Strategisk Energiplanlægning for Transport

Transporten har i mange år været en kæmpe udfordring, når det kommer til at nå de nationalt og lokalt fastsatte målsætninger, hvilket tydeligt blev eksemplificeret i daværende chef for Concito, Martin Lidegaards, udtalelse [1]: ”Transporten er klimaets smertensbarn.” Dette skyldes, at transporten i en lang periode ikke har budt på reelle alternativer til de klassiske brændstoffer, og reduktioner af forbrug har derfor været forbundet med enten forsøg på at flytte folk ud af biler eller gennem Euro-normerne på europæisk niveau. I lang tid havde Danmark endda den grønneste bilpark i Europa som resultat af afgiftsomlægningen fra 2007, hvor biler i mikro og mini-segmentet overtog hovedparten af markedsandelene. Et andet centralt element i omstillingen af transporten, som gør den svær at håndtere fra kommunalt niveau er, at der er tale om et centralt element i den personlige følelse af frihed og identitet for den enkelte. [2] Det betyder at standard processer for strategisk energiplanlægning ikke på samme måde kan appliceres i udviklingen af handlingsplaner, da det i høj grad er et spørgsmål om at forandre folks vaner. Strategisk Enerigplanlægning for Transport kræver således en multidisciplinær proces, hvor der arbejdes struktureret med interessenter på tværs af organisationsgrupper, nye måder at tænke på lokal involvering og lokal forankring samt visionær sammenkobling med eksisterende tiltag. Elementer, som passer mere til industriens strategiprocesser. Dette paper forsøger at kombinere kendte processer til udarbejdelse af strategiske energiplaner med industrielle strategiprocesser for at definere en ny tilgang til arbejdet med dette område. Den beskrevne proces er testet i samarbejde med ProjectZero og Sønderborg Kommune, hvor resultatet er implementeret politisk og i praksis

Lessons Learned from the Danish EV Living Lab

The success of EVs in the marketplace will highly depend on the end-user acceptance. Insero E-Mobility has examined the user acceptance of EVs through a living lab study, where 80 Danish families used EVs for a period of 8-10 weeks as their only car. The study included a general test and identification of problems faced during usage as well as positive features of the EVs. Fleet potentials were additionally investigated with two trials in departments in Danish municipalities for 14 days. The living lab approach was used to reveal actual and latent needs as well as to facilitate innovation processes with the purpose of rendering input for product and business model development that will increase chance of end-user acceptance of EVs in the future. Long term public user trials has also in the case of the Danish EV Living Lab proven to provide comprehensive and rich amount of information on end customer needs and perceptions that can be used to define value across a range of attributes considered in vehicle purchasing decisions. Key conclusions are that 90% of families found that an EV could fulfil their demands but that range is an important issue even though it is mostly a psychological barrier. For fleets the EVs make sense to an extent depending on the predictability of driving behaviour and available infrastructure. Document type: Articl

Randomised comparison of provisional side branch stenting versus a two-stent strategy for treatment of true coronary bifurcation lesions involving a large side branch:the Nordic-Baltic Bifurcation Study IV

Background - It is still uncertain whether coronary bifurcations with lesions involving a large side branch (SB) should be treated by stenting the main vessel and provisional stenting of the SB (simple) or by routine two-stent techniques (complex). We aimed to compare clinical outcome after treatment of lesions in large bifurcations by simple or complex stent implantation. Methods - The study was a randomised, superiority trial. Enrolment required a SB≥2.75 mm, ≥50% diameter stenosis in both vessels, and allowed SB lesion length up to 15 mm. The primary endpoint was a composite of cardiac death, non-procedural myocardial infarction and target lesion revascularisation at 6 months. Two-year clinical follow-up was included in this primary reporting due to lower than expected event rates. Results - A total of 450 patients were assigned to simple stenting (n=221) or complex stenting (n=229) in 14 Nordic and Baltic centres. Two-year follow-up was available in 218 (98.6%) and 228 (99.5%) patients, respectively. The primary endpoint of major adverse cardiac events (MACE) at 6 months was 5.5% vs 2.2% (risk differences 3.2%, 95% CI −0.2 to 6.8, p=0.07) and at 2 years 12.9% vs 8.4% (HR 0.63, 95% CI 0.35 to 1.13, p=0.12) after simple versus complex treatment. In the subgroup treated by newer generation drug-eluting stents, MACE was 12.0% vs 5.6% (HR 0.45, 95% CI 0.17 to 1.17, p=0.10) after simple versus complex treatment. Conclusion - In the treatment of bifurcation lesions involving a large SB with ostial stenosis, routine two-stent techniques did not improve outcome significantly compared with treatment by the simpler main vessel stenting technique after 2 years

Long-term results after simple versus complex stenting of coronary artery bifurcation lesions:nordic bifurcation study 5-year follow-up results

ObjectivesThis study sought to report the 5-year follow-up results of the Nordic Bifurcation Study.BackgroundRandomized clinical trials with short-term follow-up have indicated that coronary bifurcation lesions may be optimally treated using the optional side branch stenting strategy.MethodsA total of 413 patients with a coronary bifurcation lesion were randomly assigned to a simple stenting strategy of main vessel (MV) and optional stenting of side branch (SB) or to a complex stenting strategy, namely, stenting of both MV and SB.ResultsFive-year clinical follow-up data were available for 404 (98%) patients. The combined safety and efficacy endpoint of cardiac death, non–procedure-related myocardial infarction, and target vessel revascularization were seen in 15.8% in the optional SB stenting group as compared to 21.8% in the MV and SB stenting group (p = 0.15). All-cause death was seen in 5.9% versus 10.4% (p = 0.16) and non–procedure-related myocardial infarction in 4% versus 7.9% (p = 0.09) in the optional SB stenting group versus the MV and SB stenting group, respectively. The rates of target vessel revascularization were 13.4% versus 18.3% (p = 0.14) and the rates of definite stent thrombosis were 3% versus 1.5% (p = 0.31) in the optional SB stenting group versus the MV and SB stenting group, respectively.ConclusionsAt 5-year follow-up in the Nordic Bifurcation Study, the clinical outcomes after simple optional side branch stenting remained at least equal to the more complex strategy of planned stenting of both the main vessel and the side branch