In individuals with diabetes, the crude RRR for only having microangiopathy was 1.05 (95% CI 0.98 to 1.12) and was found significant when adjusting 1.10 (95% CI 1.01 to 1.19). RRR for having only macroangiopathy was 0.89 (95% CI 0.77 to 1.03) and was again significant when adjusting 0.79 (95% CI 0.66 to 0.96). In individuals without diabetes, adjustments again led to similar estimates that was not significant. The adjusted RRR for having only macroangiopathy was 1.08 (95% CI 0.98 to 1.19). CONCLUSIONS Serum vitamin K1 levels were associated with microangiopathic and macroangiopathic status in individuals with diabetes, but considered of no clinical relevance. The clinical value of other candidate markers for vitamin K status needs to be evaluated in future studies. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.OBJECTIVE Metformin, an oral medication used for type 2 diabetes mellitus, is the most commonly prescribed drug with less economic burden of patients. Although metformin's efficacy and safety have long been recognized, approximately 5% of the patients treated with this drug develop severe diarrhea as an adverse effect and have to abandon treatment. Because there is no animal model to study metformin-induced diarrhea, it is hard to develop methods to maintain quality of life of patients prescribed with metformin. RESEARCH DESIGN AND METHODS Using mouse models, we tried to develop an evaluation system for metformin-induced diarrhea to improve diarrheal symptoms in patients with diabetes. Healthy (C57BL/6J) and diabetic obese (db/db) mice were subjected to a stepwise dose escalation of metformin (250 mg/kg/day (125 mg/kg twice daily oral dose)-1000 mg/kg/day (500 mg/kg twice daily oral dose)), and fecal moisture contents and their score were monitored. To evaluate anti-diarrheal medications, wood creosote (a traditional medicine) was tested. Several groups of enterobacteria in fresh feces were examined by using PCR. RESULTS 1000 mg/kg/day (four times maximal effective dose) of metformin significantly increased fecal moisture content. Although no symptoms of diarrhea were observed in healthy C57BL/6J mice, the same dose of metformin induced severe diarrhea in diabetic obese db/db mice. A reduction in PCR signals for the Firmicutes group was associated with metformin-induced diarrhea. Wood creosote reduced diarrhea (high water-content) without affecting metformin's efficacy or enterobacterial flora levels. CONCLUSIONS We have created the first animal model of metformin-induced diarrhea using db/db mice, which will provide better quality of life for patients suffering from diarrhea caused by metformin. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC.  https://www.selleckchem.com/products/740-y-p-pdgfr-740y-p.html  No commercial re-use. See rights and permissions. Published by BMJ.The studyPalmer R, Dimairo M, Cooper C, et al. Self-managed, computerised speech and language therapy for patients with chronic aphasia post-stroke compared with usual care or attention control (Big CACTUS) a multicentre, single-blinded, randomised controlled trial. Lancet Neurol 2019;18821-33.This project was funded by the NIHR Health Technology Assessment Programme (project number 12/21/01) and the Tavistock Trust for Aphasia.To read the full NIHR Signal, go to https//discover.dc.nihr.ac.uk/content/signal-000864/after-a-stroke-computerised-speech-and-language-therapy-can-help-people-find-words. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http//group.bmj.com/group/rights-licensing/permissions.BACKGROUND Chronic obstructive pulmonary disease (COPD) is a global public health problem, and continuous monitoring is essential for both its management as well as the management of other chronic diseases. Telemonitoring using mobile health (mHealth) devices has the potential to promote self-management, improve control, increase quality of life, and prevent hospital admissions. OBJECTIVE This study aims to demonstrate whether a large-scale study assessing the use of mHealth devices to improve the treatment, assessment, compliance, and outcomes of chronic diseases, particularly COPD and cardio-metabolic syndrome, is feasible. This will allow our team to select the appropriate design and characteristics for our large-scale study. METHODS A total of 3 cohorts, with 9 participants in each, will use mHealth devices for 90 days while undergoing the current standard of care. These groups are 9 "non-COPD," otherwise healthy, smokers; 9 "grey zone" smokers (forced expiratory volume in 1 second/ forced vital capacity the appropriate design and characteristics for the large-scale study. TRIAL REGISTRATION ClinicalTrials.gov NCT04081961; https//clinicaltrials.gov/ct2/show/NCT04081961. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/16461. ©Almaz Sharman, Baurzhan Zhussupov, Dana Sharman, Irina Kim. Originally published in JMIR Research Protocols (http//www.researchprotocols.org), 26.03.2020.BACKGROUND Injury causing wounds is a frequent event. Inadequate or inappropriate treatment of injuries can threaten individual health. However, little is known about wound care knowledge, attitudes, and practices and mobile health (mHealth) use in the home environment in Taiwan. OBJECTIVE This study aimed to evaluate wound care knowledge, attitudes, and practices and mHealth technology use among social network users. METHODS A cross-sectional survey on social media platforms was conducted on adults aged 20 years and older. Data were collected from social network users in the home environment. RESULTS A total of 361 participants were enrolled. The mHealth technology use of participants was positively correlated with wound care knowledge (r=.132, P=.01), attitudes (r=.239, P less then .001), and practices (r=.132, P=.01). Participants did not have adequate knowledge (correct rate 69.1%) and were unfamiliar with the guidelines of proper wound care (correct rate 74.5%). Most participants had positive attitudes toward wound care and mHealth technology use. A total of 95.6% (345/361) of participants perceived that the use of mHealth technology can improve wound care outcomes, and 93.9% (339/361) perceived that wound care products should be optimized to be used with a mobile device. However, 93.6% (338/361) of participants had no experience using mHealth technology for wound care. CONCLUSIONS Our study shows the potential of mHealth technology to enhance wound care knowledge among social network users. Thus, government agencies and medical institutions in Taiwan should provide easy-to-use information products that enhance wound care knowledge, promote adequate behavior toward wound care, and prevent unpredictable or undesirable outcomes. ©Ya-Ting Kuan, Tze-Fang Wang, Chao-Yu Guo, Fu-In Tang, I-Ching Hou. Originally published in JMIR mHealth and uHealth (http//mhealth.jmir.org), 26.03.2020.