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River flood risk in Europe could rise to unprecedented levels due to global warming and continued development in flood-prone areas. Here, we appraise the potential of four key adaptation strategies to reduce flood risk across Europe based on flood risk modelling and cost–benefit analysis. We find that reducing flood peaks using detention areas is economically the most attractive option. In a scenario without climate mitigation (3 °C global warming), they can lower projected flood losses in Europe by 2100 from €44(30–61) billion to €8.1(5.5–10.7) billion per year and lower population exposed by 84% (75–90%) or achieve a risk level comparable to today. The economic investment required over 2020–2100 would provide a return of €4(3.5–6.3) for each €1 invested. The risk reduction potential of strengthening of dykes is somewhat lower, at 70% (59–83%) for a comparable annual investment. Implementing building-based flood proofing and relocation measures is less cost-effective but can reduce impacts in localized areas.

Hydrological extremes are non-stationary, displaying long-term trends and natural oscillations. These changes in extremes can be driven by multiple factors including climatic (climate variability, climate change) and socio-economic (land use changes, water management changes) factors. In this work, we analyse extreme river flows in Europe for the period 1950-2020. We aim to identify long-term trends in extreme floods and estimate the contribution of the two aforementioned factors in these trends. The assessment is performed with modelled streamflow data generated with the spatially distributed physically based model LISFLOOD. We force the model with bias-corrected and statistically downscaled climate data derived from the ERA5-Land climate reanalysis and the EMO-5 dataset. We also created a variant of the climate dataset with the global warming effect removed statistically from the data. Return periods of extreme flood events are estimated through a non-stationary extreme value analysis for each river point with an upstream area greater than 100 km2. To disentangle the influence of the different factors driving changes in extreme flows, the hydrological model is run under various scenarios: (i) historical (historical climate and dynamic socio-economic) (ii) static society (historical climate and static socio-economic), (iii) counterfactual climate (historical climate without global warming and dynamic socio-economic). Available preliminary results enable presenting long-term space-time dynamics of European floods.

Building reuse is a strategy for built heritage enhancement. The establishment of new activities in an existing building can have positive effects on the urban and territorial context and modify the dynamics of socio-economic development. If the reuse is considered as a cultural development strategy and not limited to a single building but to both buildings and infrastructures, these effects are amplified. This is the case of railway heritage, affected by an increasingly vast process of abandonment. The Italian policies for encouraging road transport and the communication models of the digital era have contributed to the gradual desertion of railway lines. This requires effective reuse models, to avoid that the Ferrovie dello Stato (State Railways) continue to carry the heavy burden of managing assets no longer able to generate income. The analysis of numerous station reuse cases, at an international level, lead to the selection of the case of the Postal Museum and Mail Ride in London as an example of good practice. The proposed methodology identifies a set of evaluation criteria and indicators to assess the effectiveness of adaptive reuse projects both in terms of their ability to protect built heritage identity and to modify the orientation of the territorial context’s development towards socio-economic sustainability guidelines.

OBJECTIVE Type 2 diabetes may affect the humoral immune response after vaccination, but data concerning coronavirus disease 19 (COVID-19) vaccines are scarce. We evaluated the impact of diabetes on antibody response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination in older residents of long-term care facilities (LTCFs) and tested for differences according to antidiabetic treatment. RESEARCH DESIGN AND METHODS For this analysis, 555 older residents of LTCFs participating in the GeroCovid Vax study were included. SARS-CoV-2 trimeric S immunoglobulin G (anti-S IgG) concentrations using chemiluminescent assays were tested before the first dose and after 2 and 6 months. The impact of diabetes on anti-S IgG levels was evaluated using linear mixed models, which included the interaction between time and presence of diabetes. A second model also considered diabetes treatment: no insulin therapy (including dietary only or use of oral antidiabetic agents) and insulin therapy (alone or in combination with oral antidiabetic agents). RESULTS The mean age of the sample was 82.1 years, 68.1% were women, and 25.2% had diabetes. In linear mixed models, presence of diabetes was associated with lower anti-S IgG levels at 2 (β = −0.20; 95% CI −0.34, −0.06) and 6 months (β = −0.22; 95% CI −0.37, −0.07) after the first vaccine dose. Compared with those without diabetes, residents with diabetes not using insulin had lower IgG levels at 2- and 6-month assessments (β = −0.24; 95% CI −0.43, −0.05 and β = −0.30; 95% CI −0.50, −0.10, respectively), whereas no differences were observed for those using insulin. CONCLUSIONS Older residents of LTCFs with diabetes tended to have weaker antibody response to COVID-19 vaccination. Insulin treatment might buffer this effect and establish humoral immunity similar to that in individuals without diabetes.

In recent years, the importance of continental-scale hazard maps for riverine floods has grown. Nowadays, such maps are used for a variety of research and commercial activities, such as evaluating present and future risk scenarios and adaptation strategies, as well as supporting management plans for national and local flood risk. In this paper we present a new set of high-resolution (100 m) hazard maps for river flooding that covers most European countries, as well as all of the river basins entering the Mediterranean and Black Sea in the Caucasus, the Middle East and northern Africa. The new river flood hazard maps represent inundation along 329 000 km of the river network, for six different flood return periods, expanding on the datasets previously available for the region. The input river flow data for the new maps are produced by means of the hydrological model LISFLOOD using new calibration and meteorological data, while inundation simulations are performed with the hydrodynamic model LISFLOOD-FP. In addition, we present here a detailed validation exercise using official hazard maps for Hungary, Italy, Norway, Spain and the UK, which provides a more detailed evaluation of the new dataset compared with previous works in the region. We find that the modelled maps can identify on average two-thirds of reference flood extent, but they also overestimate flood-prone areas with below 1-in-100-year flood probabilities, while for return periods equal to or above 500 years, the maps can correctly identify more than half of flooded areas. Further verification is required in the northern African and eastern Mediterranean regions, in order to better understand the performance of the flood maps in arid areas outside Europe. We attribute the observed skill to a number of shortcomings of the modelling framework, such as the absence of flood protections and rivers with an upstream area below 500 km2 and the limitations in representing river channels and the topography of lowland areas. In addition, the different designs of reference maps (e.g. extent of areas included) affect the correct identification of the areas for the validation, thus penalizing the scores. However, modelled maps achieve comparable results to existing large-scale flood models when using similar parameters for the validation. We conclude that recently released high-resolution elevation datasets, combined with reliable data of river channel geometry, may greatly contribute to improving future versions of continental-scale river flood hazard maps. The new high-resolution database of river flood hazard maps is available for download at https://doi.org/10.2905/1D128B6C-A4EE-4858-9E34-6210707F3C81 (Dottori et al., 2020a).

Motivated by the study of the metastable stochastic Ising model at subcritical temperature and in the limit of a vanishing magnetic field, we extend the notion of ($\kappa$, $\lambda$)-capacities between sets, as well as the associated notion of soft-measures, to the case of overlapping sets. We recover their essential properties, sometimes in a stronger form or in a simpler way, relying on weaker hypotheses. These properties allow to write the main quantities associated with reversible metastable dynamics, e.g. asymptotic transition and relaxation times, in terms of objects that are associated with two-sided variational principles. We also clarify the connection with the classical "pathwise approach" by referring to temporal means on the appropriate time scale., Comment: 29 pages, 1 figure

Il trattamento endoscopico dell’atresia coanale e utilizzo delle dilatazioni mediante balloon: nostra esperienza.Scopo di questo studio è quello di descrivere i risultati della nostra esperienza nel trattamento chirurgico endoscopico della atresia coanale e di illustrare in particolare il nostro protocollo che per mantenere pervio lo spazio coanale non prevede l’applicazione di uno stent ma dilatazioni endoscopiche mediante balloon ripetute nel post-operatorio al fine di stabilizzare il risultato chirurgico. Nel periodo compreso fra dicembre 2014 e dicembre 2018, abbiamo arruolato 46 pazienti affetti da atresia coanale e sottoposti a trattamento chirurgico presso l’Unità di Otorinolaringoiatria dell’Ospedale Pediatrico Bambino Gesù (17 con atresia coanale bilaterale e 29 con atresia coanale monolaterale), Tutti i pazienti sono stati sottoposti a chirurgia endoscopica transnasale. L’incisione della mucosa è stata realizzata con strumentazione a freddo e a caldo (laser a diodi). L’eliminazione della componente ossea è stata possibile mediante l’utilizzo di frese; la calibrazione delle neo-coane è stata eseguita con la tecnica di dilatazione mediante balloon. Nessuno stent è stato utilizzato e nessun paziente ha ricevuto trattamento topico con mitomicina. Il primo controllo endoscopico post-operatorio con eventuale dilatazione è stato eseguito 7 giorni dopo la procedura chirurgica. Una seconda valutazione endoscopica con medicazione e dilatazione è stata effettuata 15 giorni al fine di stabilizzare il risultato chirurgico. Ulteriori controlli sono stati pianificati ad un mese dall’intervento e i successivi sulla base dei progressi del singolo paziente. In nessuno dei 46 pazienti trattati abbiamo osservato complicanze dopo i trattamenti endoscopici. L’età media dei 17 pazienti con atresia coanale bilaterale è stata di 10,4 giorni al momento del primo trattamento; nel 64% dei casi l’atresia era associata ad altre anomalie. Il protocollo terapeutico ha garantito il raggiungimento di outcome soddisfacenti nell’82% dei casi, con una media di 4.6 procedure realizzate per ogni paziente (range: 3-11). I 29 pazienti affetti da atresia monolaterale presentavano un’età media di 36,6 mesi al primo trattamento, una prevalenza di atresia monolaterale destra (11:6), un’associazione con ulteriori anomalie nel 27% dei casi. Abbiamo ottenuto una percentuale di successo dell’85,7% con una media di 3,5 procedure per paziente (range: 3-7). La chirurgia endoscopica transnasale è attualmente considerata il gold standard terapeutico, sia per l’atresia monolaterale che bilaterale. A nostro parere, andrebbe evitato l’utilizzo di stent post-intervento, anche se ancora oggi vengono utilizzati; la recidiva è ridotta dall’utilizzo della dilatazione mediante balloon che, nella nostra esperienza, è un valido aiuto sia nel trattamento dell’atresia primaria che delle recidive.The aim of this study is to report our experience in surgical treatment of unilateral and bilateral choanal atresia. We describe the endoscopic surgical technique for creation of neo-choanes and following repeating balloon dilation after surgery to stabilise the results. The study was carried out from December 2014 to December 2018, enrolling 46 patients who underwent surgery for choanal atresia at the Otolaryngology Unit of the Paediatric hospital Bambino Gesù: 17 with bilateral choanal atresia (Group A) and 29 with unilateral choanal atresia (Group B). All patients underwent transnasal endoscopic surgery. The incision of the mucosa was made with a cold and hot system (laser diode). The elimination of atresic plaque was possible thanks to the use of a drill; the calibration of the neo-choanes was carried out with the help of balloon dilation. No stent was used, and no patient underwent treatment with topical mitomycin. The first endoscopic follow-up was made 7 days after surgery with surgical curettage and a second balloon dilation 15 days after surgery to stabilise the new choanes. Further check-ups were suggested at 1 month after surgery and later based on individual progress. In group A, the average age for the first treatment was 10.4 days, and atresia was associated with other anomalies in 64% of cases. The therapeutic protocol led to a successful outcome in 82% of cases, with an average of 4.6 procedures per patient (range: 3-11). In group B, the average age for the first treatment was 36.6 months, association with other anomalies was 27% of cases and the prevalent side was the right (11:6). We obtained surgical success in 85.7% of cases and the average number of endoscopic dilations was 3.5 (range: 3-7). Transnasal endoscopic surgery is now considered the therapeutic gold-standard for both unilateral and bilateral atresia. Even if still used, post-surgery stenting can be avoided in our opinion; relapse is reduced with the use of balloon dilation, which, in our experience, is a valid aid in both primary atresia treatment and in cases of relapse.

espanolEl Test Palografico es un test de personalidad muy utilizado en Brasil. El objetivo de la presente investigacion fue realizar un analisis sobre el modo en que la correccion de este test viene siendo efectuada por los psicologos que trabajan diariamente con evaluacion psicologica. Para ello, 295 psicologos contestaron al cuestionario. Estos tenian entre 26 y 66 anos (media=40,34, DS=9,91), siendo 94,9% mujeres. Los resultados indican una falta de estandarizacion en la correccion del test, lo que genera la posibilidad de que, dependiendo del criterio utilizado, una misma persona pueda recibir diferentes resultados. Ademas, se encontraron tres problemas: la rapidez en la correccion del test; los materiales necesarios para su correccion no fueron utilizados y el error de significado atribuido a los indicadores. A partir de esos resultados, se discute la necesidad fomentar la formacion del psicologo en evaluacion psicologica. EnglishThe teste Palografico (Palographic test) is a personality test used a lot in Brazil. The aim of this study was to perform an analysis on the way that correction of this test has been performed by psychologists that work daily with psychological evaluation. For this, questionnaires were applied to 295 licensed psychologists. These were aged between 26 and 66 years (M=40.34, SD=9.91); with 94.9% females. The results highlight the lack of standardization in the correction process of the test, which generates the possibility of the same person receiving different results depending on the criteria used. In addition, three problems were found: the time spent during the correction process; lack of application of proper methods to evaluate the tests and the incorrect interpretation of test items. From the errors in the correction of the test, we discuss the need to consider the psychologist's training regarding psychological assessment. portuguesO Teste Palografico e um teste de personalidade muito utilizado no Brasil. Objetivou-se na presente pesquisa realizar uma analise sobre o modo que a correcao deste teste vem sendo realizada por psicologos que trabalham cotidianamente com avaliacao psicologica. Para tanto, foram aplicados questionarios em 295 psicologos. Estes tinham entre 26 e 66 anos (media=40,34; DP=9,91), 94,9% eram do sexo feminino. Os resultados indicam uma falta de padronizacao na correcao do teste, o que gera a possibilidade de uma mesma pessoa receber diferentes pareceres, dependendo do criterio utilizado. Alem disso, tres problemas foram encontrados: a rapidez na correcao do teste; o nao uso dos materiais necessarios para corrigi-lo e o erro de significado atribuido aos indicadores. A partir dos erros de correcao do teste e do pouco tempo utilizado nesse processo, discute-se a necessidade de que seja dada atencao a formacao do psicologo em avaliacao psicologica.

RESUMO: Este estudo de revisão sistemática teve como objetivo identificar as características de crianças com altas habilidades/superdotação. Os critérios de inclusão foram: artigos científicos sobre pesquisas empíricas, publicados no período de 2010 a 2019, com participantes com altas habilidades/superdotação, menores de 12 anos, e a avaliação de altas habilidades/superdotação deveria ter, pelo menos, um teste de inteligência associado a outros instrumentos. Os critérios de exclusão foram: nenhum grupo composto apenas por crianças com altas habilidades/superdotação, não apresentar resultados exclusivos às crianças com altas habilidades/superdotação ou o grupo de crianças com altas habilidades/superdotação ter participantes com dupla excepcionalidade, deficiência física ou sensorial. A busca dos artigos foi feita nas bases Scopus e Web of Science em janeiro de 2020 e SciELO.org em abril de 2020. Foram analisados 29 artigos, agrupados em cinco categorias. Os resultados são apresentados em síntese narrativa e confirmam o caráter heterogêneo das altas habilidades/superdotação. A maioria dos artigos explorou características da cognição e dos processos de identificação e avaliação das crianças. Dentre as principais limitações, estão a obtenção de artigos com autores repetidos e a obtenção incompleta dos artigos potencialmente relevantes. Esta pesquisa contribui para a visibilidade sobre as características de crianças com superdotação, com um enfoque geral e amplo. ABSTRACT: This systematic review study aimed to identify the characteristics of gifted children. Inclusion criteria were: scientific articles on empirical research published in the period from 2010 to 2019, whose participants were gifted children under 12 years old, and the evaluation of giftedness should have, at least, one intelligence test associated with other instruments. The exclusion criteria were: no group consisting of only gifted children, no exclusive results presented to gifted children, or the group of gifted children have participants with double exceptionality, physical or sensory disabilities. The search for articles was made in Scopus and Web of Science databases in January 2020 and SciELO.org in April 2020. Twenty-nine articles were analyzed, grouped into five categories. The results are presented in narrative synthesis, and confirm the heterogeneous feature of giftedness. Most articles explored characteristics of children’s cognition and identification and assessment processes. Among the main limitations are the obtaining of articles with repeated authors and incomplete obtaining of potentially relevant articles. This research contributes to the visibility of the characteristics of gifted children, with a general and broad focus.

International audience

This study aims to verify the self-evaluation that people make about their ability to drive and investigate whether there is a difference between self-evaluation and evaluation about their friends’ abilities. To this end, 151 people answered three different questionnaires, one questionnaire about driving abilities (self-evaluation and evaluation of friends), the Driver’s Behavior Questionnaire and a socio-demographic questionnaire The sample consisted of 50.3% of males with a mean age of 25.32 years (sd = 1.66). As a result, self-evaluation was positively correlated with age, evaluation of friend, weekly driving hours, Common Violations, and Aggressive Violations. In addition, there was significant difference between evaluation by sex: males carry out self-assessments in a more positive way. It was also found that people evaluate themselves better than they evaluate their friends. From this research, it is possible to think the target audience that would most benefit from an intervention to reduce self-evaluation, that is, men, people over 24 years old, and people who have more driving experience.

We consider the two-star model, a family of exponential random graphs indexed by two real parameters, $h$ and $\alpha$, that rule respectively the total number of edges and the mutual dependence between them. Borrowing tools from statistical mechanics, we study different classes of correlation inequalities for edges, that naturally emerge while taking the partial derivatives of the (finite size) free energy. In particular, if $\alpha, h\ge 0$, we derive first and second order correlation inequalities and then prove the so-called GHS inequality. As a consequence, under the above conditions on the parameters, the average edge density turns out to be an increasing and concave function of the parameter $h$, at any fixed size of the graph. Some of our results can be extended to more general classes of exponential random graphs., Comment: 17 pages, 1 figure

River flooding in Europe could rise to unprecedented levels due to global warming and continued development in flood-prone areas. Here we appraise the potential of four key adaptation strategies to mitigate flood risk across Europe based on detailed flood risk modelling and cost-benefit analysis. We find that reducing flood peaks using retention areas is economically the most attractive option. In a scenario without climate mitigation, they can lower projected flood losses in Europe by the end of the century from 42 to 7.5 €billion/year and population exposed by 81%, or achieve a risk level comparable to today. This would require an investment of 2.9 €billion/year over 2020-2100, with a return of 4€ for each 1€ invested. The risk-reduction potential of economically-optimised strengthening of dykes is somewhat lower with 71% for a comparable annual investment. These measures avoid floods to happen and their cost-effectiveness increases with the level of global warming. Implementing building-based flood proofing measures and relocating people and assets are less cost-effective but can reduce impacts in localized areas.

Introduction : In Brazil, driver aggressiveness in road traffic is a critical issue and could be an important contributing factor to the high number of traffic accidents . Because no instruments are available in Portuguese to register driving aggressiveness or driving anger in Brazil, we adapted English instruments into the Brazilian context. The aims of this study were to provide a Brazilian adaptation of the Driving Anger Expression Inventory (DAX) and to try to validate it by testing its psychometric properties and investigating its relationships with risky driving behaviors (DBQ), road accidents, driving sensation seeking, and hostility. Method: The Brazilian adaptations of the DAX, DBQ, the Driving Sensation Seeking Scale (DSSS) and the hostility Scale were administered to a sample of 512 undergraduate students (with a mean age of 23.7 years, 52.1% men). Results : Confirmatory factor analysis of the Brazilian DAX (DAX-BR) items yielded a four-factor solution with 43 items, which obtained the best goodness-of-fit to the data. Cronbach’s alpha for the DAX-BR factors ranged from 0.69 to 0.88. Other results on validity were a positive correlation (range 0.39–0.59) between the factors of the DAX-BR, DSSS, and DBQ. Conclusion : DAX-BR as the same structure as the original and is a reliable instrument for use with young drivers. Other studies should be conducted to further validate the DAX-BR in different types of populations such as older and more experienced drivers, professional drivers, and traffic regulation offenders whose driver's license has been taken away. Practical applications: This Brazilian version can be recommended for the assessment of driving anger expression in Brazil among young drivers in view of helping them driver more safely, and in particular to reduce traffic violations.

Resumo (analítico): Esta pesquisa visa verificar evidências de validade da adaptação brasileira da Escala Clima Familiar para Segurança no Trânsito (Taubman-Ben-Ari & Katz-Ben- Ami, 2013), que avalia a percepção de jovens condutores sobre valores, prioridades, e práticas dos pais e da família em relação à condução segura. Participaram da pesquisa 420 universitários (63% homens), com idade entre 18 e 22 anos (média=19,7 anos; DP=1,3 anos). A análise fatorial indicou uma solução de cinco fatores: Comunicação/Mensagem (α=0,87), Monitoramento/Limites (α=0,87), Falta de Compromisso com a Segurança (α=0,70), Modelagem (α=0,79) e Feedback (α=0,80). Os dados mostram que a versão brasileira da escala apresentou resultados adequados e pode ser utilizada em estudos futuros sobre clima familiar em relação à condução. Abstract (analytical): This research has the objective of verifying the evidence of the validity of the Brazilian version of the Family Climate Scale for Road Safety (Taubman-Ben-Ari & Katz-Ben- Ami, 2013), which evaluates the perception of young drivers of their values and priorities and the practices of parents and relatives in relation to safe driving. The participants were 420 university students (63% men) aged between 18 and 22 (mean=19.7 years, SD=1.3 years). Factor analysis indicated a five-factor solution: Communication / Message (α=0.87), Monitoring / Limits (α=0.87), Lack of Commitment to Safety (α=0.70), Modeling (α=0.79) and Feedback (α=0.80). The data show that the Brazilian version of the scale achieved suitable results and can be used in future studies of family environments in relation to driving. Resumen (analítico): Esta investigación tiene como objetivo buscar evidencias de la validez de la versión brasileña de la Escala Clima Familiar para la Seguridad Vial (Taubman Ben-Ari y Katz-Bien-Ami, 2013), la cual evalúa la percepción de los conductores jóvenes sobre los valores, las prioridades y las prácticas de sus padres y de la familia con respecto a la conducción segura. Los participantes fueron 420 estudiantes universitarios (63% hombres) con edades comprendidas entre 18 y 22 años (media=19,7 años, DS=1,3 años). El análisis factorial indicó una solución en cinco factores: Comunicación/Mensaje (α=0,87), Monitoreo/Límites (α=0,87), Falta de Compromiso con la Seguridad (α=0,70), el Modelado (α=0,79) y Feedback (α=0,80). Los datos indican que la versión brasileña de la Escala Clima Familiar para la Seguridad Vial es adecuada y puede ser utilizada en futuros estudios que quieran evaluar el impacto del ambiente familiar en la formación de los conductores jóvenes.

River flooding is the costliest natural disaster in Europe. Global warming and continued development in flood prone areas will progressively increase river flood risk. Direct damages from flooding could become six times present losses by the end of the century in case of no climate mitigation and adaptation. Keeping global warming well below 2°C would halve these impacts. Adequate adaptation strategies can further substantially reduce future flood impacts. In particular, implementing building-based damage reduction measures and reducing flood peaks using retention areas can lower impacts in a cost-efficient way in most EU countries, even to flood risk levels that are lower than today. Restoring natural wetlands and floodplains to retain excess water also improves the state of water and ecosystems.

Continental scale hazard maps for riverine floods have grown in importance in the last years. Nowadays, they are used for a variety of research and commercial activities, such as evaluating present and future risk scenarios and adaptation strategies, as well as a support of national and local flood risk management plans. Here, we present a new set of hazard maps for river flooding that covers most of the geographical Europe and all the river basins entering the Mediterranean and Black Seas in the Caucasus, Middle East and Northern Africa countries. Maps represent inundation along 329’000 km of river network at 100 m resolution, for six different flood return periods. The input river flow data is produced by the hydrological model LISFLOOD, while inundation simulations are performed with the 2D hydrodynamic modelling LISFLOOD-FP. To provide an overview of the skill of the new maps, we undertake a detailed validation exercise of the new maps using official hazard maps for Hungary, Italy, Norway, Spain and the United Kingdom. We find that modelled maps can identify on average two-thirds of reference flood extent, however they also overestimate flood-prone areas for flood probabilities below 1-in-100-year, while for return periods equal or above 500 years the maps can correctly identify more than half of flooded areas. We attribute the observed skill to a number of shortcomings of the modelling framework, such as the absence of flood protections and rivers with upstream area below 500 km2, and the limitations in representing river channels and topography of low land areas. In addition, the large variability of reference maps affects the correct identification of the areas for the validation, thus penalizing scores. However, modelled maps achieve comparable results to existing large-scale flood models when using similar parameters for the validation. We conclude that recently released high-resolution elevation datasets combined with reliable data of river channel geometry may greatly contribute to improve future versions of continental-scale flood hazard maps. The database is available for download at https://data.jrc.ec.europa.eu/dataset/1d128b6c-a4ee-4858-9e34-6210707f3c81 (Dottori et al., 2020a).

We study a random walk on a point process given by an ordered array of points $(\omega_k, \, k \in \mathbb{Z})$ on the real line. The distances $\omega_{k+1} - \omega_k$ are i.i.d. random variables in the domain of attraction of a $\beta$-stable law, with $\beta \in (0,1) \cup (1,2)$. The random walk has i.i.d. jumps such that the transition probabilities between $\omega_k$ and $\omega_\ell$ depend on $\ell-k$ and are given by the distribution of a $\mathbb{Z}$-valued random variable in the domain of attraction of an $\alpha$-stable law, with $\alpha \in (0,1) \cup (1,2)$. Since the defining variables, for both the random walk and the point process, are heavy-tailed, we speak of a L\'evy flight on a L\'evy random medium. For all combinations of the parameters $\alpha$ and $\beta$, we prove the annealed functional limit theorem for the suitably rescaled process, relative to the optimal Skorokhod topology in each case. When the limit process is not c\`adl\`ag, we prove convergence of the finite-dimensional distributions. When the limit process is deterministic, we also prove a limit theorem for the fluctuations, again relative to the optimal Skorokhod topology., Comment: 30 pages, 3 figures. Final version for Electron. J. Probab

Cet article propose une discussion des usages du concept « d’institution » en sciences sociales des religions a partir de la confrontation de trois enquetes empiriques sur des terrains et des religiosites differents (pentecotisme en Suede, bouddhisme en Europe du Sud, catholicisme en Italie). L’institutionnalisation comme processus social continu n’est pas antinomique de formes de desinstitutionnalisation du religieux, si cette notion presentee par Daniele Hervieu-Leger est retravaillee pour decrire des situations de redeploiement des contraintes dans une sociologie de l’agir religieux plutot que comme paradigme de comprehension de la secularisation. Des institutionnalisations paradoxales du religieux peuvent etre etudiees dans les categorisations sociopolitiques, des roles et pratiques redefinis par des dynamiques externes, ainsi qu’a partir de trajectoires interinstitutionnelles d’acteurs.

Aims: A multicentre trial, ICOS-ONE, showed increases above the upper limit of normality of cardiac troponin (cTn) in 27% of patients within 12months after the end of cancer chemotherapy (CT) with anthracyclines, whether cardiac protection with enalapril was started at study entry in all (prevention arm) or only upon first occurrence on supra-normal cTn (troponin-triggered arm). The aims of the present post hoc analysis were (i) to assess whether anthracycline-based treatment could induce cardiotoxicity over 36month follow-up and (ii) to describe the time course of three cardiovascular biomarkers (i.e. troponin I cTnI-Ultra, B-type natriuretic peptide BNP, and pentraxin 3 PTX3) and of left ventricular (LV) function up to 36months. Methods and results: Eligible patients were those prescribed first-in-life CT, without evidence of cardiovascular disease, normal cTn, LV ejection fraction (EF) >50%, not on renin-angiotensin aldosterone system antagonists. Patients underwent echocardiography and blood sampling at 24 and 36months. No differences were observed in biomarker concentration between the two study arms, ‘prevention' vs. ‘troponin-triggered'. During additional follow-up 13 more deaths occurred, leading to a total of 23 (9.5%), all due to a non-cardiovascular cause. No new occurrences of LV-dysfunction were reported. Two additional patients were admitted to the hospital for cardiovascular causes, both for acute pulmonary embolism. No first onset of raised cTnI-Ultra was reported in the extended follow-up. BNP remained within normal range: at 36months was 23.4ng/L, higher (N.S.) than at baseline, 17.6ng/L. PTX3 peaked at 5.2ng/mL 1month after CT and returned to baseline values thereafter. cTnI-Ultra peaked at 26ng/L 1month after CT and returned to 3ng/L until the last measurement at 36months. All echocardiographic variables remained stable during follow-up with a median LVEF of 63% and left atrial volume index about 24mL/m2. Conclusions: First-in-life CT with median cumulative dose of anthracyclines of 180mg/m2 does not seem to cause clinically significant cardiac injury, as assessed by circulating biomarkers and echocardiography, in patients aged 51years (median), without pre-existing cardiac disease. This may suggest either a 100% efficacy of enalapril (given as preventive or troponin-triggered) or a reassuringly low absolute cardiovascular risk in this cohort of patients, which may not require intensive cardiologic follow-up.

River floods are among some of the costliest natural disasters1, but their socio-economic impacts under contrasting warming levels remain little explored2. Here, using a multi-model framework, we estimate human losses, direct economic damage and subsequent indirect impacts (welfare losses) under a range of temperature (1.5 °C, 2 °C and 3 °C warming)3 and socio-economic scenarios, assuming current vulnerability levels and in the absence of future adaptation. With temperature increases of 1.5 °C, depending on the socio-economic scenario, it is found that human losses from flooding could rise by 70–83%, direct flood damage by 160–240%, with a relative welfare reduction between 0.23 and 0.29%. In a 2 °C world, by contrast, the death toll is 50% higher, direct economic damage doubles and welfare losses grow to 0.4%. Impacts are notably higher under 3 C warming, but at the same time, variability between ensemble members also increases, leading to greater uncertainty regarding flood impacts at higher warming levels. Flood impacts are further shown to have an uneven regional distribution, with the greatest losses observed in the Asian continent at all analysed warming levels. It is clear that increased adaptation and mitigation efforts—perhaps through infrastructural investment4—are needed to offset increasing risk of river floods in the future. River floods have severe socio-economic impacts. A multi-model framework reveals river-flood-related human losses may rise by up to 83%, 134% and 265% at 1.5 °C, 2 °C and 3 °C warming, respectively, with economic losses also projected to rise.

Rising extreme sea levels (ESLs) and continued socioeconomic development in coastal zones will lead to increasing future flood risk along the European coastline. We present a comprehensive analysis of future coastal flood risk (CFR) for Europe that separates the impacts of global warming and socioeconomic development. In the absence of further investments in coastal adaptation, the present expected annual damage (EAD) of €1.25 billion is projected to increase by two to three orders of magnitude by the end of the century, ranging between 93 and €961 billion. The current expected annual number of people exposed (EAPE) to coastal flooding of 102,000 is projected to reach 1.52–3.65 million by the end of the century. Climate change is the main driver of the future rise in coastal flood losses, with the importance of coastward migration, urbanization and rising asset values rapidly declining with time. To keep future coastal flood losses constant relative to the size of the economy, flood defence structures need to be installed or reinforced to withstand increases in ESLs that range from 0.5 to 2.5 m. Climate change is the main driver for future coastal flood risk in Europe. However, in the absence of increased flood protection, damages may rise by two to three orders of magnitude by the end of the century.

This article presents an analysis of the role of emotions during the conversion process to a specific Tibetan Buddhism teaching – the dzogchen. It is based on qualitative data gathered from field research in France and in Italy amongst two organisations. I draw on Arlie Russel Hochschild’s interactionist approach to demonstrate that the aspiring convert carries out an emotional work on him/herself as a means of learning certain feeling rules proposed by the dzogchen organisations. This dynamic contributes significantly in the conversion process, which takes place during intersubjective interactions. Firstly, the ‘conversion agents’ use tools such as ‘training devices’, symbols, and a system that helps decide between the emotions to show and to avoid. This system stimulates the collective learning process of the dzogchen feeling rules by the social actor. Secondly, the dzogchen practitioners, by interacting with each other, learn to adjust their emotional behaviour.

KBG syndrome is a rare genetic disorder, due to a mutation of ANKRD11, characterized by specific craniofacial dysmorphism, short stature and macrodontia of upper central incisors, intellectual disability and skeletal anomalies. We report a de novo mutation of ANKRD11 gene in a 7-years old girl, affected by KBG syndrome with bilateral conductive hearing loss. The aim of this article was to review the audiological findings of this syndrome.

The development of methods for rapid flood mapping and risk assessment is a key step to increase the usefulness of flood early warning systems and is crucial for effective emergency response and flood impact mitigation. Currently, flood early warning systems rarely include real-time components to assess potential impacts generated by forecasted flood events. To overcome this limitation, this study describes the benchmarking of an operational procedure for rapid flood risk assessment based on predictions issued by the European Flood Awareness System (EFAS). Daily streamflow forecasts produced for major European river networks are translated into event-based flood hazard maps using a large map catalogue derived from high-resolution hydrodynamic simulations. Flood hazard maps are then combined with exposure and vulnerability information, and the impacts of the forecasted flood events are evaluated in terms of flood-prone areas, economic damage and affected population, infrastructures and cities.An extensive testing of the operational procedure has been carried out by analysing the catastrophic floods of May 2014 in Bosnia–Herzegovina, Croatia and Serbia. The reliability of the flood mapping methodology is tested against satellite-based and report-based flood extent data, while modelled estimates of economic damage and affected population are compared against ground-based estimations. Finally, we evaluate the skill of risk estimates derived from EFAS flood forecasts with different lead times and combinations of probabilistic forecasts. Results highlight the potential of the real-time operational procedure in helping emergency response and management.

Background Multidisciplinary team (MDT) meetings aimed at facilitating peer review have become standard practice in oncology. However, there is scant literature on the optimal structure and conduct of such meetings. Aims To develop a process for formal peer review of patients with haematological malignancies and to audit any resulting changes made to the management recommendations of the treating physician. Methods A standard operating procedure (SOP) for MDT meetings was developed essentially to integrate clinical peer review with weekly pathology and radiology meetings. The centrepiece is the electronic submission of a patient-specific proforma (Microsoft InfoPath) prior to the meeting. It serves as the template for presentation, discussion and recording of recommendations and conclusions. The final verified document is stored in the electronic patient record, and a copy is sent to the general practitioner. The proposed management plans were compared to the consensus recommendations of the meeting for the first 4 years since inception. Results Both SOP and proforma underwent continual improvements. These provided the framework for the conduct of a robust weekly MDT meeting for peer review of the management of patients with haematological malignancies. On 20% of occasions, patient management plans were altered to optimise patient care as a direct consequence on peer review at the MDT. Conclusion Our streamlined process, in its ultimate format, has provided a mature and efficient forum for formal peer review in a genuine multidisciplinary environment. Both initial data and informal feedback support its ongoing activity as an integral component of delivering quality patient care.

Critical infrastructures (CIs) are assets, systems, or parts thereof that are essential for the maintenance of socioeconomic functions, health, safety and well-being of people. The exposure of CIs to natural and man-made hazards poses a risk to the economy and society. The spatial distribution of CIs and their economic value are a prerequisite for quantifying risk and planning suitable protection and adaptation measures. However, the incompleteness and inconsistency of existing information on CIs hamper their integration into large-scale risk frameworks. We present here the ‘HARmonized grids of Critical Infrastructures in EUrope’ (HARCI-EU) dataset. It represents major CIs in the transport, energy, industry and social sectors at 1 km2 expressed in sector-specific, economically-relevant units. The HARCI-EU grids were produced by integrating geospatial and statistical data from multiple sources. Correlation analysis performed against independent metrics corroborates the approach showing average Pearson coefficients ranging between 0.61 and 0.95 across the sectors. HARCI-EU provides a consistent mapping of CIs in key sectors that can serve as exposure information for large-scale risk assessments in Europe., Design Type(s)data integration objective • modeling and simulation objectiveMeasurement Type(s)InfrastructureTechnology Type(s)digital curationFactor Type(s)Sector • geographic locationSample Characteristic(s)Europe • anthropogenic habitat Machine-accessible metadata file describing the reported data (ISA-Tab format)

Juvenile recurrent parotitis (JRP) is characterized by recurrent episodes of painful parotid swelling, generally associated with non-obstructive sialectasia of the parotid gland. The aim of this study was to evaluate the diagnostic and therapeutic effectiveness of sialography in children affected by JRP.Clinical records of 110 outpatients with a diagnosis of JRP followed up from 2008 to 2017 at the Unit of Paediatric Otorhinolaryngology, Surgery Department of the Bambino Gesù Children's Hospital of Rome, were retrospectively reviewed. Data on demographics, number of acute episodes/year, course of disease, site of symptoms and duration of follow up were collected. The inclusion criteria were: at least two or more episodes of intermittent swelling of the parotid glands on one side or both sides during the last 6 months, age16 years. Exclusion criteria were: obstructive lesions, dental malocclusion, Sjogren syndrome, congenital IgA immunodeficiency, and relevant systemic diseases. Outcome of the procedure was measured by evaluating number and degree of episodes of parotid swelling before and after sialography.Sialography has been shown in all cases to be a valid method in the diagnosis of JRP. Following the execution of the sialography, in 98 patients (89% of cases) there was a statistically significant improvement of disease with a mean reduction of 67.4% of episodes of parotid swelling (p 0.05). In 75 patients there was marked improvement of the symptomatology (p 0.05). In 23 patients partial resolution occurred (p 0.05); in 12 patients there was no resolution or a reduction less than 30% of episodes (p 0.05). There was a statistically significant relationship between the number of attacks/year and the degree of glandular function, pre and post-sialography in 2-way ANOVA test (p 0.05).Sialography is effective method not only as a diagnostic procedure but also as a therapeutic procedure in treatment of JRP. It is a method that can be carried out in ambulatory setting, without anaesthesia, with a minimum cost and with a very low rate of complications. In a disease with tendency to spontaneous resolution like JRP, sialography represent a therapeutic option alternative to more invasive treatment.

Background: Neoplastic pericardial effusion (NPE) is a life-threatening condition that can worsen clinical outcome in cancer patients. The optimal management of NPE has yet to be defined because randomized studies are lacking. Objective: We report a retrospective monoinstitutional experience describing characteristics, management and prognostic factors in NPE patients. Design: We reviewed clinical, pathological, and echocardiographic features, therapeutic strategies, and outcome in NPE patients referred to our institute from August 2011 to December 2017. Measurements: Twenty-nine patients with NPE from solid tumors have been identified: 21 lung, 5 breast, and 3 other cancer patients. Results: Median age was 62 years. Most of the patients had Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥2 (69%) and a symptomatic NPE (69%). In 52% of patients NPE was detected at first diagnosis of metastatic disease, and in 20% of patients pericardium was the only site of metastases. Most of the patients (62%) received systemic therapy, 28% received combined locoregional and systemic therapy, and 10% received locoregional therapy alone. Median overall survival (OS) from NPE diagnosis was 3.9 months. Patients with PS ≥2 had worse OS than patients with better PS

We establish metastability in the sense of Lebowitz and Penrose under practical and simple hypothesis for (families of) Markov chains on finite configuration space in some asymptotic regime, including the case of configuration space size going to infinity. By comparing restricted ensemble and quasi-stationary measures, we study point-wise convergence velocity of Yaglom limits and prove asymptotic exponential exit law. We introduce soft measures as interpolation between restricted ensemble and quasi-stationary measure to prove an asymptotic exponential transition law on a generally different time scale. By using potential theoretic tools, we prove a new general Poincar\'e inequality and give sharp estimates via two-sided variational principles on relaxation time as well as mean exit time and transition time. We also establish local thermalization on a shorter time scale and give mixing time asymptotics up to a constant factor through a two-sided variational principal. All our asymptotics are given with explicit quantitative bounds on the corrective terms., Comment: 41 pages

River floods generate a large share of the socio-economic impact of weather-driven hazards worldwide. Accurate assessment of their impact is a key priority for governments, international organization, reinsurance companies and emergency responders. Yet, available databases of flood losses over large domains are often affected by gaps and inconsistencies in reported figures. In this work, a framework to reconstruct the economic damage and population affected by river floods at continental scale is applied. Pan-European river flow simulations are coupled with a high-resolution impact assessment framework based on 2-D inundation modelling. Two complementary methods are compared in their ability to estimate the climatological average flood impact and the impact of each flood event in Europe between 1990 and 2013. The event-based method reveals key features, such as the ability to include changes in time of all three components of risk, namely hazard, exposure and vulnerability. Furthermore, it skilfully reproduces the socio-economic impact of major flood events in the past two decades, including the severe flooding hitting central Europe in June 2013. On the other hand, the integral method is capable of reproducing the average flood losses which occurred in Europe between 1998 and 2009. Strengths and limitations of the proposed model are discussed to stress the large potential for filling in the gaps of current datasets of flood impact.

While reported losses of climate-related hazards are at historically high levels, climate change is likely to enhance the risk posed by extreme weather events. Several regions are likely to be exposed to multiple climate hazards, yet their modeling in a joint scheme is still at the early stages. A multi-hazard framework to map exposure to multiple climate extremes in Europe along the twenty-first century is hereby presented. Using an ensemble of climate projections, changes in the frequency of heat and cold waves, river and coastal flooding, streamflow droughts, wildfires and windstorms are evaluated. Corresponding variations in expected annual exposure allow for a quantitative comparison of hazards described by different process characteristics and metrics. Projected changes in exposure depict important variations in hazard scenarios, especially those linked to rising temperatures, and spatial patterns largely modulated by local climate conditions. Results show that Europe will likely face a progressive increase in overall climate hazard with a prominent spatial gradient towards south-western regions mainly driven by the rise of heat waves, droughts and wildfires. Key hotspots emerge particularly along coastlines and in floodplains, often highly populated and economically pivotal, where floods and windstorms could be critical in combination with other climate hazards. Projected increases in exposure will be larger for very extreme events due to their pronounced changes in frequency. Results of this appraisal provide useful input for forthcoming European disaster risk and adaptation policy.

At the current rate of global warming, the target of limiting it within 2 degrees by the end of the century seems more and more unrealistic. Policymakers, businesses and organizations leading international negotiations urge the scientific community to provide realistic and accurate assessments of the possible consequences of so called “high end” climate scenarios. This study illustrates a novel procedure to assess the future flood risk in Europe under high levels of warming. It combines ensemble projections of extreme streamflow for the current century based on EURO-CORDEX RCP 8.5 climate scenarios with recent advances in European flood hazard mapping. Further novelties include a threshold-based evaluation of extreme event magnitude and frequency, an alternative method to removing bias in climate projections, the latest pan-European exposure maps, and an improved flood vulnerability estimation. Estimates of population affected and direct flood damages indicate that by the end of the century the socio-economic impact of river floods in Europe is projected to increase by an average 220% due to climate change only. When coherent socio-economic development pathways are included in the assessment, central estimates of population annually affected by floods range between 500,000 and 640,000 in 2050, and between 540,000 and 950,000 in 2080, as compared to 216,000 in the current climate. A larger range is foreseen in the annual flood damage, currently of 5.3 B€, which is projected to rise at 20–40 B€ in 2050 and 30–100 B€ in 2080, depending on the future economic growth.

If, nowadays, the Communities’ welfare lies in new expressions of collaboration between different types of subjects for the achievement of common objectives, cultural consensus becomes the collective transformation tool to promote regeneration interventions of life contexts encouraged by new social innovation ideas such as products, services and models. This research considers five aspects of the social dimension to define energy systems location and their acceptability. In particular: social equity: as a fair distribution of costs and risks throughout society; spatial equity: as a fair distribution of risks and costs throughout the territory; intergenerational equity: as a proper assessment of the risks that would entail current locations for future generations; procedural equity: when the location decisions and the same decision making process are perceived as legitimate by all concerned; equity structural: when the localization process involves all aspects and interests, leaving no one out for their approaches (Murphy and Stanley 2006). In relation to the analyzed aspects, this study suggests a point of view on the role of reasoning and interpreting the social activity of individuals in relation to bottom-up decision-making processes for the formation of cultural consensus when changes in the usual life and environmental contexts occur.

We consider a continuous-time random walk which is defined as an interpolation of a random walk on a point process on the real line. The distances between neighboring points of the point process are i.i.d. random variables in the normal domain of attraction of an $\alpha$-stable distribution with $0 < \alpha < 1$. This is therefore an example of a random walk in a L\'evy random medium. Specifically, it is a generalization of a process known in the physical literature as L\'evy-Lorentz gas. We prove that the annealed version of the process is superdiffusive with scaling exponent $1/(\alpha + 1)$ and identify the limiting process, which is not c\`adl\`ag. The proofs are based on the technique of Kesten and Spitzer for random walks in random scenery., Comment: Final version to be published in Stochastic Processes and their Applications. 27 pages

Highlights • Projections of multiple climate risks to critical infrastructures are assessed. • Impacts could rise up to 10 times present damages by 2100 due to global warming alone. • Damages from heatwaves, droughts and coastal floods show the most dramatic rise. • Economic losses could be highest for the industry, transport and energy sectors. • Southern and south-eastern European countries will likely be most affected., Extreme climatic events are likely to become more frequent owing to global warming. This may put additional stress on critical infrastructures with typically long life spans. However, little is known about the risks of multiple climate extremes on critical infrastructures at regional to continental scales. Here we show how single- and multi-hazard damage to energy, transport, industrial, and social critical infrastructures in Europe are likely to develop until the year 2100 under the influence of climate change. We combine a set of high-resolution climate hazard projections, a detailed representation of physical assets in various sectors and their sensitivity to the hazards, and more than 1100 records of losses from climate extremes in a prognostic modelling framework. We find that damages could triple by the 2020s, multiply six-fold by mid-century, and amount to more than 10 times present damage of €3.4 billion per year by the end of the century due only to climate change. Damage from heatwaves, droughts in southern Europe, and coastal floods shows the most dramatic rise, but the risks of inland flooding, windstorms, and forest fires will also increase in Europe, with varying degrees of change across regions. Economic losses are highest for the industry, transport, and energy sectors. Future losses will not be incurred equally across Europe. Southern and south-eastern European countries will be most affected and, as a result, will probably require higher costs of adaptation. The findings of this study could aid in prioritizing regional investments to address the unequal burden of impacts and differences in adaptation capacities across Europe.

During hospitalization in the Oncology Department, a woman with nonsmall cell lung cancer and no previous cardiac event complained of episodes of chest pain and palpitations. Preliminary instrumental examinations diagnosed atrial fibrillation in pericarditis. A subsequent complete transthoracic echocardiogram showed the presence of a large mass involving the left ventricular apex, without echo-contrast enhancement. A thoracic CT with iodized contrast agent revealed its necrotic composition and was concluded as cardiac metastasis. This is an unusual case of a malignant neoplasm showing no contrast enhancement at echocardiogram because of its necrotic composition, mimicking a thrombus. © 2015 Wiley Periodicals, Inc. J Clin Ultrasound 44:392-394, 2016.

Background Two-dimensional echocardiography is the main noninvasive imaging tool to identify cardiac masses but is unable to provide detailed tissue characterization. Aim The aim of the study was to assess the ability of low mechanical index (MI) contrast echocardiography to detect presence and amount of tissue vascularization as validated by histopathology study of cardiac masses. Methods and results Twelve consecutive patients (5 females and 7 males, age range 51–82 years) underwent conventional and contrast two-dimensional echocardiography with low MI. By contrast echocardiography, mass enhancement was classified as absent (suggesting thrombus), partial, or complete (suggesting vascularized mass, both with early or late >20 cycles of opacification) as compared to the adjacent myocardium. The precise nature of the cardiac masses was provided by histopathology examination and/or by resolution after anticoagulation therapy during follow-up. Presence, type, and degree of mass vascularization were assessed by histology, immunohistochemistry, and morphometric analysis. Among the 12 cases, mass enhancement was absent, late and peripheral, late and partial, and early and complete in three cases each. Cardiac masses consisted of thrombus (three), secondary malignant cardiac tumor (three), myxoma (three), papillary fibroelastoma (two), and cavernous hemangioma (one). At histology, cardiac hemangioma had the highest degree of vascularization, at difference from thrombi which were not vascularized, and data were in keeping with contrast echocardiography findings. Conclusions Low MI contrast echocardiography is an easy, noninvasive cardiac imaging tool to assess cardiac mass vascularization. The degree of contrast enhancement and time to opacification are highly variable among cardiac masses and correspond to different extent of vascularization.

The satisfaction rate of the subjects with an auditory implant appears strictly related to the resulting auditory improvement, and the surgical variables would play a prevailing role in respect to the esthetic factors.To assess the rate of satisfaction in subjects who underwent the surgical application of an auditory device at a single Implanting Center Unit.A series of validated questionnaires has been administered to subjects who underwent the surgical application of different auditory devices. The Glasgow Benefit Inventory (GBI), the Visual Analog Scale (VAS), and the Abbreviated Profile of Hearing Aid Benefit (APHAB) have been used to compare the implanted situation with the hearing-aided one; a percutaneous bone conductive implant (pBCI) with an active middle ear implant (AMEI) on the round window in mixed hearing loss; and an invisible, fully-implantable device with a frankly and bulky semi-implantable device.The mean GBI scores were higher in Vibrant Soundbridge (VSB)