ABSTRACT Host immunologic factors, including human immunodeficiency virus (HIV)-specific cytotoxic T lymphocytes (CTL), are thought to contribute to the control of HIV type 1 (HIV-1) replication and thus delay disease progression in infected individuals. Host immunologic factors are also likely to influence perinatal transmission of HIV-1 from infected mother to infant. In this study, the potential role of CTL in modulating HIV-1 transmission from mother to infant was examined in 11 HIV-1-infected mothers, 3 of whom transmitted virus to their offspring. Frequencies of HIV-1-specific human leukocyte antigen class I-restricted CTL responses and viral epitope amino acid sequence variation were determined in the mothers and their infected infants. Maternal HIV-1-specific CTL clones were derived from each of the HIV-1-infected pregnant women. Amino acid substitutions within the targeted CTL epitopes were more frequently identified in transmitting mothers than in nontransmitting mothers, and immune escape from CTL recognition was detected in all three transmitting mothers but in only one of eight nontransmitting mothers. The majority of viral sequences obtained from the HIV-1-infected infant blood samples were susceptible to maternal CTL. These findings demonstrate that epitope amino acid sequence variation and escape from CTL recognition occur more frequently in mothers that transmit HIV-1 to their infants than in those who do not. However, the transmitted virus can be a CTL susceptible form, suggesting inadequate in vivo immune control.

Since preterm infants and infants born to teenage mothers are noted to be at risk for developmental delays, a group of infants who were both preterm and born to teenage mothers was provided a sensorimotor exercise intervention program for the first year of infancy. The development of these infants was compared to the development of preterm infants without intervention and term infants of teenage mothers as well as term and preterm infants of adult mothers to determine the degree to which developmental delays were prevented. The intervention infants showed more optimal growth, cognitive development, temperament and play behaviors during interactions with their mothers across the first year of development.

Flower, et. al. have reported that newborn animals made hypercarbic had both an increased incidence and severity of RLF. This study concerns data on 74 surviving infants with birth weights ≤ 1000 grams, half of whom (37 infants) had RLF diagnosed either while in hospital or shortly after discharge. Twenty eight independent variables were analyzed to determine their role in the occurrence of RLF. By discriminant analysis, 9 of these variables correlated with the development of RLF (r=.70) and accounted for 49% of the variance. The total function (nos. 1-9) yielded a Chi-square of p < .0007. This function would correctly predict infants with RLF 84% of the time. The component which best predicted the outcome was the highest PaCO2 measured in the infant (#1). The second most important variable was the total number of high PaCO2's (> 50 TORR) which occurred simultaneously with an elevated PaO2 (> 100 TORR). Other variables included the total number of PaO2's > 100 TORR (#3), the Apgar Score at 1 minute (#4), the Ponderal Index (#5), total days on CPAP (#6), the highest recorded PaO2 (#7), total respirator days (#8) and the Ponderal Index Percentile (#9). These data suggest that PaCO2 may be a very significant variable in the development of RLF. Retinal vasoconstriction, if viewed as protective, may be abolished by hypercarbia; thereby allowing free flow of potentially toxic hyperoxic blood into the retinal tissues. We suggest that continuous PaCO2 monitoring may be as important as PaCO2 monitoring in the prevention of RLF.

Thirty healthy preterm infants were randomly assigned either to a control group or to one of two experimental groups. The mothers of the first experimental group were present during an administration of the Brazelton Neonatal Behavioral Assessment Scale and were asked to complete the Mother's Assessment of the Behavior of Her Infant Scale (MABI) at birth and weekly for four weeks after the discharge of their infants. The mothers of the second experimental group were not present during the administration of the Brazelton scale, but were asked to complete the MABI scale at birth and weekly for the first month after discharge. The mothers of the control infants did not observe administration of the Brazelton scale or complete the MABI scale, but were asked to complete a questionnaire on the developmental milestones of their infants. At 1, 4, and 12 months of age these infants were visited in their homes by teams of researchers blind to the hypothesis of the study and to the group assignment of the infants. The results at 1 month demonstrated that the experimental groups performed more optimally on the Brazelton scale interactive process items. These infants also received superior ratings on the video-taped feeding and face-to-face play sequences. At 4 months the experimental group infants showed better fine motor-adaptive abilities on the Denver Developmental Screening Test than did the control group. In addition, the face-to-face interaction ratings of the two experimental groups were significantly better that were those of the control group. The Bayley Scales of Infant Development were administered when the infants were 12 months corrected age. The infants of the experimental groups received significantly higher scores on the Mental Development Scale. This study suggests that teaching mothers the amazing skills of their newborns on the Brazelton and MABI scales may facilitate early interactions which, in turn, may contribute to early cognitive development.

To assess the combined risks of being born preterm and to a teenage mother, and to evaluate the effects of an early intervention, preterm infants born to lower-class, black, teenage mothers were provided a home-based, parent-training intervention, and their development was then compared with that of nonintervention controls, of term infants of teenage mothers, and of term and preterm infants of adult mothers. Despite equivalence on prenatal care, factors which placed the preterm infant of the teenage mother at greater risk at birth were the small-for-date size of the infant and the less realistic developmental milestones and child rearing attitudes expressed by the mother. The preterm infants of teenage mothers who received intervention showed more optimal growth, Denver scores, and face-to-face interactions at 4 months. Their mothers rated their infants' temperaments more optimally, expressed more realistic developmental milestones and child-rearing attitudes, and received higher ratings on face-to-face interactions. At 8 months, the intervention group received superior Bayley mental, Caldwell, and infant temperament scores.

Brazelton demonstrations and MABI assessments were provided for lower class teenage mothers of preterm infants during the neonatal period. Another group received the Mother's Assessment of the Behavior of her Infant (MABI) scale alone. The effects of these interventions were evaluated at one month by Brazelton and mother—infant feeding and face-to-face interactions. Both the Brazelton demonstration/MABI group and the MABI group showed more optimal Brazelton interactive process scores, feeding and face-to-face interaction ratings at one month than did preterm and term infant control groups. However, a greater number of effects were observed for the Brazelton demonstration/MABI group.

Infants delivered by caesarean section and general anesthesia were compared with those delivered vaginally with local-regional or no anesthesia. At birth the caesarean group showed less optimal obstetric medications and complication scores, maternal attitudes to labor and delivery, and maternal and infant blood pressures, but the group did not differ on examiner or mother assessments of neonatal behaviors. At 4 months the vaginal group was more optimal on Denver adaptability, maternal state—trait anxiety, and maternal diastolic blood pressures, but the caesarean section mothers rated their infants more optimally on temperament, expressed more realistic expectations of developmental milestones, and received, along with their infants, more optimal face-to-face and feeding interaction ratings. At 8 months there were no differences on developmental assessments, but whereas blood pressures were higher in caesarean mothers and infants, these mothers again assessed their infants as having more optimal temperaments. These results are discussed in the context of an emergency caesarean altering the mother's perceptions of her infant.

I review the current situation in neutrino physics in the context of unified gauge theories, with room for heavy quarks that carry new flavor quantum numbers. The y-anomaly is strong evidence for the existence of righthanded currents and perhaps beauty. Dileptons are evidence for charm. The case for truth is less compelling. I study equal sign dileptons and their implications on a promising field of multilepton physics. Neutral currents, the hard-fact model and madness (nondiagonal neutral currents) are also among the topics discussed.