Immunology

Cuba’s revolutionary cancer vaccine builds bridges between the island and the United States – AL DIA News

Despite the fact that Donald Trump's government is determined to continue sanctioning Cuba - the charter flights from the U.S. to nine Cuban airports were suspended last week because of the country's support for Maduro's regime, according to statements by Secretary of State Mike Pompeo - the collaboration between the United States and the island continues, at least on scientific matters. And this should not surprise us, taking into account the great medical advances made by Cuban professionals in the treatment of various types of cancer.

This is what we'll be able to witness in "Cuba's Cancer Hope," a documentary by Llew Smith that will be released next April by PBS and that sheds light on CimaVax, a revolutionary treatment against lung cancer that prolongs the life of patients in very advanced stages and that the Center of Molecular Immunology (CIM) in Habana has taken more than twenty years to develop.

In fact, the results are so encouraging that the Roswell Park Comprehensive Cancer Center in New York soon joined the project and will be the first U.S. institution to conduct a clinical trial of the drug produced on the island.

"The future of our country must necessarily be a future of men of science and thought, because that is precisely what we are sowing most," Fidel Castro, 1960.

Llew Smith himself was one of the volunteers to test this pioneering treatment, according to Prensa Latina, and his results, which were made known two years ago, will be part of the documentary.

"The wonderful thing about working with our Cuban colleagues is that they really believe, in their heart of hearts, that medical care is a human right," said Dr. Kevin Lee, director of the Roswell Park immunology department, in a dialogue with the press, praising the medical advances being made in Cuba and its "great potential to treat and prevent cancer of various kinds."

Cuba a pioneer in science

Biotechnology is one of the most developed branches of Cuban science, which began to be promoted in 1980, when Fidel Castro's government created a group dedicated to the production of interphenon, a possible cancer drug, in addition to promoting scientific parks.

This is a commitment to progress that the current president of Cuba, Miguel Daz-Canel Bermdez, acknowledged to Castro on the occasion of the documentary, and which the late revolutionary leader already advocated in a speech made in 1960when he said:

"The future of our country must necessarily be a future of men of science and thoughtbecause that is precisely what we are sowing most."

But the CimaVax is not the only discovery of Cuban scientists, whose achievements can be traced in the history of the island:

In 1881, the scientist Carlos Juan Finlay was the discoverer of the agent that transmits yellow fever, the Aedes aegypti mosquito, which made it possible to clean up the areas invaded by this infectious agent and which, in the end, has prevented millions of deaths.

"The wonderful thing about working with our Cuban colleagues is that they truly believe, deep in their hearts, that medical care is a human right," Dr. Kevin Lee from Roswell Park.

Also at Cuba's Center for Genetic Engineering and Biotechnology (CIGB), Heberprot-P was developed, a unique drug that prevents the amputation of diabetic feet by healing ulcers.

In addition, Cuba was recognized by WHO as the first country in the world to eliminate mother-to-child transmission of HIV.

The documentary "Cuba's Cancer Hope" also includes other therapies being experimented with on the island, specifically for the treatment of different types of cancer, which once again confirms thatscientific advances are breaking down the walls that apparently separate us.

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Cuba's revolutionary cancer vaccine builds bridges between the island and the United States - AL DIA News

Immunology

Scientists find powerhouses that fight tumours from within – Digital Journal

Lurking deep inside some tumours are "factories" full of immune cells that help the body fight a rearguard action against cancer and are key to helping some patients recover, new research has shown.

In recent years, doctors have turned to a new treatment for cancer, immunotherapy, which works by leveraging the body's immune system to fight tumours.

The technique has largely focused on white blood cells called T-cells, which are "trained" to recognise and attack cancer cells.

But the innovative treatment only works well for around 20 percent of patients, and researchers have been trying to understand why some people respond better than others.

Three papers published on Thursday in the journal Nature point the way, identifying a key formation inside some tumours: tertiary lymphoid structures (TLS).

These structures function like "factories or schools" for immune cells that help the body fight cancer, said Wolf H. Fridman, a professor emeritus of immunology at the Cordeliers Research Centre of the Paris Descartes University medical school, who helped lead one of the studies.

"The cells need to be educated in schools, which are the tertiary lymphoid structures," where they effectively learn to recognise and attack cancer cells, Fridman told AFP.

- No longer 'innocent bystanders' -

Key to the findings is that T-cells are far from the only immune cells capable of taking the fight to cancer, with researchers finding the TLS were full of B-cells, a kind of immune cell that produces antibodies.

"We have been T-cell addicts for 15 years in cancer," Fridman said with a laugh.

"We analysed these sarcomas to see what groups they had and what's striking is that these B-cells appeared."

Beth Helmink, a fellow in surgical oncology at the University of Texas's MD Anderson Cancer Center who worked on a second study, said the research changed perceptions of the role of B-cells in immunotherapy.

"Through these studies, we find that B-cells are not just innocent bystanders, but are themselves contributing in a meaningful way to the anti-tumour immune response," she said in a statement issued by the Center.

The discovery is something of a surprise, as an abundance of B-cells in cancer patients has sometimes been seen as a marker for poor prognosis.

But the studies found that patients with high levels of B-cells inside TLS in their tumours were more likely to respond well to immunotherapy.

"This series of studies are exciting because they represent real progress in the treatment of different types of cancer," said Louisa James, a lecturer in immunology at Barts and the London School of Medicine and Dentistry, Queen Mary University of London.

"In the short term, these results provide a new tool to help predict which patients are likely to benefit from treatment with immunotherapy and may also pave the way for improved treatments in the future," added James, who was not involved in the studies.

- Improving cancer treatment -

There are still many unanswered questions, including why the structures form in some tumours and not others.

And while it now seems clear that B-cells inside the structures play a key role in the success of immunotherapy, scientists are not sure precisely how.

It may be that the B-cells are on the frontlines, producing antibodies that attack cancer cells efficiently.

Or they may be bolstering T-cells, or perhaps doing both.

And not all TLS are created equal: the researchers found three categories, but only one type was "mature" enough to churn out cancer-fighting immune cells.

The research opens several promising avenues, the authors said.

Initially, it could help doctors screen patients to see which are most likely to respond well to immunotherapy.

And eventually, the research could mean more patients are successfully treated with the technique, said Goran Jonsson, a professor of oncology and pathology at Lund University in Sweden who worked on a third study.

"If we come up with a treatment that could enhance TLS formation, we could combine this with current immunotherapy regimens," he told AFP.

"Most likely this would lead to more patients responding to immunotherapy."

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Scientists find powerhouses that fight tumours from within - Digital Journal

Immunology

PhD life at the National Heart and Lung Institute | Imperial News – Imperial College London

Throughout the year the NHLI welcomes postgraduate research students who are progressing their careers in respiratory, vascular and cardiac sciences.

As every pathway to a PhD is different, we thought we would ask some students about their individual PhD journeys - from finding funding to advice they would give to someone thinking about applying for their own PhD.

First up, some of our respiratory students; Helen Stoelting, Lauren Headley, Karim Boustani, Nicoletta Bruno and Kunyuan Tian.

Helen My PhD centres around remodelling of the lung during asthma or allergic airway disease during early life, looking at both school-age children with asthma, but also pre-school wheezing in the chest which happens before that. A lot of children who have pre-school wheeze go on to develop asthma later in life, but some of them dont and at the moment we dont really know why that is.

Lauren - The methods of diagnosing and assessing asthma are pretty complicated and can be invasive and arent always accurate. So for me, the goal is to make a sampling method where we can just analyse it and tell people you need to be on this medication or this isnt going to work for you, just to simplify the process, making it much easier for patients and doctors and ultimately not see people suffer.

Karim - For my PhD Im looking at the role the antibody response plays in asthma and idiopathic pulmonary fibrosis (IPF) a lung disease that scars the lungs - and specifically why some types of antibodies are increased in patients with these diseases. I want to investigate why we find some types of B cells in the airways in the first place. If we can understand how these cells are contributing to inflammation and disease, we can hopefully target them with treatments.

Nicoletta - Im looking at steroid resistant asthma in particular, both in animals and humans. Im looking at the asthma types that are not strictly related to allergy and that are more resistant to the current therapies. Its more about identifying which mechanisms are going on because theres not much known about it, and when we learn more it will make a difference.

Kunyuan - Im looking at genetics and environment, recreating the onset of pre-school wheeze and the progression to asthma. The approach of my project is to set up an animal model using a virus to induce a viral response which will make the mice susceptible to asthma.

Karim - I am funded by an Asthma UK studentship as part of the Asthma UK Centre in Allergic Mechanisms of Asthma. After completing my MSc in Immunology at Imperial, I knew I wanted to study respiratory immunology at PhD level so I decided to apply.

Helen - The British Lung Foundation (BLF). My MSc research project supervisor already had funding secured for PhD students through her larger research grant and she helped guide me through the application process which was really helpful.

Lauren - I went on the FindaPhD website which found my MRC/Asthma UK joint PhD on it. It was one of the more straightforward applications Ive done. I had to send over my CV then have a Skype interview. How easy it is all depends on the funding youre applying for and the research group.

Kunyuan - My funding is from Asthma UK which I came across on the British Society of Immunology website. I think the scholarship was also advertised on the Imperial website too. I found the application process very straightforward. I didnt actually apply for this one initially but it was suggested to me that I apply for this PhD instead. I didnt think I was ready for this but when I had a closer look into it, I thought it sounded really interesting so it all worked out well.

Nicoletta - I found my MRC-Asthma UK studentship on the FindaPhD website. It was a fairly easy application process I just had to send a cover letter and my CV, and the interview was quite straightforward compared to other interviews Ive had.

Nicoletta - I studied my undergraduate degree in Biotechnology in Bologna, Italy, then I completed a MSc in Pharmaceutical Biotechnology in both Bologna and in Munich, Germany. I then worked as a research assistant in Cambridge at the Sanger Institute for two years before deciding that I wanted to do a PhD.

Helen - I did my undergraduate degree in Molecular Biomedicine at the University of Bonn in Germany and then I took a year out to do some internships at Bayer, a German biomedical company, and also worked in some university labs. This was a really helpful experience as it made me realise that I dont want to work in industry! I really enjoyed the project I did as part of my MSc in Immunology at Imperial. I had half a year of lectures and then completed my research project with Professor Clare Lloyd, whose group I am working in now.

Lauren - Before coming here I did my undergraduate degree at Kings College London which I extended into an MSci that was Integrated Physiology and Pharmacology for Research. However in order to do the BSc I had to do an Access course as I didnt actually have A Levels. I applied to a few universities for two different courses and I got offers from Kings and London Southbank which I thought was miraculous. It always seemed like it was A Levels or nothing, I was offered a place and I really enjoyed it.

Karim - I did my undergraduate degree London in Biochemistry at Kings College London and then I moved to Imperial to do an MSc in Immunology.

Kunyuan - When I was at high school in Singapore I decided that I wanted to study at a university in London so I applied for an undergraduate degree in Biomedical Sciences at University College London. I then did my MSc in Immunology here at Imperial and was a research assistant over at Imperial Colleges Hammersmith campus before starting my PhD.

Karim - I was already at Imperial for a year doing my MSc and I really liked it, and I knew I wanted to work within the field of immunology and lung inflammation. I knew Imperial had an excellent department so I thought Id apply.

Helen - It was actually more down to chance! I knew I wanted to study Immunology and in Germany there are a couple of universities that are renowned for Immunology, and one of those was where I did my undergraduate degree. I knew I didnt necessarily want to stay in the same city or at the same university so I started applying to places abroad and Imperials MSc just looked really interesting. They had a scholarship which was easy to apply for, and even though I didnt get it, I still came and I dont regret it.

Lauren - After completing my BSc in Pharmacology at Kings College London I actually had a PhD lined up in Australia. It was my dream to go out there but my husband said he didnt want to go! I told him that I would apply for this PhD at Imperial, thinking I was never going to get it so we could still go to Australiabut then I ended up getting it! Its been such an amazing opportunity; I never could have dreamed of coming here.

Nicoletta - Its quite funny actually, I applied and didnt really know that Imperial had such a good reputation for research! It was only once I started that I realised how lucky I was.

Helen - Its difficult to say now because Im still quite early in, but I think your heart has to be in it. There will be some difficult times somewhere along the line and if youre not enjoying research, dont do it. But I do think anyone can do it if you set your mind to it.

Karim - The advice that I would give to anyone thinking about doing a PhD would be to get a feel of the lab and supervisor beforehand if possible. If you can, go and meet with the principal investigator, go for an informal chat, go and see the labs, and see if they have all the equipment and funding you might want or need.

Nicoletta - It needs commitment and it can be stressful but its worth it. Its good because you keep challenging yourself all the time and you have to keep up to date on what everyone else is doing. You need to be motivated because you dont get paid much and you still have to work at weekends. But you get to work with clinicians and thats quite unique as you dont get to do that with many other places in Europe. Here you get clinicians working alongside pure scientists and you can learn from each other.

Kunyuan - Talk to postdocs because they are in a really interesting position theyve already done their PhD so can talk about their experience and at the same time they are still working up the ladder, so they are a very good source of advice.

Lauren - Go for it! The skills that you learn are so transferable, and if you enjoy learning and education, a PhD is perfect.

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PhD life at the National Heart and Lung Institute | Imperial News - Imperial College London

Anatomy

Netanyahu and the Anatomy of a Constitutional Crisis – Lawfare

Amidst a flurry of constant political maneuvering, intense legal debate and multiple Supreme Court cases, Israel has been stuck in political and constitutional deadlock for nearly a year. For the first time in its history, Israel will hold a third parliamentary election in the span of just 12 months after the previous rounds failed to produce a viable government. And also for the first time, the Israeli prime ministers office is occupied by an individual who is facing multiple graft charges involving offenses directly related to his position but refuses to resign.

Prime Minister Benjamin Netanyahu insists on running for reelection, and he still maintains robust support within his political party, the Likud. Israeli politics have thus become inextricably entangled in his legal predicament.

Israels attorney general, Avichai Mandleblit, has found himself in the untenable role of both Netanyahus prosecutor and his advocate: Mandelblit personally authorized Netanyahus indictment after lengthy deliberations, but he has also represented the government at the Supreme Court in multiple cases stemming from that same indictment. Several of these cases have challenged Netanyahus competence to serve as prime minister, while others pertain to Netanyahus effort to secure parliamentary immunity from indictment.

So far, the attorney general has refused to articulate his position on key constitutional issues raised by the current situation, although he has determined that Netanyahu may stay on as caretaker prime minister until the elections. His silence contributes to the stalemate: These are uncharted waters, and there is little legal clarity about what Israels constitutional law requires in this situation.

Many questions need answering. One category relates to Netanyahus current effort to secure parliamentary immunity from indictment. Is Netanyahu eligible for parliamentary immunity from prosecution while he remains in office? Will he be granted parliamentary immunity as a practical and political matter? Would the Supreme Court uphold a decision by the Knesset, the Israeli parliament, to grant him immunity?

Another set of questions has to do with Netanyahus substantive competence to serve as prime minister under indictment. Can Netanyahu even run for reelection under indictment? Perhaps most consequentially, if Netanyahu secures the largest number of recommenders for prime minister in the Knesset after the March elections, may Israels president, Reuven Rivlin, assign him the mandate to form a governmentdespite Netanyahus failure to put together a governing coalition in two previous rounds, and notwithstanding the indictment? If Netanyahu succeeds in forming a government, can he be judicially removed?

In what follows I consider recent developments and the stakes involved in addressing some of these legal questions. For additional detailed analysis, in Hebrew, also see this opinion from the Israel Democracy Institute.

The Immunity Standoff

Like any other member of the Knesset, the prime minister is eligible to seek parliamentary immunity from criminal indictment. Despite flatly denying that he would seek immunity if indicted before the April 2019 elections, Netanyahu has unsurprisingly requested immunity to prevent his indictment from proceeding to court. Netanyahu is being charged with bribery, fraud and breach of trust for various actions he took as prime minister. I elaborated on the allegations in a previous post.

Under the Knesset Members Immunity, Rights and Duties Law of 1951 (as amended in 2005), Netanyahu may ask the Knesset to grant him functional immunity for the duration of his service on several potential grounds. Those grounds include the degree to which the acts constituting his alleged offenses were necessary for the fulfillment of his official duties; prosecutorial maleficence or discrimination; prior disciplinary action by the Knesset; and the possibility of substantial harm to the functioning of the Knesset, one of its committees, or the representation of the electorate. The last ground requires balancing between the benefits of blocking criminal proceedings and the public interest, meaning that the Knesset must consider the severity and nature of the offense in question.

Notably, the law also grants Knesset members absolute substantive immunity for any action in their capacity as a Knesset member performed while fulfilling [their] duty or in order to fulfill [their] duty. Substantive immunity is designed primarily to protect Knesset members speech and political action, and at least a portion of the graft charges against Netanyahu clearly do not meet the laws requirements. For example, it is hard to see how accepting lavish gifts in the form of champagne and cigars could be necessary for the fulfillment of Netanyahus role as prime minister. The same could be said about providing extensive regulatory benefits in return for favorable media coverage. The Knesset Committee, a subcommittee of the full parliament, has final authority to deny immunity under Article 13(c1) of the law. If the committee decides to grant immunity, however, the Knesset plenum must vote to approve its decision.

This is where things get complicated. Once the Knesset decides to dissolve itself, as it did in December 2019, its activities are restricted until a new Knesset is elected. For this reason, and because the current Knesset was elected in September before dissolving itself only three months later, the Knesset Committee has yet to be convened in its current Knesset. When it became evident that the majority of Knesset members supported convening the committee to consider Netanyahus immunity, Netanyahu launched a campaign to stall the proceedings. He appears to have concluded that he might not have a majority in favor of immunity. Netanyahus party pressured the speaker of the Knesset, Yuli Edelsteina Likud memberto invoke his authority in order to block the Knesset Committee from being convened.

It did not work. The Knessets legal adviser has concluded in a recent legal opinion that the speaker did not have authority to prevent the Knesset Committee from convening. The adviser determined that a majority of Knesset members may convene the Knesset Committee if they see fit and that, once convened, the committee is not barred from considering Netanyahus immunity even during the transitional period before the elections as long as the proceedings begin within a reasonable distance from election day, March 2.

In the meantime, the Likud party petitioned the Supreme Court to disqualify the Knessets legal adviser for conflict of interests (the advisers spouse works at the attorney generals office). The Supreme Court has rejected the Likuds request for an injunction against the publication of the opinion, thus allowing its publication, although the case is still pending. The Knessets Organizing Committee, chaired by a member of Benny Gantzs Blue and White partythe Likuds main contender for control of the governmentthen moved to convene the Knesset Committee. Nevertheless, contrary to the opinion, the Likud party and Netanyahus other supporters have continued to pressure the speaker to prevent the Knesset Committee from convening.

It is unwise to make political predictions in the current climate. But it appears that Netanyahu may not have the votes for immunity in the committee or the Knesset plenum. Reports have indicated that he is considering withdrawing his request for immunity if he concludes that he will lose.

Importantly, the indictment could advance to court even if Netanyahu is granted immunity. The Supreme Court has previously reviewedand annulleddecisions of the Knesset Committee pertaining to the immunity of other Knesset members (see, for example, Bishara v. Attorney General; HCJ 11298/03 Movement for Quality Government in Israel v. Knesset Committee). The court has framed immunity decisions as quasi-judicial decisions that are different from ordinary legislative work. Therefore, it has held, such decisions are reviewable under a lower standard of deference.

What is more, the law has changed since these cases had been decided in a way that further weakens parliamentary immunity: The default under the previous regime was that Knesset members had immunity and the attorney general had to petition the Knesset Committee to remove it. Under current law, the default is that there is no immunity, and the Knesset Committee is allowed to grant immunity upon the request of a Knesset member, with the approval of the Knesset plenum. Only two Knesset members have petitioned the committee for immunity since the law was amended, and both requests were denied. In other words, there is reason to believe that the Supreme Court might intervene should the Knesset decide to grant Netanyahu immunityafter all, there is no presumption of immunity under current law, and this is an area where the court has intervened even when there was a presumption of parliamentary immunity.

Substantive Competence

If Netanyahu does not win immunity, Israel will face a constitutional and political Pandoras box. Under current case law, Netanyahu is not legally barred from running in the upcoming elections. There are therefore two open questions: First, can he stay on as prime minister before the elections if the indictment moves forward? As mentioned previously, the attorney general has concluded that Netanyahu can remain in office as caretaker prime minister until the elections. The second question is a trickier one: What happens if Netanyahu gets the most recommendations from Knesset members in the new Knesset after the elections?

Typically, the president assigns the mandate to form a government to whoever receives the most recommendations from Knesset members, although he has discretion in making this decision under Section 7 of Basic Law: The Government:

Could the president deny Netanyahu the mandate even if he has the greatest support among Knesset members?

The Supreme Court has thus far stayed its hand on this key issue. The court has recently dismissed without prejudice a case challenging Netanyahus competence to receive the mandate to form a government after the next elections. The court ruled that the case was not ripe for adjudication because there was no certainty that Netanyahu would in fact get the mandate to form a government after the elections. The issue, it ruled, was therefore theoretical.

At the same time, the court recognized that Israel faces an unprecedented constitutional crisis and noted that the relevant constitutional questions, in principle, are justiciable. This may signal that, if Netanyahu is assigned the mandate to form a government after the elections, the court will eventually decide whether he can serve as prime minister. The court also underlined that the president, in assigning the mandate to form a government, is allowed to factor Netanyahus criminal indictment into this decisionrejecting Netanyahu's argument that the indictment should play no role. Of course, given the seven-day clock set by the Basic Law, the court has set itself up to have to produce one of the most consequential decisions in its history in less than one week.

The courts avoidance in dismissing the case is understandable given that it is caught between a rock and a hard place. The stakes of disqualifying Netanyahuthe longest serving prime minister in Israels history, who has solidified his control over the state in the course of his 11-year reign and still enjoys substantial popular and political supportare monumental. It could result in massive political blowback against the court, which has been under sustained political attacks notwithstanding the Netanyahu saga. Therefore, the court likely prefers to have Netanyahus fate decided in the political arena. If he loses the election, the court will be spared the potentially devastating consequences of deciding the competence issue. The question is what happens in the very plausible scenario that Netanyahu wins greater support in the Knesset than his main opponent, Gantz. Disqualifying him then would be even more difficult if he secures a majority on the heels of an electoral victory.

On the merits, there are conflicting considerations at play. On the one hand, effective judicial impeachment of a sitting prime minister would be unprecedented, even though Netanyahu would technically only be a caretaker prime minister until a new government is formed. As I explained previously, there is no precedent for judicial removal of a prime minister who faces criminal charges: Previous prime ministers resigned when faced with indictments. The text of the applicable constitutional normBasic Law: The Governmentrequires automatic removal only after the prime minister is convicted and the conviction becomes final, which could take years. This is different from the arrangement that applies to other officials such as ministers and mayors, which courts have previously relied on to require their removal following indictment. As I noted before,

[T]here are ample grounds for questioning the application of [precedents] to the situation of a prime minister facing criminal charges. [Previous cases] were decided based on administrative law principles that apply to the prime minister as chief executive and to city councils as administrative authorities. The question of whether a prime minister can be removed in circumstances other than those explicitly provided for in the Basic Law implicates additional complex constitutional issues. It is one thing to hold that a city councils failure to remove a mayor who is accused of criminal wrongdoing is unreasonable as a matter of administrative law. It is a completely different thing for the Supreme Court to challenge the failure of the national legislature, the Knesset, to act, should it fail to remove the prime minister . The stakes here are particularly high because the removal of the prime minister means the resignation of the entire government.

Furthermore, the provisions of the Basic Law governing the prime ministers removal due to criminal wrongdoing seem to set the bar for removal higher than the constitutional and statutory provisions that address ministers, deputy ministers and mayors. This might serve as an additional basis for distinguishing the existing precedents in the case of the prime minister. Articles 23(b) and 27 of the Basic Law provide that a government minister or deputy minister convicted of an offense with moral turpitude would automatically be removed from office once the verdict is rendered. Unlike the prime minister, they cannot remain in office until the verdict becomes final. Article 20 of the Tenure Statute provides that a mayor would be automatically suspended if convicted with moral turpitude until the verdict becomes final. No such provision exists in the Basic Law with regard to the prime minister, which indicates that the Knesset intended to bestow a more robust constitutional protection from removal upon the prime minister.

Moreover, judicial interference in this unique context creates problems for democratic legitimacy. If the court rules that Netanyahu is incompetent to serve as prime minister due to the criminal charges against him, it would essentially recognize the unelected attorney generals power to remove a prime minister by indictment.

On the other hand, judicial approval of Netanyahus competence would send the message that pervasive corruption can be tolerated, even when it directly involves alleged abuse of the office of prime minister. Such a ruling could lead to a situation in which a prime minister faces a criminal trial while overseeing and working closely with the very institutions that participate in his prosecution. It would uphold a reality that creates a serious conflict between the prime ministers self-interest and the best interests of Israel.

It would also be in tension with previous case law that required the dismissal or resignation of officials who faced serious indictments without waiting for them to be convicted, even though the Basic Law required removal only after conviction. Under existing case law, statutory removal requirements do not exhaust the circumstances in which an elected officials tenure could be terminated due to alleged criminal wrongdoing. In fact, under existing law, Netanyahu was forced to resign from the four ministerial positions he had held in addition to being prime minister. The absurdity should be evident: How can it be that Netanyahu is legally barred from serving as an ordinary minister, but not as prime minister?

Finally, Israels parliamentary system means that barring Netanyahu from receiving the mandate to form a governmentbe it by decision of the president or as a result of a subsequent Supreme Court rulingwould not necessarily abrogate the will of those who voted for the Likud party. The prime minister is not elected directly but is the member of the Knesset who succeeds in building a majority coalition. And even then, the president has discretion in granting the mandate to form a government, so a different Likud member may be able to form a government.

Focusing on the presidents decision would arguably circumvent the problemdiscussed in the excerpt aboveof overriding the Knessets decision not to remove a prime minister already serving with its confidence. The presidents exercise of his discretion in allocating the mandate to form a government could serve as a hook for judicial review. As the Supreme Court just made clear, it would be lawful for the president to consider Netanyahus indictment (and possibly his previous failures to form a government) in assigning the mandate even if Netanyahu pulls together a majority coalition after the elections.

For these reasons, while the courts wait-and-see approach may be prudent, it is also problematic. There is an argument to be made that if the court is to disqualify Netanyahu at some point, it is better to do so before the elections. First, the public has a right to know whether the head of the party they might be voting for, who personifies and tightly controls that party, is even eligible to continue as prime minister. Another round of elections that ends in deadlock because of questions and litigation about the eligibility of Netanyahu to serve as prime minister would further undermine an already fragile and nearly dysfunctional Israeli democracy.

Second, Netanyahu is currently a caretaker prime ministerthat is, prime minister by default due to the political deadlock. He does not enjoy the confidence of the Knesset, having twice tried and failed to assemble a coalition capable of receiving that confidence. From a constitutional perspective, disqualifying a prime minister in the current situation is different from disqualifying a prime minister who heads a coalition that has the support of the majority of the Knesset and thus enjoys political and public legitimacy. It would not abrogate the will of the voters, expressed through their elected officials, to the same degree as disqualifying a prime minister who enjoys the confidence of the Knesset.

But the courts decision to stay away from the matter for now means that this ship has sailed. If Netanyahu manages to secure a majority after the March elections, his political fate will come down to the outcome of the immunity vote and the presidents decisionand the likely review of these decisions by the Supreme Court. There is no telling what the political repercussions of such a constitutional showdown would be.

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Netanyahu and the Anatomy of a Constitutional Crisis - Lawfare

Anatomy

Anatomy of the GAO Trump Smear – Newsmax

The anti-Trump chorus is breathlessly declaring that the January 16 Government Accountability Office (GAO) report asserts Trump broke the law regarding Ukraine aid.

That is not what the report states and that is not what happened.

The GAO serves a vital oversight function for the Federal Government. Annually, GAO reports on waste, fraud, and mismanagement identify billions of dollars in potential savings. The Agency studiously avoids politics by outlining procedural and legal compliance issues.

GAO Report B-331564 is different, as it is incomplete on facts while overstating the Trump Administrations noncompliance with a controversial law.

The report never admits that the Ukraine Aid in question was, in fact, released on September 11, prior to the deadline of September 30, 2019.

This omission is fundamental to the entire Ukraine matter and undermines GAOs credibility.

The GAO report centers on the Impoundment Control Act (ICA). This was passed as part of Congress reining-in President Richard Nixon. Nixon had impounded funds for many programs and agencies to counter Congressional spending sprees. His actions continued a long-standing practice, going back to Thomas Jefferson, of presidents exercising fiscal discipline to thwart Congressional overspending.

The Congress took advantage of Nixons ebbing power by pushing through the ICA and other legislation to open the spending flood gates. Discretionary spending has ballooned out of control ever since.

Presidents, Republican and Democrat, have attempted to restore the balance in budgeting and spending policy. The GAOs Ukraine report cites numerous court cases where Clinton and other presidents have sought court assistance to set limits and clarify processes.

All funds were released prior to the Congressional deadline. The delay in releasing Ukraine funds never crossed these legal lines.

In fact, the delays fully complied with the law authorizing the funds (PL 115-232), as it explicitly stated that, In order to obligate more than fifty percent of the amount appropriated, DOD was also required to certify to Congress that Ukraine had taken substantial actions on defense institutional reforms.

The Office of Management and Budget (OMB) issued numerous apportionment schedules with footnotes explaining the delay in releasing the funds was to allow for an interagency process to determine best use of such funds. Each memo consistently stated that, this brief pause in obligations will not preclude DODs timely execution of the final policy direction.

One part of the foreign military financing (FMF) earmarked for Ukraine was delayed only six days.

The GAO Ukraine report, clearly states that:

The President may temporarily withhold funds from obligationbut not beyond the end of the fiscal year in which the President transmits the special messageby proposing a deferral. 2 U.S.C. 684

At no point in the Ukraine Report does the GAO find that OMB or the president triggered a deferral or impoundment. Therefore, there was no violation of the Impoundment Control Act (ICA).

However, the GAO pours through countless memos from the OMB, as well as OMB responses to GAO questions. Unfortunately, OMBs responses dug avoidable holes into which the Trump Administration fell by raising needless challenges to the ICA.

OMB engaged in a battle it did not need to fight. This triggered GAO having to recount the ICA battles from other Administrations and pointing out the flaws in OMBs arguments. OMB responded by not responding. As the GAO-OMB dialogue dissipated, political rhetoric seeped-in.

The GAO stepped over their line by asserting there may be potential impoundments where none exist. You either impound or you dont. There is no potential. The GAO ascribes policy reasons for the delay of funds without providing any evidence.

Finally, to carve out its own place in the Impeachment, the GAO violated decades of its own professional code of conduct by declaring, We consider a reluctance to provide a fulsome response to have constitutional significance.

Senator Chris Van Hollen (D-MD), a dedicated Never-Trumper, requested the GAO Ukraine report on October 30, 2019. He kept demanding GAO provide a report sooner versus later in a letter dated December 23, 2019. The GAO admits that its report is a work in progress and states it is waiting on additional information from the State Department and OMB.

Unfortunately, Thomas Armstrong, GAO General Counsel, was willing to risk the agencys reputation as the gold standard of oversight, by prematurely releasing an incomplete and flawed report, immediately relegating it to just another politically charged smear.

Scot Faulkner is the best-selling author of: "Naked Emperors: The Failure of the Republican Revolution." He also served as the first chief administrative officer of the U.S. House, and was director of personnel for the Reagan campaign and went on to serve in the presidential transition team and on the White House staff. During the Reagan administration, he held executive positions at the FAA, the GSA, and the Peace Corps. Read more of Scot Faulker, Go Here Now.

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Anatomy

Greys Anatomy Time Jump Twist: The Season 16 Premiere Will Choose Up – Sunriseread

Grays Anatomy will likely be doing the time warp once more when it returns for Season 16 later this month, however theres a catch.

Showrunner Krista Vernoff tells TVLine that the Thursday, Sept. 26, opener will decide up moments from the place we left off within the Season 15 finale, and the entire lingering cliffhangers i.e. Meredith, Richard and Alex receiving pink slips, DeLuca sporting jail orange and Jackson vanishing into skinny air thick fog will likely be addressed fairly instantly.

However shortly thereafter, the clock will start to tick however rapidly. Well then span just a little little bit of time over the course of the hour, reveals Vernoff by the use of describing the weird time-jump situation. How a lot time will lapse by the top of the premiere? I might slightly not reveal that, she says, holding her playing cards near her vest.

Whatever the leap aheads precise size (be it weeks or months or years?), Vernoff guarantees that there will likely be fallout from the varied conflicts significantly the place Meredith and DeLuca are involved.

Theyve acquired to navigate the complexities of a brand new relationship within the wake of Meredith having been fired and having damaged the regulation, previews the EP. There are stressors on their very new relationship coming from the ramifications of these choices final season.

For extra intel on Grays Anatomys 16th season, try TVLines densely-packed, just-published Fall Preview Scoop Spectacular.

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Neuroscience

Victorian underwear reveals what it is like to live with epilepsy – Epilepsy Society

Last year we posted a call out on social media, asking people with epilepsy to share their thoughts about what it is like to live with seizures.

Now the artist, Susan Aldworth has turned those testimonies into an innovative exhibition using both antique Victorian underwear and sophisticated technology to explore the impact that epilepsy has on peoples lives.

And the exhibition, Out of the Blue, opens this weekend on 18 January at Hatton Gallery Institute of Neuroscience, Newcastle. It will run until 9 May 2020.

The worst part is that no one else notices. It feels like Im going to explode but no one else sees a thing... Im just stuck, Im still conscious. I can see, feel, and think. But I cant do anything. Im trapped in a body that wont listen to me. Sophie

The exhibition is built around more than 100 pieces of Victorian underwear chemises, nightdresses, bloomers each embroidered by members of the Royal School of Needlework with extracts from individual testimonies.

The garments are stitched in ultraviolet yellow and light blue, and black. They are then suspended by the ceiling on pulleys programmed by computers to correspond to the algorithms of electrical activity in an epileptic brain.

Out of the Blue was commissioned by the Institute of Neuroscience at Newcastle University and is funded by the Wellcome Trust. Scientists at the institute are developing experimental treatments for epilepsy that use optogenetics, a biological technique that controls the activity of neurons in the brain, using light and genetic engineering.

The fluorescent embroidery is lit by both natural and ultraviolet light to reflect the scientists light-sensitive gene therapies.

After a seizure my head feels like it has been smashed against a brick wall and my whole body aches. My epilepsy nurse once told me she had a patient who was hit by a bus and they said that was less painful than a seizure.Willow

As an artist I really wanted to explore how it makes people feel to have epilepsy and what it is like to live with it, explains Susan. I wanted to give people with epilepsy a voice and bring the condition out into the open.

Almost 100 people responded to Susans request for personal testimonies, describing the reality of how they and their families are affected by the condition.

I was really blown away by their responses, says Susan. They described their lived experience of epilepsy with amazing candour and detail. Their testimonies are incredibly emotional and real.

You can read a full interview with Susan Aldworth in our members magazine, Epilepsy Review. Find out how you can become a member and get a copy of Epilepsy Review twice a year for free. https://www.epilepsysociety.org.uk/become-member-epilepsy-society

Out of the Blue is at Hatton Gallery Institute of Neuroscience, Newcastle and runs from 18 January 9 May 2020.

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Neuroscience

JPM: Biotech, VC execs on where the industry should look beyond cancer – FierceBiotech

SAN FRANCISCOOncology is clearly a major medical and societal issue: a major killer that, while predominately affecting the older population, can strike the young through a mixture of environmental factors or a genetic lottery. Its no wonder we struggle to even call it by its name, preferring just the "big C."

Biopharma has acted accordingly over the years and spent billions (and made many more billions) developing new oncology therapies, with the media and political focus falling on cancer drugs far more acutely than any other area, whether that be over pricing (the current average cost of a new cancer drug in the U.S. is around $100,000), effectiveness/safety or rejection from healthcare gatekeepers, such as the National Institute for Health and Care Excellence in England.

But cancer is only one disease area: Heart disease is the biggest killer in the U.S., yet there are very few new and innovative CV drugs out there, with influenza complications, such as pneumonia, Alzheimers disease, stroke and diabetes complications all leading causes of death in the U.S. There has been a war on cancer, but not a war on stroke.

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There is also the growing threat of antimicrobial resistance, where decades-old antibiotics are ceasing to work against common forms of bacteria as they evolve; this, coupled with the fact that most life science companies arent working on a next generation of antibiotics (R&D costs are high with little or no ROI), means we could very well be facing a new surge in deaths in the future from once preventable diseases and infections.

At the J.P. Morgan Healthcare Conference in San Francisco this week, we at FierceBiotech wondered what the industry was doing about this and asked a range of life science C-suite execs: What therapeutic areas beyond cancer are most important to the industry now? both in terms of unmet need as well as where there is some real innovation.

Jim Robinson, chief operating officer at Paragon Biosciences, said: I spent 10 years in oncology, so I understand that point. Still, the biggest issue we face today that has to be figured out is Alzheimers. Looking at the aftermath, its scaryits going to be trillions of dollars in 20 short years in terms of the expense treating patients with Alzheimers. In 20 short years, I might be one of those patients!

I think its been a vast wasteland of failure. Im hoping something comes about before Im 70 to allow us to treat it. Whether the industry is willing to shift more resources to pursue treatments or not remains to be seen, especially after the latest failures. I dont know if the industry will shift to Alzheimers or more CNS treatments associated with cognition, but Im hoping.

Oncology good news is when the industry shifted and thousands of drugs moved through development. We see a significant transformation in certain cancers. If the incentive or the approach from a regulatory pathway that shifts incentives to research in Alzheimers, we will find some answers.

The biotechs CEO, Jeff Aronin, who is also CEO of Paragon Capital Partners, echoed this need for answers. I have a focus there with one of our companies, but in general, I would answer a little broader, he explained. Ive been involved in CNS drug development for a very long time and remember the 90s, which they called the decade of the brain, but we really didnt make a lot of advances in neuroscience and psychiatry that we thought we would have.

I think over the next few years is where we are really going to see many medicines approved. We have learned so much more and advancing in many different areas. In neuroscience and psychiatry, I would add theyre also an area of tremendous cost to the healthcare system and we still dont have a lot of great solutions, whether its Alzheimers or any of the neuropsychiatry areas were working in.

BioNTechs Sean Marrett also saw Alzheimers and other neuroscience areas, such as Parkinsons disease, as still major and unmet issues, as well as multiple sclerosis, which has seen great strides but still needs work.

Alzheimers is certainly a major issue, but also one that is more entrenched in the west: We live longer and are therefore more susceptible to diseases associated with aging.

Lyndra Therapeutics CEO Patricia Hurter asked us whether we meant our question in relation to the developed world or the developing world? We asked her two cents on both.

Women in Africa either get pregnant or get HIV, she said starkly. Their economic prospects are horrendous. It means their childrens economic prospects are horrendous. Were working with Gilead on HIV prophylaxis and on an oral birth control. Eventually, when the drugs are potent enough, we could do a once-a-month pill of each. To have them in one capsulethat would be fabulous. That would be transformative for developing countries.

For America, I think so many things like hypertension and diabetes are a chronic epidemic and people are having bad health outcomes [that could be avoided] if they took well proven drugs in an adherent way. Its an adherence issue. Theyre not feeling sick so they dont take the medicine. But in fact, it is still progressing [it, referring to stuff like hypertension, NASH that progressively gets worse without you feeling sick until its advanced].

It leads to unnecessary hospitalizations. If we could combine modern methods of distribution that a poly-pill combination that a person neededonce a week they would take one thing to keep them from progressing.

Karuna Therapeutics CEO Steve Paul also pointed to suicide rates that keep going up, whereas in certain types of cancer and cardiovascular disease theyve started tracking down.

And, finally, Westlake Village Biopartners Managing Partner Sean Harper said: Because there are so many areas of unmet need, its hard to say just one therapeutic area or one modality. Its exciting: the cellular engineering thats going to result in the ability to do regenerative medicine type efforts is I think going to be the next really amazing sort of thing.

With the fact that you can manipulate human cells now the way you can, and make multiple difficult edits to engineer things out of them and so on, that is just a new frontier. There are a lot of settings where you can just imagine what that can do. Its not 100 years away. Its now. Its happening already, people are doing it. I think that, to me, is the most exciting area.

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Neuroscience

Brain Mapping Instruments Market: Qualitative Analysis of the Leading Players and Competitive Industry Scenario, 2026 Dagoretti News – Dagoretti News

The utilization of brain mapping instruments has expanded because of increasing occurrences of brain ailments in different parts of the world. Increasing health concerns and enhanced healthcare infrastructure are a few of the foremost aspects driving the expansion of the worldwide market for brain mapping instruments. Furthermore, an increasing number of diagnostics centers is likewise driving the expansion of the market. Nonetheless, poor healthcare insurance coverage and high expenses related to the brain mapping procedure are limiting the expansion of the worldwide market for brain mapping instruments. Also, lack of helium for magnetic resonance imaging systems, saturation in mature markets and technological constraints related to independent systems are likewise constraining expansion of the worldwide market.

High affecting aspects, for example, continuous brain mapping investigation and examination projects, neuroscience-based activities by government bodies as well as technological progressions in algorithms and tools which are applied in neuroscience space are considered to enhance the market expansion. These variables are foreseen to support revenue generation by impelling the product implementation in this market over the years to follow.

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The existence of institutes & organizations, for example, NIH, University of Utah, NeuroScience Canada, Ontario Brain Institute, Max Planck Florida Institute, along with the University of Pennsylvania; in the space are anticipated to significantly affect the advancement of neuroscience field. These entities act a significant part in quickening neuroscience-based r&d to enhance patient results in those suffering from neurological ailments.

Various activities are embraced by the healthcare communities to take cerebrum related innovations and studies above and beyond. For example, in 2014, the University of Utah presented the Neuroscience Initiative keeping in mind the end goal to help mitigate the staggering impacts of brain disorders. The launch was made for developing the understanding of the impacts of brain disorders on wellbeing and channelizing the learning into inventive solutions for patient care.

Constant presentation of new products by prominent market players in the market to the battle different neurological issue will probably support the Y-O-Y development of this market. For example, in September 2015, Codman Neuro (functioning unit of DePuy Synthes) presented CODMAN CERTAS plus programmable valve, an MRI-safe programmable valve along with eight dissimilar weight settings.

Moreover, key aspects that have quickened the research studies about in this field is the development of a number of different harmful CNS issues, for example, Alzheimers and Parkinsonism sickness. As geriatric populace is inclined to different central sensory systems related disorders, for example, Alzheimers, schizophrenia and Parkinsonism with the rise in the aging populace, this market is foreseen to see lucrative development.

The requirement for minimally invasive, more precise along with manifold neuron recording system is additionally anticipated that would drive r&d of hardware and software utilized for neuro-scientific analyses. This, thusly, is considered to reinforce the overall product portfolio accessible in the market and enhance revenues all through the years to come.

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Enhancing healthcare infrastructure in developing nations, for example, India and China would generate prospects for the worldwide market for brain mapping instruments. Expanding implementation of refurbished diagnostic imaging systems would represent a challenge for expansion of the mind-brain mapping instruments market globally. A few of the foremost companies functioning in the global market are Philips Healthcare, GE Healthcare, Natus Medical, Inc and Siemens Healthcare. Other market players active in the market are Nihon Kohden Corporation, Covidien, PLC., and Advanced Brain Monitoring, Inc.

Partnerships and collaboration are preferred as a feasible strategy to remain competitory in the market by foremost companies. Companies are engrossed in strategic alliances outside the region and within the region, which helps the expansion of both the parties along with the connected regional market.

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Brain Mapping Instruments Market: Qualitative Analysis of the Leading Players and Competitive Industry Scenario, 2026 Dagoretti News - Dagoretti News

Neuroscience

Twenty-year Follow-up Study Finds Schizophrenia Medication To Be Safe – Technology Networks

Researchers at Karolinska Institutet in Sweden and their colleagues in Germany, the USA and Finland have studied the safety of very long-term antipsychotic therapy for schizophrenia. According to the study, which is published in the scientific journal World Psychiatry, mortality was higher during periods when patients were not on medication than when they were.

People with schizophrenia have an average life expectancy ten to twenty years below the norm, and there has long been concern that one of the causes is the long-term use of antipsychotic drugs. Earlier compilations (meta-analyses) of results from randomised studies, however, indicated that the mortality rate for people with schizophrenia on antipsychotic medication was 30 to 50 per cent lower than those who have received placebo.

However, most of the studies done have been shorter than six months, which does not reflect the reality of treatment often being life-long. Researchers from Karolinska Institutet and their international colleagues have now done a long-term follow-up, substantiating previous results and demonstrating that antipsychotic drugs are not associated with increased risk of co-morbid complications, such as cardiovascular disease. The study is the largest conducted in the field to date.

"It's difficult to make comparisons between people on permanent medication and those who aren't, as these groups differ in many ways," says Heidi Taipale, assistant professor at the Department of Clinical Neuroscience at Karolinska Institutet. "One common method of dealing with this has been to try to take account of such differences when making comparisons. However, we chose another method, in which each person was their own control, making it possible for us to make individual comparisons of hospitalisation during periods of antipsychotic medication and periods of no treatment."

The researchers monitored just over 62,000 Finns who had received a schizophrenia diagnosis at some time between 1972 and 2014. This they did by accessing various Finnish registries up until 2015, giving an average follow-up period of over 14 years. They found that the likelihood of being hospitalised for a somatic disease was just as high during the periods when the patients were on antipsychotic drugs as when they were not. The differences in mortality, however, were noticeable. The cumulative mortality rate in the follow-up period at periods of medication and non-medication was 26 and 46 per cent respectively.

The researchers believe that there is overwhelming support for continual antipsychotic treatment for schizophrenia being a safer option than no medication. At the same time, treatment brings the risk of adverse reactions, such as an increase in weight, which can raise the risk of cardiovascular disease. The finding that treatment with antipsychotic drugs does not increase the likelihood of hospitalisation for cardiovascular disease may be attributable, argue the researchers, to the fact that the drugs can also have an antihypertensive effect and can reduce anxiety and the risk of substance abuse. Antipsychotic treatment may also help patients adopt a healthier lifestyle and make them more likely to seek care when needed.

"Antipsychotics get something of a bad press, which can make it difficult to reach out to the patient group with information on how important they are," says Jari Tiihonen, professor of psychiatry at the Department of Clinical Neuroscience, Karolinska Institutet. "We know from previous studies that only half of those who have been discharged from hospital after their first psychotic episode with a schizophrenia diagnosis take antipsychotic drugs. Besides, there are many people with schizophrenia who are on long-term benzodiazepine medication, which is in breach of existing guidelines and is associated with increased mortality risk. Building trust and understanding towards the efficacy and safety of antipsychotic drugs is important, and we hope that this study can contribute to this end."

Reference: Taipale, H., Tanskanen, A., Mehtl, J., Vattulainen, P., Correll, C. U., & Tiihonen, J. (2020). 20-year follow-up study of physical morbidity and mortality in relationship to antipsychotic treatment in a nationwide cohort of 62,250 patients with schizophrenia (FIN20). World Psychiatry, 19(1), 6168. https://doi.org/10.1002/wps.20699

This article has been republished from the following materials. Note: material may have been edited for length and content. For further information, please contact the cited source.

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