This observational study is designed to learn more about how current standard of care treatment options are working to treat patients with Systemic Lupus Erythematosus (SLE) and lupus nephritis (LN). SLE is a disease where the body’s immune system mistakenly attacks its own healthy tissues and organs. The study population will include individuals diagnosed with SLE, who have an inadequate response (a lack of response, insufficient response, or lack of sustained response after at least 3-month treatment with appropriate doses of ...

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Injuries to the chest can cause air or blood to collect in the space between the lungs and the ribs. Doctors usually put in a tube to drain it, but we’re not sure if using a smaller tube or a bigger one is better. We will be comparing two treatments: one uses a small tube put in the chest with a needle and wire (called a small bore Seldinger chest drain), and the other uses a large tube put in ...

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Broken bones can happen to anyone, at any age. Sometimes an operation is needed to hold the broken bones together while they heal. One of the complications of this operation is an infection in the area where the bone has been fixed. These are called fracture-related infections (FRI). They can be serious, and usually require more operations. Some surgeons use local antibiotic carriers during the operation to try to lower the risk of FRIs. These are placed directly into the ...

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Angina with Non-Obstructive Coronary Arteries (ANOCA) is a common condition where patients have chest pain despite no major blockages in their heart arteries. ANOCA is caused by problems in the smaller vessels, known as coronary microvascular dysfunction (CMD), or by sudden narrowing of the arteries, called vasospasm. CMD can occur through two main mechanisms: endothelium-dependent mechanisms, where the inner lining of the vessels (the endothelium) doesn’t properly control the widening of the blood vessels or increase in blood flow when ...

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The Registry of Pulmonary Hypertension in Neonates (RePHyNe) is a prospective global multicentre observational cohort data collection study designed to collect routine clinical data including diagnostic tests and treatments delivered as part of patients’ clinical care. Participants will be recruited by clinicians working in neonatal and paediatric intensive care units who routinely provide care for neonates and young infants with pulmonary hypertension < 3 months of age,corrected for prematurity. Written informed consent will be obtained from parents/guardians. Participants will undergo ...

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Study Design: Two stage,unblinded strain-randomised controlled human infection model: Stage I – A dose-finding study using a continual reassessment method to identify the optimal nasal challenge dose for two strains of S. aureus each required to achieve colonisation in 50-70% of challenged participants. Participants will receive decolonisation therapy prior to challenge. If a strain in Stage I fails to colonise successfully or fails to progress for any other scientific,logistical or safety reason,it may be replaced by another suitable strain,restarting the strain-specific ...

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This study evaluates whether repeat surgical resection at glioblastoma recurrence improves deterioration‑free survival when added to standard second‑line medical therapy. Secondary objectives include assessing the impact of repeat surgery on health‑related quality of life,daily functioning,neurological symptoms,complications,adjuvant therapy completion,overall survival and cost‑effectiveness within the NHS. An optional sub‑study will explore the feasibility of passive physical activity monitoring using smartphones and wearable devices.

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The quality of care is affected by where people live. People with MND live longer and have better quality of life when their care is delivered and coordinated by experts in specialist teams. Due to MND being rare, expert teams are usually only available in major city hospitals. This means for people living outside of cities, non-expert community teams deliver care, who rely on communication and support from the experts. Although in some areas communication is good (for example when ...

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A multicentre,allocation concealed,randomised,open-label Bayesian adaptive multi-arm platform trial with pre-defined triggers for efficacy and futility stopping (as compared to usual care). The trial will stratify participants by biological markers into different subphenotypes. Initial stratification will be into hyperinflammatory and hypoinflammatory subphenotypes in ARDS based on plasma biomarker profiles. Regular adaptive analyses will enable efficient identification of treatment effects within each subphenotype,stopping interventions where there is evidence of efficacy or futility,and bringing in new interventions and new ...

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In the United Kingdom each year about 7000 babies are born very preterm and need specialist neonatal care. Necrotising enterocolitis (NEC) is a serious gut condition affecting 1 out of 10 extremely preterm babies (those who are born before 28 completed weeks of pregnancy). Babies with NEC commonly require surgery and, of these, one out of three unfortunately will not survive. About half of NEC survivors have long-term neurodevelopmental problems like cerebral palsy or learning difficulties. Risk factors for NEC ...

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