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Summary: Background: In non-high-risk individuals, risk-category-based atherosclerotic cardiovascular disease (ASCVD) screening strategies may be more cost-effective than one-size-fits-all approaches. However, current decisions are constrained by a lack of research evidence. We aimed to explore appropriate risk-category-based screening interval strategies for non-high-risk individuals in ASCVD primary prevention in the Chinese population. Methods: We used data from 28,624 participants in the China Kadoorie Biobank (CKB) who had completed at least two field surveys. The risk assessment tools were the 10-year ASCVD risk prediction models developed based on the CKB cohort. We constructed multistate Markov models to model disease progression and estimate transition probabilities between different risk categories. The total person-years spent unidentified in the high-risk state over a 10-year period were calculated for each screening interval protocol. We also estimated the number of ASCVD events prevented, quality-adjusted life years (QALYs) gained, and costs saved when compared to the 3-yearly screening protocol. Findings: When compared to the uniform 3-yearly protocol, most risk-category-based screening interval protocols would identify more high-risk individuals timely, thus preventing more ASCVD events and gaining QALYs. A few of them would reduce total health-care costs. The protocol, which used 6-year, 3-year, and 2-year screening intervals for low-risk, intermediate-low-risk, and intermediate-high risk individuals, was optimal, and would reduce the person-years spent unidentified in the high-risk category by 17.9% (95% CI: 13.1%–21.9%), thus preventing an estimated 113 thousand (95% CI: 83–138) hard ASCVD events for Chinese adults aged 30–79 over a 10-year period. When using a lower cost of statin therapy, more screening protocols would gain QALYs while saving costs. Interpretation: For the primary prevention of ASCVD, risk-category-based screening protocols outperformed the one-size-fits-all approach in the Chinese population. Funding: This work was supported by National Natural Science Foundation of China (82192904, 82388102, 82192900) and grants (2023YFC2509400) from the National Key R&D Program of China. The CKB baseline survey and the first re-survey were supported by a grant from the Kadoorie Charitable Foundation in Hong Kong. The long-term follow-up is supported by grants from the UK Wellcome Trust (212946/Z/18/Z, 202922/Z/16/Z, 104085/Z/14/Z, 088158/Z/09/Z), grants (2016YFC0900500) from the National Key R&D Program of China, National Natural Science Foundation of China (81390540, 91846303, 81941018), and Chinese Ministry of Science and Technology (2011BAI09B01).

Summary: Background: Hospitals in China are classified into tiers (1, 2 or 3), with the largest (tier 3) having more equipment and specialist staff. Differential health insurance cost-sharing by hospital tier (lower deductibles and higher reimbursement rates in lower tiers) was introduced to reduce overcrowding in higher tier hospitals, promote use of lower tier hospitals, and limit escalating healthcare costs. However, little is known about the effects of differential cost-sharing in health insurance schemes on choice of hospital tiers. Methods: In a 9-year follow-up of a prospective study of 0.5 M adults from 10 areas in China, we examined the associations between differential health insurance cost-sharing and choice of hospital tiers for patients with a first hospitalisation for stroke or ischaemic heart disease (IHD) in 2009–2017. Analyses were performed separately in urban areas (stroke: n = 20,302; IHD: n = 19,283) and rural areas (stroke: n = 21,130; IHD: n = 17,890), using conditional logit models and adjusting for individual socioeconomic and health characteristics. Findings: About 64–68% of stroke and IHD cases in urban areas and 27–29% in rural areas chose tier 3 hospitals. In urban areas, higher reimbursement rates in each tier and lower tier 3 deductibles were associated with a greater likelihood of choosing their respective hospital tiers. In rural areas, the effects of cost-sharing were modest, suggesting a greater contribution of other factors. Higher socioeconomic status and greater disease severity were associated with a greater likelihood of seeking care in higher tier hospitals in urban and rural areas. Interpretation: Patient choice of hospital tiers for treatment of stroke and IHD in China was influenced by differential cost-sharing in urban areas, but not in rural areas. Further strategies are required to incentivise appropriate health seeking behaviour and promote more efficient hospital use. Funding: Wellcome Trust, Medical Research Council, British Heart Foundation, Cancer Research UK, Kadoorie Charitable Foundation, China Ministry of Science and Technology, and National Natural Science Foundation of China.

Summary: Background: Previous observational studies established a positive relationship between snoring and stroke. We aimed to investigate the causal effect of snoring on stroke. Methods: Based on 82,339 unrelated individuals with qualified genotyping data of Asian descent from the China Kadoorie Biobank (CKB), we conducted a Mendelian randomization (MR) analysis of snoring and stroke. Genetic variants identified in the genome-wide association analysis (GWAS) of snoring in CKB and UK Biobank (UKB) were selected for constructing genetic risk scores (GRS). A two-stage method was applied to estimate the associations of the genetically predicted snoring with stroke and its subtypes. Besides, MR analysis among the non-obese group (body mass index, BMI

Abstract Serving the Stewart mechanism as a wheel-legged structure, the most outstanding superiority of the proposed wheel-legged hybrid robot (WLHR) is the active vibration isolation function during rolling on rugged terrain. However, it is difficult to obtain its precise dynamic model, because of the nonlinearity and uncertainty of the heavy robot. This paper presents a dynamic control framework with a decentralized structure for single wheel-leg, position tracking based on model predictive control (MPC) and adaptive impedance module from inside to outside. Through the Newton-Euler dynamic model of the Stewart mechanism, the controller first creates a predictive model by combining Newton-Raphson iteration of forward kinematic and inverse kinematic calculation of Stewart. The actuating force naturally enables each strut to stretch and retract, thereby realizing six degrees-of-freedom (6-DOFs) position-tracking for Stewart wheel-leg. The adaptive impedance control in the outermost loop adjusts environmental impedance parameters by current position and force feedback of wheel-leg along Z-axis. This adjustment allows the robot to adequately control the desired support force tracking, isolating the robot body from vibration that is generated from unknown terrain. The availability of the proposed control methodology on a physical prototype is demonstrated by tracking a Bezier curve and active vibration isolation while the robot is rolling on decelerate strips. By comparing the proportional and integral (PI) and constant impedance controllers, better performance of the proposed algorithm was operated and evaluated through displacement and force sensors internally-installed in each cylinder, as well as an inertial measurement unit (IMU) mounted on the robot body. The proposed algorithm structure significantly enhances the control accuracy and vibration isolation capacity of parallel wheel-legged robot.

Low-temperature stress seriously affects the growth, development, yield, and quality of tomato production. Bacillus methylotrophicus is an important plant growth promoting rhizobacteria (PGPR). However, the role of B. methylotrophicus under low-temperature stress is poorly understood. Accordingly, the effects of B. methylotrophicus (‘VL-10′) on tomato cold stress (15 °C/8 °C, 12 h/12 h, and day/night) were studied. B. methyltrophicus ‘VL-10′ was added into the substrate at the time of sowing, and the plants were treated at a low temperature for 2 weeks after 40 days of growth. We found that the low temperature reduced the spatial distribution of the aboveground and underground sections of tomatoes and the leaf SPAD and photochemical efficiency of PS II (Fv/Fm). After low-temperature stress, the tomato flowering was delayed, the vitamin C and lycopene content in fruit decreased, and the nitrate content increased. However, inoculated with B. methyltrophicus ‘VL-10′ during sowing promoted the growth of tomato seedlings, enhanced the native defense ability of the tomatoes, and effectively reduced the cold shock response of the roots to cold damage and the adverse effects of low temperature on leaf SPAD and Fv/Fm. After the cultivation at normal temperature, the inoculat B. methyltrophicus ‘VL-10′ could rapidly regain plant growth levers, and eliminate the delay of low temperature on flowering. TOPSIS analysis showed that the nutritional quality of tomatoes could be effectively improved by inoculation with B. methyltrophicus ‘VL-10′ regardless of normal cultivation or low-temperature stress.

The experiment aimed to obtain a quadratic regression mathematical model of the comprehensive evaluation score of yield, quality, and four macroelements (N, K, P and Ca). The suitable nutrient solution was chosen and verified via computer simulation of the model and the highest comprehensive score in all treatments. Results showed that P, K and Ca had a positive effect on the comprehensive evaluation value of tomato, whereas N showed a negative effect. The optimal formula calculated using the regression equation could promote high-yield and high-quality tomato. The single-plant yield, soluble protein, vitamin C, total sugar, lycopene, and elemental utilisation of K and Ca in the tomato were 13.93, 78.95, 3.29, 20.98, 51.91, 16.69 and 24.14% higher than those in the special formula treatment of Japanese Yamazaki tomato, respectively. In summary, the optimal nutrient solution formula of tomato cultivation was obtained, in which the N, P, K and Ca levels were 24.83, 4.50, 9.49 and 5.73 mmol/L, respectively.

Background: Many treatments are being assessed for repurposing to treat coronavirus disease 2019 (COVID-19). One drug that has shown promising results in vitro is nitazoxanide. Unlike other postulated drugs, nitazoxanide shows a high ratio of maximum plasma concentration (Cmax), after 1 day of 500 mg twice daily (BD), to the concentration required to inhibit 50% replication (EC50) of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Cmax: EC50roughly equal to 14:1). As such, it is important to investigate the safety of nitazoxanide for further trials. Furthermore, treatments for COVID-19 should be cheap to promote global access, but prices of many drugs are far higher than the costs of production. We aimed to conduct a review of the safety of nitazoxanide for any prior indication and calculate its minimum costs of production. Methods: A review of nitazoxanide clinical research was conducted using EMBASE and MEDLINE databases, supplemented by ClinicalTrials.gov. We searched for phase 2 or 3 randomised controlled trials (RCTs) comparing nitazoxanide with placebo or active control for 5–14 days in participants experiencing acute infections of any kind. Data extracted were grade 1–4 and serious adverse events (AEs). Data were also extracted on gastrointestinal (GI) AEs, as well as hepatorenal and cardiovascular effects.Active pharmaceutical ingredient cost data from 2016 to 2019 were extracted from the Panjiva database and adjusted for 5% loss during production, costs of excipients, formulation, a 10% profit margin and tax. Two dosages, at 500 mg BD and a higher dose of 1100 mg three times daily (TDS), were considered. Our estimated costs were compared with publicly available list prices from a selection of countries. Results: Nine RCTs of nitazoxanide were identified for inclusion. These RCTs accounted for 1514 participants and an estimated 95.3 person-years-of-follow-up. No significant differences were found in any of the AE endpoints assessed, across all trials or on subgroup analyses of active- or placebo-controlled trials. Mild GI AEs increased with dose. No hepatorenal or cardiovascular concerns were raised, but few appropriate metrics were reported. There were no teratogenic concerns, but the evidence base was very limited.Based on a weighted-mean cost of US $61/kg, a 14-day course of treatment with nitazoxanide 500 mg BD would cost $1.41. The daily cost would therefore be $0.10. The same 14-day course could cost $3944 in US commercial pharmacies, and $3 per course in Pakistan, India and Bangladesh. At a higher dose of 1100 mg TDS, our estimated cost was $4.08 per 14-day course, equivalent to $0.29 per day. Conclusion: Nitazoxanide demonstrates a good safety profile at approved doses. However, further evidence is required regarding hepatorenal and cardiovascular effects, as well as teratogenicity. We estimate that it would be possible to manufacture nitazoxanide as generic for $1.41 for a 14-day treatment course at 500 mg BD, up to $4.08 at 1100 mg TDS. Further trials in COVID-19 patients should be initiated. If efficacy against SARS-CoV-2 is demonstrated in clinical studies, nitazoxanide may represent a safe and affordable treatment in the ongoing pandemic.

Introduction: ‘Repurposing’ existing drugs to treat COVID-19 is vital to reducing mortality and controlling the pandemic. Several promising drugs have been identified and are in various stages of clinical trials globally. If efficacy of these drugs is demonstrated, rapid, mass availability at an affordable cost would be essential to ensuring equity and access especially amongst low- and middle-income economies. Methods: Minimum costs of production were estimated from the costs of active pharmaceutical ingredients using established methodology, which had good predictive accuracy for medicines for hepatitis C and HIV amongst others. Data were extracted from global export shipment records or analysis of the route of chemical synthesis. The estimated costs were compared with list prices from a range of countries where pricing data were available. Results: Minimum estimated costs of production were US $0.93/day for remdesivir, $1.45/day for favipiravir, $0.08/day for hydroxychloroquine, $0.02/day for chloroquine, $0.10/day for azithromycin, $0.28/day for lopinavir/ritonavir, $0.39/day for sofosbuvir/daclatasvir and $1.09/day for pirfenidone. Costs of production ranged between $0.30 and $31 per treatment course (10–28 days). Current prices of these drugs were far higher than the costs of production, particularly in the US. Conclusions: Should repurposed drugs demonstrate efficacy against COVID-19, they could be manufactured profitably at very low costs, for much less than current list prices. Estimations for the minimum production costs can strengthen price negotiations and help ensure affordable access to vital treatment for COVID-19 at low prices globally.

This paper proposes a novel fractional order impedance control. In traditional impedance control model, the orders of inertia, damping, and stiffness are integers and the contact force can be reduced effectively to some extent in robots and manipulators. However, there exists a tracking error of end-effector at the stable state due to the existence of stiffness, which is not conducive to tackle tasks based on high performance position control for robots and manipulators. Thus, an integral item is added into the traditional impedance model to eliminate the tracking error. Besides, the idea of fractional order is introduced to make the orders of inertia, damping, and stiffness change from integers to fractions to achieve more significant compliant performance. Simulation results validate the advantages of proposed fractional order impedance control and it can be also employed to absorb/increase, hold/keep, and dissipate/decrease system energy to achieve jumping, bouncing and friendly contact, respectively. Also, three criterions of choosing and tuning all these 14 parameters in the proposed fractional order impedance control are given out. This provides an insight for robot dynamic interaction, bouncing and jumping control.

In this article, the compliant behavior of an equivalent hydraulic leg is achieved by combining active compliance control of hydraulic cylinder with a passive spring at its end effector. Firstly, a position-based active compliance control is proposed based on impedance control to reduce the contact impact. Secondly, the stability of proposed compliance controller and the range of impedances (Z-width) of compliance control are analyzed, and the design procedure of proposed compliance controller is given out. Finally, experimental results show that the contact impacts could be well handled by the proposed control method. This research provides an insight for the compliance control of hydraulic legged robots.

Virtual model control is a motion control framework that uses virtual components to create virtual forces/torques, which are actually generated by joint actuators when the virtual components interact with robot systems. Firstly, this paper employs virtual model control to do a dynamic balance control of whole body of quadruped robots' trot gait in a bottom controller. In each leg, there exists a designed swing phase virtual model control and a stance phase counterparts. In the whole body, virtual model control is utilized to achieve a attitude control containing roll, pitch and yaw. In the attitude control, a forces/torques distribution method between two stance legs is pre-investigated. In a high-level implemented controller, an intuitive velocity control approach proposed by Raibert is applied for the locomotion of quadruped robots. Secondly, an anti-disturbance control, which contains compensating gravity, adjusting step length, adjusting swing trajectory, adjusting attitude, and adjusting virtual forces/torques, is investigated to improve the robustness, terrain adaptability, and dynamic balance performance of quadrupedal locomotion. Thirdly, a trajectory tracking control method based on an intuitive velocity control is addressed through considering four factors: terrain complexity index, curvature radius of given trajectory, distance to terminal, and maximum velocity of quadruped robots. Finally, simulations validate the effectiveness of proposed controllers.

The rotary vector reducer presents high precision and load capacity characteristics. The shape of the cycloidal gear tooth profile in the rotary vector reducer significantly affects its performance. Meanwhile, the effect of the machining error on the error between the designed and theoretical tooth profiles cannot be ignored. Thus, this paper analyzes the machining error items that affect the shape of the cycloidal gear profile from the machining process perspective. Due to the random characteristics and different distribution rules inherent in various machining errors, this paper proposes a cycloidal gear machining error compensation and modification model based on the Monte Carlo simulation method, providing a new theoretical method for compensating cycloidal gear machining errors. While compensating for machining errors, considering the impact of cycloidal gear modification on the carrying capacity, the NSGA-Ⅱoptimization algorithm is utilized to optimize the cycloidal gear modification parameter and finally, to solve the modification parameters with a more comprehensive performance.

Optimising fertilisation is an important part of maximising vegetable yield and quality whilst minimising environmental hazards. An accurate and efficient scheme of irrigation and fertiliser based on plants’ nutrient requirements at different growth stages is essential for the effective intensive production of greenhouse pepper (Capsicum annuum L.). In this study, the effects of reducing fertilisation rate by 20%, 40%, 60% and 80% from the day 6 to day 0 before harvest for each layer of peppers on growth, yield, quality and nutrient utilisation were evaluated. The results showed that the morphological indicators (plant height and stem diameter) and biomass of plants decreased gradually with the increase in fertiliser reduction rate. Compared with control (CK) plants, the 20–40% reduction in fertiliser application rate did not cause a significant decrease in biomass and stem diameter but significantly increased the accumulation of N (13.52–15.73%), P (23.09% in 20% reducted-treatment) and K (13.22–14.21%) elements in plants. The 20–80% reduction in fertiliser application before harvest had no significant effects on the nutrient agronomic efficiency of N, P and K elements. However, it decreased the physiological nutrient efficiency and significantly improved the nutrient harvest index of N, P and K. Appropriate reduction in fertiliser application significantly increased the nutrient recovery efficiency (20–40% reduction) and nutrient partial-factor productivity (40% reduction) of N (3.35–6.00% and 12.87%), P (2.47–2.92% and 14.01%) and K (7.49–15.68% and 14.01%), respectively. Furthermore, reducing the fertilisation rate by 20–40% before each harvest had a certain positive effect on the C and N metabolism of pepper leaves and fruits. In particular, the activities of N metabolism-related enzymes (nitrate reductase, nitrite reductase, glutamine synthase, glutamate synthase and glutamate dehydrogenase) and C metabolism-related enzymes (sucrose phosphate synthase, sucrose synthetase, acid invertase and neutral invertase) in leaves and fruits did not significantly different or significantly increased compared with those in CK plants. The results of the representative aromatic substance contents in the fruit screened by the random forest model showed that compared with the CK plants, reducing the fertiliser application by 20–40% before harvest significantly increased the content of capsaicin and main flavour substances in the fruit on the basis of stable yield. In summary, in the process of pepper substrate cultivation, reducing the application of nutrients by 40% from the day 6 to day 0 before each harvest could result in stable yield and quality improvement of the pepper. These results have important implications for institutional precision fertilisation programs and the improvement of the agroecological environment.

To improve the robustness of target tracking algorithms in a complex environment, this paper proposes the moving target detection and tracking algorithm based on context information and closed-loop learning. A context region is composed of the target region and its current neighboring background. For every frame that follows from a video stream, the long-term tracking task is principally decomposed into four parts of synchronous operation: tracking, detection, integration, and learning. First, the tracker obtains the posterior probability of the target location and estimates the target state over succeeding frames by exploiting the spatio-temporal local information. Meanwhile, the detector searches for the target in independent frames combining with the context information of tracker, and automatically reinitialize the tracker when it fails. Then, the integrator attains the best location of the target by merging the output results of tracker and detector together through an optimal strategy. Finally, the learning process is designed as the feedback and generates training samples to update the detector according to the results of tracker and detector. Experimentally, we evaluate the performance against several latest techniques on various benchmarks, and the results demonstrate that the proposed algorithm performs remarkably in terms of robustness and tracking accuracy.

Summary: Background: Stroke is a leading cause of death and disability worldwide. Despite considerable improvements in diagnosis and treatment, little is known about the short-term and long-term prognosis after a first stroke in low-income and middle-income countries, including China. We aimed to assess the short-term and long-term risk of recurrent stroke and mortality after a first stroke for each of the major pathological stroke types. Methods: This population-based cohort study included adults aged 35–74 years without disability who were recruited to the China Kadoorie Biobank (CKB). A baseline survey was conducted in ten geographical areas (five urban, five rural) in China, and participants had clinical measurements recorded. Participants were followed up by monitoring death registries and by electronic linkage to health registries and health insurance claims databases, with follow-up until Jan 1, 2017. Participants were excluded from analyses if they had a previous history of stroke, transient ischaemic attack, or ischaemic heart disease at baseline. All incidences of fatal and non-fatal stroke during the study period were recorded by type (ischaemic stroke, intracerebral haemorrhage, subarachnoid haemorrhage, and unspecified type). Primary outcome measures were 28-day mortality, recurrent stroke, major vascular events (recurrent stroke, myocardial infarction, or vascular death), vascular mortality, and all-cause mortality. Findings: Of 512 715 individuals in the CKB, 489 586 participants without previous ischaemic heart disease and stroke at recruitment were included, of whom 45 732 (42 073 [92%] confirmed by brain imaging) had a stroke during the study period. The mean age was 59·3 years (SD 9·8) for participants who had a stroke (54% women) and 50·8 years (10·3) for participants with no stroke (60% women). 36 588 (80%) of the incident cases of stroke were ischaemic stroke, 7440 (16%) were intracerebral haemorrhage, 702 (2%) were subarachnoid haemorrhage, and 1002 (2%) were an unspecified stroke type. 28-day mortality was 3% (95% CI 3–4) for ischaemic stroke, 47% (46–48)for intracerebral haemorrhage, 19% (17–22; 52% for rural areas and 32% for urban areas) subarachnoid haemorrhage, and 24% (22–27) for unspecified stroke. Among participants who survived stroke at 28 days, 41% (41–42) had recurrent stroke at 5 years (ischaemic stroke 41% [41–42], intracerebral haemorrhage 44% [42–46], subarachnoid haemorrhage 22% [18–27], unspecified stroke type 40% [35–44]) and mortality at 5 years was 17% ([17–18] ischaemic stroke 16% [15–16], intracerebral haemorrhage 28% [26–29], subarachnoid haemorrhage 16% [12–20], unspecified stroke type 15% [12–19]). After a first ischaemic stroke, 91% of recurrent strokes were also ischaemic stroke; after an intracerebral haemorrhage, 56% of recurrent strokes were intracerebral haemorrhage, and 41% of recurrent strokes were ischaemic stroke. Interpretation: After a first stroke, the risk of recurrence or death within 5 years was high among this population of Chinese adults. Urgent improvements to secondary prevention of stroke in China are needed to reduce these risks. Funding: Wellcome Trust, Medical Research Council, British Heart Foundation, Cancer Research UK, Kadoorie Charitable Foundation, Chinese Ministry of Science and Technology, National Natural Science Foundation of China. Copyright: © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.

Summary: Background: Cooking practice has transitioned from use of solid fuels to use of clean fuels, with addition of better ventilation facilities. However, the change in mortality risk associated with such a transition remains unclear. Methods: The China Kadoorie Biobank (CKB) Study enrolled participants (aged 30–79 years) from ten areas across China; we chose to study participants from five urban areas where transition from use of solid fuels to clean fuels for cooking was prevalent. Participants who reported regular cooking (weekly or more frequently) at baseline were categorised as persistent clean fuel users, previous solid fuel users, or persistent solid fuel users, according to self-reported fuel use histories. All-cause and cardiopulmonary mortality were identified through linkage to China's Disease Surveillance Point system and local mortality records. Findings: Between June 24, 2004, and July 15, 2008, 226 186 participants living in five urban areas of China were enrolled in the CKB Study. Among 171 677 participants who reported cooking regularly (weekly or more frequently), 75 785 (44%) were persistent clean fuel users, 80 511 (47%) were previous solid fuel users, and 15 381 (9%) were persistent solid fuel users. During a mean of 9·8 (SD 1·7) years of follow-up, 10 831 deaths were documented, including 3819 cardiovascular deaths and 761 respiratory deaths. Compared with persistent clean fuel users, persistent solid fuel users had significantly higher risks of all-cause mortality (hazard ratio [HR] 1·19, 95% CI 1·10–1·28), cardiovascular mortality (1·24, 1·10–1·39), and respiratory mortality (1·43, 1·10–1·85). The excess risk of all-cause and cardiopulmonary mortality fell by more than 60% in 5 years after cessation of solid fuel use and continued to decrease afterwards. Use of ventilation was associated with lower all-cause mortality risk, even among persistent clean fuel users (HR 0·78, 0·69–0·89). Interpretation: Solid fuel use for cooking is associated with a higher risk of mortality, and cessation of solid fuel use cuts excess mortality risks swiftly and substantially within 5 years. Ventilation use also lowers the risk of mortality, even among people who persistently use clean fuels. It is of prime importance for both policy makers and the public to accelerate the transition from solid fuels to clean fuels and promote efficient ventilation to minimise further adverse health effects. Funding: National Natural Science Foundation of China, Wellcome Trust, and Kadoorie Charitable Foundation.

Purpose: We aim to provide a systematic methodology for the optimal design of MRD for improved damping capacity and dynamical adjustability in performing its damping function. Methods: A modified Bingham model is employed to model and simulate the MRD considering the MR fluid’s compressibility. The parameters that describe the structure of MRD and the property of the fluid are systematically examined for their contributions to the damping capacity and dynamically adjustability. A response surface method is employed to optimize the damping force and dynamically adjustable coefficient for a more practical setting related to the parameters. Results: The simulation system effectively shows the hysteretic characteristics of MRDs and shows our common sense understanding that the damping gap width and yoke diameter have significant effects on the damping characteristics of MRD. By taking a typical MRD device setup, optimal design shows an increase of the damping force by 33% and an increase of the dynamically adjustable coefficient by 17%. It is also shown that the methodology is applicable to other types of MDR devices. Conclusion: The compressibility of MR fluid is one of the main reasons for the hysteretic characteristics of MRD. The proposed simulation and optimization methods can effectively improve the MRD’s damping performance in the design stage.

The wheel-legged hybrid robot (WLHR) is capable of adapting height and wheelbase configuration to traverse obstacles or rolling in confined space. Compared with legged and wheeled machines, it can be applied for more challenging mobile robotic exercises using the enhanced environment adapting performance. To make full use of the deformability and traversability of WHLR with parallel Stewart mechanism, this paper presents an optimization-driven planning framework for WHLR with parallel Stewart mechanism by abstracting the robot as a deformable bounding box. It will improve the obstacle negotiation ability of the high degree-of-freedoms robot, resulting in a shorter path through adjusting wheelbase of support polygon or trunk height instead of using a fixed configuration for wheeled robots. In the planning framework, we firstly proposed a pre-calculated signed distance field (SDF) mapping method based on point cloud data collected from a lidar sensor and a KD -tree-based point cloud fusion approach. Then, a covariant gradient optimization method is presented, which generates smooth, deformable-configuration, as well as collision-free trajectories in confined narrow spaces. Finally, with the user-defined driving velocity and position as motion inputs, obstacle-avoidancing actions including expanding or shrinking foothold polygon and lifting trunk were effectively testified in realistic conditions, demonstrating the practicability of our methodology. We analyzed the success rate of proposed framework in four different terrain scenarios through deforming configuration rather than bypassing obstacles.

Stability is a prerequisite for legged robots to execute tasks and traverse rough terrains. To guarantee the stability of quadruped locomotion and improve the terrain adaptability of quadruped robots, a stability-guaranteed and high terrain adaptability static gait for quadruped robots is addressed. Firstly, three chosen stability-guaranteed static gaits: intermittent gait 1&2 and coordinated gait are investigated. In addition, then the static gait: intermittent gait 1, which is with the biggest stability margin, is chosen to do a further research about quadruped robots walking on rough terrains. Secondly, a position/force based impedance control is employed to achieve a compliant behavior of quadruped robots on rough terrains. Thirdly, an exploratory gait planning method on uneven terrains with touch sensing and an attitude-position adjustment strategy with terrain estimation are proposed to improve the terrain adaptability of quadruped robots. Finally, the proposed methods are validated by simulations.

Summary: Background: China has high stroke rates despite the population being relatively lean. Uncertainty persists about the relevance of adiposity to risk of stroke types. We aimed to assess the associations of adiposity with incidence of stroke types and effect mediation by blood pressure in Chinese men and women. Methods: The China Kadoorie Biobank enrolled 512 891 adults aged 30–79 years from ten areas (five urban and five rural) during 2004–08. During a median 9 years (IQR 8–10) of follow-up, 32 448 strokes (about 90% confirmed by neuroimaging) were recorded among 489 301 participants without previous cardiovascular disease. Cox regression analysis was used to produce adjusted hazard ratios (HRs) for ischaemic stroke (n=25 210) and intracerebral haemorrhage (n=5380) associated with adiposity. Findings: Mean baseline body-mass index (BMI) was 23·6 kg/m2 (SD 3·2), and 331 723 (67·8%) participants had a BMI of less than 25 kg/m2. Throughout the range examined (mean 17·1 kg/m2 [SD 0·9] to 31·7 kg/m2 [2·0]), each 5 kg/m2 higher BMI was associated with 8·3 mm Hg (SE 0·04) higher systolic blood pressure. BMI was positively associated with ischaemic stroke, with an HR of 1·30 (95% CI 1·28–1·33 per 5 kg/m2 higher BMI), which was generally consistent with that predicted by equivalent differences in systolic blood pressure (1·25 [1·24–1·26]). The HR for intracerebral haemorrhage (1·11 [1·07–1·16] per 5 kg/m2 higher BMI) was less extreme, and much weaker than that predicted by the corresponding difference in systolic blood pressure (1·48 [1·46–1·50]). Other adiposity measures showed similar associations with stroke types. After adjustment for usual systolic blood pressure, the positive associations with ischaemic stroke were attenuated (1·05 [1·03–1·07] per 5 kg/m2 higher BMI); for intracerebral haemorrhage, they were reversed (0·73 [0·70–0·77]). High adiposity (BMI >23 kg/m2) accounted for 14·7% of total stroke (16·5% of ischaemic stroke and 6·7% of intracerebral haemorrhage). Interpretation: In Chinese adults, adiposity was strongly positively associated with ischaemic stroke, chiefly through its effect on blood pressure. For intracerebral haemorrhage, leanness, either per se or through some other factor (or factors), might increase risk, offsetting the protective effects of lower blood pressure. Funding: UK Wellcome Trust, UK Medical Research Council, British Heart Foundation, Cancer Research UK, Kadoorie Charitable Foundation, Chinese Ministry of Science and Technology, Chinese National Natural Science Foundation.

Summary: Background: The age-specific association between blood pressure and vascular disease has been studied mostly in high-income countries, and before the widespread use of brain imaging for diagnosis of the main stroke types (ischaemic stroke and intracerebral haemorrhage). We aimed to investigate this relationship among adults in China. Methods: 512 891 adults (59% women) aged 30–79 years were recruited into a prospective study from ten areas of China between June 25, 2004, and July 15, 2008. Participants attended assessment centres where they were interviewed about demographic and lifestyle characteristics, and their blood pressure, height, and weight were measured. Incident disease was identified through linkage to local mortality records, chronic disease registries, and claims to the national health insurance system. We used Cox regression analysis to produce adjusted hazard ratios (HRs) relating systolic blood pressure to disease incidence. HRs were corrected for regression dilution to estimate associations with long-term average (usual) systolic blood pressure. Findings: During a median follow-up of 9 years (IQR 8–10), there were 88 105 incident vascular and non-vascular chronic disease events (about 90% of strokes events were diagnosed using brain imaging). At ages 40–79 years (mean age at event 64 years [SD 9]), usual systolic blood pressure was continuously and positively associated with incident major vascular disease throughout the range 120–180 mm Hg: each 10 mm Hg higher usual systolic blood pressure was associated with an approximately 30% higher risk of ischaemic heart disease (HR 1·31 [95% CI 1·28–1·34]) and ischaemic stroke (1·30 [1·29–1·31]), but the association with intracerebral haemorrhage was about twice as steep (1·68 [1·65–1·71]). HRs for vascular disease were twice as steep at ages 40–49 years than at ages 70–79 years. Usual systolic blood pressure was also positively associated with incident chronic kidney disease (1·40 [1·35–1·44]) and diabetes (1·14 [1·12–1·15]). About half of all vascular deaths in China were attributable to elevated blood pressure (ie, systolic blood pressure >120 mm Hg), accounting for approximately 1 million deaths (

Summary: Background: In developed countries, smoking is associated with increased risk of diabetes. Little is known about the association in China, where cigarette consumption has increased (first in urban, then in rural areas) relatively recently. Moreover, uncertainty remains about the effect of smoking cessation on diabetes in China and elsewhere. We aimed to assess the associations of smoking and smoking cessation with risk of incident diabetes among Chinese adults. Methods: The prospective China Kadoorie Biobank enrolled 512 891 adults (59% women) aged 30–79 years during 2004–08 from ten diverse areas (five urban and five rural) across China. Participants were interviewed at study assessment clinics, underwent physical measurements, and had a non-fasting blood sample taken. Participants were separated into four categories according to smoking history: never-smokers, ever-regular smokers, ex-smokers, and occasional smokers. Incident diabetes cases were identified through linkage with diabetes surveillance systems, the national health insurance system, and death registries. All analyses were done separately in men and women and Cox regression was used to yield adjusted hazards ratios (HRs) for diabetes associated with smoking. Findings: 68% (n=134 975) of men ever smoked regularly compared with 3% (n=7811) of women. During 9 years' follow-up, 13 652 new-onset diabetes cases were recorded among 482 589 participants without previous diabetes. Among urban men, smokers had an adjusted HR of 1·18 (95% CI 1·12–1·25) for diabetes. HRs increased with younger age at first smoking regularly (1·12, 1·20, and 1·27 at ≥25 years, 20–24 years, and

This paper proposes a new unsupervised image segmentation method by using Bhattacharyya distance‐based irregular pyramid, termed as ‘BDIP’ algorithm. The proposed BDIP algorithm obtains a suboptimal labelling solution under the condition that the number of segments is not manually given. It hierarchically builds each level of the irregular pyramid, with the result that the final segments emerge as they are represented by single nodes at certain levels. The BDIP algorithm employs Bhattacharyya distance to estimate the intra‐level similarity at higher pyramidal levels so as to improve the accuracy and robustness to noise. Furthermore, an adaptive neighbour search method is proposed such that the BDIP algorithm can self‐determine the number of segments. This method considers not only the graphic constraint, but also the similarity constraint in the sense that a candidate node is selected as a neighbour of the centre node if there is no boundary evidence between these two nodes. With the pyramidal accumulation, this evaluation is aggregated into the approximately global evidence, based on which the number of segments can be self‐determined. Experimental results have shown that this proposed BDIP algorithm outperforms other benchmark segmentation algorithms in terms of segmentation accuracy, labelling cost and robustness to noise.

To reduce the computation and to improve the performance of object detection and tracking algorithm with object appearance variation, a tracker based on sparse eigenbasis is proposed. According to the compressive sensing theory, the objects are described in a low‐dimensional sub‐space representation based on Karhunen–Loeve transform learned online. Meanwhile, combining the Bayesian inference, an adaptive object tracker is presented. First, the authors represent the appearance of the object in a low‐dimensional sub‐space, then the authors obtain the optimal estimation of the state parameters by Bayesian inference. Finally, the authors update the eigenbasis space using the optimal observations. Experimental results show that the proposed method is able to track the objects effectively and robustly under temporary occlusion and large illumination changes.

BackgroundBreastfeeding confers substantial benefits to child health and has also been associated with lower risk of maternal cardiovascular diseases (CVDs) in later life. However, the evidence on the effects of CVD is still inconsistent, especially in East Asians, in whom the frequency and duration of breastfeeding significantly differ from those in the West. Methods and ResultsIn 2004–2008, the nationwide China Kadoorie Biobank recruited 0.5 million individuals aged 30 to 79 years from 10 diverse regions across China. During 8 years of follow‐up, 16 671 incident cases of coronary heart disease and 23 983 cases of stroke were recorded among 289 573 women without prior CVD at baseline. Cox regression yielded adjusted hazard ratios (HRs) and 95% CIs for incident CVD by breastfeeding. Overall, ≈99% of women had given birth, among whom 97% reported a history of breastfeeding, with a median duration of 12 months per child. Compared with parous women who had never breastfed, ever breastfeeding was associated with a significantly lower risk of CVD, with adjusted HRs of 0.91 (95% CI, 0.84–0.99) for coronary heart disease and 0.92 (95% CI, 0.85–0.99) for stroke. Women who had breastfed for ≥24 months had an 18% (HR, 0.82; 0.77–0.87) lower risk of coronary heart disease and a 17% (HR, 0.83; 0.79–0.87) lower risk of stroke compared with women who had never breastfed. Among women who ever breastfed, each additional 6 months of breastfeeding per child was associated with an adjusted HR of 0.96 (95% CI, 0.94–0.98) for coronary heart disease and 0.97 (95% CI, 0.96–0.98) for stroke. ConclusionsAmong Chinese women, a history of breastfeeding was associated with an ≈10% lower risk of CVD in later life and the magnitude of the inverse association was stronger among those with a longer duration of breastfeeding.

Background and purpose Previous studies, mostly focusing on the European population, have reported polygenic risk scores (PRSs) might achieve risk stratification of stroke. We aimed to examine the association strengths of PRSs with risks of stroke and its subtypes in the Chinese population.Methods Participants with genome-wide genotypic data in China Kadoorie Biobank were split into a potential training set (n=22 191) and a population-based testing set (n=72 150). Four previously developed PRSs were included, and new PRSs for stroke and its subtypes were developed. The PRSs showing the strongest association with risks of stroke or its subtypes in the training set were further evaluated in the testing set. Cox proportional hazards regression models were used to estimate the association strengths of different PRSs with risks of stroke and its subtypes (ischaemic stroke (IS), intracerebral haemorrhage (ICH) and subarachnoid haemorrhage (SAH)).Results In the testing set, during 872 919 person-years of follow-up, 8514 incident stroke events were documented. The PRSs of any stroke (AS) and IS were both positively associated with risks of AS, IS and ICH (p