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Thermal storage system (TES) with phase change material (PCM) is an important device to store thermal energy. It works as a thermal buffer to reconcile the supply energy with the energy demand. It has a wide application field, especially for solar thermal energy storage. The main drawback is the low value of thermal conductivity of the PCM making the system useless for thermal engineering applications. A way to resolve this problem is to combine the PCM with a highly conductive material like metal foam and/or nanoparticles. In this paper a numerical investigation on the metal foam effects in a latent heat thermal energy storage system, based on a phase change material with nanoparticles (nano-PCM), is accomplished. The modelled TES is a typical 70 L water tank filled with nano-PCM with pipes to transfer thermal energy from a fluid to the nano-PCM. The PCM is a pure paraffin wax and the nanoparticles are in aluminum oxide. The metal foam is made of aluminum with assigned values of porosity. The enthalpy-porosity theory is employed to simulate the phase change of the nano-PCM and the metal foam is modelled as a porous media. Numerical simulations are carried out using the Ansys Fluent code. The results are shown in terms of melting time, temperature at varying of time, and total amount of stored energy.

A numerical investigation on the effects of the metal foam into the Latent Heat Thermal Energy Storage System, based on a phase change material, is accomplished. The geometry of the system is a rectangular box heated from below. The PCM is completely embedded in the rectangular box, it is pure paraffin wax with a low value of thermal conductivity and it melts in a range of temperatures. The metal foam is made of copper and it partially fills the rectangular box in order to understand the optimal filling ratio of the foam to have the better thermal performance. The enthalpy-porosity theory is employed to simulate the phase change of the PCM and the metal foam is modelled as a porous media that follow the Brinkman-extended Darcy model. The results are shown in term of melting time, temperature and energy at varying of time or at varying the filling height ratio.

Les mousses métalliques constituent une catégorie relativement récente de matériaux utilisés dans différentes applications, telles que: dissipateurs de chaleur compacts, opérations géothermiques, échangeurs de chaleur et centrales thermiques solaires. L'utilisation de mousses métalliques dans les échangeurs de chaleur leur confère efficacité, compacité et légèreté pour la porosité ouverte, une conductivité thermique élevée et une grande surface accessible par unité de volume. Une étude numérique a été menée pour évaluer les comportements thermiques et hydrodynamiques d'un échangeur de chaleur tubulaire en mousse d’aluminium. La condition d’énergie non thermique d’équilibre est considérée comme ce qui permet d’exécuter des simulations bi-dimensionnelles sur l’échangeur thermique en mousse métallique. Les mousses examinées sont caractérisées par une porosité distincte, de 0,90 à environ 0,97, pour différentes valeurs de pores par pouce égales à 5, 10, 20 et 40. Différents débits d'air et une température de tube de surface assignée sont imposés. Les résultats sont donnés en termes de coefficient de transfert de chaleur et de nombre de Nusselt local évalués sur la surface externe du tube. Les paramètres globaux typiques dans un échangeur de chaleur compact, tels que l'efficacité et le NTU, sont présentés. De plus, les profils de température et de vitesse de l'air local sont présentés dans la section transversale, entre deux tubes consécutifs. Enfin, le Rapport Performance Énergie (RPE) est présenté afin de démontrer l'efficacité des mousses métalliques. Metal foams are a relatively recent category of materials used in different applications, such as: compact heat sinks, geothermal operations, heat exchanger and solar thermal plants. The use of metal foams in heat exchangers gives it efficiency, compact and light for the open porosity, a high thermal conductivity and a large accessible surface area per unit volume. A numerical study has been conducted to evaluate the thermal and fluid dynamic behaviors of a tubular aluminum foam heat exchanger. The thermal non-equilibrium energy condition is considered to execute two-dimensional simulations on metal foam heat exchanger. The examined foams are characterized by distinct porosity, from 0.90 to about 0.97, for different values of pores per inch, equal to 5, 10, 20 and 40. Different air flow rates and an assigned surface tube temperature are imposed. The results are given in terms of heat transfer coefficient and local Nusselt number evaluated on the external surface of the tube. Typical global parameters in a compact heat exchanger, such as effectiveness and NTU, are showed. Moreover, local air temperature and velocity profiles are presented in the cross section, between two consecutive tubes. Finally, the Energy Performance Ratio (EPR) is showed in order to demonstrate the effectiveness of the metal foams.

Background/Objectives: Satisfaction among undergraduate nursing students plays a crucial role in student retention, helping to mitigate nursing shortages in the workforce, reduce academic costs, and uphold universities’ reputations. The Nursing Student Satisfaction Scale (NSSS) measures three theoretical domains: Professional Social Interaction, Curriculum and Teaching, and Learning Environment. Although the NSSS has demonstrated reliability and validity with respect to American nursing students, its psychometric properties have not been tested on a population of Italian nursing students. Therefore, this study aimed to determine the reliability and validity of the NSSS in regard to Italian nursing students. Methods: A multicenter observational study was conducted on undergraduate nursing students in Central Italy. A confirmatory approach was used to assess structural validity. The construct validity, internal consistency, test–retest reliability, and responsiveness to change of the NSSS were evaluated using correlation analyses, reliability coefficients, and measurement error determination. Results: Confirmatory factor analysis supported the three-factor first-order structure of the NSSS as well as the presence of a single second-order factor. Reliability was adequate for all the coefficients computed (with values ranging from 0.924 to 0.974). Construct validity was supported. The measurement error was adequate. Conclusions: The NSSS exhibited robust measurement properties, confirming its validity and reliability as an instrument for assessing nursing student satisfaction in the Italian context. Furthermore, our results indicate that, after the translation and cultural adaptation of the scale, the construct of nursing student satisfaction remains consistent with the theoretical model.

Intensive care units (ICUs) are among the most resource-intensive healthcare settings and represent a strategic priority for environmental sustainability policies. While technological solutions are increasingly promoted, sustainable practice in ICUs also depends on nurses’ knowledge, attitudes, and behaviors, which remain insufficiently studied using validated, context-specific tools and longitudinal designs. This research protocol describes a multi-phase, theory-driven study aimed at developing and validating the Knowledge, Attitudes, and Behaviors Questionnaire on Environmental Sustainability in Intensive Care Units (KABQES-ICU) and at evaluating the longitudinal impact of a structured sustainability training program. Phase 1 focuses on instrument development and psychometric validation, grounded in a conceptual framework integrating individual, psychological, and organizational determinants and informed by qualitative evidence from ICU nurses. Phase 2 consists of a longitudinal intervention study assessing changes in sustainability-related competencies and their effects on nurse, patient, caregiver, organizational, and environmental outcomes. This protocol is designed to generate robust evidence to support the integration of sustainability into ICU quality improvement strategies and health policy frameworks without compromising patient safety.

Background Self-care is essential for patients with diabetes mellitus. Both clinicians and researchers must be able to assess the quality of that self-care. Available tools have various limitations and none are theoretically based. The aims of this study were to develop and to test the psychometric properties of a new instrument based on the middle range-theory of self-care of chronic illness: the Self-Care of Diabetes Inventory (SCODI). Methods Forty SCODI items (5 point Likert type scale) were developed based on clinical recommendations and grouped into 4 dimensions: self-care maintenance, self-care monitoring, self-care management and self-care confidence based on the theory. Content validity was assessed by a multidisciplinary panel of experts. A multi-centre cross-sectional study was conducted in a consecutive sample of 200 type 1 and type 2 diabetes patients. Dimensionality was evaluated by exploratory factor analyses. Multidimensional model based reliability was estimated for each scale. Multiple regression models estimating associations between SCODI scores and glycated haemoglobin (HbA1c), body mass index, and diabetes complications, were used for construct validity. Results Content validity ratio was 100%. A multidimensional structure emerged for the 4 scales. Multidimensional model-based reliabilities were between 0.81 (maintenance) and 0.89 (confidence). Significant associations were found between self-care maintenance and HbA1c ( p  = 0.02) and between self-care monitoring and diabetes complications ( p  = 0.04). Self-care management was associated with BMI ( p  = 0.004) and diabetes complications ( p  = 0.03). Self-care confidence was a significant predictor of self-care maintenance, monitoring and management (all p  < 0.0001). Conclusion The SCODI is a valid and reliable theoretically-grounded tool to measure self-care in type 1 and type 2 DM patients.

Aims Self‐care, an essential component of heart failure (HF) treatment, is inadequate in most patients. We evaluated if motivational interviewing (MI) (i) improves patient self‐care maintenance (primary endpoint; e.g. taking medications), self‐care management (e.g. responding to symptoms) and self‐care confidence (or self‐efficacy) 3 months after enrolment; (ii) changes self‐care over 1 year, and (iii) augments patient self‐care if informal caregivers are involved. Methods and results Parallel randomized controlled trial (1:1:1). A sample of 510 patients (median 74 years, 58% male) and caregivers (median 55 years, 75% female) was randomized to Arm 1 (MI only for patients), Arm 2 (MI for patients and caregivers), or Arm 3 (usual care). The intervention in Arms 1 and 2 consisted of one face‐to‐face MI session with three telephone contacts. Self‐care was evaluated with the Self‐Care of HF Index measuring self‐care maintenance, management, and confidence. Scores on each scale range from 0 to 100 with higher scores indicating better self‐care; ≥70 is considered adequate. At 3 months, self‐care maintenance improved 6.99, 7.42 and 2.58 points in Arms 1, 2, and 3, respectively (P = 0.028). Self‐care maintenance was adequate in 18.4%, 19.4%, and 9.2% of patients in Arms 1, 2 and 3, respectively (P = 0.016). Over 1 year, self‐care maintenance, management, and confidence scores in Arms 1 and 2 were significantly higher than in Arm 3 in several follow‐ups. Over 1 year, Arm 2 had the best scores in self‐care management. Conclusions MI significantly improved self‐care in HF patients. Including caregivers may potentiate the effect, especially in self‐care management. ClinicalTrial.gov, identifier: NCT02894502.

Several reports have indicated that SARS-CoV-2 infection displays unexpected mild clinical manifestations in people with cystic fibrosis (pwCF), suggesting that CFTR expression and function may be involved in the SARS-CoV-2 life cycle. To evaluate the possible association of CFTR activity with SARS-CoV-2 replication, we tested the antiviral activity of two well-known CFTR inhibitors (IOWH-032 and PPQ-102) in wild type (WT)-CFTR bronchial cells. SARS-CoV-2 replication was inhibited by IOWH-032 treatment, with an IC50 of 4.52 μM, and by PPQ-102, with an IC50 of 15.92 μM. We confirmed this antiviral effect on primary cells (MucilAirTM wt-CFTR) using 10 μM IOWH-032. According to our results, CFTR inhibition can effectively tackle SARS-CoV-2 infection, suggesting that CFTR expression and function might play an important role in SARS-CoV-2 replication, revealing new perspectives on the mechanisms governing SARS-CoV-2 infection in both normal and CF individuals, as well as leading to potential novel treatments.

We know that patient and caregiver sex influence patient self-care and caregiver contribution to self-care in multiple chronic conditions. However, the role of dyad sex combination (e.g., male patient and female caregiver, female patient and male caregiver, male patient and caregiver, and female patient and caregiver) in influencing patient self-care and caregiver contribution to self-care remains unexplored. Our aim was to investigate the relationship between patient and caregiver sex combination and patient self-care and caregiver contribution to self-care in multiple chronic conditions.INTRODUCTIONWe know that patient and caregiver sex influence patient self-care and caregiver contribution to self-care in multiple chronic conditions. However, the role of dyad sex combination (e.g., male patient and female caregiver, female patient and male caregiver, male patient and caregiver, and female patient and caregiver) in influencing patient self-care and caregiver contribution to self-care remains unexplored. Our aim was to investigate the relationship between patient and caregiver sex combination and patient self-care and caregiver contribution to self-care in multiple chronic conditions.Multicentre cross-sectional study.DESIGNMulticentre cross-sectional study.We enrolled patients with multiple chronic conditions and caregiver dyads in outpatient and community settings from April 2017 to December 2019. We used the Self-Care of Chronic Illness Inventory and the Caregiver Contribution to Self-Care of Chronic Illness Inventory that measure, from the patient and caregiver perspective, self-care maintenance (i.e., behaviors to maintain illness stability), self-care monitoring (i.e., monitoring of illness signs and symptoms), and self-care management (i.e., behaviors to manage signs and symptoms). We used multivariate analysis of covariance to evaluate the association between sex and self-care and caregiver contribution to self-care.METHODSWe enrolled patients with multiple chronic conditions and caregiver dyads in outpatient and community settings from April 2017 to December 2019. We used the Self-Care of Chronic Illness Inventory and the Caregiver Contribution to Self-Care of Chronic Illness Inventory that measure, from the patient and caregiver perspective, self-care maintenance (i.e., behaviors to maintain illness stability), self-care monitoring (i.e., monitoring of illness signs and symptoms), and self-care management (i.e., behaviors to manage signs and symptoms). We used multivariate analysis of covariance to evaluate the association between sex and self-care and caregiver contribution to self-care.We recruited 540 patient-caregiver dyads. Male patients cared by female caregivers performed higher self-care maintenance compared to female patients cared by female caregivers. Female caregivers caring for female patients performed higher caregiver contribution to self-care monitoring compared to male caregivers caring for female or male patients.RESULTSWe recruited 540 patient-caregiver dyads. Male patients cared by female caregivers performed higher self-care maintenance compared to female patients cared by female caregivers. Female caregivers caring for female patients performed higher caregiver contribution to self-care monitoring compared to male caregivers caring for female or male patients.Clinicians should consider the influence of patient and caregiver sex combination on self-care and caregiver contribution to self-care in multiple chronic conditions to provide tailored interventions.CONCLUSIONSClinicians should consider the influence of patient and caregiver sex combination on self-care and caregiver contribution to self-care in multiple chronic conditions to provide tailored interventions.Healthcare professionals should consider the patient and caregiver sex combination in the dyad to tailor better interventions aimed at improving patient self-care and caregiver contribution to self-care in multiple chronic conditions.CLINICAL RELEVANCEHealthcare professionals should consider the patient and caregiver sex combination in the dyad to tailor better interventions aimed at improving patient self-care and caregiver contribution to self-care in multiple chronic conditions.

PurposeHeart failure (HF) affects up to 14% of the elderly population and its prevalence is increasing. Self-care is fundamental to living successfully with this syndrome, but little is known about how self-care evolves over time. The present study aimed to (a) identify longitudinal trajectories of self-care confidence and maintenance among HF patients, (b) investigate whether each trajectory is characterized by specific sociodemographic and clinical patients’ characteristics, and (c) assess the association between the self-care confidence and maintenance trajectories.MethodWe conducted a prospective descriptive study of 225 HF patients followed for 6 months with data collected at baseline and 3 and 6 months. Latent class growth analysis (LCGA) was used to identify longitudinal trajectories. ANOVA and contingency tables were used to characterize trajectories and investigate their association.ResultsThree self-care confidence (persistently poor, increasingly adequate, and increasingly optimal) and three self-care maintenance (persistently poor, borderline but improving, and increasingly good) trajectories were identified. Married individuals were less likely to be in the persistently poor trajectory of self-care confidence. Patients with persistently poor self-care maintenance took fewer medications than patients with one of the better self-care maintenance trajectories. The two sets of trajectories were significantly and meaningfully associated.ConclusionPatients in a poor self-care trajectory (confidence or maintenance) are at high risk to stay there without improving over time. These results can be used to develop tailored and potentially more effective health care interventions.