Application and validation of the Feeding Infants: Behaviour and Facial Expression Coding System (FIBFECS) to assess liking and wanting in infants at the time of complementary feeding

Introduction: The aim of this study was to validate a novel tool developed to measure liking and wanting in infants during the weaning period. The Feeding Infants: Behaviour and Facial Expression Coding System (FIBFECS; Hetherington et al., in press) is an evidence based video coding tool, consisting of 13 items. There are 6 measures of avoidance/approach behaviours (turns head away, arches back, pushes spoon away, crying/fussy, leaning forward and rate of acceptance) to assess wanting and 7 facial expressions (brow lowered, inner brow raised, squinting, nose wrinkling, lip corners down, upper lip raised and gaping) to assess liking. Lower scores on the total scale indicated greater wanting and/or liking. The tool was applied to a recent randomized control trial (Hetherington et al., 2015). Method: 36 mother-infant dyads took part in the study and were randomised to the intervention or the control group. Infants were filmed on two occasions whilst eating a generally liked vegetable (carrots) and less preferred vegetable (green bean). 72 video extracts were coded by 4 trained researchers with adequate certification scores, each video was coded by at least two coders. Items and scales were tested for discrimination ((1) intervention vs control; (2) liked vs disliked vegetable) and construct validity (correlation with intake and liking assessed by mother and researcher). Results: Very good discrimination (p < 0.001) was obtained for carrots vs green bean for the total score and total negative facial expressions and rejection behaviours (p=0.003). Discrimination for the intervention vs control groups was only obtained for the total rejections and the rate of acceptance (p < 05). The FIBFECS subscales had good construct validity as these were significantly correlated with intake and liking ratings (p < 0.01). Items such as crying/fussy and leaning forward were removed from the scale as well as inner brow raised, squinting and lip corners down, as these do not correlate with other variables. Their removal did not affect the integrity of the scale. The rate of acceptance parameter was found to have potential as a short method to measure wanting in infants. Conclusion: The present study has demonstrated that the FIBFECS can be used to identify liking and wanting independent of subjective ratings from mothers and researchers, therefore, this tool can be used widely in the study of infant responses to novel foods at the time of weaning. There is potential to develop the tool for infants beyond the period of complementary feeding and to assist in identifying fussy eating in the early stages of development

Italian guidelines for primary headaches: 2012 revised version

The first edition of the Italian diagnostic and therapeutic guidelines for primary headaches in adults was published in J Headache Pain 2(Suppl. 1):105–190 (2001). Ten years later, the guideline committee of the Italian Society for the Study of Headaches (SISC) decided it was time to update therapeutic guidelines. A literature search was carried out on Medline database, and all articles on primary headache treatments in English, German, French and Italian published from February 2001 to December 2011 were taken into account. Only randomized controlled trials (RCT) and meta-analyses were analysed for each drug. If RCT were lacking, open studies and case series were also examined. According to the previous edition, four levels of recommendation were defined on the basis of levels of evidence, scientific strength of evidence and clinical effectiveness. Recommendations for symptomatic and prophylactic treatment of migraine and cluster headache were therefore revised with respect to previous 2001 guidelines and a section was dedicated to non-pharmacological treatment. This article reports a summary of the revised version published in extenso in an Italian version

Evaluation and registration of adverse events in clinical drug trials in migraine.

Tolerability of a drug should be regarded as important as its efficacy. In all four phases of drug development evaluation of adverse events is important. Recommendations for assessment of adverse events in acute and prophylactic clinical drug trials in migraine are given. Tolerability may be indirectly assessed using measures of general well-being and eight such tools are presented. Finally, recommendations for reporting of adverse events are given

RESEARCH High level of susceptibility to human TRIM5α conferred by HIV-2 capsid sequences

Background: HIV-2, which was transmitted to humans from a distant primate species (sooty mangabey), differs remarkably from HIV-1 in its infectivity, transmissibility and pathogenicity. We have tested the possibility that a greater susceptibility of HIV-2 capsid (CA) to the human restriction factor TRIM5α (hTRIM5α) could contribute to these differences. Results: We constructed recombinant clones expressing CA from a variety of HIV-2 viruses in the context of HIV-1 NL4-3-luciferase. CA sequences were amplified from the plasma of HIV-2 infected patients, including 8 subtype A and 7 subtype B viruses. CA from 6 non-epidemic HIV-2 subtypes, 3 HIV-2 CRF01_AB recombinants and 4 SIVsmm viruses were also tested. Susceptibility to hTRIM5α was measured by comparing single-cycle infectivity in human target cells expressing hTRIM5α to that measured in cells in which hTRIM5α activity was inhibited by overexpression of hTRIM5γ. The insertion of HIV-2 CA sequences in the context of HIV-1 did not affect expression and maturation of the HIV-2 CA protein. The level of susceptibility hTRIM5α expressed by viruses carrying HIV-2 CA sequences was up to 9-fold higher than that of HIV-1 NL4-3 and markedly higher than a panel of primary HIV-1 CA sequences. This phenotype was found both for viruses carrying CA from primary HIV-2 sequences and viruses carrying CA from laboratoryadapte