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Article: The Reasonableness Standard for Conscientious Objection in Healthcare.

Reichlin, Massimo

2022 Volume 19, Issue 2, Page(s) 255–264

Abstract: In complex, pluralistic societies, different views concerning the moral duties of healthcare professionals inevitably exist: according to some accounts, doctors can and should cooperate in performing abortion or physician-assisted suicide, while ... ...

Abstract	In complex, pluralistic societies, different views concerning the moral duties of healthcare professionals inevitably exist: according to some accounts, doctors can and should cooperate in performing abortion or physician-assisted suicide, while according to others they should always defend human life and protect their patients' health. It is argued that the very plurality of responses presently given to questions such as these provides a liberal argument in favour of conscientious objection (CO), as an attempt to deal with moral diversity by protecting both the professionals' claim to moral integrity and the patients' claim to receive lawful and safe medical treatments. A moderate view on CO is defended, according to which none of these claims can be credited with unconditional value. Claims to CO by healthcare professionals can be justified but must be subjected to a reasonableness standard. Both the incompatibility of CO with the medical profession and its unconditional sanctioning by conscience absolutism are therefore rejected. The paper contributes to the definition of the conditions of such reasonableness, particularly by stressing the role played by conceptions of good medicine in discriminating claims to CO; it is argued that respecting these conditions prevents from having the negative consequences dreaded by critics. The objection according to which accepting the physician's duty to inform and refer is inconsistent with the professed value of moral integrity is also discussed.
MeSH term(s)	Conscience ; Delivery of Health Care ; Female ; Humans ; Moral Obligations ; Morals ; Pregnancy ; Refusal to Treat
Language	English
Publishing date	2022-02-01
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2253038-1
ISSN	1872-4353 ; 1176-7529
ISSN (online)	1872-4353
ISSN	1176-7529
DOI	10.1007/s11673-021-10165-5
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Article ; Online: Human Brain Organoids: Why There Can Be Moral Concerns If They Grow Up in the Lab and Are Transplanted or Destroyed.

Lavazza, Andrea / Reichlin, Massimo

Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees

2023 , Page(s) 1–15

Abstract: Human brain organoids (HBOs) are three-dimensional biological entities grown in the laboratory in order to recapitulate the structure and functions of the adult human brain. They can be taken to be novel living entities for their specific features and ... ...

Abstract	Human brain organoids (HBOs) are three-dimensional biological entities grown in the laboratory in order to recapitulate the structure and functions of the adult human brain. They can be taken to be novel living entities for their specific features and uses. As a contribution to the ongoing discussion on the use of HBOs, the authors identify three sets of reasons for moral concern. The first set of reasons regards the potential emergence of sentience/consciousness in HBOs that would endow them with a moral status whose perimeter should be established. The second set of moral concerns has to do with an analogy with artificial womb technology. The technical realization of processes that are typically connected to the physiology of the human body can create a manipulatory and instrumental attitude that can undermine the protection of what is human. The third set concerns the new frontiers of biocomputing and the creation of chimeras. As far as the new frontier of organoid intelligence is concerned, it is the close relationship of humans with new interfaces having biological components capable of mimicking memory and cognition that raises ethical issues. As far as chimeras are concerned, it is the humanization of nonhuman animals that is worthy of close moral scrutiny. A detailed description of these ethical issues is provided to contribute to the construction of a regulative framework that can guide decisions when considering research in the field of HBOs.
Language	English
Publishing date	2023-06-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	1146581-5
ISSN	1469-2147 ; 0963-1801
ISSN (online)	1469-2147
ISSN	0963-1801
DOI	10.1017/S096318012300021X
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Article ; Online: A Balance of Rights: The Italian Way to the Abortion Controversy.

Reichlin, Massimo / Lavazza, Andrea

Cambridge quarterly of healthcare ethics : CQ : the international journal of healthcare ethics committees

2023 Volume 32, Issue 3, Page(s) 368–377

Abstract: The U.S. Supreme Court' ... ...

Abstract	The U.S. Supreme Court's
MeSH term(s)	Female ; Pregnancy ; United States ; Humans ; Abortion, Legal ; Abortion, Induced ; Italy ; Women's Rights
Language	English
Publishing date	2023-01-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	1146581-5
ISSN	1469-2147 ; 0963-1801
ISSN (online)	1469-2147
ISSN	0963-1801
DOI	10.1017/S0963180122000834
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Article: Generation of low m.w., C3-bearing immunoglobulin in human serum.

Jacobs, R J / Reichlin, M

Journal of immunology (Baltimore, Md. : 1950)

1983 Volume 130, Issue 6, Page(s) 2775–2781

Abstract: The generation of low m.w. C3-bearing immunoglobulin (lg) in normal human serum by an immune ... material was low m.w. (7S), rather than greater than or equal to 19S as expected for IC, in agreement ... with a previous report. Low m.w., C3-bearing Ig was found in normal EDTA plasma after extended storage at -29 ...

Abstract	The generation of low m.w. C3-bearing immunoglobulin (lg) in normal human serum by an immune complex (IC) model was investigated in vitro by using discontinuous sucrose density gradient centrifugation (DGC) and an assay that measures C3-bearing Ig. In this method developed to measure circulating IC, all C3 and C3-bearing material is precipitated from serum by using anti-C3 sera in C3d antibody excess, and immune precipitated, C3-bearing Ig is quantitated by the uptake of 125I-5S-anti-IgG. When plasma from patients with clinically active systemic lupus erythematosus was assayed after DGC, most of the reactive material was low m.w. (7S), rather than greater than or equal to 19S as expected for IC, in agreement with a previous report. Low m.w., C3-bearing Ig was found in normal EDTA plasma after extended storage at -29 degrees C but not after storage at -70 degrees C. Such material was also generated in normal human serum during incubation at 37 degrees C and its generation was stimulated by the addition of an IC model, high m.w., heat-aggregated IgG (HMW-HAIgG). In experiments in which the participation of serum IgG was monitored by the addition of 125I-7S-IgG and 131I-HMW-HAIgG was used as an IC model, low m.w., C3-bearing Ig was generated exclusively from serum IgG and the amount generated was proportional to the concentration of 131I-HMW-HAIgG. No significant decrease in sedimentation of 131I-HMW-HAIgG was observed, but the ability of anti-C3 sera to precipitate 131I-HMW-HAIgG decreased 66% 4 hr after initial C activation. These results indicate that generation of nascent C3b in serum results in its interaction with monomeric serum IgG, producing low m.w., C3-bearing IgG. In addition, the data indicate that circulating IC that activate C have a brief time span during which they can be detected by methods that depend upon the binding of C3.
MeSH term(s)	Animals ; Antibodies, Anti-Idiotypic/analysis ; Centrifugation, Density Gradient ; Complement C3/biosynthesis ; Complement C3/immunology ; Complement C3b/biosynthesis ; Complement C3d ; Freezing ; Humans ; Immune Sera/pharmacology ; Immunoglobulin G/biosynthesis ; Immunoglobulin G/immunology ; Immunoglobulin G/metabolism ; Lupus Erythematosus, Systemic/immunology ; Molecular Weight ; Preservation, Biological ; Rabbits
Chemical Substances	Antibodies, Anti-Idiotypic ; Complement C3 ; Immune Sera ; Immunoglobulin G ; Complement C3b (80295-43-8) ; Complement C3d (80295-45-0)
Language	English
Publishing date	1983-06
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	3056-9
ISSN	1550-6606 ; 0022-1767 ; 1048-3233 ; 1047-7381
ISSN (online)	1550-6606
ISSN	0022-1767 ; 1048-3233 ; 1047-7381
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Article ; Online: A Direct-Digital 40 μA 100 kb/s Intracardiac Communication Receiver with 250 μs Startup Time for Low Duty-Cycle Leadless Pacemaker Synchronization.

Ryser, Adrian / Baeriswyl, Christof / Moser, Michel / Burger, Jurgen / Reichlin, Tobias / Niederhauser, Thomas / Haeberlin, Andreas

IEEE transactions on biomedical circuits and systems

2024 Volume PP

Abstract: The first commercial dual-chamber leadless pacemaker (LLPM) was introduced recently. The system combines two separate implants situated in the right atrium and the right ventricle of the heart. Implant synchronization is accomplished with conductive ... ...

Abstract	The first commercial dual-chamber leadless pacemaker (LLPM) was introduced recently. The system combines two separate implants situated in the right atrium and the right ventricle of the heart. Implant synchronization is accomplished with conductive intracardiac communication (CIC) using the myocardium and blood as transmission channel. Successful implant synchronization of this dual-chamber LLPM has been demonstrated. However, the continuously active synchronization transceivers, consuming about 800 nA, cause a 25-45% reduction in the projected device longevity. This work proposes an alternative strategy for power-optimized LLPM synchronization, which is based on synchronous duty-cycling of the transceivers and direct-digital CIC (DD-CIC). In line with this strategy, a novel low-power DD-CIC receiver for short-packet communication based on Manchester-encoded data and with fast startup time is presented. The circuit was fabricated in 180 nm CMOS technology and analyzed with respect to sensitivity, current consumption and startup time under highly duty-cycled operation. The receiver achieves a sensitivity of 81.6±7.4 μV at a data rate of 100 kb/s, with an active current consumption of 39.1±0.6 μA and a startup time below 250 μs. Operating the receiver as specified by the proposed LLPM synchronization strategy reduces the current consumption to a measured average value of 73 nA. In conclusion, this work suggests synchronous duty-cycling for CIC-based implant synchronization as a promising concept to severely reduce the current consumption of contemporary dual-chamber LLPMs. Consequently, device longevity may be increased significantly, potentially reducing the frequency of costly and complication-prone re-interventions.
Language	English
Publishing date	2024-04-17
Publishing country	United States
Document type	Journal Article
ISSN	1940-9990
ISSN (online)	1940-9990
DOI	10.1109/TBCAS.2024.3390620
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Article: Splenic Infarction Diagnosed by Contrast-enhanced Ultrasound in Infectious Mononucleosis - An Appropriate Diagnostic Option: A Case Report with Review of the Literature.

Reichlin, Mélanie / Bosbach, Simon Johannes / Minotti, Bruno

Journal of medical ultrasound

2022 Volume 30, Issue 2, Page(s) 140–142

Abstract: Infectious mononucleosis is caused by Epstein.Barr virus (EBV) infection. Although typically self.limiting, complications such as splenic infarction and splenic rupture are described. A 17.year.old man presented in the emergency department due to a 3 ... ...

Abstract	Infectious mononucleosis is caused by Epstein.Barr virus (EBV) infection. Although typically self.limiting, complications such as splenic infarction and splenic rupture are described. A 17.year.old man presented in the emergency department due to a 3 days history of fever with chills, soreness, fatigue, and loose stool. Ultrasound examination showed a homoechogenic splenomegaly. Viral enteritis was diagnosed and the patient was dismissed. Six days later, he reassessed due to increasing left upper quadrant abdominal pain. Ultrasound showed inhomogeneous splenomegaly with irregular hypoechogenic subcapsular lesions. Contrast.enhanced ultrasound (CEUS) characterized the lesions as not perfused tissue until the late venous phase, compatible with spleen infarctions. Serologic studies were positive for EBV. In the literature, splenic infarction is considered under.recognized. Contrast.enhanced computed tomography (CECT) and magnetic resonance imaging are associated with costs and radiation (CECT). B.mode ultrasound examination is usually used as the first imaging modality, although showing a poor sensitivity in the question of splenic lesions/infarctions. CEUS has shown instead very good sensitivity and does not harm. Therefore, we recommend CEUS examination as the first imaging modality if suspicion of spleen infarction arises, especially when B.mode ultrasound is normal.
Language	English
Publishing date	2022-01-06
Publishing country	India
Document type	Case Reports
ISSN	0929-6441
ISSN	0929-6441
DOI	10.4103/JMU.JMU_87_21
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Article: On the ethics of withholding and withdrawing medical treatment.

Reichlin, Massimo

Multidisciplinary respiratory medicine

2014 Volume 9, Issue 1, Page(s) 39

Abstract: A general rationale is presented for withholding and withdrawing medical treatment in end-of-life situations, and an argument is offered for the moral irrelevance of the distinction, both in the context of pharmaceutical treatments, such as chemotherapy ... ...

Abstract	A general rationale is presented for withholding and withdrawing medical treatment in end-of-life situations, and an argument is offered for the moral irrelevance of the distinction, both in the context of pharmaceutical treatments, such as chemotherapy in cancer, and in the context of life-sustaining treatments, such as the artificial ventilator in lateral amyotrophic sclerosis. It is argued that this practice is not equivalent to sanctioning voluntary active euthanasia and that it is not likely to favour it.
Language	English
Publishing date	2014-07-16
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2677839-7
ISSN	2049-6958 ; 1828-695X
ISSN (online)	2049-6958
ISSN	1828-695X
DOI	10.1186/2049-6958-9-39
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Article ; Online: Anomalous, Dual Left Coronary System: an Exceedingly Rare Variant.

Reichlin, Katy M / Crimm, Hampton A

Journal of cardiovascular imaging

2019 Volume 28, Issue 1, Page(s) 67–69

Language	English
Publishing date	2019-09-02
Publishing country	Korea (South)
Document type	Case Reports
ZDB-ID	3020035-0
ISSN	2586-7296 ; 2586-7210
ISSN (online)	2586-7296
ISSN	2586-7210
DOI	10.4250/jcvi.2019.0055
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Article ; Online: Introgression from extinct species facilitates adaptation to its vacated niche.

Frei, David / Reichlin, Pascal / Seehausen, Ole / Feulner, Philine G D

Molecular ecology

2022 Volume 32, Issue 4, Page(s) 841–853

Abstract: ... species, Coregonus macrophthalmus, and caught spawning individuals at greater depths (down to 90 m ... populations (4, 12, 20, 40, 60 and 90 m), to document genomic intraspecific differentiation along a water ... the deepest (90 m) and all shallower (4-60 m) spawning habitats. At 12 (23.1%) of these 52 loci ...

Abstract	Anthropogenic disturbances of ecosystems are causing a loss of biodiversity at an unprecedented rate. Species extinctions often leave ecological niches underutilized, and their colonization by other species may require new adaptation. In Lake Constance, on the borders of Germany, Austria and Switzerland, an endemic profundal whitefish species went extinct during a period of anthropogenic eutrophication. In the process of extinction, the deep-water species hybridized with three surviving whitefish species of Lake Constance, resulting in introgression of genetic variation that is potentially adaptive in deep-water habitats. Here, we sampled a water depth gradient across a known spawning ground of one of these surviving species, Coregonus macrophthalmus, and caught spawning individuals at greater depths (down to 90 m) than historically recorded. We sequenced a total of 96 whole genomes, 11-17 for each of six different spawning depth populations (4, 12, 20, 40, 60 and 90 m), to document genomic intraspecific differentiation along a water depth gradient. We identified 52 genomic regions that are potentially under divergent selection between the deepest (90 m) and all shallower (4-60 m) spawning habitats. At 12 (23.1%) of these 52 loci, the allele frequency pattern across historical and contemporary populations suggests that introgression from the extinct species potentially facilitates ongoing adaptation to deep water. Our results are consistent with the syngameon hypothesis, proposing that hybridization between members of an adaptive radiation can promote further niche expansion and diversification. Furthermore, our findings demonstrate that introgression from extinct into extant species can be a source of evolvability, enabling rapid adaptation to environmental change, and may contribute to the ecological recovery of ecosystem functions after extinctions.
MeSH term(s)	Animals ; Humans ; Biodiversity ; Ecosystem ; Lakes ; Salmonidae/genetics ; Salmonidae/physiology ; Genetic Introgression/genetics ; Adaptation, Biological/genetics ; Europe ; Extinction, Biological ; Biological Evolution ; Genome/genetics ; Genome/physiology
Language	English
Publishing date	2022-12-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1126687-9
ISSN	1365-294X ; 0962-1083
ISSN (online)	1365-294X
ISSN	0962-1083
DOI	10.1111/mec.16791
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Article: Studies on the chymotrypsin C and papain fragments of human immunoglobulin M.

Chen, J P / Reichlin, M / Tomasi, T B

Biochemistry

1969 Volume 8, Issue 6, Page(s) 2246–2254

MeSH term(s)	Animals ; Antigens ; Chemical Phenomena ; Chemistry ; Chromatography, Gel ; Chymotrypsin ; Complement Fixation Tests ; Cysteine ; Electrophoresis, Disc ; Hexoses/analysis ; Humans ; Immunodiffusion ; Immunoelectrophoresis ; Immunoglobulin M/analysis ; Macroglobulins ; Molecular Weight ; Oxidation-Reduction ; Papain ; Peptides ; Rabbits ; Ultracentrifugation ; Waldenstrom Macroglobulinemia/immunology
Chemical Substances	Antigens ; Hexoses ; Immunoglobulin M ; Macroglobulins ; Peptides ; Chymotrypsin (EC 3.4.21.1) ; Papain (EC 3.4.22.2) ; Cysteine (K848JZ4886)
Language	English
Publishing date	1969-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1108-3
ISSN	1520-4995 ; 0006-2960
ISSN (online)	1520-4995
ISSN	0006-2960
DOI	10.1021/bi00834a003
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