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Bidirectionally chargeable electric vehicles (EVs) can provide flexibility through smart charging and discharging. The aim of this dissertation is therefore to quantify the resulting added value for both the user and the energy system. For this purpose, different use cases are modeled from the user's perspective and the most important factors influencing the revenue potentials are evaluated. In contrast, the systemic added value of bidirectionally chargeable EVs under cost-optimal penetration rates in the future European energy system is highlighted. Bidirektionale Elektrofahrzeuge (EVs) können durch das gesteuerte Laden und Entladen als Speicher Flexibilität bereitstellen. Ziel dieser Dissertation ist daher die Quantifizierung des daraus entstehenden Mehrwerts sowohl für den Nutzer als auch das Energiesystem. Dafür werden verschiedene Use Cases aus Nutzersicht modelliert und die wichtigsten Einflussfaktoren auf die Erlöspotenziale bewertet. Demgegenüber wird der systemische Mehrwert bidirektionaler EVs unter kostenoptimalen Durchdringungsraten im zukünftigen europäischen Energiesystem herausgestellt.

Josefin Sundh,1 Hanan Tanash,2 Rahi Arian,3 Alessandra Neves-Guimaraes,3 Katrin Broberg,4 Gustav Lindved,5 Timo Kern,5 Konrad Zych,5 Henrik Bjørn Nielsen,5 Anders Halling,6 Bodil Ohlsson,7 Daniel Jönsson4,8,9 1Department of Respiratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; 2Department of Respiratory Medicine, Skåne University Hospital, Lund University, Malmö, Sweden; 3Department of Periodontology and Implantology, Public Dental Service, Örebro, Sweden; 4Public Dental Service of Skåne, Lund, Sweden; 5Clinical Microbiomics, Copenhagen, Denmark; 6Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden; 7Department of Internal Medicine, Skåne University Hospital, Lund University, Malmö, Sweden; 8Hypertension and Cardiovascular Disease, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden; 9Faculty of Odontology, Malmö University, Malmö, SwedenCorrespondence: Josefin SundhDepartment of Respiratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, 70185, SwedenTel +36702349517Fax +4619-186526Email josefin.sundh@oru.sePurpose: Infections from the oral microbiome may lead to exacerbations of chronic obstructive pulmonary disease (COPD). We investigated whether advanced dental cleaning could reduce exacerbation frequency. Secondary outcomes were disease-specific health status, lung function, and whether the bacterial load and composition of plaque microbiome at baseline were associated with a difference in outcomes.Patients and Methods: One-hundred-one primary and secondary care patients with COPD were randomized to intervention with advanced dental cleaning or to dental examination only, repeated after six months. At baseline and at 12 months, data of exacerbations, lung function, COPD Assessment Test (CAT) score, and periodontal status were collected from questionnaires, record review, and periodontal examination. Student’s t-test and Mann–Whitney-U (MWU) test compared changes in outcomes. The primary outcome variable was also assessed using multivariable linear regression with adjustment for potential confounders. Microbiome analyses of plaque samples taken at baseline were performed using Wilcoxon signed ranks tests for calculation of alpha diversity, per mutational multivariate analysis of variance for beta diversity, and receiver operating characteristic curves for prediction of outcomes based on machine learning models.Results: In the MWU test, the annual exacerbation frequency was significantly reduced in patients previously experiencing frequent exacerbations (p = 0.020) and in those with repeated advanced dental cleaning (p = 0.039) compared with the non-treated control group, but not in the total population including both patients with a single and repeated visits (p = 0.207). The result was confirmed in multivariable linear regression, where the risk of new exacerbations was significantly lower in patients both in the intention to treat analysis (regression coefficient 0.36 (95% CI 0.25– 0.52), p < 0.0001) and in the population with repeated dental cleaning (0.16 (0.10– 0.27), p < 0.0001). The composition of microbiome at baseline was moderately predictive of an increased risk of worsened health status at 12 months (AUC = 0.723).Conclusion: Advanced dental cleaning is associated with a reduced frequency of COPD exacerbations. Regular periodontal examination and dental cleaning may be of clinical importance to prevent COPD exacerbations.Keywords: alpha diversity, periodontal disease, beta diversity, health status, lung function, plaque microbiome

Purpose: Infections from the oral microbiome may lead to exacerbations of chronic obstructive pulmonary disease (COPD). We investigated whether advanced dental cleaning could reduce exacerbation frequency. Secondary outcomes were disease-specific health status, lung function, and whether the bacterial load and composition of plaque microbiome at baseline were associated with a difference in outcomes. Patients and Methods: One-hundred-one primary and secondary care patients with COPD were randomized to intervention with advanced dental cleaning or to dental examination only, repeated after six months. At baseline and at 12 months, data of exacerbations, lung function, COPD Assessment Test (CAT) score, and periodontal status were collected from questionnaires, record review, and periodontal examination. Student's t-test and Mann- Whitney-U (MWU) test compared changes in outcomes. The primary outcome variable was also assessed using multivariable linear regression with adjustment for potential confounders. Microbiome analyses of plaque samples taken at baseline were performed using Wilcoxon signed ranks tests for calculation of alpha diversity, per mutational multivariate analysis of variance for beta diversity, and receiver operating characteristic curves for prediction of outcomes based on machine learning models. Results: In the MWU test, the annual exacerbation frequency was significantly reduced in patients previously experiencing frequent exacerbations (p = 0.020) and in those with repeated advanced dental cleaning (p = 0.039) compared with the non-treated control group, but not in the total population including both patients with a single and repeated visits (p = 0.207). The result was confirmed in multivariable linear regression, where the risk of new exacerbations was significantly lower in patients both in the intention to treat analysis (regression coefficient 0.36 (95% CI 0.25-0.52), p < 0.0001) and in the population with repeated dental cleaning (0.16 (0.10-0.27), p < 0.0001). The composition of microbiome at baseline was moderately predictive of an increased risk of worsened health status at 12 months (AUC = 0.723). Conclusion: Advanced dental cleaning is associated with a reduced frequency of COPD exacerbations. Regular periodontal examination and dental cleaning may be of clinical importance to prevent COPD exacerbations.

Figure S1. Volcano plots separated by weeks showing gut microbial taxa that are differentially abundant in pairwise comparisons of wild-type mice fed ad libitum (WT), ob/ob mice fed ad libitum (OB) and ob/ob mice pair-fed according to WT intake (OB-PF). X-axis shows fold changes (in log2 scale) and Y-axis shows unadjusted p-values as reported by DESeq2 (in negative log10 scale). Each point represents an ASV, and its color represents whether a given ASV is significantly differentially abundant in that comparison after adjusting for multiple correction (as reported by DESeq2). (PDF 5436 kb)

Figure S3. Daily food intake of wild-type mice fed ad libitum (WT), ob/ob mice fed ad libitum (OB) and ob/ob mice pair-fed according to WT intake (OB-PF). Intake was precisely measured with TSE system (PhenoMaster, Bad Homburg, Germany) in week 3 (A) and week 9 (B). ***PÂ

Figure S2. Heatmaps showing associations between ASVs and host metabolic phenotypes within the three groups: wild-type mice fed ad libitum (WT), ob/ob mice fed ad libitum (OB) and ob/ob mice pair-fed according to WT intake (OB-PF). Associations that are not statistically significant are shown with white cells. (A) Effect size from linear mixed models between ASVs and three phenotypes: body weight, lean body mass and fat mass. (B) Spearman correlation co-efficient between ASVs and two phenotypes: area-under-the-curve for glucose response curves and insulin levels 2â h after glucose administration. (PDF 256 kb)