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Samsung Android Remote Code Execution

Samsung Android suffers from multiple interaction-less remote code execution vulnerabilities as well as other remote access issues in the Qmage image codec built into Skia.








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NextEra, Con Ed warn patent dispute could roil US solar sector

Two of America’s biggest solar-farm owners are warning that a patent dispute between panel makers could roil a sector already shaken by President Donald Trump’s import tariffs.




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NCUA: Craftsman Credit Union, Detroit, Closes

The Michigan Department of Insurance and Financial Services liquidated Craftsman Credit Union of Detroit and appointed the National Credit Union Administration as liquidating agent.




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Deconstructing The Malicious Falsehood Against Dr Aniekeme Uwah By Asteroid Bassey

Since the controversial removal of Dr Aniekeme Uwah as the Akwa Ibom State Epidemiologist, several lies have continuously been peddled by media hirelings of 'powers that be' to smear the character of the renowned and celebrated medical expert. Ordinarily , one would not bother about their mischief; but in an article titled " COVID-19 testing and controversies in Akwa Ibom" published in some national dailies and online platforms  by Usman Yusuf ( obviously a fake name), the hireling struggled albeit unsuccessfully to paint a picture of Dr Aniekeme Uwah being removed for unethical practices.

As the Akwa Ibom NMA PRO stated on a Live radio interview, after the infamous redeployment, the reason for Dr Aniekeme Uwah's removal as state Epidemiologist was his refusal to carry out the Commissioner for health's bidding of testing  only 10 persons instead of 31 who had met the case definition .

To cover up the overwhelming public backlash that greeted the politicization of Dr Uwah's removal, aides and hirelings of 'powers that be' have tried justifying the removal of the epidemiologist by first claiming he "banged the phone on the Governor " to later changing the story, that the cerebral Doctor is responsible for the number of positive COVID-19 cases in the state amongst other fables. 

This only proves the truism , that " to cover up one lie, many other lies will have to be told..." and desperately so if I may add.

 Some of the despicable falsehood peddled against  Dr Aniekeme Uwah include falsifying NCDC results.This assertion betrays the writer's ignorance of the procedures for sample collection and test results. 

As the State Epidemiologist, it should be noted that Dr Uwah worked with an incident Management Committee (IMC) which included doctors and other Supervisory agencies like NCDC and the World Health Organization(WHO).

It is under the watchful eyes of these disciplined medical professionals, that samples which meet case definition are gotten and sent to laboratories in Edo State or Ebonyi State with adequate security escort. The results are instantly communicated  by the Laboratory to the NCDC headquarters and the state is copied.

One wonders how Dr Aniekeme Uwah had the powers to change negative results in these laboratories to positive and subsequently force or bribe 12 persons (as at when he was epidemiologist) who were predominantly medics to move into the Isolation Center for treatment. This thinking is not only absurd, but smirks of conspiracy by the writer and cohorts. 

Moreover, four new positive cases have been confirmed after he was redeployed as state Epidemiologist, did he still influence those results?

In another online defamatory write up by yet another faceless hireling Bassey Wils, it was alleged that the former Epidemiologist was angered that his proposal for purchase of laboratory equipment was rejected.

This is obviously far from the truth. The writer is obviously unaware of the workings of Government and the procedures for procurement in a ministry that has a Commissioner.   Even if the Epidemiologist would have recommended that the state had its own laboratory to stop incessant travels to other states for tests confirmations, it would best remain only a novel suggestion as the implementation of such ideas rest between the Commissioner for health and agencies of Government responsible for such procurement . 

The said fake Bassey Wils also blamed the former Epidemiologist for the embarrassment the state suffered during it's infamous imbrioglio with NCDC over the 5 index cases..This is a case of selective amnesia suffered by Blackmailer hiding under the moniker of Bassey Wils. For the avoidance of doubt, It was the Commissioner for Health who held a world press conference to disagree with the results of the 5 index cases and NCDC procedures not Dr Aniekeme Uwah. This further goes to buttress the allegations against " Powers" over their intentions to suppress testing to avoid a record of high positive results by the state as stated by the NMA PRO on radio. 

Further more, the fake Bassey Wills claimed Dr Aniekeme Uwah  went against NCDC guidelines which stated that only 10 samples should be sent in a day.  

For avoidance of doubt, it must be stated unequivocally that such guidelines does not exist.

On April 27, 2020 Dr Sani Aliyu, National Coordinator presidential task force ( PTF) on COVID-19 said on National TV and i quote " I will like to emphasize that there is no limit to testing when it comes to COVID-19. Covid numbers is not an issue of competition between states. There is no shame if a state comes up with positive numbers. In other to deal with an epidemic, we need to have transparency in numbers and that transparency is linked to the number of tests. If you do not know the extent of the problem, you will not be able to deal with it. I am appealing to state governments to please continue helping the state emergency operating centers and state ministry of health to make sure that everybody that needs to be tested has the opportunity to get the test done " . 

One would expect that after such affirmative words by the PTF on no ceilings for tests , Fake Bassey Wils and his gang of liars will bury their heads in shame. 

It shouldn't be taken for granted that the suspected case confirmed positive from the 31 would have been missed if Dr Aniekeme Uwah had carried out the Commissioner 's directive to take only 10samples.  This most likely would have led to more spread of the pandemic in the state if that suspected case was not tested or would have made the health of the patient worse if not timely diagnosed. 

Apart from this,  a large number of Doctors who were exposed to COVID-19 had been out of work for up to a month on self isolation because they had not been tested, thus leading to loss of man hours and critical essential services, and inadvertently leading to denial of life - saving services by these experts to those who needed their expertise. 

The fact that Dr Aniekeme Uwah insisted on these Doctors getting tested as part of the 31 , helped seventeen out of the eighteen of them whose results came out negative return to work at the University of Uyo teaching Hospital almost immediately. 

Dr Aniekeme Uwah should be commended for such clinical dexterity.  This tests are conducted free of charge by NCDC, so why the fuss of testing a large number? Why the insistence of testing a smaller number when everyone that met case definition at the time could be tested at once to save time and ensure clinical efficacy? 

The state loses nothing by testing more as tests are free of charge. Instead, the more agressive it gets with testing, the clearer the picture of viral penetration. That is pure Epidemiology! 

In the words of Dr Emmanuel John, the NMA PRO on radio, " testing is a clinical decision. And no doctor should have recourse to a political mastermind before taking such decisions"

Another allegation by Bassey Wils bothering a late surgeon need not be dignified for the respect of the dead and family. But it must be noted that the allegations remain false and spurious, tailored only the damage reputation of Dr Aniekeme Uwah. fortunately for every discerning mind, Bassey Wil's campaign of calumny has largely been mischievous, comic at it's best and utterly balderdash.

Fake Bassey Wil's nonsensical allegation of having evidence of text messages between Dr Aniekeme Uwah and "middle men" is not only absurd and baseless but further attempts to 'give a dog a bad name in order to hang it'. Such text messages remain only in the conjecture of his imagination. If there is any iota of truth, I challenge fake Bassey Wils to produce such evidences in court or forever bury his head in the pit of hell.

Lastly Fake Bassey Wils, a leader of the blackmail syndicate alleged that Dr Aniekeme Uwah put the state in bad light during a National Survey that ranked the state as leading in the number of persons living with HIV/AIDs in the country.  He doesn't realize that his particular allegation, provides more evidence as to the unquenching thirst for suppressing data and statistics by those in authority.

The fact remains that after the result of the HIV/AIDs National and Impact survey was published in Abuja by Federal Ministry Of Health, Dr Aniekeme Uwah moved by passion and love for his people, sensitized the public on the dangers of HIV/ AIDs and how infection can be reduced.

 He admonished on Abstainance, faithfulness to sexual partners, usage condoms and usage of anti-retroviral drugs to suppress the viral load  thereby hindering further transmission. 

In saner climes, Such patriotic zeal, would  been encouraged ; as truly there is need for sensitization of the masses whose majority especially in rural areas are still in illusion about HIV/AIDs.

 Instead of commending Dr Uwah for putting in time and personal resources to educate the masses, the "powers that be" sternly condemned Dr Aniekeme Uwah  for educating the masses about HIV/AIDs and claimed he put state in bad light. He was queried! What a sad irony!

One would ask, what is the gain of the state if it hides the figures of the HIV/AIDs prevalence from the masses? What is the intention of hiding the result of  the national survey? To record more infections due to ignorance of the populace? It has been a long walk to trampling on truth, honesty and dedication to duty.

In the court of public opinion, Dr Aniekeme Uwah has acquitted himself as a professional of unparalleled integrity.

A courageous medical doctor whose commitment to the service of humanity is common to none. 

Dr Uwah is loyal to the Hippocratic oath and will remain resolute in advocating for better health care delivery to the people.

 His award of Honor by the African Union for dedicating Six months of his life to Liberia in the fight of Ebola remains indelible.

He was also honoured as the most outstanding NMA state chairman by the National President and National Officers Committee of the NMA during his tenure as Chairman. 

His exploits as NMA Chairman include building the first Doctors Mess in Nigeria, The first NMA Clinic in Nigeria, Doctors Court as well as numerous free Surgical outreach accross the state. 

It is worthy of note that during his tenure as NMA Chairman, he pushed for the establishment of the State Primary Health Care Development Agency and State Insurance Scheme.

In the past two years, Dr Aniekeme Uwah was the chairman Planning Committee of National Physicians Week in Rivers State and Ondo State as well as the chairman Planning committee of the National Executive Council meeting of the Association in Akwa Ibom State. This is a testament to his Sterling leadership qualities which has earned him the trust of his colleagues Nationwide. 

As State Epidemiologist,  Dr Aniekeme Uwah's achievements are enormous but to mention

1. Partnering with WHO to donate motorcycles to all the 31 Disease Surveillance Officers (DSNOs) in the 31 LGAs in the state to enhance their mobility.

2. Training of the 31DSNOs and other Health workers on frontline field epidemiology in partnership with AFENET.

3. Donation of Lap top computers and android phones to all the 31DSNOs to enhance their disease surveillance activities etc

Recently , Dr Aniekeme Uwah was appointed Secretary of the Common Wealth Medical Association's Committee on Covid-19 response. The Common Wealth Comprises of 54 countries accross all continents. Only Men of proven track record get such International appointments. 

These and more are some of Dr Aniekeme Uwah's legacies that his blackmailers cannot wish away.

No greater testimonial would Dr Uwah wish  for in times like this, than that of The DG of NCDC,  Dr Chikwe Ihekweazu who while responding to the redeployment saga on national TV said "The state Epidemiologist, Dr Aniekeme Uwah is a great colleague who did his work creditably. He is one of my great colleagues .. we worked on Ebola outbreak together. I wish him well in his new assignment".

I understand that Dr Uwah's traducers and their media hirelings are intimidated by his towering profile. I would rather implore them to work hard on improving their miserable lives rather than constantly attempt to defame and disparage a man whose track record is way beyond their reach. It will remain a mere waste of time! 

It is worthy of note, that Dr Aniekeme Uwah's removal as state Epidemiologist to suppress Covid 19 test results has already made him a hero, a professional of no mean repute in the court of public opinion and no volume of blackmail can change that narrative!

- Asteroid Bassey writes in from Uyo.

Opinion AddThis :  Original Author :  Asteroid Bassey Disable advertisements : 




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Crise sanitaire - Croissance �conomique compromise, selon la BFM

A l'instar de tous les pays dans le monde affect�s par la pand�mie Covid-19, Madagascar conna�tra �galement une r�cession �conomique. ......




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Hacker Claims Android App Store Breached: Publishes 20 Million User Credentials

The stolen records of 20 million users of a popular Android app store have been published online by a hacker who claims to have 19 million more. Not all app stores are the same. Android users have access to the … read more



  • Sci & Tech

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Fiat Chrysler Uconnect 5 Infotainment Switches To Android




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HARMAN Introduces Return-to-Work Program for Detroit-Area Professionals Rejoining the Workforce

At HARMAN, we believe the future of the workplace is one where individuals can take time away from work to focus on their families and caregiving duties without sacrificing the ability to drive a successful career. Through our partnership with Path...




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Inside the mission to stop killer asteroids from smashing into Earth

When asteroid Armageddon is upon us, we can't just call Bruce Willis. Meet the people who really do watch the skies – and make detailed plans for our survival




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Dino-killing asteroid choked whole world in dust within a few hours

When a large asteroid hit the Earth 66 million years ago, it sent huge curtains of dust flying tens of kilometres up into the air that quickly covered the planet




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Asteroid strike may have forged the oldest rocks ever found on Earth

The oldest rocks ever found are over four billion years old and we don’t know how they formed – but a massive asteroid bombardment may be responsible




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Don’t miss: Earth from space, asteroid workouts and nature’s giants

Watch a new series charting our planet from above, read all about the biggest living things, fend off space rocks for fun, plus more picks for your diary




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Auto Show Season Kicks off with In-Car Audio Taking Center Stage in Detroit

At this year’s North American International Auto Show (NAIAS) in Detroit, HARMAN and its automotive partners brought the latest evolution of premium in-car experiences that reflect and seamlessly connect with your lifestyle. Ensuring users are...




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Coffee and croissants back on the menu in Italy

Romans flocked to the city's bars and cafes for their caffeine fix on Tuesday - but only takeaway options are permitted.




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Inside the mission to stop killer asteroids from smashing into Earth

When asteroid Armageddon is upon us, we can't just call Bruce Willis. Meet the people who really do watch the skies – and make detailed plans for our survival




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FDA approves Eli Lilly drug for thyroid, lung cancers driven by a genetic mutation

The U.S. Food and Drug Administration on Friday approved a drug to treat lung and thyroid cancers driven by a specific genetic mutation that Eli Lilly and Co acquired with its 2019 purchase of Loxo Oncology.




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We may have found 19 more interstellar asteroids in our solar system

A bunch of asteroids near Jupiter and Neptune with orbits perpendicular to the plane of the solar system may have come here from a different star system




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Hypothyroidism

Title: Hypothyroidism
Category: Diseases and Conditions
Created: 12/31/1997 12:00:00 AM
Last Editorial Review: 9/18/2019 12:00:00 AM




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Thyroid Nodules

Title: Thyroid Nodules
Category: Diseases and Conditions
Created: 2/23/2005 12:00:00 AM
Last Editorial Review: 10/25/2019 12:00:00 AM




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Thyroid Peroxidase Test

Title: Thyroid Peroxidase Test
Category: Procedures and Tests
Created: 11/18/2001 12:00:00 AM
Last Editorial Review: 11/13/2019 12:00:00 AM




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Hyperthyroidism

Title: Hyperthyroidism
Category: Diseases and Conditions
Created: 12/31/1997 12:00:00 AM
Last Editorial Review: 11/20/2019 12:00:00 AM




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Thyroid Blood Tests

Title: Thyroid Blood Tests
Category: Procedures and Tests
Created: 2/18/2001 12:00:00 AM
Last Editorial Review: 1/8/2020 12:00:00 AM




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Being Chained to Your Desk Might Harm Your Thyroid

Title: Being Chained to Your Desk Might Harm Your Thyroid
Category: Health News
Created: 3/31/2020 12:00:00 AM
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Is Thyroid Hormone Dangerously Overprescribed in Older Patients?

Title: Is Thyroid Hormone Dangerously Overprescribed in Older Patients?
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Common Treatment May Not Help Seniors With Underactive Thyroid

Title: Common Treatment May Not Help Seniors With Underactive Thyroid
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Created: 5/4/2020 12:00:00 AM
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Steroids Could Harm Heart's Pumping Ability

Title: Steroids Could Harm Heart's Pumping Ability
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Lower-Dose Radioiodine Effective Against Thyroid Cancer

Title: Lower-Dose Radioiodine Effective Against Thyroid Cancer
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Heroin Use Surges Among Whites Who Abuse Prescription Painkillers

Title: Heroin Use Surges Among Whites Who Abuse Prescription Painkillers
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U.S. Workplaces Roiled by Post-Election Discord, Poll Finds

Title: U.S. Workplaces Roiled by Post-Election Discord, Poll Finds
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New Drug Could Help Stop Blindness From Thyroid Eye Disease

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Prescription-Strength Steroid Creams Sold Over-the-Counter Can Be Dangerous

Title: Prescription-Strength Steroid Creams Sold Over-the-Counter Can Be Dangerous
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Taking Steroids for Rheumatoid Arthritis, IBD? Your Odds for Hypertension May Rise

Title: Taking Steroids for Rheumatoid Arthritis, IBD? Your Odds for Hypertension May Rise
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Created: 3/23/2020 12:00:00 AM
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Are Steroids Really the Answer for Arthritic Knees?

Title: Are Steroids Really the Answer for Arthritic Knees?
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Broiling in a Heat Wave? Wet T-shirt Can Safely Cool You Down

Title: Broiling in a Heat Wave? Wet T-shirt Can Safely Cool You Down
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Created: 4/13/2020 12:00:00 AM
Last Editorial Review: 4/14/2020 12:00:00 AM




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Anti-KIT DNA Aptamer for Targeted Labeling of Gastrointestinal Stromal Tumor

Gastrointestinal stromal tumor (GIST), the most common sarcoma, is characterized by KIT protein overexpression, and tumors are frequently driven by oncogenic KIT mutations. Targeted inhibition of KIT revolutionized GIST therapy and ushered in the era of precision medicine for the treatment of solid malignancies. Here, we present the first use of a KIT-specific DNA aptamer for targeted labeling of GIST. We found that an anti-KIT DNA aptamer bound cells in a KIT-dependent manner and was highly specific for GIST cell labeling in vitro. Functionally, the KIT aptamer bound extracellular KIT in a manner similar to KIT mAb staining, and was trafficked intracellularly in vitro. The KIT aptamer bound dissociated primary human GIST cells in a mutation agnostic manner such that tumors with KIT and PDGFRA mutations were labeled. In addition, the KIT aptamer specifically labeled intact human GIST tissue ex vivo, as well as peritoneal xenografts in mice with high sensitivity. These results represent the first use of an aptamer-based method for targeted detection of GIST in vitro and in vivo.




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Lipid rafts in glial cells: role in neuroinflammation and pain processing [Thematic Reviews]

Activation of microglia and astrocytes secondary to inflammatory processes contributes to the development and perpetuation of pain with a neuropathic phenotype. This pain state presents as a chronic debilitating condition and affects a large population of patients with conditions like rheumatoid arthritis and diabetes, or after surgery, trauma, or chemotherapy. Here, we review the regulation of lipid rafts in glial cells and the role they play as a key component of neuroinflammatory sensitization of central pain signaling pathways. In this context, we introduce the concept of an inflammaraft (i-raft), enlarged lipid rafts harboring activated receptors and adaptor molecules and serving as an organizing platform to initiate inflammatory signaling and the cellular response. Characteristics of the inflammaraft include increased relative abundance of lipid rafts in inflammatory cells, increased content of cholesterol per raft, and increased levels of inflammatory receptors, such as toll-like receptor (TLR)4, adaptor molecules, ion channels, and enzymes in lipid rafts. This inflammaraft motif serves an important role in the membrane assembly of protein complexes, for example, TLR4 dimerization. Operating within this framework, we demonstrate the involvement of inflammatory receptors, redox molecules, and ion channels in the inflammaraft formation and the regulation of cholesterol and sphingolipid metabolism in the inflammaraft maintenance and disruption. Strategies for targeting inflammarafts, without affecting the integrity of lipid rafts in noninflammatory cells, may lead to developing novel therapies for neuropathic pain states and other neuroinflammatory conditions.




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Erratum for Townsend et al., "A Master Regulator of Bacteroides thetaiotaomicron Gut Colonization Controls Carbohydrate Utilization and an Alternative Protein Synthesis Factor"




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Genetic Manipulation of Human Intestinal Enteroids Demonstrates the Necessity of a Functional Fucosyltransferase 2 Gene for Secretor-Dependent Human Norovirus Infection

ABSTRACT

Human noroviruses (HuNoVs) are the leading cause of nonbacterial gastroenteritis worldwide. Histo-blood group antigen (HBGA) expression is an important susceptibility factor for HuNoV infection based on controlled human infection models and epidemiologic studies that show an association of secretor status with infection caused by several genotypes. The fucosyltransferase 2 gene (FUT2) affects HBGA expression in intestinal epithelial cells; secretors express a functional FUT2 enzyme, while nonsecretors lack this enzyme and are highly resistant to infection and gastroenteritis caused by many HuNoV strains. These epidemiologic associations are confirmed by infections in stem cell-derived human intestinal enteroid (HIE) cultures. GII.4 HuNoV does not replicate in HIE cultures derived from nonsecretor individuals, while HIEs from secretors are permissive to infection. However, whether FUT2 expression alone is critical for infection remains unproven, since routinely used secretor-positive transformed cell lines are resistant to HuNoV replication. To evaluate the role of FUT2 in HuNoV replication, we used CRISPR or overexpression to genetically manipulate FUT2 gene function to produce isogenic HIE lines with or without FUT2 expression. We show that FUT2 expression alone affects both HuNoV binding to the HIE cell surface and susceptibility to HuNoV infection. These findings indicate that initial binding to a molecule(s) glycosylated by FUT2 is critical for HuNoV infection and that the HuNoV receptor is present in nonsecretor HIEs. In addition to HuNoV studies, these isogenic HIE lines will be useful tools to study other enteric microbes where infection and/or disease outcome is associated with secretor status.

IMPORTANCE Several studies have demonstrated that secretor status is associated with susceptibility to human norovirus (HuNoV) infection; however, previous reports found that FUT2 expression is not sufficient to allow infection with HuNoV in a variety of continuous laboratory cell lines. Which cellular factor(s) regulates susceptibility to HuNoV infection remains unknown. We used genetic manipulation of HIE cultures to show that secretor status determined by FUT2 gene expression is necessary and sufficient to support HuNoV replication based on analyses of isogenic lines that lack or express FUT2. Fucosylation of HBGAs is critical for initial binding and for modification of another putative receptor(s) in HIEs needed for virus uptake or uncoating and necessary for successful infection by GI.1 and several GII HuNoV strains.




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Synergy between Cell Surface Glycosidases and Glycan-Binding Proteins Dictates the Utilization of Specific Beta(1,3)-Glucans by Human Gut Bacteroides

ABSTRACT

The human gut microbiota (HGM) has far-reaching impacts on human health and nutrition, which are fueled primarily by the metabolism of otherwise indigestible complex carbohydrates commonly known as dietary fiber. However, the molecular basis of the ability of individual taxa of the HGM to address specific dietary glycan structures remains largely unclear. In particular, the utilization of β(1,3)-glucans, which are widespread in the human diet as yeast, seaweed, and plant cell walls, had not previously been resolved. Through a systems-based approach, here we show that the symbiont Bacteroides uniformis deploys a single, exemplar polysaccharide utilization locus (PUL) to access yeast β(1,3)-glucan, brown seaweed β(1,3)-glucan (laminarin), and cereal mixed-linkage β(1,3)/β(1,4)-glucan. Combined biochemical, enzymatic, and structural analysis of PUL-encoded glycoside hydrolases (GHs) and surface glycan-binding proteins (SGBPs) illuminates a concerted molecular system by which B. uniformis recognizes and saccharifies these distinct β-glucans. Strikingly, the functional characterization of homologous β(1,3)-glucan utilization loci (1,3GUL) in other Bacteroides further demonstrated that the ability of individual taxa to utilize β(1,3)-glucan variants and/or β(1,3)/β(1,4)-glucans arises combinatorially from the individual specificities of SGBPs and GHs at the cell surface, which feed corresponding signals to periplasmic hybrid two-component sensors (HTCSs) via TonB-dependent transporters (TBDTs). These data reveal the importance of cooperativity in the adaptive evolution of GH and SGBP cohorts to address individual polysaccharide structures. We anticipate that this fine-grained knowledge of PUL function will inform metabolic network analysis and proactive manipulation of the HGM. Indeed, a survey of 2,441 public human metagenomes revealed the international, yet individual-specific, distribution of each 1,3GUL.

IMPORTANCE Bacteroidetes are a dominant phylum of the human gut microbiota (HGM) that target otherwise indigestible dietary fiber with an arsenal of polysaccharide utilization loci (PULs), each of which is dedicated to the utilization of a specific complex carbohydrate. Here, we provide novel insight into this paradigm through functional characterization of homologous PULs from three autochthonous Bacteroides species, which target the family of dietary β(1,3)-glucans. Through detailed biochemical and protein structural analysis, we observed an unexpected diversity in the substrate specificity of PUL glycosidases and glycan-binding proteins with regard to β(1,3)-glucan linkage and branching patterns. In combination, these individual enzyme and protein specificities support taxon-specific growth on individual β(1,3)-glucans. This detailed metabolic insight, together with a comprehensive survey of individual 1,3GULs across human populations, further expands the fundamental roadmap of the HGM, with potential application to the future development of microbial intervention therapies.




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Inhaled corticosteroids and COVID-19: a systematic review and clinical perspective

The current coronavirus 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection, raises important questions as to whether pre-morbid use or continued administration of inhaled corticosteroids (ICS) affects the outcomes of acute respiratory infections due to coronavirus. Many physicians are concerned about whether individuals positive for SARS-CoV-2 and taking ICS should continue them or stop them, given that ICS are often regarded as immunosuppressive. A number of key questions arise. Are people with asthma or COPD at increased risk of developing COVID-19? Do ICS modify this risk, either increasing or decreasing it? Do ICS influence the clinical course of COVID-19? (figure 1). Whether ICS modify the risk of developing COVID-19 or the clinical course of COVID-19 in people who do not have lung disease should also be considered (figure 1).




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Adherence to corticosteroids and clinical outcomes in mepolizumab therapy for severe asthma

Introduction

Inhaled corticosteroids (ICS) achieve disease control in the majority of asthmatic patients, although adherence to prescribed ICS is often poor. Patients with severe eosinophilic asthma may require treatment with oral corticosteroids (OCS) and/or biologic agents such as mepolizumab. It is unknown if ICS adherence changes on, or alters clinical response to, biologic therapy.

Methods

We examined ICS adherence and clinical outcomes in OCS-dependent severe eosinophilic asthma patients who completed 1 year of mepolizumab therapy. The ICS medicines possession ratio (MPR) was calculated (the number of doses of ICS issued on prescription/expected number) for the year before and the year after biologic initiation. Good adherence was defined as MPR >0.75, intermediate 0.74–0.51 and poor <0.5. We examined outcomes after 12 months of biologic therapy, including OCS reduction and annualised exacerbation rate (AER), stratified by adherence to ICS on mepolizumab.

Results

Out of 109 patients commencing mepolizumab, 91 who had completed 12 months of treatment were included in the final analysis. While receiving mepolizumab, 68% had good ICS adherence, with 16 (18%) having poor ICS adherence. ICS use within the cohort remained similar before (MPR 0.81±0.32) and during mepolizumab treatment (0.82±0.32; p=0.78). Patients with good adherence had greater reductions in OCS dose (median (interquartile range) OCS reduction 100 (74–100)% versus 60 (27–100)%; p=0.031) and exacerbations (AER change –2.1±3.1 versus 0.3±2.5; p=0.011) than those with poor adherence. Good ICS adherence predicted the likelihood of stopping maintenance OCS (adjusted OR 3.19, 95% CI 1.02–9.94; p=0.045).

Conclusion

ICS nonadherence is common in severe eosinophilic asthma patients receiving mepolizumab, and is associated with a lesser reduction in OCS requirements and AER.