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Technologies such as AI, autonomous drones, gene-editing tools, and climate engineering are profoundly transforming human life in the third decade of the 21st century. Experience of previous technological leaps points to ambivalent effects that at times may be considered "tragic." This paper examines the relationship between technology and tragedy, contributing to the fields of technology ethics, technology assessment, and the philosophy of the human-environment relationship. The relationship between technology and tragedy is double-edged. On the one hand, technology can serve to eliminate tragedy, e.g. by ensuring safety by design, albeit never with guaranteed success. On the other hand, tragic experiences of technological consequences may result from the discrepancy between initial expectations and actual outcomes. A technological consequence is often framed as "tragic" if it was initially associated with high expectations of existential improvement (first necessary condition). Furthermore, a consequence can be labeled "tragic" in perspective only. Tragic is a personal or cultural narration, experiences that a technology's promise of progress is at least partially reversed to produce the opposite (second necessary condition). As elaborated in this paper, tragic consequences can manifest in two ways: First-order tragedy refers to direct reversals of intended effects (e.g. a technology designed to alleviate hunger exacerbates it). Second-order tragedy involves gradual qualitative changes in life, such as diminished human agency or reduced participation - as if humankind were to become "part of a techno-economical system" and lose the freedom to shape life. This is the "tragic of the machine". Ultimately, some "tragic technologies" narrations may also reflect the one-sided projection of experiences of tragedy onto technology.

Embryo adoption has emerged as one of the most contested questions in contemporary Catholic bioethics, arising from the widespread practice of embryo cryopreservation associated with in vitro fertilization. While the Church affirms without qualification the full dignity of every human embryo, it has not judged embryo adoption to be a morally licit response, and it states that the situation of abandoned embryos cannot be resolved through proposals of embryo transfer. This article argues that such restraint reflects moral coherence rather than indecision. Drawing on magisterial teaching, Thomistic moral analysis, and ecclesial considerations, the article examines embryo adoption through the lens of the moral object of procreation. It first analyzes cryopreservation as an expression of a disordered anthropology that fragments embodiment and temporality, thereby constraining later moral options. It then evaluates embryo adoption as an act that initiates pregnancy apart from the marital act, concluding that neither benevolent intention nor tragic circumstance alters its moral species. The article further engages common Catholic defenses of embryo adoption, assesses the risks of moral confusion and scandal in ecclesial witness, and considers pastoral care for infertility within the limits of licit action. By distinguishing the unconditional dignity of children from the moral evaluation of acts, the article contends that embryo adoption represents a tragic limit rather than a moral solution. The Church's hesitation thus bears witness to a vision of human procreation grounded in marriage, embodiment, and moral truth, even amid unresolved suffering.

Acute kidney injury (AKI) during the postpartum period remains a significant cause of maternal morbidity and mortality, particularly in low-resource settings. Despite advances in obstetric care, little is known about the short-term renal outcomes following postpartum AKI. The aim of the study was to assess the short-term outcomes of renal function in postpartum acute kidney injury patients. This prospective observational study was conducted at Mymensingh Medical College Hospital in Bangladesh between March 2020 and April 2021. The study enrolled 153 postpartum acute kidney injury (AKI) patients from the Departments of Nephrology and Obstetrics & Gynaecology using purposive sampling. Data on patient demographics, etiology and presentation were collected. Statistical analysis was performed using SPSS version 22.0, with a significance threshold of p<0.05 for all tests. After three months, 77.8% fully recovered, 4.6% developed chronic kidney disease and 2.0% needed dialysis. Sadly, 15.7% didn't survive, highlighting postpartum acute kidney injury's severity. Mortality rates didn't significantly differ between vaginal delivery (14.9%0) and cesarean section (16.0%) groups (p=0.488). Both groups saw positive outcomes, with 75.5% of vaginal delivery and 79.2% of cesarean section patients achieving full recovery. Serum creatinine dropped from 4.13&#xb1;1.51 to 1.53&#xb1;1.83 mg/dl after 3 months, indicating treatment success. Blood urea also significantly decreased from 128.51&#xb1;39.59 to 101.65&#xb1;55.57 mg/dl during this period. Most postpartum acute kidney injury patients show promising recovery, but some still grapple with persistent kidney issues. Tragically, mortality rates underscore the severity of this condition. Importantly, survival rates don't significantly differ between vaginal delivery and cesarean section patients, emphasizing timely interventions. Improved serum creatinine and reduced blood urea levels highlight treatment effectiveness.

The tragic story of Captain Robert Falcon Scott and the British Antarctic Expedition (1910-13) is a cornerstone of British cultural memory. While Scott's heroism has been widely studied in historiography and biography, the commercial mobilization of his public image has received comparatively little attention. This paper offers the first systematic analysis of advertisements associated with Scott's final expedition, combining visual social semiotic analysis with archival research to examine the interplay of commercial representations and public perceptions of polar exploration. Building on the work of Nielsen, it identifies three overlapping themes-Heroic Masculinity in Extreme Environments, Domestic Comfort andCivilizedConsumption, and Scientific Authority andRationalizedExpertise-through which advertisers constructed Scott's image and conveyed values associated with the expedition. The analysis shows that scientific labour was consistently marginalized; instead, brands prioritized emotionally imagery of endurance, suffering and-following Scott's death-martyrdom. When invoked, science served primarily to signal technical ingenuity and product reliability, often supported by testimonials. At the same time, references to domestic comfort served to bridge Antarctica and home, enabling consumers to participate imaginatively in the expedition. The paper also examines more recent reinterpretations of Scott's image in advertising, demonstrating how he endures as a flexible cultural symbol and a lasting emblem of British exceptionalism.

Acquired thrombotic thrombocytopenic purpura (aTTP) is a severe microangiopathic hemolytic anemia (MAHA) characterized by profound ADAMTS13 deficiency. MAHA can also manifest as a paraneoplastic syndrome, particularly in advanced malignancies, with cancer-associated MAHA (CA-MAHA) linked to signet ring cell carcinoma being exceptionally rare. We present the case of a 42-year-old Arab male who initially presented with classic features of aTTP, including severe MAHA, profound thrombocytopenia, and renal and neurological dysfunction, confirmed by an ADAMTS13 activity level of 6%. Despite standard TTP therapy including plasma exchange, his atypical response and rapid deterioration prompted further investigation, leading to the diagnosis of aggressive, metastatic signet ring cell carcinoma. Tragically, he passed away less than a week after first presentation. This case underscores the critical importance of maintaining a high index of suspicion for occult malignancies in patients with atypical thrombotic microangiopathy presentations, especially those with an incomplete response to conventional TTP therapies. It emphasizes the need for comprehensive diagnostic workup and a multidisciplinary approach to manage these complex and often fatal conditions, as early identification of underlying cancer is crucial for guiding appropriate, often tumour-directed, therapy and improving patient outcomes. An atypical response to standard thrombotic thrombocytopenic purpura therapy warrants immediate investigation for alternate diagnoses.Underlying malignancy should be actively considered in patients presenting with thrombotic microangiopathy, particularly in cases with atypical features, poor response to standard therapy, or rapid clinical deterioration.

Post partum psychosis is a rare but severe psychiatric emergency, and its comorbidity with a new onset focal seizure disorder can pose a profound diagnostic and therapeutic challenge. We present a tragic traumatic case where a 30-year-old multiparous woman, 12&#x2009;weeks postpartum, with delusions of control, persecution, and an EEG-confirmed focal impaired awareness seizure (complex partial seizure), killed her two children. She was referred to our facility by the police 3&#x2009;days after the tragic event in a confused and disoriented state. She had no previous history of psychiatric or neurological disorders. A multidisciplinary team of psychiatrists, neurologists, and clinical psychologists successfully managed her condition, and the associated police investigation was concluded without a formal prosecution because her family and the law enforcement agencies opted to drop the case. This case report emphasizes the need for a multidisciplinary collaboration to identify and manage neurological disorders in patients presenting with first episode psychiatric disorders, especially in the postpartum period. It highlights the forensic implications of the overlap between neurological and psychiatric disorders.

Huntington's disease (HD) is usually described as rare, tragic, and intractable. Yet, HD offers a strategically unique entry point for neuroscience. With its genetic clarity, relatively predictable course, and organized global community, HD provides the clearest path to advancing brain repair.

Metabolic associated fatty liver disease (MAFLD) has high morbidity and tragically lacks effective therapeutic remedies. Tormentic acid (TA) has been shown to have therapeutic effect on liver fibrosis, but its role in MAFLD remains unknown. Therefore, we employed multi-omics analyses to investigate the effects of TA on MAFLD. In this study, male C57BL/6J mice were fed a methionine- and choline- deficiency (MCD) diet to induce MAFLD and subsequently treated with TA for 4&#x2009;weeks. The therapeutic efficacy of TA was then evaluated through histopathological examination and biochemical analysis. In addition, multi-omics analyses including transcriptomics, proteomics and metabolomics were conducted to identify potential pathways associated with TA treatment. Finally, key genes and proteins in the identified pathways were validated by qPCR and Western blot. Our results showed that TA significantly alleviated liver damage and excessive lipid accumulation. Importantly, our integrative multi-omics analyses identified tryptophan metabolism and glycolysis as pivotal pathways associated with TA treatment in our fatty liver mouse model. Subsequent validation demonstrated the TA-induced upregulation of IDO2 and HAAO, suggesting engagement of tryptophan metabolism. Concurrently, TA treatment downregulated HK2, PFKP, and PKM2, indicative of altered rate-limiting glycolytic enzyme expression. These findings suggest that TA alleviates MCD diet-induced MAFLD, potentially involving modulation of enzyme expression in tryptophan metabolism and glycolysis.

Neutropenic enteropathy (NEP) is one of the important causes of death due to infectious complication during induciton phase of chemotherapy in children with Acute Lymphoblastic Leukemia (ALL). So the objective of this study was to identify the risk factors of NEP. This prospective study was conducted in the Department of Pediatric Hematology & Oncology, Bangladesh Medical University (BMU), Bangladesh from November 2018 to January 2021. Total 98 ALL children were included in this study, among them 36 children developed NEP and 62 children did not develop NEP. Detailed history, clinical examination, hematological examination, laboratory examination, plain X-ray abdomen, abdominal ultrasonogram were performed in all cases. Majority of children with ALL were within the age of 1-10 years (70.0%) and females (63.3%). Children receiving regimen B were more common in children with NEP (80.6%) which was statistically significant (p=0.004). Hypokalemia (13.9%), hyponatremia combined with hypokalemia (44.4%) and hypoalbuminemia (41.2%) was significantly higher in children with NEP (p<0.05). Ultra sonogram findings revealed increased BWT (13.9%) and distended bowel loop (58.3%) was significantly higher in children with NEP (p<0.05). Regarding risk factors of neutropenic enteropathy mucositis, prolonged neutropenia (>7 days), septicemia and use of daunorubicin were found to be significantly different between children with NEP and children without NEP (p<0.05). Multivariate analysis demonstrated, prolonged neutropenia [OR (95% CI) = 44.5(2.82-701.6); p=0.007] and septicemia [OR (95% CI)=44.1(1.46-1334.1); p=0.029] were found to be significant risk factors for development of NEP. NEP is a life-threatening condition especially during the induction phase of chemotherapy, often leading to tragic outcomes, including death, which is often exacerbated by prolonged and profound neutropenia and septicaemia.

Hemophilia A and B are X-linked hemorrhagic disorders, characterized by low/dysfunctional factor (F)VIII or FIX, respectively. The history of hemophilia treatment has evolved remarkably over time from the introduction of cryoprecipitate in the 1960s to plasma-derived factors in the 1970s. The 1980s brought a tragic chapter, as many plasma-derived products were contaminated with blood-borne viruses. In response to ongoing safety concerns, recombinant factors were developed in the 1990s. However, coagulation factors had a relatively short half-life upon infusion. As technology progressed, extended half-life factors were introduced in the 2010s. More recently, the development of non-transfusional therapies such as emicizumab has revolutionized prophylaxis. Additionally, gene therapy is emerging as a potentially curative approach. Despite these advances, discrepancies in laboratory assays have emerged as a significant challenge. Treatments employing extended half-life products and/or gene therapy, may yield variable results depending on the type of assays used, typically one-stage clotting vs. chromogenic assays. These discrepancies can lead to confusion in monitoring factor levels and assessing treatment outcome. This article aims to review the current situation on results discrepancies recorded when measuring post infusion extended half-life factors with different methods and to provide guidance on options that may be adopted to minimize discrepancies.

Animal hoarding is directly associated with impaired human and animal health. In this study, we describe the tragic end of a household fire involving an individual who was hoarding animals. In 2013, the city fire department and the Animal Protection Department of Curitiba were called to respond to a house fire at the residence of an elderly woman with around 70-80 dogs. She had a long-standing diagnosis of animal hoarding behavior and was involved in multiple ongoing judicial processes for animal neglect and cruelty. According to witnesses, the most likely cause of the fire was the lighting of candles indoors, as electricity and water had been cut off on the premises for at least 3 years. A woman in her late 60s fled the scene, but 43 dogs were found dead due to asphyxiation and fire in the main bedroom, with another seven dead dogs found beneath the house. A total of 29 dogs were recaptured after they escaped into the streets during the fire. Despite their infrequency, incidents of household fires involving animal hoarding require increased attention from public health authorities to prevent them effectively. The consequences and implications of these incidents are discussed, and a protocol for preventive strategies is proposed.

Munchausen Syndrome by Proxy (MSBP), or Fabricated or Induced Illness (FII), is a form of physical and emotional child abuse and maltreatment that remains frequently under-detected due to a significant lack of clinical awareness. This case report aims to highlight the challenges of diagnosing MSBP, its impact on victims, and the ethical implications for healthcare professionals. A 37-year-old woman charged with filicide of two of her offspring and deliberate intoxication of her remaining 3-year-old boy was diagnosed with MSBP. Despite the tragic outcome for two siblings, the timely intervention saved the life of the third child. This case adds to the existing literature related to MSBP. It illustrates the difficulties posed by and the perpetrator's ability to deceive healthcare providers. It emphasizes the need for a sound understanding of victims' and perpetrators' features to facilitate early evocation of the condition and thus prompt the adoption of adequate measures. To conclude, MSBP is a complex issue with significant diagnostic and ethical challenges. Early suspicion, careful evaluation, and a multidisciplinary approach are crucial for the protection of children and the appropriate management of perpetrators.

The intersection of sex trade involvement and substance use disorder is a deeply complex and tragic issue for many women, as decades of research reflect that traditional substance use treatment modalities often fail to meet many of these women's unique needs. Sex trafficking specialty court programs constitute a unique and promising avenue to deliver evidence-based practices to treat substance use disorders and to support health and well-being among this largely service disconnected and marginalized population. A growing body of evidence suggests these specialty court programs may be strengthened by the inclusion of family-based interventions. A critical preliminary step to the potential integration of family interventions is the development of processes to identify and engage supportive family members, as well as guidelines on discerning which family members' inclusion is likely to be beneficial versus detrimental. The current study provides direct insights from sex trafficking specialty court participants and their family members regarding family involvement within specialty court treatment programming and potential family therapy services. Fifteen family dyads consisting of one sex trafficking specialty court program participant paired with a supportive family member (identified by program participants) were invited to participate in interviews exploring best practices for identifying and engaging supportive family members in sex trafficking specialty court programming. Inductive Content Analysis was used to analyze interview transcript data. Four themes were identified: (1) characteristics and dynamics within familial relationships; (2) selection criteria for family members to be invited to participate; (3) barriers to successful family participation; and (4) perceptions of family therapy. This study provides insights to inform efforts to engage family supports through the development and integration of family interventions that may bolster substance use treatment success among sex trafficking specialty court participants.

The United States' epidemic of youth firearm suicide represents both a clinical challenge and an existential crisis, with firearm suicide rates increasing yearly. Efforts to mount effective responses, however, are thwarted by cultural, social, and political barriers that affect our ability to understand youth firearm practices, develop risk-reduction strategies, and communicate those strategies to families. The psychological autopsy, a methodology wherein researchers interview the family members and associates of youth firearm suicide decedents, offers tremendous potential for reconstructing the lived experience of children and adolescents lost to suicide. Since its introduction in the 1950s, however, the psychological autopsy has largely developed into a tool that filters lived experience through the lens of clinical scales and validated batteries to facilitate quantitative analysis of suicide risk factors. I argue that we cannot build a deep or actionable understanding of the cultural, sociological, and historical circumstances that subtend youth firearm suicide if we rely solely upon analytical models rooted in the quantitative analysis of clinical constructs. To attain an actional understanding of this tragic epidemic, we must develop practices that apply psychological autopsy methodologies in the service of generating thick descriptions of youth firearm practice and suicide. Several disciplinary traditions, including anthropological ethnography and oral history practice, offer insights that can help us realize psychological autopsy's potential to generate new knowledge, develop interventions to stem the rising tide of youth firearm suicide, and communicate these interventions in an increasingly polarized political environment.