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A commercial H5N8 assay detected H5 in only 6% (3/48) and N8 in 92% (44/48). Thirteen (13/25; 52%) A(H5N8) genomes generated from veterinary specimens clustered in a single monophyletic clade. These sequences contained the NS (P42S) and PB2 (L89V) mutations noted as markers of mammalian adaptation. CONCLUSIONS Diagnostic assays were able to detect and characterize influenza A(H5N8) viruses, but poor performance is reported for a commercial assay. Absence of influenza A(H5N8) in humans with occupational exposure and no clear impression of molecular adaptation for mammalian infection suggest that this avian pathogen continues to be low-risk human pathogen. © 2020 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.Dr. Rothschild provides important insights regarding the study of anticoagulation in persons with antiphospholipid syndrome (APS). The presence of any of several antiphospholipid antibodies can result in a hypercoagulable state leading to increased incidence of arterial and/or venous thromboses. © 2020, American College of Rheumatology.OBJECTIVES To evaluate the clinical efficacy of a high-efficiency air purifier in patients with allergic rhinitis. DESIGN We conducted a randomized, double-blind, clinical controlled trial with active and inactive versions of an air purifier. Our study included patients with allergic rhinitis who were sensitive to Artemisia pollen and treatment of the indoor environment using air filtration at night. We evaluated the clinical efficacy of indoor air filtration during the Artemisia pollen scattering season in Yulin City in Shangxi Province, China. AZD7648 clinical trial SETTING The First Hospital of Yulin. (Yulin City, Shanxi Province, China). PARTICIPANTS A total of 90 patients with allergic rhinitis who were sensitive to allergens of Artemisia pollen were randomly assigned to one of two groups in equal numbers. MAIN OUTCOME MEASURES The primary outcome measure was the difference in visual analog scale scores from baseline. Secondary outcomes were changes from baseline in nasal symptoms, allergy symptom scores, responses to the Rhinoconjunctivitis Quality of Life Questionnaire, Epworth Sleepiness Scale scores, and tolerability scores for the air purifier. RESULTS Based on the allergy symptom score, we found significant differences in rhinitis symptoms between the groups who used the active versus the inactive air purifier. CONCLUSIONS The results of our investigation demonstrated the health benefits of particle filtration. This article is protected by copyright. All rights reserved.Intratumour heterogeneity fuels carcinogenesis and allows circumventing specific targeted therapies. HER2 gene amplification is associated with poor outcome in invasive breast cancer. Heterogeneous HER2 amplification has been described in 5-41% of breast cancers. Here, we investigated the genetic differences between HER2-positive and HER2-negative admixed breast cancer components. We performed an in-depth analysis to explore the potential heterogeneity in the somatic mutational landscape of each individual tumour component. Formalin-fixed, paraffin-embedded breast cancer tissue of ten patients with at least one HER2-negative and at least one HER2-positive component was microdissected. Targeted next-generation sequencing was performed using a customized 53-gene panel. Somatic mutations and copy number variations were analysed. Overall, the tumours showed a heterogeneous distribution of 12 deletions, 9 insertions, 32 missense variants and 7 nonsense variants in 26 different genes, which are (likely) pathogenic.r progression, and others will be mere ‘passenger’ molecular anomalies. © 2020 The Authors. Published by FEBS Press and John Wiley & Sons Ltd.Research into the development of Theory of Mind (ToM) has shown how children from a very early age infer other people’s goals. However, human behaviour is sometimes driven not by plans to achieve goals, but by habits, which are formed over long periods of reinforcement. Habitual and goal-directed behaviours are often aligned with one another but can diverge when the optimal behavioural policy changes without being directly reinforced (thus specifically hobbling the habitual learning strategy). Unlike the flexibility of goal-directed behaviour, rigid habits can cause agents to persist in behaviour that is no longer adaptive. In the current study, all children predict agents will tend to behave consistently with their goals, but between the ages of 5 and 10, children showed an increasing understanding of how habits can cause agents to persistently take suboptimal actions. These findings stand out from the typical way the development of social reasoning is examined, which instead focuses on children’s increasing appreciation of how others’ beliefs or expectations affect how they will act in service of their goals. The current findings show that children also learn that under certain circumstances, people’s actions are suboptimal despite potentially ‘knowing better.’ © 2020 John Wiley & Sons Ltd.OBJECTIVES To describe the clinical characteristics and outcomes of systemic sclerosis -mixed connective tissue disease (SSc-MCTD) and SSc-overlap. METHODS We included patients from the Australian Scleroderma Cohort Study who met ACR/EULAR criteria for SSc. Three mutually exclusive groups were created SSc-MCTD, SSc-overlap and SSc-only. Univariate comparison of clinical features was performed by ANOVA or chi-square. Survival analysis was performed using Kaplan-Meier (KM) curves and Cox regression. RESULTS Of 1728 patients, 97 (5.6%) had SSc-MCTD and 126 (7.3%) SSc-overlap. Those with MCTD-SSc were more commonly Asian (18.3% vs 10.1% in SSc-overlap and 3.6% in SSc-only, p less then 0.0001) and younger at disease onset (38.4 years versus 46.5 or 46.8 years, p less then 0.0001). Those with SSc-MCTD or SSc-overlap were more likely to have limited SSc. All three groups had similar frequency of interstitial lung disease (ILD), although pulmonary arterial hypertension (PAH) was less common in SSc-overlap. Synovitis and myositis were more common in SSc-overlap and SSc-MCTD than in SSc-only. KM curves showed better survival in SSc-MCTD than SSc-overlap or SSc-only (p=0.011), but this was not significant after adjustment for sex and age at disease onset. SSc-specific antibodies were survival prognostic markers, with ANA-centromere or anti-RNP conferring better survival than anti-Scl-70 or anti-RNA polymerase 3 (p=0.005). SSc-MCTD and SSc-overlap had lower mortality following diagnosis of ILD and PAH than patients with SSc-only. CONCLUSION This study provides insights into the clinical characteristics of patients with SSc-MCTD, SSc-overlap and SSc-only and shows that anti-RNP antibodies are associated with better survival than anti-Scl-70 and anti-RNA polymerase III antibodies. © 2020, American College of Rheumatology.