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This research paper examines threshold spaces in traditional housing within historic Indian cities, emphasizing how these transitional areas are shaped by cultural, social, and environmental influences. It underscores that thresholds function beyond mere physical divisions between interior and exterior; they are intricate spatial elements that engage the senses and perception. Key findings include the following: (a) Historical evolution: traditional dwellings display layers of history, shaped by cultural, economic, and climatic factors. (b) Character and morphology: this paper explores the qualities and structures of threshold spaces, analyzing features such as transparency, material choice, hierarchy, and enclosure. (c) Social significance: thresholds play essential roles, supporting a variety of activities, providing shelter, defining boundaries, enhancing community interaction and security, and contributing to residents’ identities. (d) Design implications: insights from this study suggest that a deeper understanding of these spaces can enhance design strategies for transitional areas in housing, highlighting their functional and socio-cultural value. The study adopts a structured comparative analysis of six case studies, evaluated at four scales—township, neighborhood, dwelling, and threshold—focusing on spatial parameters including design, function, definition, structure, and sequence. Overall, this paper highlights the critical role of threshold spaces in architecture and urban design, demonstrating their potential to enhance social interaction, define spatial relationships, and reflect cultural significance in contemporary design practices.

The aim of this research project is the investigation of the forgotten landscape of transhumance in mainland Greece, focusing on areas that have been abandoned by modern society and their historical significance. The goal is to make these lands functional again by preserving their cultural heritage and developing a sustainable community that meets the needs of people, livestock, and the environment. The investigation employs a dual approach: examining transhumance as a cultural and natural practice while analyzing vernacular architecture to preserve collective memory. This involves extensive historical research and a simultaneous analysis of spatial, social, symbolic, and architectural elements. This study identifies points of convergence between cultural practices and architectural heritage, applying these insights to contemporary redevelopment scenarios. Findings reveal a significant interplay between transhumance practices and the region’s anonymous architecture. Key characteristics of the landscape and its spatial identity are documented, providing insights into effective preservation and redevelopment strategies. Specific case studies validate these strategies, demonstrating their relevance to current and future efforts. This study concludes that understanding the historical context and spatial identity of transhumance landscapes is crucial for sustainable redevelopment. By preserving cultural practices and architectural heritage, this project provides a framework for revitalizing these landscapes, ensuring a balanced coexistence of people, livestock, and the environment.

In the contemporary world of social change, accelerated mobility and plural identities, the creation of open and inclusive environments seems to be a recurrent aim at all levels from cities to buildings and to museums in particular. Through the first-hand study and analysis of current case studies, the paper will argue that museums engage space to express the contemporary museological concepts of accessibility, openness and inclusiveness, and through these to engage visitors in cross cultural informational experiences and social encounters. The spatial nature of the contemporary museum, it is proposed, points to a new concept of the museum, which often aims to be part of the city, both in the sense of how it connects to it and in being internally more like a city, and so a continuation of it.

This paper deals with the landscape design strategy that was followed in the proposal that was submitted to the International Architecture Competition of the New Archaeological Museum of Cyprus. The aim of this document is to analyze how landscape and architecture interact. In the author’s design proposal for the New Archaeological Museum of Cyprus, the various “gardens” integrated into the Landscape are analyzed. The concept of landscape design is related to the sacredness of trees to certain gods in Ancient Greece and Greek Mythology. The proposal addresses the symbolic meaning of trees and water. The design triggered the creation of several “gardens”: the “Sacred Garden”, the “Stone Garden”, the “Olive Garden”, the “Sacred Grove”, and the “Public Garden”, combining their soft landscapes with the hard landscape of the “Plaza” and the “Courtyard”. Each figure in the garden has a symbolic meaning that allows for a dialogue between landscape and architectural design. In addition, the findings provide valuable insights into the historical and spiritual value of landscape elements (plants, water) that are also thermal regulators for sustainable urban planning. The research results may be of value to landscape architects, architects, and landscape designers in the Mediterranean region.

Green infrastructure and nature-based solutions are crucial for the sustainable transformation of cities into more resilient and inclusive places. However, the planning and design of these interventions must be tailored to different urban environments and socioeconomic contexts. Despite being one of the most urbanised global areas, the Latin American and Caribbean region still needs to be more researched. In this regard, this contribution provides an analytical and design framework for integrating nature-based solutions in dense urban contexts for microclimate mitigation and improved usability. It is constructed by considering the morphological, historical, climatic, and administrative peculiarities of Latin America, and it has been applied and tested in the case study of Bogotá (Colombia). The result is a matrix for constructing design strategies based on three key attributes of outdoor spaces and four design components. Article info Received: 18/03/2024; Revised: 22/04/2024; Accepted: 02/05/2024

The city, like a piece of architecture, is a structure in space, but one of gigantic scale, something perceived only over a long period. A space is termed a place when it acquires an identity. The entirety of urban personality, urban communication, urban conduct, and urban design constitute the urban identity. This research delves into divided urban identities and examines how urban and architectural design influence the fragmentation of the cityscape. It explores the connection between urban environments’ physical attributes and the divide of social, cultural, and political identities within cities. This study uses a multidisciplinary method to acquire thorough knowledge by combining architectural studies, urban planning theories, and social-cultural perspectives. The case study of reference is the city of Matera, in southern Italy, which has a unique history of a slow shaping of its urban and productive landscape throughout centuries due to heavy environmental constraints and resource availability and which has suffered forced evacuation and major discontinuities in the past century. Here, the opposing traits of the historical Sassi district and the new town are examined, focusing on their resulting separated urban identities. The study also looks at how divided cities may be reconciled and integrated, emphasizing the relevance of a holistic urban approach for the framing of complex issues. The research proposes methods and best practices for developing inclusive urban settings that promote cohesion and shared identities through the analysis of successful cases of urban regeneration, adaptive reuse of spaces, and participatory design processes. The findings of this research contribute to both academic and practical knowledge by deepening the understanding of the relationship between urban design, architecture, and divided urban identities. It emphasizes the value of comprehensive approaches to urban planning that take into account the social, cultural, and historical settings of cities to foster inclusivity, rapprochement, and the development of common urban identities.

In hot and arid environments, courtyards are essential architectural elements that significantly contribute to microclimate regulation and enhanced thermal comfort. Beyond providing protection against environmental severities, these spaces elevate the standards of livability and sustainability in urban design. The traditional landscape of Mardin, Turkey, exemplifying such challenges, takes center stage in this study, where courtyards hold a prominent role in architectural composition. Facilitated by the ENVI-met software, the evaluation process herein comprehensively analyzes four representative courtyard case studies in Mardin. Key parameters, including air temperature, humidity, predicted mean vote (PMV), and wind speed, are considered to gain a nuanced understanding of their thermal dynamics. The initial evaluation of existing conditions reveals varying thermal comfort levels, with higher PMV values indicating discomfort in the courtyards, underscoring the need for interventions to enhance their microclimate regulation and resilience to climate change challenges. This study aims to enhance our comprehension of the relationship between courtyards and microclimate regulation, particularly in hot–dry regions. By examining the design principles and passive strategies of courtyards, this research identifies effective approaches for optimizing courtyard design, aiming to create sustainable and comfortable living environments.

Urban heat island (UHI) mitigation and adaptation are urgent needs in a built environment, which requires us to search for sustainable solutions to limit the urban heat island effect and improve the energy efficiency of building envelopes. Among these solutions, vertical green structures (VGSs) have recently attracted significant attention for their potential to mitigate adverse effects, especially in densely built areas. This study presents a comprehensive data analysis of the microclimate of a living wall in Milan, Italy. Our aim was to evaluate this VGS’s performance in mitigating temperature increases caused by the UHI effect. In the literature, similar studies are limited to shorter monitoring periods (mostly in cooling seasons) and specific orientations (mostly facing south). However, the VGS presented in this case study here faces northwest and was continuously monitored for one calendar year. During this continuous in situ monitoring campaign, air temperature data from sensors either embedded in vegetation or exposed on a bare wall were collected and analysed over a whole calendar year, which is a novelty compared to the existing literature focused on VGSs due to the long duration. The findings indicate that the studied VGS has the ability to influence the outdoor microclimate depending on the season, the precipitation events, the wall exposure, the type of vegetation, and the vegetation’s phenological attributes. The analysis showed that the VGS consistently maintained cooler temperatures than the bare wall, with mean temperature differences ranging from 2.8 °C in autumn to 0.8 °C in spring through the winter. The vegetation acted as a natural insulator by reducing the air temperature during the hot summer and in early autumn, corresponding to the growing period of the vegetation. Thus, VGSs show potential to mitigate the global warming effect. These findings provide valuable insights on vegetation’s capability to act as a thermal regulator for sustainable urban planning and energy-efficient building design and retrofitting.

IntroductionDespite being recognized as a cost-effective method to enhance physical and mental health, Healing Gardens remain insufficiently popularized in outdoor spaces of hospitals. This paper aims to introduce a new perspective and offer guidelines for their implementation within general hospitals.MethodsA methodology is proposed for formulating hospital-specific guidelines, encompassing the extraction of successful Healing Garden features from case studies, definition of key components grounded in theoretical frameworks, validation of essential features through user questionnaires, and comprehensive site analyses.ResultsThe methodology was applied in a case study at Zhongnan Hospital in Wuhan. This research presents a novel perspective and robust methodology for implementing Healing Gardens in general hospital settings, potentially improving physical and mental health in a cost-efficient manner.DiscussionThis work aims to encourage the adoption of Healing Gardens as preventive medical tools in more healthcare settings. By providing a comprehensive methodology and a case study illustration, this research endeavors to stimulate broader acceptance and utilization of Healing Gardens in healthcare environments.

Recommendation systems are widely used in tourism in order to provide people personalized suggestions that would make their trip memorable. Nowadays, mobile assisted guided tours based on recommendation services are used in museums to enhance visitors ’ experience. However, all those systems have been designed to target indoor or outdoor museum visits. Is it feasible to design a system that supports mobile services that connect a museum visit to artworks situated outdoor in the city environment? Is it possible to connect the artworks of a city center to the exhibits of a museum? In this work, we attempt to give a first answer to such questions proposing and implementing a set of services that connects the museum to the city public space. In order to show the strength of the implemented services, we present a basic usage scenario along with a first system evaluation showing positive results.

The need for effective cognitive training methodologies has increased, particularly for individuals dealing with Attention Deficit Hyperactivity Disorder (ADHD). In response to this demand, Virtual Reality (VR) technology emerges as a promising tool to support cognitive functions. Addressing this imperative, our paper introduces ADHD Dog, a VR game designed to aid individuals with ADHD by harnessing the advancements in VR technology and cognitive science. Our approach integrates behavioral and sociocultural theories, alongside gamification, to foster player engagement and reinforce cognitive functions. The theories employed, including operant conditioning and social constructivism, are specifically chosen for their relevance to ADHD’s cognitive aspects and their potential to promote active and context-based engagement. ADHD Dog, grounded in the principles of neuroplasticity and behaviorist methods, distinguishes itself by utilizing technology to amplify cognitive functions, like impulse control, attention, and short-term memory. An evaluation by individuals with ADHD, psychologists and computer scientists yielded promising results, underscoring the significant contribution of blending narrative-driven gameplay with behavioral and sociocultural theories, along with gamification, to ADHD cognitive training.

The trend of urbanization nowadays has caused serious issues related to climate. One of the most important ones is that of the ‘Urban Heat Island (UHI)’ and it occurs in major cities throughout the world. The most important categories, and therefore the most studied ones, are the canopy urban heat island (CUHI) and surface heat island (SUHI). The aim and the novelty of the current study was to assess different remote sensing approaches to detect the thermal environment of an open area inside a large city. The study was undertaken in an urban area with green spaces, in the Bosco Verticale area in the city of Milan, during the spring and summer period of 2021. The area is characterized by different types of cover materials, which were investigated in terms of surface temperature under shaded and non-shaded conditions. Both field measurements and remote sensing techniques were applied. Remote sensing techniques included downscaling techniques and the usage of different split-window algorithms applied on the Landsat8 satellite sensor data. The land surface temperature (LST) extracted from remote sensing methods was compared with the surface temperature derived from in situ measurements. For the needs of the study, both in situ measurements and the collection of meteorological data from different fixed meteorological stations throughout the city of Milan were carried out. The results revealed the significance of greenery presence inside the urban environment, as a comparison of the meteorological data across the urban area of Milan showed that the areas with a low presence of greenery were found to be warmer than those with a higher presence of green elements. Concerning the field measurements in the study area, the results showed a significant reduction in both surface and air temperature in shaded places. On the other hand, the presence of conventional artificial materials in sunny areas led to relatively high values of both surface and air temperature. The downscaling method showed satisfying results in terms of average LST values; however, some discrepancies appeared in terms of the RMSE index. The application of split-window algorithms has shown that some forms of the ‘Generalized split-window algorithm’ and some forms of the ‘Jimenez-Munoz algorithm’ presented better performance among the studied algorithms. Comparing the LST values derived from the most representative algorithm, the ‘Du, Wan algorithm’, with those derived from downscaling methods, it was found to be quite close. However, under shaded conditions, the results derived from the ‘Split-window algorithm’ were found to be more precise. The application of remote sensing techniques in microscale in urban regions should be further studied in future, as they could be an essential tool for observing microclimatic conditions in urban areas and on building scale.

With escalating adverse effects, climate change is, presently, a critical global issue. The primary agent is the atmospheric high level of carbon dioxide and other pollutants. Concrete significantly contributes to greenhouse gas emissions. Green building is, therefore, a professional responsibility. This analysis briefly proposes various possibilities for reverting to green concrete in construction, advising strategies and solutions implementable at the several life cycle phases of the construction material. Multi-faceted sustainable aspects would pertain to eco-friendly extraction and manufacturing processes, thermal energy-efficient layout, scrubbing of pollutants, and recyclability. In particular, the study sheds light on an important experimental possibility of symbiosing the inert building material with the biological realm: the Living Concrete. At Politecnico Di Milano – Department of Architecture, Built Environment & Construction Engineering, we, first, realized a symbiotic concrete tile with macro-algae Ulva lactuca; then, we developed the experiment to conceive a novel “living concrete” construction finish material designed to absorb/scrub carbon dioxide from the atmosphere. This material consists of concrete blocks with Chlorella vulgaris cultivated on their surface. C. vulgaris is common microalgae with photosynthetic activity. This new photosynthetic concrete finish material was further developed and realized at the University of Verona – Department of Biotechnology with the help of expert professors. Researching effective negative greenhouse gas emissions techniques (NGHGET) from the chemical, physical and/or biological realm presents a valid approach to address and solve climate change problem.

In recent years, policymakers worldwide have emphasized innovative solutions for urban challenges, guided by initiatives like the UN’s Sustainable Development Goals and the European Green Deal. Nature-based solutions (NBS) play a crucial role in addressing climate issues and improving urban well-being. With urban areas witnessing a surge in NBS demand due to their dense populations, initiatives like green wall technologies, such as Living Walls (LW), are becoming more prevalent. However, integrating vegetation onto buildings presents complexities requiring structured support. This research aims to establish a robust foundation for LW design by combining existing standards, exploring current approaches, and pushing architectural and structural practices. It seeks to provide comprehensive guidelines for LW design to enhance efficacy, durability, and safety while preventing errors. Notably, existing global guidance lacks uniformity, necessitating a detailed European guide for LW design and maintenance. The methodology involves consolidating global guidelines and analysing current LW solutions to identify guidance gaps. Anticipated outcomes include foundational guidelines for architects and structural designers to improve LW processes, guiding further research and testing for advanced LW practices.

Abstract Background Wearing facemasks is of proven efficacy as a public health protective measure against COVID-19. Currently there are no observational data concerning the wearing of facemasks and the adherence to guidelines concerning their handling. Methods Registration of the way passers-by were wearing facemasks at 26 different locations of five major cities in Greece. The results were correlated with the rate of COVID-19 deaths in the region. Results In total, 119,433 passers-by were registered, 57,043 females (47.8%) and 62,390 males (52.2%). From the total sample, 81.1% were wearing the mask properly, 10.8% had their nose out, 6.2% were wearing it under the jaw, and 1.9% had no mask at all . There was a significant difference between males and females concerning any use of mask. Inappropriate use of was correlated with COVID-19 death rate in the studied region. Conclusion Our findings suggest that under conditions of mandatory wearing and in central locations of major cities, during walking, proper use of masks is suboptimal, but still contributes with some protection. Fear and risk perception seem to be strong factors contributing to adherence to proper mask wearing.

Iraklis C Mitsogiannis,1 Maria Mitsogianni,1 Vissarion Bakalis,2 Anna Tzortzi de Paz,3 Panagiotis J Vlachostergios,4,&ast; Vassilios Tzortzis3,&ast; 1Second Department of Urology, National and Kapodistrian University of Athens, Sismanoglio General Hospital, Athens, Greece; 2Department of Nursing, University of Thessaly, University Hospital of Larissa, Larissa, Greece; 3Department of Urology, University of Thessaly, Faculty of Medicine, University Hospital of Larissa, Larissa, Greece; 4Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY, USA&ast;These authors contributed equally to this workCorrespondence: Panagiotis J Vlachostergios, Division of Hematology and Medical Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY, 10065, USA, Tel +1 646-962-2072, Email pjv9003@med.cornell.eduPurpose: Health-related quality of life (HRQoL) assessment has become an integral part of clinical research across different disciplines. However, the degree of incorporation of QoL standardized questionnaires in daily routine is variable. This survey study examined how HRQoL is perceived and utilized among urologists from the Hellenic Urological Association (HUA) in their daily practice.Methods: A nationwide survey of Greek urologists registered with the HUA was conducted. Participants were asked to complete a questionnaire sent via email. The survey questionnaire consisted of demographic data including sex, age, working position and working environment and 11 Likert-scale questions regarding perception and use of HRQoL in clinical practice.Results: A total of 1000 Greek urologists were contacted, of whom 400 (40%) responded. Participants were predominantly male (94.8%) with a mean age of 43.7 years and a mean working experience of 12.5 years. Most participants considered HRQoL assessment to be important in their clinical practice (95.3%) and valuable in both patient consultation (95.8%) and treatment follow-up (91.8%). Half of urologists (51%) agreed with the statement that there is limited time for HRQoL assessment in daily practice. Validated questionnaires were rated as useful by 75.5% of participants. Overall, only 26.7% of participants stated they have incorporated HRQoL questionnaires in their daily practice. A subgroup analysis of participants showed that experienced physicians (> 10 years) were less likely to utilize HRQoL (OR 0.38, p=0.008, 95% CI 0.19– 0.77) and experienced difficulty in distinguishing between HRQoL assessment and symptom-rating (OR 0.32, p< 0.001, 95% CI 0.17– 0.61). Lack of time for HRQoL assessment was a main concern for urologists in-training (OR 0.7, p< 0.001, 95% CI 0.57– 0.85).Conclusion: HRQoL assessment is well-perceived by Greek urologists, although it has yet to achieve a substantial degree of integration in their daily practice.Keywords: health-related quality of life assessment, urologic daily practice, survey, questionnaire

IntroductionThe use of immune checkpoint inhibitors (ICIs) as a front-line treatment for metastatic renal cell carcinoma (RCC) has significantly improved patient’ outcome. However, little is known about the efficacy or lack thereof of immunotherapy after prior use of anti-PD1/PD-L1 or/and anti-CTLA monoclonal antibodies.MethodsElectronic databases, including PubMed, EMBASE, Medline, Web of Science, and Cochrane Library, were comprehensively searched from inception to July 2022. Objective response rates (ORR), progression-free survival (PFS), and ≥ grade 3 adverse events (AEs) were assessed in the meta-analysis, along with corresponding 95% confidence intervals (CIs) and publication bias.ResultsTen studies which contained a total of 500 patients were included. The pooled ORR was 19% (95% CI: 10, 31), and PFS was 5.6 months (95% CI: 4.1, 7.8). There were ≥ grade 3 AEs noted in 25% of patients (95% CI: 14, 37).ConclusionThis meta-analysis on different second-line ICI-containing therapies in ICI-pretreated mRCC patients supports a modest efficacy and tolerable toxicity.

The symbiosis between vegetation and the built environment in the context of the historic city poses questions and challenges that require a multidisciplinary approach. Today, Urban Green Infrastructure strategies exclude historic centres, where density, preservation constraints, and morphological complexities make it infeasible to apply standardized greening processes focused exclusively on public space. This study aims to provide an assessment of the solutions that are most compatible with historical areas and a methodology to develop green strategies that respect the cultural peculiarities of each context, reconciling the objectives of regeneration with those of cultural heritage enhancement. The ecological potential offered by private spaces is discussed based on the in-depth analysis of the case study focusing on the city of Milan.

Background: Population data on tobacco use and its determinants require continuous monitoring and careful inter-country comparison. We aimed to provide the most up-to-date estimates on tobacco smoking from a large cross-sectional survey, conducted in selected European countries. Methods: Within the TackSHS Project, a face-to-face survey on smoking was conducted in 2017–2018 in 12 countries: Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania, and Spain, representing around 80% of the 432 million European Union (EU) adult population. In each country, a representative sample of around 1,000 subjects aged 15 years and older was interviewed, for a total of 11,902 participants. Results: Overall, 25.9% of participants were current smokers (31.0% of men and 21.2% of women, P < 0.001), while 16.5% were former smokers. Smoking prevalence ranged from 18.9% in Italy to 37.0% in Bulgaria. It decreased with increasing age (compared to

Objective: The TackSHS project aims to comprehensively elucidate the impact that exposure to second-hand smoke (SHS) from cigarettes and second-hand aerosols (SHA) from electronic cigarettes have on the respiratory health of the European population according to socioeconomic characteristics and other determinants. Method: The TackSHS project involves a series of coordinated studies carried out by 11 academic and public health organisations from six European countries. The project will investigate: a) the determinants of SHS and SHA exposure assessed at the individual level (surveys on representative general population samples) and in common environments (environmental sampling in specific settings); b) the overall disease burden, mortality and morbidity attributable to such exposure; and c) its economic impact in terms of direct health care costs. The project will also examine specific acute respiratory health changes in healthy individuals and patients with respiratory diseases exposed to SHS and SHA. In addition, the project will examine the effectiveness of a novel intervention to reduce SHS exposure in households where smoking is permitted. All these studies are inter-related and involve collaborative coordination among the participant organisations. Conclusion: The comprehensive, integrated approach of the TackSHS project will enable a significant step forward from the current status quo in the understanding of the impact of SHS and SHA exposure on health and provide the basis for health policy recommendations to help European countries to further reduce the harm caused by SHS and SHA exposure. Resumen: Objetivo: El proyecto TackSHS pretende caracterizar el impacto global de la exposición al humo ambiental de tabaco (HAT) y al aerosol de los cigarrillos electrónicos (ACE) en la salud respiratoria de la población europea según variables socioeconómicas y otros determinantes. Método: El proyecto TackSHS consiste en una serie de estudios coordinados y gestionados por 11 organizaciones académicas y de salud pública de seis países europeos. El proyecto estudiará: a) los determinantes de la exposición al HAT y al ACE a nivel individual (encuestas en muestras representativas de la población general) y en espacios comunes (muestras ambientales en lugares específicos); b) su carga general de enfermedad y la morbimortalidad atribuible a tal exposición; y c) su impacto económico en términos de costes sanitarios directos e indirectos. Además, el proyecto investigará cambios específicos a corto plazo en la salud respiratoria en personas sanas y en pacientes con enfermedades respiratorias expuestos al HAT y al ACE. También examinará la efectividad de una intervención novedosa para reducir la exposición al HAT en hogares donde se permite fumar. Todos estos estudios están interrelacionados y conllevan una coordinación colaborativa entre las instituciones participantes. Conclusión: El enfoque integral del proyecto TackSHS permitirá un avance significativo en la evidencia sobre la comprensión del impacto de la exposición al HAT y al ACE en la salud, y proporcionará una base para desarrollar recomendaciones políticas sanitarias para ayudar a los países europeos a reducir los daños causados por la exposición al HAT y al ACE. Keywords: Second-hand smoke, Passive smoking, Electronic cigarette, Electronic nicotine delivery systems, Aerosols, Second-hand aerosols, Respiratory health, Burden of disease, Economic impact, Palabras clave: Humo ambiental del tabaco, Tabaquismo pasivo, Cigarrillos electrónicos, Sistemas electrónicos de administración de nicotina, Exposición al aerosol, Salud respiratoria, Carga de enfermedad, Impacto económico

Summary: The dorsal striatum plays a central role in the selection, execution, and evaluation of actions. An emerging model attributes action selection to the matrix and evaluation to the striosome compartment. Here, we use large-scale cell-type-specific calcium imaging to determine the activity of striatal projection neurons (SPNs) during motor and decision behaviors in the three major outputs of the dorsomedial striatum: Oprm1+ striosome versus D1+ direct and A2A+ indirect pathway SPNs. We find that Oprm1+ SPNs show complex tunings to simple movements and value-guided actions, which are conserved across many sessions in a single task but remap between contexts. During decision making, the SPN tuning profiles form a complete representation in which sequential SPN activity jointly encodes task progress and value. We propose that the three major output pathways in the dorsomedial striatum share a similarly complete representation of the entire action space, including task- and phase-specific signals of action value and choice.

Introduction: Tobacco presence in outdoor children’s playgrounds is concerning not only because it leads to secondhand smoke (SHS) exposure, but also cigarette butt pollution and tobacco normalization. Objectives: This study aimed to assess SHS exposure in children’s playgrounds, according to area-level socioeconomic status (SES), smoke-free regulations, national smoking prevalence, and SHS exposure prevalence in playgrounds (2017–2018). Methods: We monitored vapor-phase nicotine concentration and tobacco-related variables in 20 different playgrounds in 11 European countries (n = 220 measurements) from March 2017 to April 2018. Playgrounds were selected according to area-level SES. Data on the number of people smoking, and cigarette butts inside the playground and on playground surroundings (

Introduction: Second-hand smoke exposure in the home is a serious cause of ill-health for children. Behaviour change interventions have been developed to encourage parents to keep homes smoke-free. This study evaluates a novel air quality feedback intervention using remote air quality monitoring with SMS and email messaging to promote smoke-free homes among families from deprived areas. Methods: This paper presents a pre-post study of this intervention. Using internet connected monitors developed with the Dylos DC1700, daily SMS and weekly email feedback provided for 16 days to participants recruited in four European countries. Participants were recruited based on their stage of change, in order to target those most able to achieve smoke-free homes. The primary outcome measure was median change in mean fine particulate matter (PM2.5) concentration between baseline and follow-up periods, while secondary outcome measures included change in time over the World Health Organisation (WHO) guideline limit for PM2.5 exposure over 24 h (25 µg/m3) in those periods and the number of homes where PM2.5 concentrations reduced. Telephone interviews were conducted with participants in Scotland post-intervention to explore intervention experience and perceived effectiveness. Results: Of 86 homes that completed the intervention study, 57 (66%) experienced pre-post reductions in measured PM2.5. The median reduction experienced was 4.1 µg/m3 (a reduction of 19% from baseline, p = 0.008). Eight homes where concentrations were higher than the WHO guideline limit at baseline fell below that level at follow-up. In follow-up interviews, participants expressed positive views on the usefulness of air quality feedback. Discussion: Household air quality monitoring with SMS and email feedback can lead to behaviour change and consequent reductions in SHS in homes, but within the context of our study few homes became totally smoke-free.

In the present study, results from the examination of mammalian teeth from the cave of Kalamakia with modern techniques, as well as a qualitative overview of the microvertebrate and lithic material, are presented together with a revision of previous related work done for the site, in order to assess the palaeoenvironmental conditions in the area and the role they played in the Neanderthal's repeated occupation of the cave. Geometric morphometrics analyses performed on the first lower molars of Microtus spp. individuals revealed persistent populations of the subgenus Terricola, in which the presence of Microtus thomasi and Microtus subterraneus are continuous through the stratigraphic units. Mesowear analyses performed on ruminant teeth showed no significant variation in toothwear through time, except for relatively elevated levels of dietary abrasion for the more recent samples. The study of the lithics revealed that Neanderthals visited the cave in alternating short and more permanent episodes of occupation, with the human occupants exhibiting special concern for raw material economy, while exploiting poor raw materials for the construction of their tools. The overview of the microvertebrate remains showed a growing trend towards the upper stratigraphic units, where taxa typical of temperate climate, open woodland and shrubland become more dominant. These results, along with observations derived from previous studies, suggest that temperate climate and open environment were the factors that mainly contributed to making the cave of Kalamakia attractive as a habitation site to the humans of the area.

Summary: The striatum is organized into two major outputs formed by striatal projection neuron (SPN) subtypes with distinct molecular identities. In addition, histochemical division into patch and matrix compartments represents an additional spatial organization, proposed to mirror a motor-motivation regionalization. To map the molecular diversity of patch versus matrix SPNs, we genetically labeled mu opioid receptor (Oprm1) expressing neurons and performed single-nucleus RNA sequencing. This allowed us to establish molecular definitions of patch, matrix, and exopatch SPNs, as well as identification of Col11a1+ striatonigral SPNs. At the tissue level, mapping the expression of candidate markers reveals organization of spatial domains, which are conserved in the non-human primate brain. The spatial markers are cell-type independent and instead represent a spatial code found across all SPNs within a spatial domain. The spatiomolecular map establishes a formal system for targeting and studying striatal subregions and SPNs subtypes, beyond the classical striatonigral and striatopallidal division. : Märtin et al. define the molecular identity of striatal projections neurons, focusing on the characterization of the patch and matrix compartments. Genetic labeling of mu opioid receptor (Oprm1)-expressing neurons reveals the identity of neuron subtypes, and also establishes spatial markers for the identification of subregions in striatum. Keywords: neuroanatomy, single-cell RNA-seq, basal ganglia, striatum, patch, matrix, striosome, oprm1, opioid, dopamine

The Tobacco Products Directive (TPD) is a complex binding European Union (EU) legislative document. The aim of the TPD is to preserve a high level of European public health and support the functioning of the internal market of tobacco products in the EU. The European Commission concluded that the European Union Member states need additional assistance in this daunting task. Over the 3 years period (2017-2020) the TPD will come into full swing and the wealth of information that will be available to regulators will be unprecedented. The Joint Action for Tobacco Control (JATC) presents action oriented, evidence-based initiative that should provide support the implementation of the TPD. This collaboration between 30 partners from 23 European countries is funded through the European Commission’s 3rd Health program. The aim of the JATC is to harmonize the regulation of tobacco products in all EU Member States, through the analysis of data submitted by the tobacco industry to EU regulators and development of actions needed to take place in tobacco product licensing and regulation. Objective of the symposium is to provide information on the TPD and JATC and to foster communication and collaboration between relevant stakeholders. The symposium target audiences are EU Regulators and Policymakers, International and National Tobacco Control Stakeholders and researchers who will benefit from the findings and the project’s broader policy implications – as the largest current European Public Health Policy in implementation. The nine work packages of the JATC are Coordination, Dissemination, Evaluation, Integration into National Policies and Sustainability, EU Common Entry Gate (EU-CEG) data, Extraction and Handling, Tobacco Product Evaluation, E-cigarette Product Evaluation, Laboratory Verification, Collaboration and Analyses and Additives Subject to Enhanced Reporting Obligations. Under the TPD (2014/40/EU), manufacturers and importers of tobacco products, have to submit key information to the authorities in the Member States in which they plan to market the products. This submission of information is performed through the EU Common Entry Gate (EU-CEG). While the EU-CEG IT-system is owned by the European Commission, each EU MS own their data in the EU-CEG. TPD states that EU MS should share data with other EU MS and with the Commission. Furthermore, this data is, to the extent possible, to be released to the public. Actions within this package bring significant added value as it addresses the issue of tobacco product monitoring at an EU wide level – an activity that would be impossible to be done by one, or a few, EU MS by themselves. One of the specific aims of the JATC is dissemination of information and project’s results to the public, regulators and researchers. Dissemination of information relevant to Tobacco Products Directive and tobacco control in general is essential for maximizing the impact of the JATC. Finding the most appropriate way of dissemination with protection of sensitive data is of great importance. However, despite the numerous available communication tools, dissemination of information is challenging. Funding JATC has received funding from the European Union’s Health Programme (2014-2020).

Background The current study, part of the EU H2020 funded TackSHS project, aimed to test the hypothesis that passive exposure to e-cigarette emissions provokes systemic symptoms and to determine their severity and timing. Methods 30 nonsmokers, 18-35 years old, BMI< 30, with no significant medical history, no medications, normal physical examination and spirometry, were passively exposed in a 35m 3 room, during a 30-minute Control (no passive smoking) and Experimental (standardized e-cigarette smoking by a human smoker) session. PM 2.5 concentrations were 0.027 mg/m 3 and 3.3 mg/m 3 during the Control and Experimental sessions, respectively. Participants completed an irritation questionnaire, grading symptom severity at T 0 (pre-exposure), T 15 (midway), T 30 (exposure endpoint) and T 60 (30-minute post-exposure) in both sessions. The questionnaire showed internal consistency (Cronbach's α>0.70). Scores 1-5 were generated for the environmental, ocular, nasal, airway and general complaints by adding symptoms per system. Analysis was performed using Wilcoxon-signed rank sum test and Spearman correlation (p< 0.05). Results The most frequent and intense symptoms reported were mild eye burning, nasal and airway dryness. Ocular irritation score gradually increased from T 0 reaching a significant increase by T 30 (p=0.034). Nasal score increased significantly from T 0 to T 15 (p=0.008) and remained significantly higher at T 30 . Airway irritation score increased significantly from T 0 to T 15 (p=0.004) and furthermore from T 15 to T 30 (p=0.018). All symptoms returned to T 0 scores by T 60 (p>0.05). The increased scores for ocular, nasal and airway complaints were positively correlated with increased environmental scores at T 15 and T 30 . General complaint scores showed a tendency to increase at T 30 that was positively correlated with increased environmental scores at T 30 . Conclusions Short-term exposure of nonsmokers to e-cigarette emissions resulted in mild ocular, nasal and airway symptoms that persisted up to 30 minutes and were positively correlated with environmental indices. Further research is needed to investigate long-term health implications.

Background and challenges to implementation Tobacco prevention and cessation are two key approaches of tackling the tobacco epidemic. Nearly all first use of tobacco occurs before secondary school graduation; hence if adolescents can be kept away from smoking, most of them will never start it. The school community, though, consists of a range of age groups with different needs and approach requirements. Intervention or response Substantial public health efforts in Greece have begun since 2009 to prevent tobacco use focusing especially on youth. An educational campaign, called “SmokeFreeGreece” which emphasizes the importance of following a healthy lifestyle linked to non- smoking one has been developed and implemented in Greece. This campaign includes intervention seminars about tobacco use for school students between 10-17 years old, “train the trainer” workshops for teachers, annual school student conferences called "Education for A Smoke Free World", the production of educational material addressed to both students and teachers and collaboration with Symplefsi, an NGO, that improves the living conditions of the inhabitants of the remote Greek islands. More specifically, three individual interventions were created to address tobacco use in ages 10-12, 13-15 and 16-17 years old. This methodological framework indicates the importance of creating a “tailor fitted programme”. Results and lessons learnt The educational seminars offered in specially designed centers have served over 26,000 students and 1,750 teachers. The material has been distributed to date more than 285,000 Greek school students, throughout Greece including visits to 13 remote islands of the Aegean. Conclusions and key recommendations The educational campaign has reached a substantial percentage of the Greek school population. As a motivational buffer to continue our efforts, during the years of the campaign, smoking prevalence among 16- 24 year olds has decreased by 33.3 % (Hellenic Statistical Authority, 2016) and we do believe that our activities are related with this reduction.

Vaccine acceptance is a critical component of sustainable immunization programs, yet rates of vaccine hesitancy are rising. Increased access to misinformation through media and anti-vaccine advocacy is an important contributor to hesitancy in the United States and other high-income nations with robust immunization programs. Little is known about the content and effect of information sources on attitudes toward vaccination in settings with rapidly changing or unstable immunization programs.The objective of this study was to explore knowledge and attitudes regarding vaccines and vaccine-preventable diseases among caregivers and immunization providers in Botswana, the Dominican Republic, and Greece and examine how access to information impacts reported vaccine acceptance.We conducted 37 focus groups and 14 semi-structured interviews with 96 providers and 153 caregivers in Botswana, the Dominican Republic, and Greece. Focus groups were conducted in Setswana, English, Spanish, or Greek; digitally recorded; and transcribed. Transcripts were translated into English, coded in qualitative data analysis software (NVivo 10, QSR International, Melbourne, Australia), and analyzed for common themes.Dominant themes in all three countries included identification of health care providers or medical literature as the primary source of vaccine information, yet participants reported insufficient communication about vaccines was available. Comments about level of trust in the health care system and government contrasted between sites, with the highest level of trust reported in Botswana but lower levels of trust in Greece.In Botswana, the Dominican Republic, and Greece, participants expressed reliance on health care providers for information and demonstrated a need for more communication about vaccines. Trust in the government and health care system influenced vaccine acceptance differently in each country, demonstrating the need for country-specific data that focus on vaccine acceptance to fully understand which drivers can be leveraged to improve implementation of immunization programs.

Introduction We aimed to investigate the immediate respiratory effects of cigar smoking(CS), among young smokers with and without mild asthma. Material and Methods Forty-seven young smokers (18–31years old, 29 males, average pack-years = 3.6 ± 2.8) were enrolled. Twenty-two were mild asthmatics(MA-subgroup) and the remaining 25 were otherwise healthy smokers(HS-subgroup). Exhaled carbon monoxide(eCO), multi-frequency respiratory system impedance(Z), resistance(R), reactance(X), frequency-dependence of resistance(fdr = R5Hz - R20Hz), resonant frequency(fres), reactance area(AX) and exhaled nitric oxide(FENO) were measured at the aforementioned sequence, before and immediately after 30 min of CS, or equal session in the smoking area while using a sham cigar(control group). Chi-square, student’s t-tests, mixed linear models and Pearson correlation tests were used for the statistical analysis; level of significance was defined as p

The museum is not only a transmitter of information about objects, but also ‘a technology in its own right’: the spatial and conceptual arrangement of its display and the architectural layout of its spaces, which together constitute the spatiality of the museum, act as media that generate and structure the way it presents knowledge. This paper explores whether museums seek to re-present their spatiality in the virtual sphere of the website, and if so, in what ways and why. Studies of the use of websites which stress interdependence with the real museum, provide the grounding for these questions. Forty-three websites of the most visited European museums are analyzed, on the basis of 16 themes that index spatiality. The paper clarifies high variability in the way they interpret spatiality, distinguishing three modes of relating real and virtual: the synergetic, the presentational and the discursive. Methodologically, a conceptual framework is developed for interpreting these strategic differences. Theoretically, website design is related to museum theory, in that the philosophy among leading museums to transmit their spatiality powerfully through the website can be theorized as reflecting a performing, rather than informing, museological approach, and a move towards a more ‘participatory’ website culture.

Purpose. The aim of this study was to evaluate the 30-year progress of research on exhaled breath condensate in a disease-based approach. Methods. We searched PubMed/Medline, ScienceDirect, and Google Scholar using the following keywords: exhaled breath condensate (EBC), biomarkers, pH, asthma, gastroesophageal reflux (GERD), smoking, COPD, lung cancer, NSCLC, mechanical ventilation, cystic fibrosis, pulmonary arterial hypertension (PAH), idiopathic pulmonary fibrosis, interstitial lung diseases, obstructive sleep apnea (OSA), and drugs. Results. We found 12600 related articles in total in Google Scholar, 1807 in ScienceDirect, and 1081 in PubMed/Medline, published from 1980 to October 2014. 228 original investigation and review articles were eligible. Conclusions. There is rapidly increasing number of innovative articles, covering all the areas of modern respiratory medicine and expanding EBC potential clinical applications to other fields of internal medicine. However, the majority of published papers represent the results of small-scale studies and thus current knowledge must be further evaluated in large cohorts. In regard to the potential clinical use of EBC-analysis, several limitations must be pointed out, including poor reproducibility of biomarkers and absence of large surveys towards determination of reference-normal values. In conclusion, contemporary EBC-analysis is an intriguing achievement, but still in early stage when it comes to its application in clinical practice.