The purpose of this study is to evaluate the effectiveness and cost-effectiveness of a toric intraocular lens in patients with mild astigmatism. The toric intraocular lens can give patients better vision without needing distance glasses after cataract surgery. We compare the effectiveness of a toric intraocular lens with a non-toric intraocular lens.

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Mitochondria are crucial components found in most cells that generate energy from food to enable cells to function normally. “Spelling mistakes” (mutations) in the POLG gene, cause mitochondrial dysfunction and subsequently disease, in organs with high energy demands. Cerebellum, the part of the brain that regulates our balance and movement coordination, and peripheral nerves, are frequently affected in people with POLG-related mitochondrial disease. They develop ataxia, which is a medical term describing symptoms related to balance impairment and muscle incoordination, ...

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In the UK, heart operations have steadily increased since 2010, and 36,166 heart operations were performed in 2016. Following cardiac surgery, patients currently attend their first outpatient review six weeks after hospital discharge, where recovery is assessed and fitness to commence cardiac rehabilitation (CR) is determined. CR is then started from eight weeks. In a survey we conducted in May/June 2017, 35 of the 42 UK cardiac centres responded, and confirmed this as current practice. The long interval before postoperative ...

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Despite advances with the introduction of anti-GD2 immunotherapy,there is a major unmet need to develop new drugs for treatment of high-risk neuroblastoma. Around half of patients relapse despite intensive therapies,and outcome following relapse is dismal (<10% long term survival). The BEACON2 trial will confirm which combination of drugs tested in the phase II BEACON study should be taken forward and identify novel combinations that further improve survival in this patient group. Based on our experience in a previous trial (BEACON),the ...

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This is a multicentre,double blinded,randomised,active-controlled study of a novel vaccine SII-TCV(B) against typhoid and paratyphoid A infection,using a healthy adult participant controlled human challenge model of paratyphoid A infection compared with a licensed Vi-polysaccharide vaccine against typhoid infection (Typhim Vi). The aim is to assess the efficacy of SII-TCV(B) against S. Paratyphi A using the challenge model and to demonstrate the non-inferiority of the immune response to the S. Typhi component of SII-TCV(B),when compared to Typhim Vi. In total,192 participants will ...

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This is a platform trial testing the addition of experimental treatments to standard of care (SoC) with two randomised controlled trials called research comparisons. The platform design allows the addition of other research treatments into the structure following protocol amendment. The primary objectives of each comparison are to test whether survival and/or cancer outcomes can be improved by the addition of the research treatments to SoC in men with metastatic prostate cancer and starting long-term androgen deprivation therapy. Key secondary objectives ...

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We will use state-of-the-art imaging to look at heart disease in people with haemophilia. Haemophilia is an inherited disorder in which blood does not clot properly because of lack of a key ‘glue’ blood component (chemicals known as factor VIII or IX). People with haemophilia are 40% less likely to die of heart disease, but we don’t know why. Understanding heart disease in people with haemophilia is important because better treatments for haemophilia mean that these patients are now ...

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Total hip arthroplasty (THA) is one of the most commonly performed and most successful orthopaedic operations. A THA procedure involves implanting a prosthetic stem & cup into the femur and acetabulum respectively. The implants can be secured to the host bone in two ways; with bone cement (a cemented implant) or by relying upon bone growth into or onto the implant (an uncemented implant). Several design features of THA implants have been areas of research interest, aimed at improving outcomes, ...

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Design: A 2x2 factorial pragmatic open-label randomised controlled trial,with an embedded randomised double-blind parallel group trial Setting: 60 general ICUs in the UK Target population: Adult patients who are critically ill due to sepsis Inclusion criteria - Adult patients admitted to ICU due to suspected sepsis and expected to stay for at least 48 hours - Receiving intravenous antibiotics for suspected sepsis - Initial early fluid resuscitation complete - Acute organ dysfunction due to infection Additional criteria for GM-CSF subset - Mechanically ventilated - Receiving vasopressors/inotropes - Absolute lymphocyte count <1.2 ...

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Cytomegalovirus (CMV), the international leading cause of neurodevelopmental impairment from infection acquired during pregnancy, is estimated to affect over 4200 babies and cost over £750 million each year in the UK. CMV is a common virus usually causing mild infection in healthy individuals, however CMV can cause serious disease if it affects a baby during pregnancy. Only the most severely affected cases of CMV acquired in pregnancy tend to be identified by healthcare professionals because there is currently no screening ...

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