Dimopoulos, Christos

In recent years, there has been a rise in Major Incidents with big impact on the citizens health and the society. Without the possibility of conducting live experiments when it comes to physical trauma, only an accurate in-silico reconstruction allows us to identify organizational solutions with the best possible chance of success, in correlation with the limitations on available resources (e.g. medical team, first responders, treatments, transports, and hospitals availability) and with the variability of the characteristic of event (e.g. type of incident, severity of the event and type of lesions). Utilizing modelling and simulation techniques, a simplified mathematical model of physiological evolution for patients involved in physical trauma incident scenarios has been developed and implemented. The model formalizes the dynamics, operating standards and practices of medical response and the main emergency service in the chain of emergency management during a Major Incident.

The workplace's burden remains a significant concern to workers in the oil and gas industry, where workers are continually exposed to various kinds of occupational risks. The study aimed to identify the different health hazards and their sources across the oil and gas industry to determine the risks associated with health hazards. Methods: A qualitative approach was employed to identify the different hazards connected with the operational environment. A total of 1000 questionnaires were distributed randomly across the various departments in the Nigerian oil and gas industry, and 327 returned to the research team. Analysis of data was carried out using the SPSS. Results: The result shows that ergonomic hazards were found to be most predominant among the hazards assessed in the industry. Ergonomic hazards are 30%, physical hazards 26%, chemical hazards 23%, psychosocial hazards 18%, and biological 3%. Conclusion: Considering the aims of this study, the hazards that exposed workers to ill-health were identified with their sources in the oil and gas operational environment. Some of the health hazards were identified to have short-term health effects on workers, such as headaches, skin burn, eye and skin irritation, and rashes. In contrast, musculoskeletal disorders, respiratory disease, leukaemia, asphyxiates, hypertension, and cardiovascular disease are long-term health effects caused by other hazards. Recommendations: Adequate supervision should be imposed on the workers in their workplace, proper hazards assessment should be conducted in the industry, and compulsory medical testing should be carried out on workers always to know their health status.

Background: Recently, immune-checkpoint blockade has shown striking clinical results in different cancer patients. However, a significant inter-individual and inter-tumor variability exists among different cancers. The expression of the toxins granzyme A (GZMA) and perforin 1 (PRF1), secreted by effector cytotoxic T cells and natural killer (NK) cells, were recently used as a denominator of the intratumoral immune cytolytic activity (CYT). These levels are significantly elevated upon CD8+ T-cell activation as well as during a productive clinical response against immune-checkpoint blockade therapies. Still, it is not completely understood how different tumors induce and adapt to immune responses. Methods: Here, we calculated the CYT across different cancer types and focused on differences between primary and metastatic tumors. Using data from 10,355, primary tumor resection samples and 2,787 normal samples that we extracted from The Cancer Genome Atlas and Genotype-Tissue Expression project databases, we screened the variation of CYT across 32 different cancer types and 28 different normal tissue types. We correlated the cytolytic levels in each cancer type with the corresponding patient group's overall survival, the expression of several immune-checkpoint molecules, as well as with the load of tumor-infiltrating lymphocytes (TILs), and tumor-associated neutrophils (TANs) in these tumors. Results: We found diverse levels of CYT across different cancer types, with highest levels in kidney, lung, and cervical cancers, and lowest levels in glioma, adrenocortical carcinoma (ACC), and uveal melanoma. GZMA protein was either lowly expressed or absent in at least half of these tumors; whereas PRF1 protein was not detected in almost any of the different tumor types, analyzing tissue microarrays from 20 different tumor types. CYT was significantly higher in metastatic skin melanoma and correlated significantly to the TIL load. In TCGA-ACC, skin melanoma, and bladder cancer, CYT was associated with an improved patient outcome and high levels of both GZMA and PRF1 synergistically affected patient survival in these cancers. In bladder, breast, colon, esophageal, kidney, ovarian, pancreatic, testicular, and thyroid cancers, high CYT was accompanied by upregulation of at least one immune-checkpoint molecule, indicating that similar to melanoma and prostate cancer, immune responses in cytolytic-high tumors elicit immune suppression in the tumor microenvironment. Conclusion: Overall, our data highlight the existence of diverse levels of CYT across different cancer types and suggest that along with the existence of complicated associations among various tumor-infiltrated immune cells, it is capable to promote or inhibit the establishment of a permissive tumor microenvironment, depending on the cancer type. High levels of immunosuppression seem to exist in several tumor types.

Background: Microsatellite unstable colorectal cancers (MSI+ CRCs) expressing PD-L1, respond to anti-PD-1 or anti-PD-L1 checkpoint blockade, whereas microsatellite-stable tumors do not respond the same. Our aim was to examine how the immune landscape relates to different aspects of the CRC's biology, including neoepitope burden. Methods: We used TCGA data to stratify patients based on a cytolytic T-cell activity expression index and correlated immune cytolytic activity (CYT) with mutational, structural, and neoepitope features of each tumor sample. The expression of several immune checkpoints was verified in an independent cohort of 72 CRC patients, relative to their MSI status, using immunohistochemistry and RT-qPCR. Results: CRC exhibits a range of intertumoral cytolytic T-cell activity, with lower cytolytic levels in the tumor, compared to the normal tissue. We separated CRC patients into CYT-high and CYT-low subgroups. High cytolytic activity correlated with increased mutational load in colon tumors, the count of MHC-I/-II classically defined and alternatively defined neoepitopes, high microsatellite instability and deregulated expression of several inhibitory immune checkpoints (VISTA, TIGIT, PD-1, IDO1, CTLA-4, and PD-L1, among others). Many immune checkpoint molecules (IDO1, LAG3, TIGIT, VISTA, PD-1, PD-L1 and CTLA-4) expressed significantly higher in MSI+ CRCs compared to MSS tumors. The expression of Treg markers was also significantly higher in CYT-high tumors. Both individual and simultaneous high levels of CTLA-4 and PD-L1 had a positive effect on the patients' overall survival. On the reverse, simultaneous low expression of both genes led to a significant shift towards negative effect. Assessed globally, CYT-low CRCs contained more recurrent somatic copy number alterations. PD-L1 protein was absent in most samples in the independent cohort and stained lowly in 33% of MSI CRCs. PD-L1+ CRCs stained moderately for CD8 and weakly for FOXP3. CYT-high colon tumors had higher TIL load, whereas CYT-high rectum tumors had higher TAN load compared to their CYT-low counterparts. Conclusions: Overall, we highlight the link between different genetic events and the immune microenvironment in CRC, taking into consideration the status of microsatellite instability. Our data provide further evidence that MSI+ and CYT-high tumors are better candidates for combinatorial checkpoint inhibition.

Working environment is constantly changing with working population increasing in terms of ageing, feminization and immigration. Due to the changes in the working pattern, new emerging risks have been introduced at the workplace along with many challenges that employers are called to manage. While ageing has been identified by Occupational Safety and Health (OSH) community as an emerging risk, organisations stand in need of guidelines on how to manage this additional challenge. Occupational Health and Safety Performance (OHSP) is acknowledged as one of the factors affecting the future of an organisation and should be considered when dealing with OSH management with the aim to accomplish Industrial System Productivity (ISP). Nowadays, OSH management should be able to adapt to changes and consider emerging risks within the risk assessment, the procedures and policies. The aim of this paper is to introduce guidelines and practical solutions on OSH management helping the employers and employees adapt to the changing working environment, while explicitly considering individual's characteristics. Using the focus group method, factors affecting the ability to work have been identified and valued. In particular, the Work Individual Performance (WIP) tool is introduced as a tool which is specifically designed to identify factors, potentially affecting the performance of the workers and assist the employers in the identification and implementation of protective and preventive measures, focusing on worker's well-being, OHSP and ISP. The tool has been tested in 2019, during a research which took place in Cyprus involving the police workforce (559 police officers).

This chapter discusses the insights developed for designing scheduling algorithms according to three design projects where algorithms have been developed. The choice of applications covers a broad spectrum. The methods used are from three different fields, namely combinatorial optimization, genetic (evolutionary) algorithms, and mathematical optimization. The application areas differ also in terms of the role of a human user of the algorithm. Some of these algorithms have been developed without detailed study of the competences of the perceived users. Others have examined humans when performing the scheduling tasks manually, but have not considered the change in cognitive load if the process of planning changes due to the new algorithm and computerized support. Although none of the design projects fulfils all criteria developed in the framework of Chap. 12, we show that the framework helps to assess the design projects and the resulting algorithms, and to identify the main weaknesses in these applications. Finally, we show how they can be addressed in future. The three application areas are: 1. Decision support for shunting yard scheduling using a network flow heuristic. 2. An evolutionary multi-objective decision tool for job-shop scheduling. 3. Group sequencing. A predictive-reactive scheduling method for job-shop scheduling.

Micro and small enterprises (MSEs) constitute the cornerstone of the economy in each country, especially in the European Union, where they are perceived as main components for economic development, innovation, employment and social integration. Effective management of occupational safety and health (OSH) in MSEs’ working environment contributes in sustaining corporate longevity and protects workers’ well-being and productivity. This may become essential, especially for economies that are struggling to recover from economic recession. One essential aspect of OSH involves the identification and management of psychosocial risks. EU-OSHA (2010) has launched two significant surveys related to psychosocial risks; named ESENER 1 and ESENER 2. Since micro-enterprises (employing 1–5 employees) were not included in ESENER 2 (EU-OSHA, 2015), an important part of the picture has been left unattended on a European level. This paper aims to address this gap by focussing on the case of Cyprus, since insufficient amount of micro enterprises from Cyprus participated in ESENER 2. A survey utilising ESENER-2 questions was adapted for exploring micro-enterprises’ employees’ perceptions and awareness about psychosocial risks and their management in the work setting. The main differences and some similarities that were spotted between the results of this study and ESENER-2 results regarding Cyprus are highlighted. The differences indicate that the size of the business and the peculiarities of the Cypriot context impact on the perception and management of psychosocial risks. Further research is required in the field of microenterprises that employ from 1 to 5 people, on an EU and international level with a special focus on psychosocial risk issues in micro-enterprises at the service sector and family businesses.

Automated systems are becoming increasingly prevalent in our environment. This leads to a new tasks repartition between the human operator and automation. Understanding human-machine cooperation including potential failures has become a hot topic. In this study we focus on a possible negative consequence of automation: the complacency phenomenon. This phenomenon has been repeatedly observed in dynamic situations in which automation execute an action in order to relieve the human operator from his/her activity. In static task, automation often serves to simplify/pre-process the data and not to directly make a decision. The goal of automation in a static task (like planning) is to optimize an external representation and allow the human operator to make his choices more easily. The Eye Tracker is used to understand human behaviors and their strategies in these static situations. The purpose of this study is therefore to compare complacency to “action execution” from complacency to “data simplification”. We confronted 96 participants to these two automation types on the Multi Attribute Task Battery. We also manipulated four levels of automation reliability (0%; 56.25%; 87.5%, 100%). In all these conditions we assessed complacency through the detection rate of automation failure. In addition, we used an eye tracker to assess a potential low level of suspicion regarding automation failure.

Hierarchical clustering has been widely used for the solution of problems in the area of cellular manufacturing. Hierarchical clustering procedures utilize coefficients that quantify the level of similarity between pairs of machines or parts in the plant. An evolutionary methodology is proposed for the construction of new similarity coefficients that can be used by standard hierarchical clustering methodologies for the solution of cell-formation problems. A typical application is presented for the simplest case of the cell-formation problem. However, alternative similarity coefficients can be evolved for advanced formulations of the problem by suitably modifying the set of fitness cases that constitute the environment of the evolutionary process.

Inspired by the emerging technologies of Augmented and Mixed Reality (AR/MR), the Enlivened Laboratories in Science, Technology, Engineering and Mathematics (EL-STEM) project aims to develop a new approach, integrating these technologies into school laboratories, for encouraging secondary school students’ STEM engagement. In particular, EL-STEM’s main objectives are to attract students who might not be interested in STEM-related studies/careers, enhance the interest of those who have already chosen these fields of studies/careers, and improve students’ performance in STEM-related courses. Moreover, EL-STEM provides teachers with high quality professional development opportunities to acquire knowledge and skills to effectively embed AR/MR in teaching and learning. This book chapter aims to provide an overview of the EL-STEM project and describe use cases of Augmented Reality in STEM education.