1.Prediction of major adverse cardiovascular events after acute type A aortic dissection combined with coronary malperfusion by machine learning-based interpretable models
Hao ZHANG ; Bo JIA ; Zuo ZHANG ; Huanyu QIAO ; Bo YANG ; Jing YANG ; Feilong HEI ; Xiaotong HOU ; Junming ZHU ; Yongmin LIU
Chinese Journal of Thoracic and Cardiovascular Surgery 2025;41(3):129-135
Objective:To explore and model risk factors in patients with major adverse cardiovascular events (MACEs) after acute type A aortic dissection (ATAAD), and to develop and validate a personalized machine learning model to assess risk factors and predict MACEs in these patients.Methods:Clinical data of patients who attended Beijing Anzhen Hospital and underwent surgical treatment for ATAAD from January 2018 to October 2022 were retrospectively analyzed. Using MACEs as the endpoint, 70% of these patients were randomly divided into the training set and the remaining 30% into the validation set. LASSO regression was applied to explore key clinical variables in the training set. The optimal predictive model was selected from nine machine learning algorithms based on area under the curve. And Shapley Additive explanations was used to elucidate the predictive model. Results:Of the 481 patients included in this study, 135 (35.6%) patients experienced an endpoint event. By combining the results of the training and validation sets, when assessing the validity of the single model with the highest predictive accuracy for the outcome, it was shown that the logistic model (0.774, 95% CI: 0.717-0.830) was the most effective in the combined effect and had a high model accuracy (0.743, 95% CI: 0.720-0.766). According to the results of the LASSO, the factors most associated with postoperative MACEs were history of cerebrovascular disease, coronary artery involvement, shock status on admission to the operating room, FDP, PLT, CPB, ascending aortic clamping, and age. Conclusion:In this study, nine machine learning models were developed to predict the occurrence of postoperative MACEs in patients with acute type A aortic dissection. The logistic model performed significantly better compared to other algorithms. Our study successfully predicted postoperative MACES and identified the factors most associated with MACEs.
2.The impact of aerobic calisthenics exercise on sleep quality in children with attention deficit hyperactivity disorder
Dongqing KUANG ; Feilong ZHU ; Xiaoyu BI ; Xiaotong ZHU ; Fangyuan YAO ; Yuanchun REN
Chinese Journal of Sports Medicine 2025;44(6):435-441
Objective To explore the effect of aerobic calisthenics on sleep quality in children with attention-deficit/hyperactivity disorder(ADHD).Methods Forty children with ADHD(aged 9~11 years;mean age 9.83±0.76 years)were recruited from the pediatric outpatient department of some class-3 grade-A hospital in Beijing.They were randomized into an intervention group(n=21)and a control group(n=19).Both groups participated in standard school physical education programs,while the intervention group underwent 60-minute aerobic calisthenics exercise sessions three times weekly for 8 weeks.Before and after the intervention,the sleep condition was measured using the children's sleep habits questionnaire(CSHQ)and the three-axis acceleration recorder.The inter-group differenc-es in sleep dimensions were analyzed using independent samples t-tests,while the intra-group ones were evaluated using paired t-tests.Results(1)Inter-group comparison:Before the experiment,no sig-nificant differences were detected between the two groups in sleep characteristics.After the experi-ment,in comparison with the control group,there was a significant decrease in awakening time,aver-age awakening time,and sleep latency time of the intervention group,but a significant increase in sleep efficiency(P<0.05).Moreover,the total score of CSHQ,as well as the sleep resistance and sleep delay scores,were significantly lower in the intervention group(P<0.05).(2)Intra-group com-parison:In the intervention group,after the experiment,there were significant reductions in awakening time and sleep latency time,and a significant enhancement in sleep efficiency(P<0.05).Moreover,the total score of CSHQ,along with the scores of sleep resistance,sleep delay,and daytime sleepi-ness,decreased significantly(P<0.05).In the control group,the daytime sleepiness score decreased af-ter the experiment(P<0.05).Conclusion An 8-week aerobic calisthenics exercise(60 minutes/session,3 sessions/week)significantly improves overall sleep quality in children with ADHD.Therefore,it is worth application in the clinical practice.
3.Associations between sleep and executive function development in children with attention deficit hyperactivity disorder
Dongqing KUANG ; Feilong ZHU ; Baohua XU ; Shengqi LIN ; Xiaoyu BI ; Xiaotong ZHU ; Yuanchun REN
Chinese Mental Health Journal 2025;39(12):1043-1049
Objective:To investigate the sleep characteristics and executive function development in children aged 6-12 years with attention deficit hyperactivity disorder(ADHD),and to examine the relationship between them.Methods:A total of 112 children diagnosed with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ),and 45 age-and gender-matched typically developing children were recruited.Sleep characteristics were assessed with the Chinese version of Children's Sleep Habits Questionnaire(CSHQ)and ActiGraph GT9X Link Three-axis acceleration body dynamometert.Core ADHD symptoms and multi-ple dimensions of executive function were evaluated withthe Swanson,Nolan,and Pelham scale,Fourth Edition(SNAP-Ⅳ)assessment scale,Stroop Color-Word Test(SCWT),Rey-Osterrieth Complex Figure Test(ROCFT),and Trail Making Test(TMT).Results:Compared with controls,children with ADHD showed significantly higher total CSHQ scores,sleep resistance,sleep anxiety,and sleep maintenance time(P<0.05),and had significantly lower sleep efficiencies measured by ActiGraph GT9X Link(P<0.05).In the SCWT,children with ADHD re-quired more time in the word interference and color interference tests(P<0.05).In the ROCFT,the scores of im-mediate details,delayed details,immediate structure,and delayed structure were lower in the children with ADHD(P<0.05).In the TMT,the number of errors in the digit connection and the time and number of errors in the digit-letter connection were higher in the children with ADHD(P<0.05).The total CSHQ scores of ADHD children were negatively correlated with the working memory scores and positively correlated with the core symptom scores.Conclusion:Children with ADHD exhibit notable sleep disturbance and underdeveloped executive func-tion.the sleep problems,as measured by CSHQ are associated significantly with deficits in executive function.
4.Associations between sleep and executive function development in children with attention deficit hyperactivity disorder
Dongqing KUANG ; Feilong ZHU ; Baohua XU ; Shengqi LIN ; Xiaoyu BI ; Xiaotong ZHU ; Yuanchun REN
Chinese Mental Health Journal 2025;39(12):1043-1049
Objective:To investigate the sleep characteristics and executive function development in children aged 6-12 years with attention deficit hyperactivity disorder(ADHD),and to examine the relationship between them.Methods:A total of 112 children diagnosed with ADHD according to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ),and 45 age-and gender-matched typically developing children were recruited.Sleep characteristics were assessed with the Chinese version of Children's Sleep Habits Questionnaire(CSHQ)and ActiGraph GT9X Link Three-axis acceleration body dynamometert.Core ADHD symptoms and multi-ple dimensions of executive function were evaluated withthe Swanson,Nolan,and Pelham scale,Fourth Edition(SNAP-Ⅳ)assessment scale,Stroop Color-Word Test(SCWT),Rey-Osterrieth Complex Figure Test(ROCFT),and Trail Making Test(TMT).Results:Compared with controls,children with ADHD showed significantly higher total CSHQ scores,sleep resistance,sleep anxiety,and sleep maintenance time(P<0.05),and had significantly lower sleep efficiencies measured by ActiGraph GT9X Link(P<0.05).In the SCWT,children with ADHD re-quired more time in the word interference and color interference tests(P<0.05).In the ROCFT,the scores of im-mediate details,delayed details,immediate structure,and delayed structure were lower in the children with ADHD(P<0.05).In the TMT,the number of errors in the digit connection and the time and number of errors in the digit-letter connection were higher in the children with ADHD(P<0.05).The total CSHQ scores of ADHD children were negatively correlated with the working memory scores and positively correlated with the core symptom scores.Conclusion:Children with ADHD exhibit notable sleep disturbance and underdeveloped executive func-tion.the sleep problems,as measured by CSHQ are associated significantly with deficits in executive function.
5.Association between gross motor development characteristics and child Chinese developmental dyslexia
Yuanchun REN ; Biyao FAN ; Yiling SONG ; Jiuju WANG ; Feilong ZHU ; Ning JI ; Qingjiu CAO
Chinese Mental Health Journal 2025;39(1):37-42
Objective:To explore the association between the gross motor development of children and Chi-nese developmental dyslexia.Methods:A total of 54 children were enrolled,indadit 27 children with Chinese DD and 27 age-gender-matched normal children.The Test of Gross Motor Development-Third Edition(TGMD-3),and the balance tests from the Movement Assessment Battery for Children(M-ABC)were used to evaluate the children's gross motor development level.Children's reading ability was evaluated by primary school students'literacy test question bank,one-minute reading task,and the Reading Test on Pupils.Results:The overall analysis of motortests showed that the grossmotor total score,locomotor score,object control score,and balance score in the DD group were significantly lower than those in the normal control group(P<0.05).Logistic regression analysis revealed a negative association between balance scores,locomotor scores,object control scores,TGMD-3 total scores and indi-viduals with dyslexia(OR=3.08,1.35,1.16,1.13,Ps<0.05).Conclusion:The delayed gross motor development of children is associated with the occurrence of Chinese developmental dyslexia.
6.The impact of aerobic calisthenics exercise on sleep quality in children with attention deficit hyperactivity disorder
Dongqing KUANG ; Feilong ZHU ; Xiaoyu BI ; Xiaotong ZHU ; Fangyuan YAO ; Yuanchun REN
Chinese Journal of Sports Medicine 2025;44(6):435-441
Objective To explore the effect of aerobic calisthenics on sleep quality in children with attention-deficit/hyperactivity disorder(ADHD).Methods Forty children with ADHD(aged 9~11 years;mean age 9.83±0.76 years)were recruited from the pediatric outpatient department of some class-3 grade-A hospital in Beijing.They were randomized into an intervention group(n=21)and a control group(n=19).Both groups participated in standard school physical education programs,while the intervention group underwent 60-minute aerobic calisthenics exercise sessions three times weekly for 8 weeks.Before and after the intervention,the sleep condition was measured using the children's sleep habits questionnaire(CSHQ)and the three-axis acceleration recorder.The inter-group differenc-es in sleep dimensions were analyzed using independent samples t-tests,while the intra-group ones were evaluated using paired t-tests.Results(1)Inter-group comparison:Before the experiment,no sig-nificant differences were detected between the two groups in sleep characteristics.After the experi-ment,in comparison with the control group,there was a significant decrease in awakening time,aver-age awakening time,and sleep latency time of the intervention group,but a significant increase in sleep efficiency(P<0.05).Moreover,the total score of CSHQ,as well as the sleep resistance and sleep delay scores,were significantly lower in the intervention group(P<0.05).(2)Intra-group com-parison:In the intervention group,after the experiment,there were significant reductions in awakening time and sleep latency time,and a significant enhancement in sleep efficiency(P<0.05).Moreover,the total score of CSHQ,along with the scores of sleep resistance,sleep delay,and daytime sleepi-ness,decreased significantly(P<0.05).In the control group,the daytime sleepiness score decreased af-ter the experiment(P<0.05).Conclusion An 8-week aerobic calisthenics exercise(60 minutes/session,3 sessions/week)significantly improves overall sleep quality in children with ADHD.Therefore,it is worth application in the clinical practice.
7.Association between gross motor development characteristics and child Chinese developmental dyslexia
Yuanchun REN ; Biyao FAN ; Yiling SONG ; Jiuju WANG ; Feilong ZHU ; Ning JI ; Qingjiu CAO
Chinese Mental Health Journal 2025;39(1):37-42
Objective:To explore the association between the gross motor development of children and Chi-nese developmental dyslexia.Methods:A total of 54 children were enrolled,indadit 27 children with Chinese DD and 27 age-gender-matched normal children.The Test of Gross Motor Development-Third Edition(TGMD-3),and the balance tests from the Movement Assessment Battery for Children(M-ABC)were used to evaluate the children's gross motor development level.Children's reading ability was evaluated by primary school students'literacy test question bank,one-minute reading task,and the Reading Test on Pupils.Results:The overall analysis of motortests showed that the grossmotor total score,locomotor score,object control score,and balance score in the DD group were significantly lower than those in the normal control group(P<0.05).Logistic regression analysis revealed a negative association between balance scores,locomotor scores,object control scores,TGMD-3 total scores and indi-viduals with dyslexia(OR=3.08,1.35,1.16,1.13,Ps<0.05).Conclusion:The delayed gross motor development of children is associated with the occurrence of Chinese developmental dyslexia.
8.Prediction of major adverse cardiovascular events after acute type A aortic dissection combined with coronary malperfusion by machine learning-based interpretable models
Hao ZHANG ; Bo JIA ; Zuo ZHANG ; Huanyu QIAO ; Bo YANG ; Jing YANG ; Feilong HEI ; Xiaotong HOU ; Junming ZHU ; Yongmin LIU
Chinese Journal of Thoracic and Cardiovascular Surgery 2025;41(3):129-135
Objective:To explore and model risk factors in patients with major adverse cardiovascular events (MACEs) after acute type A aortic dissection (ATAAD), and to develop and validate a personalized machine learning model to assess risk factors and predict MACEs in these patients.Methods:Clinical data of patients who attended Beijing Anzhen Hospital and underwent surgical treatment for ATAAD from January 2018 to October 2022 were retrospectively analyzed. Using MACEs as the endpoint, 70% of these patients were randomly divided into the training set and the remaining 30% into the validation set. LASSO regression was applied to explore key clinical variables in the training set. The optimal predictive model was selected from nine machine learning algorithms based on area under the curve. And Shapley Additive explanations was used to elucidate the predictive model. Results:Of the 481 patients included in this study, 135 (35.6%) patients experienced an endpoint event. By combining the results of the training and validation sets, when assessing the validity of the single model with the highest predictive accuracy for the outcome, it was shown that the logistic model (0.774, 95% CI: 0.717-0.830) was the most effective in the combined effect and had a high model accuracy (0.743, 95% CI: 0.720-0.766). According to the results of the LASSO, the factors most associated with postoperative MACEs were history of cerebrovascular disease, coronary artery involvement, shock status on admission to the operating room, FDP, PLT, CPB, ascending aortic clamping, and age. Conclusion:In this study, nine machine learning models were developed to predict the occurrence of postoperative MACEs in patients with acute type A aortic dissection. The logistic model performed significantly better compared to other algorithms. Our study successfully predicted postoperative MACES and identified the factors most associated with MACEs.
9.A meta-analysis of effects of acute exercise on executive function in patients with attention deficit hyperactivity disorder
Jingyi ZHOU ; Li HE ; Feilong ZHU ; Yuanchun REN
Chinese Mental Health Journal 2024;38(12):1058-1065
Objective:To explore the effect of acute exercise on the executive function in patients with atten-tion deficit hyperactivity disorder(ADHD),and to provide a theoretical basis for the exercise intervention of ADHD.Methods:Experimental studies on the effect of acute exercise on executive function in patients with ADHD published up to 21 April 2023 were searched from PubMed,Web of Science,Cochrane Library,Embase,CNKI,Wanfang,and other data platforms.Results:A total of 15 studies were included,and 515 patients with ADHD were included.The results of meta-analysis showed that a single exercise could improve inhibitory control(SMD=0.36,95%CI=0.17-0.55,P<0.05)and cognitive flexibility(SMD=0.40,95%CI=0.10-0.69,P<0.05)in pa-tients with ADHD.The results of subgroup analysis showed that in terms of the age of the participants,a single ex-ercise could only improve inhibitory control and cognitive flexibility in children and adolescents with ADHD(SMD=0.36,0.43,Ps<0.05),but not in adult patients with ADHD(SMD=0.34,0.14,Ps>0.05).In terms of exer-cise regimen,only a single exercise with moderate and high intensity,≤ 20 minutes,and open motor skills could simultaneously improve inhibitory control(SMD=0.47,0.51,0.47,Ps<0.05)and cognitive flexibility(SMD=0.86,0.65,0.86,Ps<0.05)in patients with ADHD.Conclusion:Acute exercise could improve inhibitory control and cognitive flexibility in children and adolescents with ADHD,but has no significant effect on working memory and executive function in adult patients.
10.Effects of exercise intervention on reading abilities of children with Chinese developmental dyslexia
Biyao FAN ; Yuanchun REN ; Yiling SONG ; Feilong ZHU ; Fangzhou GENG ; Rongjie SUN ; Jiuju WANG
Chinese Journal of Sports Medicine 2024;43(5):364-371
Objective To explore the impact of exercise intervention on the reading abilities of chil-dren with Chinese developmental dyslexia(CDD).Methods Twenty-seven CDD children were recruited from patients of Peking University Sixth Hospital,and randomly divided into a CDD exercise interven-tion group of 14 and a CDD control group of 13.Another 14 age-matched normal children were select-ed into a normal control group.All groups kept daily physical activities in school,while the CDD ex-ercise intervention group additionally underwent 8-week individualized gross and fine motor interven-tion.The literacy,reading fluency and reading comprehension of all groups were evaluated by using"Elementary School Students'Literacy Test and Evaluation Scale",one-minute word reading and ele-mentary school students'reading ability assessment.Results Before the intervention,there were no sig-nificant differences between the exercise intervention and control groups in the literacy level,reading fluency,and reading comprehension(P>0.05),which were all significantly lower than the normal con-trol group(P<0.05).However,after the intervention,significant improvement was observed in the aver-age literacy level,reading fluency,and reading comprehension of the CDD exercise intervention group,and the literacy and reading fluency of the CDD control group,as well as the average literacy level and reading comprehension of the normal control group.Moreover,there were no significant differ-ences between the CDD exercise intervention and control groups in the average literacy level and read-ing fluency score(P>0.05),both significantly lower than the normal control group(P<0.05).Mean-while,the reading comprehension score of the CDD exercise intervention group was significantly higher than the CDD control group(P<0.05),but significantly lower than the normal control group(P<0.05).Conclusion Eight-week targeted gross and fine motor intervention can effectively improve reading abili-ty of DD children,especially their reading comprehension.

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