The polypill in the primary prevention of heart attacks and strokes: Overcoming barriers to implementation.

This commentary, linked to our paper in the same issue of the , discusses the reluctance to consider and adopt the polypill in the primary prevention of heart attacks and strokes, access to the polypill as a public health service, the formulation of the polypill in current use, its prescription as an unlicensed medicine, and what can be done to facilitate the adoption of the polypill approach as a routine public health service.

Comparing screening based on the NHS Health Check and Polypill Prevention Programmes in the primary prevention of heart attacks and strokes.

Objective: To compare the NHS Health Check Programme with the Polypill Prevention Programme in the primary prevention of heart attacks and strokes.

Design: Use of published data and methodology to produce flow charts of the two programmes to determine screening performance and heart attacks and strokes prevented.

Setting: The UK population.

The impact of restricting sleep duration on physical activity: Secondary analysis of a randomized crossover study.

Objectives: This study investigated the causal impact of sleep durations on participants' physical activity (PA) in real-world conditions.

Method: We performed a secondary analysis of PA data from 146 young adults using a randomized crossover design: both restricted (5-6 hr/night) and well-rested (8-9 hr/night) sleep weeks were assessed, with a washout week in between. Sleep and activity were tracked via research-grade actigraphy.

Antenatal screening for Down's syndrome: Revised nuchal translucency upper truncation limit due to improved precision of measurement.

Objective: To determine whether the improved precision of nuchal translucency (NT) measurement used in antenatal screening for Down's syndrome observed over time as evidenced by a decrease in the multiple of the median (MoM) standard deviation requires a modification to the NT MoM truncation limits to maintain accurate risk estimation.

Methods: Probability plots were derived from the measurements of NT MoM values used in a 2018 audit of 22,362 unaffected pregnancies. The plots were used to determine whether the NT MoM upper truncation limit should be lowered.

Analogues of Marine Guanidine Alkaloids Are in Vitro Effective against Trypanosoma cruzi and Selectively Eliminate Leishmania (L.) infantum Intracellular Amastigotes.

Synthetic analogues of marine sponge guanidine alkaloids showed in vitro antiparasitic activity against Leishmania (L.) infantum and Trypanosoma cruzi. Guanidines 10 and 11 presented the highest selectivity index when tested against Leishmania.

The effect of the introduction of a case-mix-based funding model of rehabilitation for severe stroke: an Australian experience.

Objective: To compare resource use of, and outcomes for, rehabilitation for severe stroke before and after the implementation of the Casemix and Rehabilitation Funding Tree case-mix-based funding model.

Design: Prospective, observational cohort study.

Setting: Eight inpatient rehabilitation centers in Australia.