Thermogravimetric experiments based prediction of biomass pyrolysis behavior: A comparison of typical machine learning regression models in Scikit-learn.

A variety of machine learning (ML) models have been extensively utilized in predicting biomass pyrolysis owing to their prowess in deciphering complex non-linear relationships between inputs and outputs, but there is still a lack of consensus on the optimal methods. This study elaborates on the development, optimization, and evaluation of three ML methodologies, namely, artificial neural networks, random forest (RF), and support vector machines, aimed to determine the optimal model for accurate prediction of biomass pyrolysis behavior using thermogravimetric data. This work assesses the utility of thermal data derived from these models in the computation of kinetic and thermodynamic parameters, alongside an analysis of their statistical performance. Eventually, the RF model exhibits superior physical interpretability and the least discrepancy in predicting kinetic and thermodynamic parameters. Furthermore, a feature importance analysis conducted within the RF model framework quantitatively reveals that temperature and heating rate account for 98.5 % and 1.5 %, respectively.

Kinetic reaction mechanism of lignocellulosic biomass oxidative pyrolysis based on combined kinetics.

The kinetics knowledge of lignocellulosic biomass decomposition is essential to develop efficient thermochemical conversion technology. However, the simplification of reaction mechanisms in existing oxidative pyrolysis studies largely compromises the application of kinetic models. To explore more exact kinetic parameters and reaction mechanism of lignocellulosic biomass oxidative pyrolysis, an updated oxidative pyrolysis kinetic model (seven-step reaction combined kinetics model) coupled with an optimization algorithm is proposed. Based on a series of thermogravimetric experiments in an air atmosphere, the extra oxidative pyrolysis kinetic parameters are obtained by the Shuffled Complex Evolution method. The proposed kinetic model is validated based on the degradation process of each component (hemicellulose, cellulose, and lignin). Furthermore, the obtained kinetic parameters are applied to predict the oxidative pyrolysis behavior, and the predicted mass loss rate is in good agreement with the experimental data. Eventually, according to the key combined kinetics parameters, it is found that the oxidative pyrolysis mechanisms of hemicellulose, cellulose, and lignin correspond to the power law, nucleation & growth, and chemical reaction order, respectively, while the combustion of char corresponds to the reaction order mechanism.

The mediating role of resilience in the relationship between social support and quality of life among patients after radical cystectomy: A structural equation model analysis.

AIM: This study aimed to examine the relationship between social support and quality of life in urostomy patients and identify the mediating role of resilience in that relationship. DESIGN: A cross-sectional design. METHODS: Participants included 232 patients who were recruited from a tertiary hospital in Beijing during March 2020 and August 2020. They completed questionnaires about perceived social support, resilience and ostomy-related quality of life. Structural equation modelling was performed to analyse the data. RESULTS: The mean age of patients was 65.79 (SD = 8.67) years, and the mean length of time after surgery was 42.14 (SD = 15.76) months. Urostomy patients' quality of life, social support and resilience were all above moderate. Social support had a positive direct effect on the quality of life and a positive indirect effect on the quality of life through the mediating role of resilience.

Translation and validation of 17-item Wound-QoL questionnaire in a Chinese population.

We aimed to translate the 17-item questionnaire to measure the quality of life of patients with chronic wounds (Wound-QoL-17) and verify its reliability and validity in the Chinese population. The standard Chinese version of the Wound-QoL-17 was determined through translation, back translation, and cultural adaptation. A total of 121 patients with chronic wounds from the wound center of a tertiary hospital in Beijing were recruited. Through a questionnaire and physical examination, we tested the criterion-related validity, known group validity, structural validity, internal consistency coefficient (Cronbach's alpha), and test-retest correlation. A new structure of four factors was extracted by exploratory factor analysis, and the cumulative contribution rate was 72.23%. The total score and that of the four factors, which were significantly correlated with the EuroQol Five Dimensions Questionnaire (EQ-5D) and the Short Form-36 Health Survey (SF-36) (P < 0.05), also showed statistically significant differences between patients with different pain grades, with or without wound odour, and between different groups of patients reporting wound changes in the past 2 weeks. Cronbach's alpha was between 0.779 and 0.906, while the test-retest reliability was between 0.532 and 0.802. We concluded that the Chinese Wound-QoL-17 has good reliability and validity and is suitable for evaluating the quality of life of patients with chronic wounds.

Incidence of and risk factors for post-intensive care syndrome among Chinese respiratory intensive care unit patients: A cross-sectional, prospective study.

BACKGROUND: Patients transferred from the respiratory intensive care unit (ICU) can experience post-intensive care syndrome (PICS), which comprises cognitive, psychological, and physical disorders that seriously affect the quality of life. Therefore, it was necessary to explore the incidence of and the risk factors for PICS among respiratory ICU patients. OBJECTIVES: This study evaluated PICS among respiratory ICU patients and explored the risk factors for PICS. METHODS: This cross-sectional, prospective study was performed at one hospital in China. Using convenience sampling, 125 respiratory ICU patients from August 2018 to June 2019 were recruited for the study. The Mini-Mental State Examination, Confusion Assessment Method for the Intensive Care Unit, Hospital Anxiety and Depression Scale, Medical Research Council Scale, activities of daily living scale, Pittsburgh Sleep Quality Index, and the 14-item fatigue scale were used to comprehensively assess the patients' cognitive status, psychological status, and physiological status when entering the ICU and 2 weeks after leaving the ICU. Factors affecting PICS were measured using researcher-created questionnaires of patients' general information and disease-related information. RESULTS: Fifteen patients were lost to follow-up. Fifty-nine patients had PICS (incidence rate, 53.6%). Logistic regression showed that risk factors for PICS were age, invasive mechanical ventilation, noninvasive ventilator-assisted ventilation, and coronary heart disease (P < 0.05). CONCLUSION: The PICS incidence was high. Older age, longer invasive mechanical ventilation times, longer noninvasive ventilator times, and coronary heart disease were risk factors for PICS. ICU medical workers in China should pay more attention on PICS, know the risk factors, and implement preventive measures.

Administration approaches of nursing assistants in hospitals: a scoping review.

OBJECTIVES: The administration of nursing assistants (NAs) is closely associated with patient outcomes, but studies evaluating intrahospital administration of NAs are limited. This study aimed to identify existing literature on intrahospital NAs' administration approaches. DESIGN: Scoping review. DATA SOURCES: PubMed, Embase, CINAHL, Scopus, ProQuest, CNKI, APA PsycInfo, Wanfang Med, SinoMed, Ovid Emcare, NICE, AHRQ, CADTH, JBI EBP and Cochrane DSR were searched for articles published between January 2011 and March 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Qualitative, quantitative or mixed-method studies and evidence syntheses that evaluate administration approaches, models and appraisal tools of intrahospital NAs were included. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers conducted search, data selection and data extraction according to Joanna Briggs Institute guidance and methodology for scoping review. The quality of included studies was assessed using Mixed Methods Appraisal Tool or AMSTAR V.2. Data were synthesised using narrative methods and frequency effect size analysis. RESULTS: Thirty-six studies were eligible, with acceptable quality. We identified 1 administration model, 9 administration methods, 15 educational programmes and 7 appraisal tools from the included studies. The frequency effect size analysis yielded 15 topics of the main focus at four levels, suggesting that included articles were mainly (33%) focused on the competency of NAs, and the lectures were the most (80%) used strategy in quality improvement projects. Evidence from the studies was of low-to-moderate quality, indicating huge gaps between evidence-based research and management practice. CONCLUSIONS: Practical intrahospital administration approaches were revealed, and fifteen primarily focused topics were identified. We should explore this area more thoroughly using structured frameworks and standardised methodology. This scoping review will help managers find more effective ways to improve the quality of care. Researchers may focus more on evidence-based practice in NA administration using the 15 topics as a breakthrough.

Status of core competencies of wound, ostomy and continence nurses and their influence on career success: a cross-sectional study.

OBJECTIVES: The wound, ostomy and continence nursing practice has its own scope and standards, and each standard requires relevant competency. However, the core competencies of wound, ostomy and continence nurses that contribute to the career success are poorly known. To identify associations between career success and core competencies of wound, ostomy and continence nurses in China. DESIGN: A cross-sectional survey with a convenience sample. SETTING: Participants were recruited from 108 hospitals in 28 provinces. PARTICIPANTS: A total of 123 wound, ostomy and continence nurses were surveyed. MEASURES: Career success, core competencies and demographic characteristics of wound, ostomy and continence nurses, were measured in this study. METHODS: A survey was distributed to 123 wound, ostomy and continence nurses were recruited from 108 hospitals in 28 provinces. Multivariate logistic regression was undertaken to explore associations between career success outcomes and core competency scores of wound ostomy and continence nurses and their demographic characteristics. RESULTS: The career success and core competency of wound, ostomy and continence nurses were both above average. Nurses who had higher total scores of core competency were more likely to have higher career success, including total score (OR=4.90), career satisfaction (OR=5.58) and perceived internal (OR=4.55)/external (OR=3.42) organisation competitiveness. Higher competency in interpersonal communication (OR=7.70) and more time for wound care per month (OR=8.80) predicted higher career satisfaction. Additionally, nurses with higher professional development were more likely to score higher in perceived internal organisation competitiveness of career success (OR=4.36) and the overall career success (OR=5.96). CONCLUSIONS: The career success and core competency of the wound, ostomy and continence nurses in China were at an above average level. The associations between career success and core competency of the wound, ostomy and continence nurses were positive, suggesting that competency enhancement could improve nurses' career success.

Numerical Simulation of the Smoke Recirculation Behavior in Street Canyons with Different Aspect Ratios and Cross-Wind Conditions.

This study investigated smoke dispersion inside a street canyon in a series of numerical simulations. The building height and street width as well as the cross-wind velocity were changed during the simulation, and the smoke recirculation behavior inside the canyon is presented and discussed. The results show that the smoke recirculation behavior could be distinguished into two different stages, i.e., the "fully recirculation stage" and "semi recirculation stage", which is strongly determined by the canyon aspect ratio (the building height divided by street width). It was found that the critical wind velocity at which the smoke recirculation would take place was almost constant for an ideal street canyon with an aspect ratio of 1; however, this velocity was decreased with increasing building height or decreasing street width, indicating a much more dangerous circumstance when the aspect ratio is greater. Finally, a new piecewise function is proposed for the critical smoke recirculation velocity for all cases, which can provide some theoretical basis for building designs and emergency rescue for human beings inside the street canyon.

Effects of heating rate on thermal degradation behavior and kinetics of representative thermoplastic wastes.

Waste thermoplastics are the most common solid wastes, and thermal degradation has excellent advantages in the disposal of these wastes and obtaining valuable hydrocarbon fuels. As a significant factor, the heating rate is crucial to the thermal degradation process. Consequently, thermal degradation behavior and kinetics of representative thermoplastics under different heating rates were investigated by using thermogravimetric analysis and differential scanning calorimetry in the air. Kinetic parameters were estimated by using the Coats-Redfern method. Subsequently, the Shuffled Complex Evolution (SCE) method was used to optimize kinetic parameters, and the optimized results were compared with the calculated kinetics of distributed activation energy model (DAEM) method to find the effects of heating rate on kinetic parameters. The results showed that with the increase of heating rate, thermogravimetric curves moved to the right, which corresponded to a higher temperature range. The number of mass loss rate peaks and exothermic peaks decreased. Additionally, activation energy was the same at the determined minimum and maximum heating rates, and other heating rates had little effect on kinetic parameters. Moreover, the calculated activation energy of the DAEM method at the minimum heating rate of 5 K/min was closest to the optimized values of the SCE method, indicating that the lower the minimum heating rate was, the more accurate the activation energy was.

Pyrolysis and combustion characteristics of typical waste thermal insulation materials.

Thermal insulation materials are important for building energy conservation, but their wastes have increased sharply. Furthermore, pyrolysis and combustion are increasingly utilized to dispose of solid wastes and convert them into value-added fuels. To better understand the pyrolysis and combustion characteristics of these materials, typical thermal insulation materials (expanded polystyrene (EPS) and extruded polystyrene (XPS)) were investigated by employing thermogravimetry and differential scanning calorimetry as well as cone calorimetry experiments. Pyrolysis behavior, kinetic parameters, pyrolysis index, thermodynamic parameters, endothermic properties and combustion parameters were estimated comprehensively. The results showed that EPS had better pyrolysis properties, while XPS had better combustion characteristics. Activation energies of EPS and XPS were 158.82 kJ/mol and 200.70 kJ/mol, respectively. Additionally, EPS had a higher pyrolysis stability index and comprehensive pyrolysis index, meaning a more intense reaction. Moreover, thermodynamic parameters indicated that the devolatilization products could be obtained easily from the two materials, and EPS and XPS could be converted into fuels. For the combustion, XPS had a smaller fire performance index and a larger fire growth index. These results can guide the reactor design and optimization for better converting polymer wastes into fuels and managing wastes.

Registered nurses' approach to pressure injury prevention: A descriptive qualitative study.

AIMS: To explore Registered Nurses' approaches to pressure injury prevention, including how they perceive their roles, how they prioritize pressure injury prevention and factors influencing prevention in the Chinese context. DESIGN: A qualitative descriptive study. METHODS: Audio-recorded, face-to-face, semi-structured individual interviews were conducted with Registered Nurses in a large tertiary hospital in China from August to December 2020. Using the System Engineering Initiative for Patient Safety Model, the interview guide was developed to describe the work system, processes and outcomes (three domains) associated with nurses' pressure injury prevention practices. Deductive and inductive content analyses were used. FINDINGS: Twenty-seven nurses participated in the interviews. Four themes related to two domains of the model emerged: Work system: (i) Nurses lead and coordinate pressure injury prevention; Work processes: (ii) Individualized pressure injury prevention is founded on comprehensive patient assessment; (iii) Collaborating ensures patients receive appropriate pressure injury prevention; and (iv) Competing factors influence the delivery of appropriate pressure injury prevention. One category emerged about work outcome: Nurses strive to do their best in pressure injury prevention but hold major concerns when pressure injuries occur. CONCLUSIONS: Nurses play a leading role in pressure injury prevention delivery but require appropriate resources and assistance and support from other healthcare personnel, patients and carers. Understaffing, lack of resources, complex reporting and poor patient compliance challenge nurses in their delivery of pressure injury prevention. IMPACT: Pressure injury prevention is primarily a nursing responsibility therefore nurses' approaches to prevention were explored. Nurses rely on collaboration with others and access to various resources to provide pressure injury prevention. They recognize the patients' and carers' roles and acknowledge the importance of accessing guidance and support from nursing leaders and wound experts. Acknowledging nurses leading role in prevention and ensuring they have adequate resources are important for quality care.

Pressure injury prevention practices among medical surgical nurses in a tertiary hospital: An observational and chart audit study.

Pressure injuries are frequently occurring adverse events in hospitals, negatively impacting patient safety and quality of care. Most pressure injuries are avoidable if effective prevention strategies are used. However, the extent to which various settings influence their use of prevention strategies is unknown. The aim of this study was to describe and compare pressure injury prevention strategies used by medical and surgical nurses in the Chinese context. In this observational study, we used semi-structured observations with chart audits to collect data in two medical and two surgical wards in a tertiary hospital from June to December 2020. Observations were patient-focused; any prevention practices the patient received were recorded, and a chart audit was used to identify documented prevention strategies. The frequency of each prevention strategy was reported, and differences between medical and surgical wards were analysed using independent t-test or χ2 test. A total of 577 patients (n = 294, 50.9% medical; n = 283, 49.1% surgical) were observed and their charts audited. Risk assessment was completed on admission for all patients. Repositioning was the most frequently used strategy, with about 84% (n = 486) patients being repositioned regularly. However, skin care, nutritional risk screening and the use of support surfaces were suboptimal. Patient education was not commonly observed but was documented in 75% (n = 433) of audited charts. More medical patients' skin was kept clean and hydrated, but more surgical patients received barrier creams, had a support surface and received more nutrition support and if a prone position was used, they were more likely to be turned after 2 hr and to be repositioned after sitting in a chair for an hour. Prevention strategies were more likely to be documented in surgical patients' charts. Despite pressure injury prevention guideline recommendations provided various prevention strategies for nurses to apply, the observed use of some strategies such as nutrition, skin care and support surfaces was not ideal. Nurses relied heavily on repositioning for pressure injury prevention. Most pressure injury prevention practices need improvement although surgical patients generally received better preventative care. These findings can facilitate clinicians and nurse managers when tailoring future pressure injury prevention work.

Pressure injury prevalence and risk factors in Chinese adult intensive care units: A multi-centre prospective point prevalence study.

Despite increasing preventive efforts, pressure injury still occurs in intensive care patients. This study was aimed to describe pressure injury prevalence, risk factors, and prevention practices in adult intensive care patients. This was a multi-centre, one-day, prospective point prevalence study in which a total of 198 intensive care units from 21 provinces in China participated. Overall and ICU-acquired prevalence in intensive care patients were 12.26% and 4.31%, respectively. Consistent with earlier reports, almost half of the ICU-acquired pressure injuries were at stage I, one-fourth were at stage 2, and the most common body sites for pressure injuries were sacral and heel region. Risk factors identified were consistent with prior studies. Repositioning was the most commonly used pressure injury prevention strategy, followed by alternating pressure mattresses/overlays, floating heels, and air-filled mattresses/overlays. These reflect a good level of adherence to recommended international pressure injury prevention clinical practice guidelines. The results provide a baseline reference for overall and ICU-acquired prevalence among adult intensive care patients in China. Future research on what contributed to the lower pressure injury incidence in China needs to be conducted to inform healthcare organisations on their future preventive strategies for pressure injury prevention.

Routine replacement versus replacement as clinical indicated of peripheral intravenous catheters: A multisite randomised controlled trial.

AIMS AND OBJECTIVES: To compare the safety of replacing peripheral intravenous catheter as clinically indicated versus routine replacement on patient outcomes in the Chinese context. BACKGROUND: Some evidence from developed countries recommend replacing peripheral intravenous catheter as clinically indicated; however, there is limited evidence from developing countries. DESIGN: A multisite randomised controlled trial. METHODS: The 3050 participants from three hospitals in China were randomly assigned to clinically indicated or routine replacement groups. Patients in the clinically indicated group had the catheters kept in situ until any of the following clinical signs appeared: phlebitis, infiltration, occlusion, displacement, local infection and diagnosed catheter-related bloodstream infection. Patients in the routine replacement group had their peripheral intravenous catheters replaced every 96 hours. The outcomes of phlebitis, infiltration, occlusion, displacement; catheter-related bloodstream infection, all-cause bloodstream infection, and local infection were compared. CONSORT checklist was used to guide the reporting of this RCT. RESULTS: The risk of phlebitis, phlebitis per 1000 catheter days, occlusion, dislodgement, all bloodstream infections, local infection and mortality between the two groups were not significantly different. The risk of infiltration was increased in the clinically indicated group (HR 1.29). There was no catheter-related bloodstream infection reported in either group. Patients' first peripheral intravenous catheter dwelling time and cumulative indwelling time of all peripheral intravenous catheters in the clinically indicated group were significantly longer than the routine replacement group. There was no statistical significant difference in survival times from phlebitis between the two groups. CONCLUSIONS: In the Chinese context, removing peripheral catheters as clinical indicated did not increase the risk of phlebitis, occlusion, catheter displacement and catheter infection; however, there was an increased infiltration incidence. RELEVANCE TO CLINICAL PRACTICE: In developing countries, removing peripheral catheters as clinical indicated is feasible, but more frequent observations of infiltration are highly recommended.

Knowledge of pressure injury in medical and surgical nurses in a tertiary level hospital: A cross-sectional study.

BACKGROUND: Nurses play a vital role in pressure injury prevention (PIP) but require foundational knowledge to ensure appropriate PIP strategies are enacted. AIMS: To describe and compare medical and surgical nurses' knowledge of pressure injury (PI) in a tertiary level hospital in China, and to identify predictors of PI knowledge among these groups. DESIGN: A cross-sectional survey was conducted between June and December 2020. METHODS: Registered nurses from nine medical and fifteen surgical wards in a tertiary hospital were invited. The survey was composed of two parts; demographic and professional characteristics; and the Chinese translated version of the Pressure Ulcer Knowledge Assessment Tool 2.0 (PUKAT 2.0) where the total score ranged from 0 to 25; higher scores imply more knowledge. Medical and surgical nurses' knowledge test scores were compared using independent t-test. Multiple linear regression analysis was used to determine factors predictive of nurses' knowledge. RESULTS: In total, 423 nurses from 24 wards participated the study and 404 nurses (95.5%) completed the knowledge test (Surgical n = 236, 58.4%; Medical n = 168, 41.6%). The PUKAT 2.0 mean score was 11.6 ± 3.0 (Surgical 12.2 ± 3.0; Medical 10.7 ± 2.8) with 335 (82.9%) nurses scoring <60%. Multiple linear regression showed working in surgical wards, nurse-in-charge position and previous PI training were significant predictors of knowledge scores. CONCLUSION: Knowledge is a precursor to safe practice. Nurses demonstrated poor knowledge of PIP. Pressure injury related education may help improve nurses' knowledge but the extent to which it is used in place and impacts patients' outcome requires more investigation.

Postprostatectomy Incontinence and Self-management for Urinary Incontinence After Laparoscopic Radical Prostatectomy: A Cross-sectional Study.

PURPOSE: The purpose of this study was to describe postprostatectomy incontinence (PPI) after laparoscopic radical prostatectomy (LRP), self-management strategies for managing incontinence, and factors influencing self-management. DESIGN: A descriptive, cross-sectional study. SUBJECTS AND SETTING: The sample comprising 37 males with prostate cancer who underwent LRP was recruited within first 2 years. The study setting was a tertiary care hospital in Beijing, China. An additional 78 individuals who responded to a mailed invitation sent from September 2015 to October 2016 participated in the study. METHODS: Participants completed a questionnaire that queried demographic and pertinent clinical data. The questionnaire also included 2 validated instruments. The International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) was used to assess urinary incontinence (UI) following radical prostatectomy and its severity. The Strategy and Effectiveness of Symptom Self-Management questionnaire of Postprostatectomy Incontinence (SESSM-PPI) was used to evaluate self-management of UI, including strategies used and their perceived effectiveness. RESULTS: Data analysis was based on 115 respondents who completed all components of the questionnaire; 95 (82.6%) indicated having UI. Forty-one patients (43.2%) indicated mild UI, 47 (49.5%) indicated moderate UI, and 7 (7.4%) indicated severe UI. The mean score of the SESSM-PPI was 14.04 ± 7.92, indicating a low level of self-management.The top 5 strategies with moderate effectiveness were in the following order: "use pads or adult diapers"; "pelvic floor muscle training"; "avoid extracting heavy objects"; "avoid drinking"; and "eat more fruit to prevent constipation." The Spearman correlation analysis revealed a positive correlation between the frequency of use of self-management strategies and incontinence severity. CONCLUSIONS: Urinary incontinence is prevalent among males with prostate cancer managed by radical prostatectomy. Respondents tended to report mild to moderate UI severity. Self-management of UI among respondents is low.

Nephrotoxicity of Immune Checkpoint Inhibitors: A Disproportionality Analysis from 2013 to 2020.

Nephrotoxicity occasionally occurs during treatment with immune checkpoint inhibitors (ICIs). Few related studies compare the differences between these drugs. This study aimed to systematically characterize nephrotoxicity after ICI initiation. Data were extracted from the US FDA Adverse Event Reporting System (FAERS) database. Disproportionality analysis, including information components (ICs) and reporting odds ratios (RORs), was performed to determine the potential renal toxicity of ICIs. A total of 7,204 reports of renal adverse events (AEs) were identified in the FAERS database. Renal AEs were most commonly reported for nivolumab (46.84%). Strong signals were detected in male patients combined with ICIs. In the clinical application of ICIs, attention should be paid to patients, especially male patients, with acute kidney injury, nephritis, autoimmune nephritis and other nephrotoxic AEs. The use of ICIs is likely to aggravate their condition.

Does Social Support Moderate Wound Pain and Health-Related Quality of Life in Patients With Chronic Wounds? A Multicenter Descriptive Cross-sectional Study.

PURPOSE: We sought to explore the relationships among social support, health-related quality of life (HRQOL), and wound pain, and to examine whether social support would moderate the relationship between wound pain and HRQOL. DESIGN: A multicenter descriptive cross-sectional study. SUBJECTS AND SETTINGS: Individuals with chronic wounds attending wound clinics affiliated with 3 public hospitals in Beijing, China. METHODS: Sociodemographic and wound characteristics of 162 participants were retrieved from medical records. Participants completed questionnaires for wound-related pain intensity (Numerical Rating Scale), social support (Social Support Rating Scale), and HRQOL (Medical Outcome Study Short Form-36). The moderating effect analysis was examined using the PROCESS analytic tool developed by Hayes, based on the bias-corrected bootstrapping method. RESULTS: Results revealed that higher pain intensity was significantly related to lower HRQOL (P < .01), and higher social support was associated with better HRQOL (P < .01). However, there was no significant correlation between social support and wound pain (P = .55). Importantly, the moderating effect of social support on the relationship between wound pain and HRQOL was statistically significant (P = .008). CONCLUSIONS: We found that social support moderated the impact of wound pain on HRQOL in patients with chronic wounds. This finding suggests that support obtained from social networks may be a beneficial intervention to improve the HRQOL of patients with chronic wounds, especially those suffering from high-intensity wound pain.

The development of a behaviour questionnaire for stoma self-management for persons with bladder cancer and an ileal conduit.

AIMS: To develop and preliminarily test the reliability and validity of a behaviour questionnaire for stoma self-management for patients with bladder cancer after radical cystectomy and ileal conduit. DESIGN: A psychometric instrument validation study conducted in two phases. METHODS: The initial version of behaviour questionnaire was developed based on guidelines for people living with a stoma. Five experts validated the content of the preliminary 29-item questionnaire. A cross-sectional survey was then conducted in Beijing for preliminary reliability and validity tests between 4 December 2017-28 April 2018. A total of 151 participants in the survey, 147 of whom completed the study and 16 completed a 2-week test-retest reliability test. RESULTS: The content validity indices were satisfied. A principal component analysis with direct oblimin rotation was performed. Sixteen items were retained, and three factors were identified, namely, pouching system change, emotional management, and role management. The 16-item questionnaire showed acceptable internal consistency and test-retest reliability. The mediational effect of self-management behaviour on the relationship between self-efficacy and stoma quality of life was confirmed via convergent validity testing. CONCLUSION: The behaviour questionnaire for stoma self-management appears to have adequate initial reliability and validity. More observational and interventional studies need to be conducted for further evaluation of its psychometric properties. IMPACT: This study developed a reliable instrument to measure self-management behaviours for persons living with a stoma after radical cystectomy and ileal conduit. The questionnaire has practical value for both healthcare providers and researchers working in this field. The 16-item questionnaire can be administered quickly in clinical practice. Based on the questionnaire and the elicited mediational model, psycho-education programs tailored to improve self-management should be designed, implemented, and re-inspected regarding their effectiveness for the target population in China.

Pyrolysis Kinetic Properties of Thermal Insulation Waste Extruded Polystyrene by Multiple Thermal Analysis Methods.

Extruded polystyrene (XPS) is a thermal insulation material extensively applied in building systems. It has attracted much attention because of outstanding thermal insulation performance, obvious flammability shortcoming and potential energy utilization. To establish the reaction mechanism of XPS's pyrolysis, thermogravimetric experiments were performed at different heating rates in nitrogen, and multiple methods were employed to analyze the major kinetics of pyrolysis. More accurate kinetic parameters of XPS were estimated by four common model-free methods. Then, three model-fitting methods (including the Coats-Redfern, the iterative procedure and masterplots method) were used to establish the kinetic model. Since the kinetic models established by the above three model-fitting methods were not completely consistent based on different approximations, considering the effect of different approximates on the model, the reaction mechanism was further established by comparing the conversion rate based on the model-fitting methods corresponding to the possible reaction mechanisms. Finally, the accuracy of the above model-fitting methods and Particle Swarm Optimization (PSO) algorithm were compared. Results showed that the reaction function g(α) = (1 - α)-1 - 1 might be the most suitable to characterize the pyrolysis of XPS. The conversion rate calculated by masterplots and PSO methods could provide the best agreement with the experimental data.