Catastrophic Outcomes Research Articles

Bioterrorism: – Threats and Possible Implications on National Security in Kenya

Bioterrorism presents a substantial global threat to national security, with potentially catastrophic outcomes. The primary aim of this research was to evaluate Kenya’s preparedness to tackle bioterrorism. The study specifically sought to grasp the magnitude of bioterrorism as a threat to Kenya’s national security, assess the legal and policy framework addressing bioterrorism, and gauge Kenya’s readiness to confront such threats. Employing a mixed-methods approach, questionnaires were administered to various stakeholders, encompassing policymakers, security professionals, healthcare experts, and the general public. Furthermore, in-depth interviews and document analysis were conducted to gain comprehensive insights into the research objectives. The results unveil a nuanced understanding of bioterrorism as a multifaceted hazard to Kenya’s national security. While existing legal and policy structures demonstrate dedication, gaps in execution and enforcement impede their efficacy. Kenya’s preparedness levels fluctuate among stakeholders, with some expressing confidence in current measures, while others highlight deficiencies in technological capabilities and resource distribution. Notably, a significant proportion of respondents at 59 % are in agreement that global advancements in technology have heightened the risks and magnitude of bioterrorism. In summary, Kenya’s endeavors to combat bioterrorism encompass legislative, policy, and operational measures. Nevertheless, enhanced coordination, capacity-building, and resource allocation are imperative to effectively address identified shortcomings. The study underscores the significance of proactive measures and holistic strategies in fortifying national security resilience against bioterrorism threats. Drawing from the findings, the study proposes several recommendations including; Strengthening collaboration and coordination among relevant stakeholders; Investing in technological infrastructure and capacity-building endeavors to enhance surveillance and detection; Regular assessments and revisions of existing legal and policy frameworks are also advised to ensure their pertinence and efficacy in addressing evolving bioterrorism threats. Further research is warranted to explore the socio-economic ramifications of bioterrorism incidents in Kenya and devise strategies to mitigate their impact. Assessing public awareness and magnitude of bioterrorism risks to inform targeted communication and educational campaigns is indispensable. Additionally, studying international best practices and drawing lessons from other nations’ experiences in countering bioterrorism would be advantageous for policy and strategy development in Kenya.

Five-year overview of penile prosthesis implantation: general considerations from real-life practice

Objective: Penile prosthesis (PP) is the third-line therapy for erectile dysfunction in patients who do not respond to pharmacotherapy or who prefer a permanent solution to their problem. Even though the satisfaction rate is high, implantation is irreversible, and complications such as infection can lead to catastrophic outcomes. The objective of this study is to provide a 5-year (2018-2022) overview of patients who underwent penile prosthesis implantation, including techniques using both an inflatable penile prosthesis and semirigid prosthesis. Materials and Methods: Aspects of the study include pre-surgical counseling, patient and device selection, operative technique, and special considerations in relation to implantation in complex cases, such as those involving corporal fibrosis, Peyronie’s disease, or revision procedures. Results: This 5-year overview demonstrates that the techniques remain effective and safe (0% infection rate) with a high satisfaction rate (84%) when compared to several prior studies. Better understanding and advancement in surgical techniques provide good outcomes; thus, implantation of a penile prosthesis is a good option for treatment of erectile dysfunction. Conclusion: This 5-year review of PP implantation carried out in 35 patients by a single surgeon shows a very low complication rate after surgery with a high level of patient satisfaction. To maximize the potential for a good outcome, prior to surgery the physical status of patients should be evaluated and counseling is essential. In patients identified as being at a high risk, the implantation team should be prepared for complications using evidence-based data.

Critical Minerals, Critical Capacity and Critical Evaluation

The battery industry is placed at a critical intersection between the two most extractive and unsustainable industries: mining and energy, where current ‘business as usual’ will lead to catastrophic outcomes for society and life on earth. This gives it a unique opportunity to be an extremely effective disruptive technology, helping end colonial systems which rely on extraction and transfer of wealth and resources from the global south to the global north, and create fair and just energy systems. In order to do this, the battery industry must make batteries from ethically sourced materials, with long lifetimes, that are recyclable. A key question remains on how exactly to evaluate the true sustainability of the components of the electric future, particularly lithium-ion batteries (LIB).This study presents electrochemical and materials characterisation data on several components of LIB, and a set of devised metrics for sustainability, to truly evaluate the potential of research cells in an industrial landscape.Lithium-ion batteries challenge the current energy system, rather than a single use system that must extract, ship and burn fuels constantly, LIB present a potential cyclical system where batteries are recharged, then repurposed before finally being recycled. Metals must still be mined, but this can be achieved sustainably in conjunction with the communities that reside in those areas, as part of an ESG initiative. In developing new technology and with the vast expansion of new industry particularly across Europe, there is enormous potential and responsibility to put in systems to facilitate a just energy transition. This applies all the way down at a materials development level. The systems to evaluate this however, are few and not widely discussed.In this work a case-study that aims to improve existing cell chemistry whilst focusing on its sustainability is presented. This includes the global context and in particular European criticality. The study builds on the premise behind the “Strategic materials Weighting And Value Evaluation" (SWAVE) framework to develop it further for new cell components and combinations.1 This study will focus primarily on the race to reduce cobalt and replace it with nickel and other transition metals. Reducing cobalt dependency is important to battery performance and ensuring that the energy transition is not reliant on a metal with restricted resourcing. However, whilst high nickel cathode content exhibits a higher specific capacity than cobalt-based material, it is less stable due to disordered Li+/Ni2+ cation mixing, lithium residuals upon the surface of the materials, and irreversible phase changes between the H2 and H3 phases at 4.2-4.3 V vs Li/Li+.2 Our results illustrate the difficulty in stabilizing the high nickel cathode materials with long lifetimes and discuss the possible successes in the results seen.Our study also explores the possibility of expanding beyond single ion systems, using alternative anode and electrolyte materials containing different ion transport. One example is Sodium, which offers a cheaper and more sustainable alternative to Lithium, and so replacing any sodium in existing cells would reduce the cost of the cell and reduce the reliance on the critical material lithium. With the creation of metrics of sustainability as within this study, any loss of capacity can be evaluated in context of the sustainability analysis to give the true ‘value’ of a potential cell in the industrial context. The feasibility of these full cell configurations are discussed, with formation, capacity and life-time testing. These results show some promising cell capacities with a variety of cell chemistries and components, whilst keeping in mind the overarching aim of a just energy transition to evaluate the developments made. References 1 R. Sommerville, P. Zhu, M. A. Rajaeifar, O. Heidrich, V. Goodship and E. Kendrick, Resour Conserv Recycl, 2021, 165, 105219.2 H. Ronduda, M. Zybert, A. Szczęsna-Chrzan, T. Trzeciak, A. Ostrowski, D. Szymański, W. Wieczorek, W. Raróg-Pilecka and M. Marcinek, Nanomaterials, 2020, 10, 2018.

Rescue Strategy for Hemorrhagic Complication During Mechanical Thrombectomy and the Clinical Outcome.

Hemorrhagic complications occasionally occur during mechanical thrombectomy and may lead to catastrophic outcomes. Therefore, remedial strategies require careful investigation. Herein, we aimed to evaluate a cohort of patients who experienced hemorrhage during endovascular procedures, the rescue methods used, and outcomes observed. This prospective study included patients who had hemorrhagic complications observed on digital subtraction angiography (DSA) during mechanical thrombectomy, between October 2017 and October 2022, at a high-volume stroke center. Functional outcomes were assessed using the modified Rankin scale (mRS) score at a 90-day follow-up. The primary outcomes were favorable outcomes (mRS score: 0-2 points) and mortality rates. The secondary outcomes were rescue therapy success rates, according to extravasation observed on the final DSA, recanalization status, and causes of hemorrhage. From October 2017 to October 2022, 1537 patients with stroke received emergency endovascular therapy, and 1147 patients completed a 90-day follow-up. Hemorrhage was observed in 33 (2.1%) patients in the process of endovascular interventions. Eighteen (54.5%) cases of hemorrhage were caused by microwire or microcatheter perforation. Mechanical stretching of the vessel during stent retriever withdrawal resulted in 8 (24.2%) cases of hemorrhage. Nine (27.3%) instances of hemorrhage stopped after the reversal of heparin administration and introduction of blood pressure control measures. Further endovascular rescue treatment was performed in 11 patients. Intracranial inflation of the balloon for tamponade stopped 10 hemorrhages, and 1 patient underwent additional coil embolization. Fifteen (45.5%) patients died within 90 days after the procedure. Three (9.1%) patients recovered functional independence (mRS score: 0-2 points) within 90 days. Hemorrhage during mechanical thrombectomy is a rare but severe complication of acute ischemic stroke with high mortality and disability rates. Intracranial inflation of a balloon for tamponade can effectively stop extravasation. This paper described haemorrhagic events characterised by contrast extravasation in the procedure of mechanical thrombectomy due to various causes. Although this complication is rare, patients showed a high mortality and disability rate. There are limited reports available. We found self-limiting haemorrhage had a rather benign prognosis and balloon tamponade could effectively stop the extravasation and might reduce the death rate within 90d. The methods we adopted could be applied in the clinical practice and help neuro-interventionist cope with this complication more promptly and effectively.

Prevalence of co-morbidities and referral patterns in routine preoperative evaluation: A retrospective observational analysis in a tertiary care government hospital

The initial interaction between patients and anaesthesiologists during pre-anaesthesia check-ups (PAC) is a crucial opportunity to diagnose and pre-optimize co-morbidities that might go unnoticed. This proactive approach contributes to safe anaesthesia administration, uneventful intra-operative experiences, and smooth post-operative recovery. Our study assesses the prevalence of diverse co-morbidities within a tertiary care centre's PAC. After analysing data from 3 months involving 905 patients, 624 individuals exhibited co-morbidities, with 217 cases being newly identified within the PAC clinic. Among female patients, anaemia emerged as the most prevalent anomaly (219 cases), while hypertension dominated among male patients (171 cases). Overall, anaemia constituted the most common co-morbidity (362 cases). A comprehensive clinical assessment during the Pre-Anaesthetic Clinic empowers formulation strategies for pre-optimization and treatment of co-morbidities. Timely intervention is pivotal, not only to prevent surgery delays but also to avert potentially catastrophic outcomes arising from untreated conditions. This approach translates into expedited patient recovery, minimizing anaesthesia-related complications. The Pre-Anaesthetic Clinic plays a pivotal role in diagnosing and intervening in patient co-morbidities. Beyond diagnosis, it is a crucial early intervention and treatment platform, significantly enhancing the overall surgical recovery process.

Treatment adherence and its determinants among the rheumatic fever/rheumatic heart disease patients during COVID 19 pandemic - A cross sectional study from Chandigarh, India.

Rheumatic heart disease/Rheumatic fever is a non - communicable disease being a major neglected health problem. Recurrent attacks of rheumatic fever can have catastrophic outcomes, therefore regular administration of antibiotics is recommended. During COVID 19 pandemic, people were afraid to approach hospitals hence the compliance and follow up of patients were affected. This study had planned to assess the treatment adherence of patients diagnosed with rheumatic fever/rheumatic heart disease during COVID 19 pandemic and to describe the socio demographic factors, clinical characteristics. This study also determines the factors associated with the treatment adherence. A cross sectional study was conducted among Rheumatic Fever/Rheumatic Heart Disease patients, attending Outpatient department at tertiary care hospital during COVID 19 pandemic. Mean score with confidence interval was calculated for quantitative data. P value less than 0.05 is significant. The Mean (SD) age of the study participants was 41 ± 14.17 years. Treatment adherence was found to be 94.5 percent among Rheumatic Fever/Rheumatic Heart Disease patients during COVID 19 pandemic. 89.5% of injection benzathine penicillin users had an adherence rate above 80 percent. It was found that the presence of comorbidities (Diabetes/Hypertension/both Diabetes and Hypertension) had a statistically significant association with treatment adherence. Rheumatic Heart Disease is a disease of young and middle -age population affecting predominantly females. The overall adherence rate among Rheumatic Fever/Rheumatic Heart Disease patients was high. High time to maintain hospital-based registry to have follow up of patients.

Successful recognition and management of life-threatening multivessel coronary artery vasospasm after conventional coronary artery bypass grafting.

Background: The occurrence of native coronary artery vasospasm after coronary artery bypass grafting (CABG) is a rare phenomenon with potentially catastrophic outcomes. The absence of a clear understanding of contributing factors and an undetermined occurrence rate underscores the importance of coronary angiography as the primary diagnostic tool for this condition. Case Presentation: We present the case of a 70-year-old Asian male with a 14-year history of diabetes mellitus, seven years of Giant Cell Arteritis (GCA), and Ischemic Heart Disease (IHD). The patient experienced severe native coronary artery vasospasm following conventional CABG, prompting intervention through coronary angiography. Management & Results: The patient underwent coronary angiography, revealing multivessel coronary artery vasospasm. Intracoronary administration of nitroglycerin and diltiazem was initiated promptly. The swift identification and treatment of vasospasm were instrumental in preventing severe myocardial injury. Conclusion: Coronary artery vasospasm post-CABG poses a significant threat, emphasizing the need for early identification and intervention. The successful management presented in this case underscores the importance of timely recognition and the administration of vasodilators in mitigating potential myocardial damage. This report contributes to the growing understanding of this rare but critical complication, highlighting the necessity for vigilance in post-CABG patient care.

Broken Heart Syndrome: A Rare Case of Recurrent Reverse Takotsubo Cardiomyopathy Associated with Acute Respiratory Failure.

Takotsubo cardiomyopathy accounts for one percent of acute coronary syndrome presentations and has been increasingly recognized [1]. Reverse Takotsubo cardiomyopathy, a variant form of Takotsubo cardiomyopathy presenting with the hyperdynamic function of the apical segments and hypokinesis of the basal or mid-ventricular segments is the rarest type of acute stress cardiomyopathy, with mid-ventricular akinesia and preservation of apical and basal contractility [2]. We report a rare case of an elderly woman admitted to the Intensive Care Unit at Case Western Reserve University Hospital in Cleveland, USA. The patient experienced acute respiratory failure as a result of exacerbated chronic obstructive lung disease and heart failure. Echocardiography revealed reverse Takotsubo cardiomyopathy. Cardiac catheterization showed nonobstructive coronary artery disease. The wall motion abnormalities resolved within two weeks. The case is unique in that she had an identical presentation one year earlier after she had entered the same dusty room! Our case report is unique and describes the rarest form of recurrent reverse Takotsubo cardiomyopathy. Our case demonstrates that reverse Takotsubo cardiomyopathy with identical wall motion abnormalities can recur in a patient upon re-exposure to a similar stressful situation. Early recognition and appropriate treatment can prevent catastrophic outcomes.

Malignant Otitis Externa: Unveiling the Hidden Danger of ICA Pseudoaneurysm.

Pseudoaneurysm of the internal carotid artery following otogenic infection is rare but leads to catastrophic outcomes. In our case series, we present two patients with ICA pseudoaneurysm complicated by malignant otitis externa, and we emphasise the importance of timely diagnosis and management to prevent fatal outcomes. A pseudoaneurysm should be ruled out in a patient with malignant otitis externa presenting with recurrent epistaxis or ear bleed.

Impact of Universal Vasa Previa Screening With Color Doppler During the OB Ultrasound Anatomy Scan.

Our institution introduced universal vasa previa (VP) screening utilizing transabdominal ultrasound with color Doppler for all pregnancies at the second trimester anatomy scan. Our study sought to describe the clinical impact of this intervention. Radiology records from the 12 months pre- and post-intervention were queried for "vasa previa." Records included for analysis were those with a first-time diagnosis or discussion of VP at the anatomy scan. Cases were categorized by outcome: (Group 1) True VP, with subgroups A, unresolved by time of delivery and B, resolved by delivery; (Group 2) False positives; (Group 3) Possible VP without definitive diagnosis; and (Group 4) VP ruled out, for example, "no features of VP." Group size was expressed as a percentage of total anatomy scans during pre- or post-intervention periods respectively. Absolute and relative percent change were calculated for each group. In the pre-intervention period, 1 case (0.36% of total scans) was categorized in Group 1A, 1 case (0.36%) in Group 3, and 7 cases (2.53%) in Group 4. In the post-intervention period, 2 cases (0.30%) were in Group 1A, 4 cases (0.61%) in Group 1B, 2 cases (0.30%) in Group 2, 1 case (0.15%) in Group 3, and 7 cases (1.06%) in Group 4. There was a +153% relative change in true positives, from 0.36 to 0.91%. Universal color Doppler screening may have increased detection (sensitivity) while simultaneously increasing false positives (decreased specificity). While decreasing sensitivity is not ideal, this is acceptable given the potential catastrophic outcome of a missed VP.

In Vitro Evaluation of Vancomycin-Induced Toxicity in Human Primary Knee Chondrocytes.

Septic arthritis as a complication of orthopaedic joint surgery can have catastrophic outcomes for patients. To minimise infection risk associated with elective orthopaedics, topical vancomycin during surgery has become increasingly common. Evidence suggests that high concentrations of vancomycin, following direct application of the drug to the joint, are toxic towards various local cell types in the joint, including chondrocytes. However, the mechanism of this vancomycin tissue toxicity is yet to be determined. The aim of this study was to evaluate the toxicity of vancomycin on chondrocytes and the mechanisms of cell death involved. Human primary knee chondrocytes were exposed to vancomycin (1.25-10mg/mL) for 24h and their viability assessed using the resazurin reduction assay in vitro. Specific cell death mechanisms and their contributors, including reactive oxygen species (ROS) production and apoptosis, were measured. This study showed that high concentrations of vancomycin (5 and 10mg/mL) were toxic towards human primary knee chondrocyte cells, while lower concentrations (1.25 and 2.5mg/mL) were not. Cell death studies found that this occurred through an apoptotic pathway. This study provides additional support that vancomycin in high doses is toxic towards chondrocytes and preliminary evidence that this toxicity occurs via apoptotic cell death mechanisms.

Derailment risk: A systems analysis that identifies risks which could derail the sustainability transition

Abstract. The consequences of climate change, nature loss, and other changes to the Earth system will impact societies' ability to tackle the causes of these problems. There are extensive agendas of study and action on the risks resulting from changes in the Earth system. These consider the failure to realise rapid sustainability transitions to date (“physical risk”) and the risks resulting from these transitions going forward (“transition risk”). Yet there is no established agenda on the risks to sustainability transitions from both physical and transition risks and their knock-on consequences. In response, we develop a conceptual socio-ecological systems model that explores how the escalating consequences of changes in the Earth system impacts the ability of societies to undertake work on environmental action that, in turn, re-stabilises natural systems. On one hand, these consequences can spur processes of political, economic, and social change that could accelerate the growth in work done, as societies respond constructively to tackle the causes of a less stable world. Conversely, escalating demands to manage increasingly chaotic conditions could divert work and political support from environmental action, deepening changes in the Earth system. If the latter dynamic dominates over the former, the chance is increased of passing a planetary threshold over which human agency to re-stabilise the natural world is severely impaired. We term this “derailment risk”: the risk that the journey to bring the world back into a safe operating space is derailed by interacting biophysical and socio-economic factors. We use a case study of a climate tipping element – the collapse of the Atlantic Meridional Overturning Circulation (AMOC) – to illustrate derailment risk. A range of policy responses can identify and mitigate derailment risk, including transformational adaptation. Acting on derailment risk is a critical requirement for accelerating the re-stabilisation of Earth system elements and avoiding catastrophic outcomes.

CE Workshop 11: The Cognitive Contraindications, Complications and Costs of Epilepsy Surgery

Abstract & Learning ObjectivesThe role of the neuropsychologist in epilepsy surgery programs has evolved considerably over the past decade. In addition to gatekeeping against catastrophic outcomes, the preoperative neuropsychological assessment is also used to predict the nature and extent of likely postoperative cognitive change and to guide the preparation of prospective candidates accordingly. This workshop will introduce the concepts of contraindication, complication and cost with respect to cognitive outcomes following traditional and newer, less invasive forms of epilepsy surgery. We will explore how neuropsychological data can be integrated with the findings from the wider presurgical evaluation to assess the cognitive risk in each of these categories, with a particular focus on functional and structural imaging techniques. Finally we will look at ways in which information about risks to cognitive function can be shared with both fellow clinicians and patients at each stage along the surgical pathway. Upon conclusion of this course, learners will be able to: 1.Recognize the distinction between cognitive contraindications, complications and costs in cognitive outcomes following epilepsy surgery2.Summarize the latest developments in non invasive epilepsy surgery investigations and techniques and their implications for neuropsychological function3.Apply neuropsychological data to predict postoperative cognitive outcomes and use these predictions to prepare surgical candidates for any anticipated changes.

Athletic Trainers’ Proficiency in Evaluating Emergency Action Plans and a Subset of Catastrophic Policies and Procedures

Written health and safety policies mitigate catastrophic outcomes resulting from sport injuries. The purpose of this project was to evaluate athletic trainers’ proficiency in evaluating catastrophic policies and procedures alignment with best practices. This study found athletic trainers were not able to identify the majority of policy and procedure components based on evidence-based best practice documents. Furthermore, athletic trainers tended to focus more on aesthetics and feasibility versus alignment with current best practices. Results support the need to enhance education specific to policy and procedure development, evaluation, and implementation in order to improve proficiency of clinicians.

Abstract 018: External carotid artery Pseudo aneurysm induced Internal Carotid Artery compression causing acute ischemic stroke

Introduction Here, we describe a patient in whom ischemic stroke was caused by compression of the Internal Carotid Artery (ICA) by a Pseudoaneurysm (PSA) of the External Carotid Artery (ECA) after Gun Shot injury. Eventually, the PSA of the Internal maxillary artery (IMAX) was embolized, resulting in resolution of the patient's symptoms. Methods Case Report Results A 75‐year‐old male with a history of atrial fibrillation on Eliquis presented to the emergency department after sustaining a gunshot wound to the left face. He had extensive injuries through the left masticator and submandibular space with an inferior orbital wall fracture. A Computed Tomography Angiography (CTA) neck showed injuries to the left proximal IMAX with a small PSA. As the PSA was asymptomatic it was managed with observation. On HOD day 13, CTA was done for a brief period of unresponsiveness, which showed high‐grade narrowing of left cervical ICA due to extrinsic compression from PSA which was supplied by a branch of the left ECA with distal re‐constitution (image A). The next day, patient developed right sided plegia and aphasia with NIHSS of 17. A CT head showed no acute intracranial abnormality. The patient underwent emergent Digital Subtraction Angiography (DSA), which demonstrated occlusion of the left cervical ICA from compression from a left IMAX PSA which was treated with n‐butyl‐cyanoacrylate TRUFILL embolization with resolution of flow limitation in the left cervical ICA (Image B1,B2). After embolization, the patient was oriented and able to lift right arm and leg anti‐gravity. Magnetic Resonance Imaging (MRI) was contraindicated due to retained bullet fragments. Repeat CT head did not show stroke. Conclusion A Pseudo aneurysm is characterized by a rupture of the arterial wall and the formation of an aneurysmal sac by the adjacent structures while the sustaining artery remains intact. The most prevalent causes are penetrating or acute blunt neck trauma, hyperextension injury, and injury to the base of the skull (1). Predisposing factors for PSA include carotid endarterectomy or a late complication of carotid artery dissection, infection, radiotherapy, and malignancy (1‐2). Cox et al. reported 124 patients with significant neck and head penetrating injuries. Eleven patients were found to have thirteen head and neck PSA: two in the ICA, one in the vertebral artery, and ten involving branches of the ECA. Two of seven symptomatic PSAs manifested with episodes of massive hemorrhage (3). There have been case reports describing the consequences of an elongated styloid process causing an ischemic stroke due to subsequent dissection and PSA formation (4). According to our knowledge, this case report is one of the first to describe acute ischemic symptoms resulting from ECA PSA‐induced ICA compression, with resolution of symptoms following PSA embolization. The educational value of our case lies not only in the rarity of the condition but also in the uniqueness of its presentation. This case is a fundamental addition to the existing literature on rare neuro‐vascular anomalies leading to potential catastrophic outcomes.

Current cases of AI misalignment and their implications for future risks

How can one build AI systems such that they pursue the goals their designers want them to pursue? This is the alignment problem. Numerous authors have raised concerns that, as research advances and systems become more powerful over time, misalignment might lead to catastrophic outcomes, perhaps even to the extinction or permanent disempowerment of humanity. In this paper, I analyze the severity of this risk based on current instances of misalignment. More specifically, I argue that contemporary large language models and game-playing agents are sometimes misaligned. These cases suggest that misalignment tends to have a variety of features: misalignment can be hard to detect, predict and remedy, it does not depend on a specific architecture or training paradigm, it tends to diminish a system’s usefulness and it is the default outcome of creating AI via machine learning. Subsequently, based on these features, I show that the risk of AI alignment magnifies with respect to more capable systems. Not only might more capable systems cause more harm when misaligned, aligning them should be expected to be more difficult than aligning current AI.

For a Better Disaster Management in Türkiye's 100th Anniversary: District Disaster Management

On the planet, there are various natural hazards, and in the coming years, their frequencies and intensities are likely to vary. These disasters can be diversified into subcategories. Regardless of the way disasters occur, the consequences they create can lead to catastrophic outcomes for both humanity and the environment. It is evident that inequalities among countries result in some nations bearing a more severe burden of the consequences, despite being less responsible for environmental degradation. Due to inadequate infrastructure and financial resources, these countries endure the repercussions more harshly and become more vulnerable. Despite differences in the levels of fragility and development among countries, it is possible to minimize the risks of disasters turning into catastrophes through organized disaster management. In the study, the distinction between the terms hazard, disaster, and catastrophe is clarified in order to eliminate conceptual confusion. Additionally, the development indices of countries and their vulnerability to disasters are evaluated. In the second section, the essential elements of effective disaster management are outlined in subcategories. The third and final section of the study elaborates with examples on why district disaster management plans should be an effective model in disaster management.

Experimental and numerical analysis of low-density gas dispersion characteristics in semi-confined environments

Hydrogen, as a clean fuel, offers a practical pathway to achieve net-zero targets. However, due to its physical and chemical characteristics, there are some safety concerns for large-scale hydrogen utilisation, particularly in process safety management. Leakage of gaseous hydrogen, especially in semi-confined spaces such as tunnels, can lead to catastrophic outcomes including uncontrolled fire and explosion. The current paper describes the outcome of an experimental and numerical study that aims to understand the dispersion of leaked light gas in a semi-confined space to support the adoption of hydrogen. A dispersion chamber with dimensions of 4m × 0.3m × 0.3m was constructed to investigate a baseline gas leakage scenario. To reduce the risk of the experiment in the laboratory, helium is utilised as a surrogate for hydrogen. Computational fluid dynamics simulations are conducted using FLACS-CFD to model the dispersion of leaked gas in different scenarios focusing on the impact of the ventilation velocity, leakage rate, and slope. The results from comprehensive numerical simulations show that ventilation is a critical safety management measure that can significantly reduce the growth of flammable clouds and mitigate the fire and explosion risk. Even with the lowest ventilation velocity of 0.25 m/s, an improvement in the gas concentration level of 29.34% can be achieved in the downstream chamber. The current results will help to further enhance the understanding of hydrogen safety aspects.

Taming Simulators: Challenges, Pathways and Vision for the Alignment of Large Language Models

As AI systems continue to advance in power and prevalence, ensuring alignment between humans and AI is crucial to prevent catastrophic outcomes. The greater the capabilities and generality of an AI system, combined with its development of goals and agency, the higher the risks associated with misalignment. While the concept of superhuman artificial general intelligence is still speculative, language models show indications of generality that could extend to generally capable systems. Regarding agency, this paper emphasizes the understanding of prediction-trained models as simulators rather than agents. Nonetheless, agents may emerge accidentally from internal processes, so-called simulacra, or deliberately through fine-tuning with reinforcement learning. As a result, the focus of alignment research shifts towards aligning simulacra, comprehending and mitigating mesa-optimization, and aligning agents derived from prediction-trained models. The paper outlines the challenges of aligning simulators and presents research directions based on this understanding. Additionally, it envisions a future where aligned simulators are critical in fostering successful human-AI collaboration. This vision encompasses exploring emulation approaches and the integration of simulators into cyborg systems to enhance human cognitive abilities. By acknowledging the risks associated with misaligned AI, delving into the concept of simulacra, and presenting strategies for aligning agents and simulacra, this paper contributes to the ongoing efforts to safeguard human values in developing and deploying AI systems.

State-of-the-Art Review: Fiber-Reinforced Soil as a Proactive Approach for Liquefaction Mitigation and Risk Management

Soil liquefaction is a phenomenon that occurs in which the behavior of soils changes from solid to viscous liquid due to the effect of earthquake intensity or other sudden loadings. The earthquake results in excess pore water pressure, which leads to saturated loose soil with weaker characteristics and potentially causes large ground deformation and lateral spreading. Soil liquefaction is a dangerous event that can lead to catastrophic outcomes for humans and infrastructures, especially in countries prone to earthquake shaking, where soil liquefaction is considered one of the most prevalent types of ground failure. Hence, precautions to reduce and/or prevent soil liquefaction are essential and required. One of the countermeasures to avoid soil liquefaction is the introduction of fibers in the soil since fibers can act as reinforcement by enhancing the soil’s strength and resistance to liquefaction. The process of including fibers into the soil is known as soil stabilization and is considered one of the ground improvement techniques. Therefore, this paper aims to summarize and review the consequences of adding fiber as a reinforcement technique to overcome the issue of soil liquefaction.