.