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California is facing three major challenges in electrical grid operation: renewableovergeneration, steep evening ramping, and growing peak demand. The state has identifieddynamic retail price response as a key strategy evidenced by CPUC’s Dynamic Rates proceedingand CEC’s Load Management Standards. Furthermore, the CEC launched a $16M “CaliforniaLoad Flexibility Research and Deployment Hub (CalFlexHub)” administered by Berkeley Lab toaccelerate price-response flexible load technologies in buildings and EV charging.There are more than 16 laboratory and field demonstration projects in CalFlexHub, eachdemonstrating innovative automated price-response technologies. CalFlexHub tests variouspathways through which hourly price signals and triggered control commands are communicatedto load-flexible devices such as smart thermostats, heat pumps, water heaters, and EVs. Weidentified seven unique communication and control pathways, which involve combinations ofthird-party cloud, device OEM’s cloud, building central gateway, and local controller in betweenthe price server and the load-flexible devices.It is important for utilities and policy makers to understand the long-term implications ofeach pathway in designing future programs and creating related policies and mandates for markettransformation. We propose an evaluation framework including the following aspects:● Functionality: connectivity and uptime, resilience, and optimization;● Customer experience: simplicity in setup, troubleshooting support, continuity,customer choice, first cost, and ongoing cost;● Business model and scalability: advance interoperability, holistic solution, bridgeunique gap, customer base, and value streams and pricing structures.In this paper, we identify emerging business models associated with each communicationpathway and discuss their positive features and challenges from the above aspects.

ISO 50001:2011 is a voluntary international standard that provides a flexible framework for implementing a continual improvement-based system to manage energy. Experience shows that institutionalizing ISO 50001’s proven best practices can lead to deep total energy savings of 5–20 percent annually. Based on an internationally developed methodology for predicting future impacts of ISO 50001 uptake within a region from McKane et al. (2017), we estimate that adopting ISO 50001 within the U.S. commercial buildings sector can generate annual energy savings of approximately 65 billion Btu in 2030. Commercial properties also could leverage ISO 50001 to unlock benefits through increased property values, rental premiums, company valuations, and access to new capital markets. Currently, within the United States, ISO 50001 has been primarily adopted in the industrial sector, with limited uptake in the commercial sector. This paper discusses the motivation, implementation approach, and achieved benefits of two ISO 50001-certified companies with commercial building portfolios in the United States. Anecdotal results from these companies show that the commercial buildings sector has an opportunity to implement ISO 50001 cost-effectively at the enterprise level and scale energy savings quickly—especially among organizations with campuses and/or chains of geographically scattered buildings with similar building energy systems. These early results, coupled with estimated impacts from ISO 50001 uptake within the U.S. commercial buildings sector, suggest that direct uptake and incorporation of the standard in utility and government programs will generate significant energy and greenhouse gas reductions.

Building demand flexibility (DF) has attracted significant attention in recent years among researchers, technology developers and control companies, aggregators, utilities, and many others. There are numerous challenges with today’s electricity systems such as managing peak demand capacity and integrating variable renewables into the grid. Flexible building loads can provide various grid services to help reduce electricity costs, smooth out renewables intermittency and balance supply and demand. Recognizing this, the US DOE is leading the Grid-interactive Efficient Buildings (GEB) initiative which includes research to evaluate the potential, availability and timing of flexible loads.In this paper we present load shed metrics for three building types – medium office, large office and retail store – and compare prototype simulation results with measured data from 12 actual buildings that participated in hot summertime utility demand response (DR) events. The DR strategies included varying zone temperature and reducing light levels. The magnitude of a key DF metric, “demand decrease intensity” (or “shed intensity”) (W/ft2), between the simulation results and field data are similar (14-32% differences) for both mean and median values, though the field data show much larger variation among DR events. The coefficient p-values from linear regression model tests showed that outside air temperature is a significant variable for the whole building shed intensity when the resetting zone temperature strategy is deployed. These findings support the concept of using prototype building simulation to estimate building DF and expanding future simulation research to additional building types and climate zones.

The U.S. Department of Energy’s National Roadmap for Grid-interactive Efficient Buildings (GEB) acknowledged that building demand flexibility (DF) is both an important strategy to decarbonizing the buildings sector and an important resource for meeting the changing needs of the electrical grid such as improving grid reliability. However, understanding the complexity and uncertainties in real building field performance of DF strategies is a large gap hindering stakeholders on both grid and buildings side to make investments on deploying such strategies. The research work in this report intended to advance understanding of the variability and influential factors in building demand flexibility. Adding such knowledge based on lab testing results and measured performance data from real buildings is an important contribution.The report uses standardized metrics and methods to quantify DF performance from field-measured DF datasets of two significant building groups of big-box retail and medium office buildings to present the challenge of building DF variability in multiple dimensions. The report presents findings related to how several key factors influence building demand flexibility from implementing a common, cost-effective DF control strategy (i.e., adjusting zone temperatures). The findings are supported by full-scale lab testing, field data analysis and simulation research. The authors also provided application-oriented recommendations to stakeholders such as building aggregators, utility program design professionals, sophisticated building portfolio owners, and more.

This energy services interface (ESI) requirements document represents a process step in the path for creating an ESI specification, which will describe the technical characteristics of an ESI. This document outlines the concepts that need to be covered in the ESI specification, such as principal functions of the ESI, grid services communicated through the ESI, and the ESI lifecycle. It provides context for the Department of Energy’s (DOE’s) Grid Modernization Laboratory Consortium (GMLC) to engage industry participants in the development of the ESI specification. To do this, it describes the desired contents of the ESI specification and provides examples of the type of material that needs to be included in it.The purpose of the ESI specification is to define the requirements that are to be addressed in information and communications technology (ICT) interface standards for enabling the integration of a facility containing responsive distributed energy resources (DER facility) to an electric system consistent with the fundamental ESI principles. In this context, a DER facility may consist of a single DER with a communicating controller or may be as complex as a microgrid campus with several buildings and many DERs. The ESI specification is not a technical interface standard, but the requirements in the specification can be used to check that existing, augmented, or new interface standards meet the interoperability requirements of the ESI concept, which is explained further in this document. In this way, the ESI specification can be used to guide standards advancement work in multiple standards development organizations.To explain the scope of the ESI specification, this ESI requirements document provides examples of situations (or illustrative applications) for using an ESI to coordinate DER flexibility for grid operations. These examples originate from foundational work for describing common grid-DER service agreements that are anticipated to be supported using this interface.

Commercial building energy benchmarking has been used as a mechanism to evaluate energy use of a single building over time, relative to other similar buildings, or to simulations of a reference building conforming to various energy standards. Lack of empirical demand flexibility data and consistent flexibility metrics has limited the ability to compare demand flexibility performance with estimated demand flexibility in buildings. In this study, we collected demand response performance data for a total of 831 demand response events from 192 sites as a first step to build such a building demand flexibility dataset, and propose a standard core data schema to consolidate field data from different sources. We also performed parametric simulations of a control strategy called “global temperature adjustment” using commercial office prototype building models. We then compared the simulated demand flexibility performance against the actual data for offices with global temperature adjustment strategy implemented. During demand response events with an average outside air temperature of 34 °C (range 23 °C–42 °C), the measured demand decrease intensity of the demand flexibility metrics were 6.1 watts per square meter (W/m2), 10.0 W/m2, 11.1 W/m2, 7.1 W/m2, and 4.7 W/m2 for small, small–medium, medium, medium–large, and large office buildings, respectively. Compared to the measured data in medium- and large-size buildings, the simulated demand decrease intensity was 0.7 W/m2 (17%) lower on average. The discrepancy between simulated and measured peak demand intensities fell within one standard deviation of the mean measured data. The comparison results validate the credibility of simulations in capturing real building data for assessing the technical potential of building demand flexibility.

Objective To construct a perioperative and postoperative home nutritional intervention regimen for children with hepatoblastoma, and to evaluate its clinical application effect. Methods Semi-structured interviews, literature research, and Delphi methods were used to construct a perioperative and postoperative nutritional intervention regimen for children with he-patoblastoma. A total of 31 children with hepatoblastoma who underwent surgery in our hospital from January 2019 to August 2021 were enrolled as control group, and 31 children with hepatoblastoma who underwent surgery from September 2021 to December 2023 were enrolled as experimental group. The children in the control group received routine diagnosis, treatment, and nursing, and those in the experimental group received the nutritional intervention regimen in addition to the intervention in the control group. The two groups were compared in terms of nutritional status, blood biochemical parameters (serum albumin, serum prealbumin, and blood hemoglobin), body height, body weight, and body mass index at 1 week before surgery and at 1 week, 1 month, and 3 months after surgery, and the clinical guiding significance and practical effect of the nutritional intervention regimen was assessed. Results At 1 and 3 months after surgery, compared with the control group, the experimental group had a significant reduction in the numbers of children with mild-to-moderate malnutrition and severe malnutrition (Z=-2.799,-3.697,P

This paper gives a full description of development of foreign air-to-air missiles in 2023. It pre-sents the latest advancement progress and testing situation of AIM-9X, AIM-120,AIM-260, LongShot program, Modular Advanced Missile, MUTANT project, ASRAAM, IRIS-T, Meteor missile, innovative missile technologies, and RVV-MD2, JNAAM, Sky Spear, Astra BVRAAM. In the end, this paper summarizes the new development features of air-to-air missiles.

Critically ill patients are at high risk for hospital acquired infections, which can significantly increase the mortality rate and treatment costs for these patients. Therefore, in the process of treating the primary disease, strict prevention and control of new hospital infections is an essential component of the treatment for critically ill patients. The treatment of critically ill patients involves multiple steps and requires a concerted effort from various aspects such as theory, management, education, standards, and supervision to achieve effective prevention and control of hospital infections. However, there is currently a lack of unified understanding and standards for hospital infection prevention and control. To address this, in March 2024, a group of experts in critical care medicine, infectious diseases, and hospital infection from China discussed the current situation and issues of hospital infection control in the intensive care unit together. Based on a review of the latest evidence-based medical evidence from both domestic and international sources, 2024 Expert Consensus on Hospital Acquired Infection Control Principles in the Department of Critical Care Medicine was formed, aiming to provide a basis for the development of hospital infection prevention and control strategies in the field of critical care medicine.

The department of critical care medicine has a high prevalence of hospital acquired infections, which are closely associated with prognosis of critically ill patients. With hospital acquired infections as the axis, the treatment of critically ill patients can be divided into three phases: management of the primary disease and support of organ function, treatment of various complications resulting from the primary disease, and control of further damage and new complications. The cycle of the last two phases may put the patient in a state of Persistent inflammation, Immunosuppression, and Catabolism Syndrome (PICS), which ultimately leads to a poor prognosis. Fine control of the above three stages to reduce the risk of hospital acquired infections is a non-negligible component of the critical care process. Therefore, how to understand, prevent and treat hospital acquired infections is a top priority in the current development of critical care medicine. This review provides a comprehensive overview of strategies for the prevention and management of hospital acquired infections in critical care, covering five areas: changing the perception of hospital acquired infections, standardizing specific prevention interventions, consolidating the theoretical basis, recognizing that hospital acquired infection prevention are treatments, and integrating treatment to quality assurance. The aim is to develop the concept of severe treatment based on the prevention and control of severe patients, reduce the risk of hospital acquired infections of severe patients and improve the quality of critical care.

Currently, the situation of global food security is complicated and severe, and diet-derived chronic diseases are sweeping the world. Meanwhile, the views of “health-centered”, “nutritional diversity”, and “Food is Medicine” have become the general consensus. Using agricultural biodiversity to explore a new generation of crops that are both high-yield and nutritious has become an international trend, and Huangjing (i. e., Polygonati rhizoma) has notable characteristics and advantages. To fully unleash the potentials of Huangjing, this study systematically summarizes its history as both food and medicine, material basis of nutrition and efficacy as forest grain, as well as resource distribution and food production potentials. Huangjing does not contain starch, but rich in nutrients such as fructans with a complex structure, easy degradation, and energy, which is vital for serving life and health. Huangjing is suitable for in-forest planting or intercropping with maize and does not take up the farmland or compete for forest land. It has enormous production capacities and is crucial for ensuring food security. Huangjing is suitable for planting and processing in thousands of households, with good economic benefits, and is of great significance for achieving common prosperity. However, the Huangjing industry of China currently faces multiple challenges in terms of basic research, application technologies, as well as cultural heritage and policy support. Therefore, it is necessary to strengthen research on the basic sciences and application technologies of the industry. Meanwhile, we suggest to incorporate Huangjing production into the policy and funding guarantee system for woody grain and oil, integrate Huangjing application into the healthcare and population health planning, and regard the Huangjing industry as an important carrier for rural revitalization and common prosperity, thus to establish a complete innovation and application system covering the entire industrial chain.