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Abstract Background Genomic and pathology analysis has revealed enormous diversity in genes involved in disease, including those encoding host resistance and parasite effectors (also known in plant pathology as avirulence genes). It has been proposed that such variation may persist when an organism exists in a spatially structured metapopulation, following the geographic mosaic of coevolution. Here, we study gene-for-gene relationships governing the outcome of plant-parasite interactions in a spatially structured system and, in particular, investigate the population genetic processes which maintain balanced polymorphism in both species. Results Following previous theory on the effect of heterogeneous environments on maintenance of polymorphism, we analysed a model with two demes in which the demes have different environments and are coupled by gene flow. Environmental variation is manifested by different coefficients of natural selection, the costs to the host of resistance and to the parasite of virulence, the cost to the host of being diseased and the cost to an avirulent parasite of unsuccessfully attacking a resistant host. We show that migration generates negative direct frequency-dependent selection, a condition for maintenance of stable polymorphism in each deme. Balanced polymorphism occurs preferentially if there is heterogeneity for costs of resistance and virulence alleles among populations and to a lesser extent if there is variation in the cost to the host of being diseased. We show that the four fitness costs control the natural frequency of oscillation of host resistance and parasite avirulence alleles. If demes have different costs, their frequencies of oscillation differ and when coupled by gene flow, there is amplitude death of the oscillations in each deme. Numerical simulations show that for a multiple deme island model, costs of resistance and virulence need not to be present in each deme for stable polymorphism to occur. Conclusions Our theoretical results confirm the importance of empirical studies for measuring the environmental heterogeneity for genetic costs of resistance and virulence alleles. We suggest that such studies should be developed to investigate the generality of this mechanism for the long-term maintenance of genetic diversity at host and parasite genes.

Objective: Understanding patterns of suicide risk over the course of development can aid our ability to prevent suicide. Our community-based study examined changes in suicide risk status and predictors of changes in risk status in a sample of 521 adolescents over six assessments between the start of middle school and young adulthood (ages 12-22)., Methods: Suicidal thoughts and behaviors (STB) were measured with the Diagnostic Interview Schedule for Children and the Moods and Feelings Questionnaire. Latent transition analysis (LTA) was utilized to evaluate transitions in suicide risk status over the course of development. Nine risk factors' initial values and change over time were modeled as predictors in the LTA., Results: Latent class analysis identified a four-class model of developmental suicide risk patterns: Class 1: Infrequent STB (73-87% of participants), Class 2: Diminishing STB (1-17% of participants), Class 3: Escalating STB (6-16% of participants), and Class 4: Consistently High STB (1-5% of participants). LTA demonstrated that infrequent STB members and escalating STB members were likely to maintain their risk class across time points., Conclusions: Classification of STB trajectories demonstrated self-worth and family involvement were salient variables affecting transitions in risk over time and suggest prevention targets early in adolescence that could have impact on suicide risk in adulthood.

Background: Non-suicidal self-injury (NSSI) is a significant public health concern that is thought to increase risk for future self-injurious behaviors, including suicide attempts. Notably, NSSI is especially prevalent among adolescents, which underscores a critical need to identify modifiable risk factors that could be targeted to reduce future risk. The current study examined self- and co-regulation of physiological responses during mother-daughter interactions in adolescent girls with and without a history of NSSI., Methods: Participants were 60 girls aged 13-17 with (n = 27) and without (n = 33) a history of NSSI and their mothers. Adolescents and their mothers completed positive and negative interaction tasks during which physiological reactivity was assessed via respiratory sinus arrhythmia (RSA)., Results: Using Actor-Partner Interdependence Modeling (APIM), we found that adolescents with an NSSI history demonstrated a higher RSA setpoint than adolescents without this history during the negative, but not positive, interaction task. In addition, there were differences in co-regulation during the negatively valenced interaction, such that mothers of daughters with NSSI were more reactive to fluctuations in their daughters' RSA than mothers of daughters without an NSSI history., Conclusions: These findings highlight intra- and interpersonal aspects of physiological dysregulation associated with NSSI that could provide promising targets of intervention to reduce future risk in adolescent girls., (© 2023 Association for Child and Adolescent Mental Health.)

FOLFOX (5-fluorouracil, leucovorin, oxaliplatin) chemotherapy is a treatment for colorectal cancer that can induce persistent fatigue and metabolic dysfunction. Regular exercise after chemotherapy cessation is widely recommended for cancer patients and has been shown to improve fatigue resistance in mice. However, gaps remain in understanding whether the early systemic and skeletal muscle adaptations to regular exercise are altered by prior FOLFOX chemotherapy treatment. Furthermore, the effects of exercise duration on early metabolic and skeletal muscle transcriptional adaptations are not fully established. Purpose : Investigate the effects of prior FOLFOX chemotherapy treatment on the early adaptations to repeated short- or long-duration treadmill exercise, including the fasting regulation of circulating metabolic regulators, skeletal muscle COXIV activity and myokine/exerkine gene expression in male mice. Methods : Male C57BL6/J mice completed 4 cycles of FOLFOX or PBS and were allowed to recover for 4-weeks. Subsets of mice performed 14 sessions (6 d/wk, 18 m/min, 5% grade) of short- (10 min/d) or long-duration (55 min/d) treadmill exercise. Blood plasma and muscle tissues were collected 48-72 h after the last exercise bout for biochemical analyses. Results : Long-duration exercise increased fasting plasma osteocalcin, LIF, and IL-6 in healthy PBS mice, and these changes were ablated by prior FOLFOX treatment. Slow-oxidative soleus muscle COXIV activity increased in response to long-duration exercise in PBS mice, which was blocked by prior FOLFOX treatment. Fast-glycolytic plantaris muscle COXIV activity increased with short-duration exercise independent of FOLFOX administration. There was a main effect for long-duration exercise to increase fasting muscle IL-6 and COXIV mRNA expression independent of FOLFOX. FOLFOX administration reduced muscle IL-6, LIF, and BDNF mRNA expression irrespective of long-duration exercise. Interestingly, short-duration exercise suppressed the FOLXOX induction of muscle myostatin mRNA expression. Conclusion: FOLFOX attenuated early exercise adaptations related to fasting circulating osteocalcin, LIF, and IL-6. However, prior FOLFOX treatment did not alter the exercise adaptations of plantaris muscle COXIV activity and plasma adiponectin. An improved understanding of mechanisms underlying exercise adaptations after chemotherapy will provide the basis for successfully treating fatigue and metabolic dysfunction in cancer survivors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2023 Halle, Counts, Zhang, James, Puppa, Alway and Carson.)

During the COVID-19 pandemic lockdown, adolescents relied on social technology for social connection. Although some research suggests small, negative effects for quantity of social technology use on adolescent mental health, the quality of the interaction may be more important. We conducted a daily diary study in a risk-enriched sample of girls under COVID-19 lockdown to investigate associations between daily social technology use, peer closeness, and emotional health. For 10 days, 93 girls (ages 12-17) completed an online daily diary (88% compliance) assessing positive affect, symptoms of anxiety and depression, peer closeness, and daily time texting, video-chatting and using social media. Multilevel fixed effects models with Bayesian estimation were conducted. At the within-person level, more daily time texting or video-chatting with peers was associated with feeling closer to peers that day, which was associated with more positive affect and fewer depressive and anxiety symptoms that day. At the between-person level, more time video-chatting with peers across the 10 days was indirectly associated with higher average positive affect during lockdown and less depression seven-months later, via higher mean closeness with peers. Social media use was not associated with emotional health at the within- or between-person levels. Messaging and video-chatting technologies are important tools for maintaining peer connectedness during social isolation, with beneficial effects on emotional health., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Non-suicidal self-injury (NSSI) is an alarming public health concern that is particularly widespread among adolescents. The current study examined affective responses during mother-daughter interactions in adolescent girls with and without a history of NSSI. Participants were 60 girls aged 13-17 with (n = 27) and without (n = 33) a history of NSSI and their mothers. Adolescents and their mothers completed two interaction tasks: one positive and one negative. During these interactions, facial affect was assessed via electromyography (EMG). Results of Actor-Partner Interdependence Modeling (APIM) revealed several intra- and interpersonal disruptions in affect during both tasks among dyads in which the adolescent had an NSSI history. Findings suggest deficits in both self- and co-regulation of facial affect during mother-daughter interactions involving dyads in which the adolescents reports NSSI. Ultimately, if replicated and extended in longitudinal research, these disruptions may prove to be promising targets of intervention to reduce risk for future NSSI in adolescent girls., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

The goal of this study was to examine the relation between real-world socio-emotional measures and neural activation to parental criticism, a salient form of social threat for adolescents. This work could help us understand why heightened neural reactivity to social threat consistently emerges as a risk factor for internalizing psychopathology in youth. We predicted that youth with higher reactivity to parental criticism (vs neutral comments) in the subgenual anterior cingulate cortex (sgACC), amygdala and anterior insula would experience (i) less happiness in daily positive interpersonal situations and (ii) more sadness and anger in daily negative interpersonal situations. Participants (44 youth aged 11-16 years with a history of anxiety) completed a 10-day ecological momentary assessment protocol and a neuroimaging task in which they listened to audio clips of their parents' criticism and neutral comments. Mixed-effects models tested associations between neural activation to critical (vs neutral) feedback and emotions in interpersonal situations. Youth who exhibited higher activation in the sgACC to parental criticism reported less happiness during daily positive interpersonal situations. No significant neural predictors of negative emotions (e.g. sadness and anger) emerged. These findings provide evidence of real-world correlates of neural reactivity to social threat that may have important clinical implications., (© The Author(s) 2023. Published by Oxford University Press.)

Background: Non-suicidal self-injury (NSSI) is a significant public health concern, not only because of the personal and social cost of the behavior itself, but also because it increases risk for future self-injurious behaviors, including suicide attempts. NSSI is increasingly prevalent during adolescence, which highlights the need for research aimed at identifying modifiable risk factors that can be targeted to reduce future risk. Building from theoretical models that highlight interpersonal processes, this study examined whether adolescents with an NSSI history exhibit greater difficulty inhibiting attention to emotionally salient interpersonal stimuli (face), indexed via steady state visual evoked potentials (SSVEPs), which provide a direct neural index of the ability to inhibit attention to task-irrelevant stimuli., Methods: Adolescent girls aged 13-17 with (n = 26) and without (n = 28) an NSSI history completed a change-detection computer task during which frequency-tagged SSVEPs were used to assess adolescents' ability to inhibit attention to affectively salient stimuli from spatially superimposed targets., Results: Compared with adolescents with no NSSI history, adolescents with NSSI demonstrated difficulty inhibiting attention to angry adult faces., Conclusions: These findings underscore specific deficits in attentional filtering among girls with an NSSI history, which, if replicated and extended, could be a promising intervention target for reducing risk for future NSSI., (© 2022 American Association of Suicidology.)

Background: Short-term starvation and severe food deprivation (FD) reduce dietary iron absorption and restricts iron to tissues, thereby limiting the amount of iron available for erythropoiesis. These effects may be mediated by increases in the iron regulatory hormone hepcidin; however, whether mild to moderate FD has similar effects on hepcidin and iron homeostasis is not known., Objectives: To determine the effects of varying magnitudes and durations of FD on hepcidin and indicators of iron status in male and female mice., Methods: Male and female C57BL/6J mice (14 wk old; n = 170) were randomly assigned to consume AIN-93M diets ad libitum (AL) or varying magnitudes of FD (10%, 20%, 40%, 60%, 80%, or 100%). FD was based on the average amount of food consumed by the AL males or females, and food was split into morning and evening meals. Mice were euthanized at 48 h and 1, 2, and 3 wk, and hepcidin and indicators of iron status were measured. Data were analyzed by Pearson correlation and one-way ANOVA., Results: Liver hepcidin mRNA was positively correlated with the magnitude of FD at all time points (P < 0.05). At 3 wk, liver hepcidin mRNA increased 3-fold with 10% and 20% FD compared with AL and was positively associated with serum hepcidin (R = 0.627, P < 0.0001). Serum iron was reduced by ∼65% (P ≤ 0.01), and liver nonheme iron concentrations were ∼75% greater (P ≤ 0.01) with 10% and 20% FD for 3 wk compared with AL. Liver hepcidin mRNA at 3 wk was positively correlated with liver Bmp6 (R = 0.765, P < 0.0001) and liver gluconeogenic enzymes (R = >0.667, P < 0.05) but not markers of inflammation (P > 0.05)., Conclusions: FD increases hepcidin in male and female mice and results in hypoferremia and tissue iron sequestration. These findings suggest that increased hepcidin with FD may contribute to the disturbances in iron homeostasis with undernutrition., (© The Author(s) 2022. Published by Oxford University Press on behalf of the American Society for Nutrition.)

The knowledge of what separates us genetically from our less-evolved relatives is crucial for gaining new biomedical insight about the human-chimpanzee relatedness that could influence the development of new treatments and diagnostic aids for various ailments. Especially, more than 300 diseases have been mapped to the X chromosome, which has unique and complicated characteristics than other chromosomes in the human genome. Although the genomes of humans and chimpanzees share 99% similarity, significant differences exist between the two species in their non-coding intronic regions. Therefore, this evolutionary-based genome annotation study attempted to computationally compare, contrast, and annotate the homologous miRNAs and their gene regulatory mechanisms in the intronic regions of the PHEX gene on the human X chromosome of the two species. From our results, we identified a total of 1296 human miRNAs and 46, 957 gene targets. Similarly, 30, 563 targets of homologous chimp miRNAs were predicted. miRNAs like hsa-miR-17-5p showed a maximum number of interactions while miRNAs like hsa-miR-107 with the least number of interactions in the human/chimp gene networks. A few top-ranked miRNAs such as hsa-miR-24, hsa-miR-145, hsa-miR-34a, and hsa-miR-378 were observed to be common between the two genera. The cooperativity and multiplicity of certain miRNAs were predicted to regulate the expression of diverse cancer-associated genes such as Cyclin D1, Notch1, CDK-6, E2F3, ALK4, CKDN2A, DHFR, and MAPK14. Nevertheless, further in vitro and in vivo experimental validations of these gene candidates are required before they could be used as potential diagnostic markers and drug targets., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Although treatments for youth at risk for suicide have been successful, they are not similarly effective for everyone. Anxiety may interfere with adolescents' ability to engage with therapy and explain why some adolescents do not respond as well as others to treatment. The current study tested whether an anxiety diagnosis predicted treatment outcome among a sample of adolescents with suicidal ideation and depressive symptoms participating in either attachment-based family therapy or family-enhanced nondirective supportive therapy (N = 129; M age = 14.87, SD = 1.68; 81.9% female). The data set that the current study used had a high representation of Black/African American adolescents (48.8% of sample), which is valuable, as few studies have included adequate representation of this population. A significant indirect effect (.88; 95% confidence interval [.01, 2.64]) showed that across both treatment conditions, participants who met criteria for an anxiety disorder had greater difficulties engaging in goal-directed behavior midtreatment, and these difficulties, in turn, predicted more posttreatment suicidal ideation. The effect of anxiety on treatment outcome via difficulties with goal-directed behavior was nonspecific to the treatment condition. However, attachment-based family therapy was superior to family-enhanced nondirective supportive therapy in improving this aspect of emotion regulation among adolescents who did not have anxiety. In addition, difficulties with goal-directed behavior on treatment outcome were worse for adolescents' who reported greater attachment avoidance to their parents. Future research should test whether targeting goal-directed behavior and attachment avoidance would result in better treatment outcome for adolescents with suicidal ideation and anxiety. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Parental criticism is linked to a number of detrimental child outcomes. One mechanism by which parental criticism may increase risk for negative outcomes in children is through children's neural responses to valenced information in the environment. The goal of the current study, therefore, was to examine the relation between maternal criticism and children's neural responses to monetary gains and losses. To represent daily environmental experiences of reward and punishment, we focused on reactivity to monetary gains versus losses in a guessing task. Participants were 202 children and their mothers recruited from the community. The average age of the children was 9.71 years (SD = 1.38, range = 7-11), with 52.0% of them male and 72.8% Caucasian. Mothers completed the Five Minute Speech Sample to assess expressed emotion-criticism, and of these dyads 51 mothers were rated as highly critical. In addition, children completed a simple guessing game during which electroencephalography was recorded. Children of critical mothers displayed less neural reactivity to both monetary gain and loss than children without critical mothers. Our results were at least partially independent of children's and mothers' current levels of internalizing psychopathology. These findings suggest that children exposed to maternal criticism may exhibit disruptions in adaptive responses to environmental experiences regardless of valence. Targeted interventions aimed at reducing expressed emotion-criticism may lead to changes in a child's reward responsiveness and risk for psychopathology., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Purpose: Provide a direct, non-invasive diagnostic measure of microscopic tissue texture in the size scale between tens of microns and the much larger scale measurable by clinical imaging. This paper presents a method and data demonstrating the ability to measure these microscopic pathologic tissue textures (histology) in the presence of subject motion in an MR scanner. This size range is vital to diagnosing a wide range of diseases., Theory/methods: MR micro-Texture (MRµT) resolves these textures by a combination of measuring a targeted set of k-values to characterize texture-as in diffraction analysis of materials, performing a selective internal excitation to isolate a volume of interest (VOI), applying a high k-value phase encode to the excited spins in the VOI, and acquiring each individual k-value data point in a single excitation-providing motion immunity and extended acquisition time for maximizing signal-to-noise ratio. Additional k-value measurements from the same tissue can be made to characterize the tissue texture in the VOI-there is no need for these additional measurements to be spatially coherent as there is no image to be reconstructed. This method was applied to phantoms and tissue specimens including human prostate tissue., Results: Data demonstrating resolution <50 µm, motion immunity, and clearly differentiating between normal and cancerous tissue textures are presented., Conclusion: The data reveal textural differences not resolvable by standard MR imaging. As MRµT is a pulse sequence, it is directly translatable to MRI scanners currently in clinical practice to meet the need for further improvement in cancer imaging., (© 2021 International Society for Magnetic Resonance in Medicine.)

Background: Despite the fact that cervical cancer is preventable and curable in the early stages, it still remains to be a major public health problem in India. This study was conducted to assess the knowledge and awareness regarding the Human Papilloma Virus (HPV) vaccination among health care professionals working in a tertiary care hospital in urban India., Methods: To this aim, we conducted a cross-sectional study among 318 health care professionals working in tertiary hospitals across Chennai, Tamil Nadu, India. Our research group designed a structured questionnaire with 31 items to assess the knowledge and attitudes on cervical cancer, its prevention, and HPV vaccination., Results: Among the 318 respondents, 90.6% were aware of cervical cancer, 83.3% were aware that PAP (Papanicolaou) smear test detects cervical cancer, and 86.2% of the respondents knew that HPV causes cervical cancer. 29.2% of the eligible respondents underwent the screening against cervical cancer, and 19.8% of the study participants were vaccinated for HPV. Only 34.9% know that the HPV vaccine could be given to boys. The most common reason for not being vaccinated against HPV was the lack of awareness. In our study, 77.2% of the respondents were willing to be vaccinated and recommend HPV vaccination to their family members., Conclusion: From this study, it was evident that there is a lack of awareness about HPV vaccination and its importance in preventing cervical cancer among healthcare professionals. Our finding clearly establishes the need to devise intervention programs to promote vaccination against HPV and periodical screening for cervical cancer among healthcare professionals.

Background: Suicidal thoughts and behavior can begin early in childhood and are a leading cause of death in youth. Although specific mechanisms of risk remain largely unknown, theorists and researchers highlight the importance of the parent-child relationship. The current study focused on one aspect of this relationship: the dynamic exchange of facial affect during interactions. Specifically, we examined the relation between children's history of suicidal ideation (SI) and synchrony of facial expressions during positive and negative mother-child interactions., Methods: Participants were 353 mother-child dyads. Of these, 44 dyads included a child with an SI history. Dyads engaged in positive and negative discussions during which their facial electromyography was recorded from mothers and children to index second-to-second changes in positive (zygomaticus) and negative (corrugator) facial affect., Results: Child SI dyads were characterized specifically by reduced synchrony of positive facial affect during the positive discussion compared to dyads without child SI., Conclusions: These findings suggest child SI dyads exhibit reduced synchrony of normative positive expressions during mother-child interactions. If replicated and extended in longitudinal research, these results may help to explain one mechanism of risk among children with SI., (© 2020 Association for Child and Adolescent Mental Health.)

Biased attention to sad faces is associated with depression in adults and is hypothesized to increase depression risk specifically in the presence, but not absence, of stress by modulating stress reactivity. However, few studies have tested this hypothesis, and no studies have examined the relation between attentional biases and stress reactivity during adolescence, despite evidence that this developmental window is marked by changes in depression risk, stress, and the function of attention. Seeking to address these limitations, the current study examined the impact of adolescents' sustained attention to facial displays of emotion on individual differences in both mood reactivity to real-world stress and physiological (i.e., respiratory sinus arrhythmia [RSA]) reactivity to a laboratory-based stressor. Consistent with vulnerability-stress models of attention, greater sustained attention to sad faces was associated with greater depressive reactions to real-world stress. In addition, there was preliminary evidence from exploratory analyses that the impact of sustained attention on mood and/or physiological reactivity may be moderated by adolescents' age and sex such that relations are stronger for older adolescents and girls. The results of this study contribute to the current body of research on the role of attention in stress reactivity and depression risk and highlight the importance of considering age differences when examining these relations.

There is a growing body of evidence supporting the association between immune processes and psychopathology, including major depressive disorder (MDD). However, lack of diagnostic specificity has given rise to a search for specific symptom types, as opposed to more heterogeneous categorical diagnoses, linked to increased inflammation. One such symptom could be anhedonia, which is not only a key feature of MDD, but also a pervasive and persistent transdiagnostic symptom. To evaluate the specific role of anhedonia as well as categorical MDD diagnoses, we examined endotoxin-evoked immune responses in vitro in relation to current levels of anhedonia and history of recurrent MDD (rMDD) in a sample of adults recruited from the community. A total of 39 participants either had a history of rMDD ( n = 20) or no lifetime history of any MDD episodes ( n = 19). The average age of participants was 36.81 years and the majority were women (87.2%) and Caucasian (76.3%). We found that higher levels of current anhedonia, but not history of rMDD, were associated with increased lipopolysaccharide-stimulated levels of inflammatory markers even after we statistically controlled for the potential influence of participants' demographic (age, sex, ethnicity, income) and physiological (body temperature, BMI) characteristics, current symptoms of depression and anxiety, and the time of day of the sample collection. These findings highlight the relation of anhedonia specifically, rather than rMDD more generally, with inflammatory processes and identify endotoxin-stimulated cytokine production as a plausible biological marker of current anhedonia.

Although there is a robust link between resting respiratory sinus arrhythmia (RSA), a biological marker of emotion regulation, and risk for psychopathology, the factors that may be associated with aberrant RSA development remain unclear. The goal of the current study was to examine the relation between children's resting levels of RSA and neighborhood crime, a macro-level environmental stressor associated with increased risk for multiple forms of psychopathology in youth. The levels of neighborhood crime were obtained using a geocoded neighborhood crime exposure database, allowing for the objective assessment of the likelihood of crime occurring in the child's community. The results indicated that the relation between neighborhood crime and resting RSA differed for girls and boys such that living in a neighborhood with higher risk of exposure to violent crimes was associated with lower RSA for girls, but not boys. These results suggest that living in a higher crime neighborhood is associated with an objective, biologically-based marker of emotion regulation and highlight how neighborhood crime may be specifically associated with risk for girls., (© 2019 Wiley Periodicals, Inc.)

Maternal history of Major Depressive Disorder (MDD) dramatically increases children's risk for developing depression, highlighting the critical need for further research on the specific processes involved in the intergenerational transmission of depression. Although previous research suggests that maternal depression may adversely affect the quality of mother-child interactions, less is known about the role of maternal MDD in the moment-to-moment changes in affect that occur during these interactions. The goal of this project, therefore, was to examine synchrony of facial displays of affect during a positive (Vacation Planning) and a negative (Issues Discussion) mother-child interaction, and how this synchrony may be impacted by maternal history of MDD. In doing so, we examined both concurrent and lagged synchrony of facial affect. We recruited 341 mother-child dyads (child average age = 9.30 years; 50.1% girls; 71.6% Caucasian) with and without a maternal history of MDD. Facial electromyography (EMG), continuously recorded during those tasks, was used to index mother and child facial affect. We found that a maternal history of MDD was associated with reduced concurrent synchrony and lagged synchrony (mother facial affect predicting changes in child facial affect) of positive affect during Vacation Planning. Reduced concurrent mother-child synchrony of positive affect during the discussion was also associated with an increase in child self-reported sad affect from before to after the discussion. These findings provide promising initial evidence for how the dynamic exchange of positive affect during mother-child interactions may be disrupted in families with maternal MDD history. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Although non-suicidal self-injury (NSSI) is a significant public health concern in youth, most of the extant research on NSSI has focused on adults and, to a lesser extent, adolescents. Therefore, little is known about the correlates and potential risk factors for NSSI in school-aged children. One factor that may be particularly important to children is their exposure to maternal criticism. Thus, the goal of this study was to examine the association between maternal expressed emotion-criticism (EE-Criticism) and NSSI in children, and to determine whether this relation is similar for girls and boys. Participants were 204 children (ages 7-11; 39.7% female, 81.9% Caucasian) and their mothers. Participants completed interviews assessing the child's history of NSSI. Mothers completed the Five-Minute Speech Sample to determine levels of EE-Criticism toward their child. We found that girls exposed to high levels of EE-Criticism were more likely to have a lifetime history of NSSI than girls of mothers exhibiting low levels of EE-Criticism; however, the relation between EE-Criticism and NSSI was not significant for boys. These results are consistent with interpersonal models of risk for NSSI, but suggest that one interpersonal factor, maternal criticism, is more strongly related to NSSI in girls than in boys., (Copyright © 2019. Published by Elsevier B.V.)

Osteoporosis, characterized by increased fracture risk and bone fragility, impacts millions of adults worldwide, but effective, non-invasive and easily accessible diagnostic tests of the disease remain elusive. We present a magnetic resonance (MR) technique that overcomes the motion limitations of traditional MR imaging to acquire high-resolution frequency-domain data to characterize the texture of biological tissues. This technique does not involve obtaining full two-dimensional or three-dimensional images, but can probe scales down to the order of 40 μm and in particular uncover structural information in trabecular bone. Using micro-computed tomography data of vertebral trabecular bone, we computationally validate this MR technique by simulating MR measurements of a 'ratio metric' determined from a few k -space values corresponding to trabecular thickness and spacing. We train a support vector machine classifier on ratio metric values determined from healthy and simulated osteoporotic bone data, which we use to accurately classify osteoporotic bone., Competing Interests: C.N., K.J.S. and J.M.C. are paid consultants of bioProtonics, LLC., a company that holds intellectual property on the magnetic resonance technique μTexture described in this paper. T.W.J. and K.M.J. are co-founders and employees of bioProtonics, LLC.

Although suicide attempts (SA) occur across a broad range of diagnoses as well as in the absence of a diagnosable disorder, most studies to date have focused on them within a single, specific disorder. Consistent with the NIMH RDoC initiative to identify biobehavioral vulnerabilities that cut across diagnoses, the goal of the present study was to examine potential differences in resting respiratory sinus arrhythmia (RSA) levels in a large, diagnostically heterogeneous sample of women with and without a history of SA who were matched on a broad range of demographic and clinical variables. Participants were 112 women with (n = 56) and without (n = 56) a history of SA recruited from the community. The two groups were equated on approximate age, race, household income, and lifetime histories of psychiatric diagnoses. Resting electrocardiogram was recorded during a 2-min rest period. RSA was calculated via spectral power analyses with a fast Fourier transform. We found that women with a history of SA exhibited significantly lower resting RSA levels than women with no history of SA, and this difference was maintained even after statistically controlling for the potential influence of women's history of psychiatric diagnoses and their current symptoms of depression and anxiety. These findings suggest the presence of a link between resting RSA and SA history., (© 2017 Society for Psychophysiological Research.)

There is growing evidence for the role of environmental influences on children's information-processing biases for affectively salient stimuli. The goal of this study was to extend this research by examining the relation between parental criticism (expressed emotion-criticism, or EE-Crit) and children's processing of facial displays of emotion. Specifically, we examined the relation between EE-Crit and children's sensitivity in detecting facial displays of emotion. We also examined a neural marker of sustained attention, the late positive potential (LPP) event-related potential component (ERP). Participants were 87 children (ages 7-11 years; 53.3% female, 77.8% Caucasian) and their parents (ages 24-71; 90% female, 88.9% Caucasian). Parents completed the Five-Minute Speech Sample to determine levels of EE-Crit toward their child. Children completed a morphed faces task during which behavioral and ERP responses were assessed. Although there were no group differences in sensitivity in detecting facial displays of emotion, we found that children of parents exhibiting high, compared to low, EE-Crit displayed less attention (smaller LPP magnitudes) to all facial displays of emotion (fearful, happy, sad). These results suggest that children of critical parents may exhibit an avoidant pattern of attention to affectively-salient interpersonal stimuli.

Objective: The goal of this study was to examine physiological reactivity during parent-child interactions in children with and without a history of suicidal ideation (SI), a group known to be at increased risk for suicidal thoughts and behaviors in the future. We also examined the potential moderating role of parental expressed emotion-criticism (EE-Crit) to determine whether the presence of parental criticism may help to identify a subgroup of children with a history of SI most at risk for physiological dysregulation., Method: Participants were 396 children (age 7-11; 54% male, 71.7% Caucasian) and their biological parent. Children's levels of high frequency heart rate variability (HF-HRV) were assessed during a resting baseline period followed by a positive and negative discussion with their parent. Additionally, parents completed the Five-Minute Speech Sample to determine levels of EE-Crit toward their child, and children completed an interview assessing their history of SI., Results: Consistent with our hypothesis, we found that exposure to parental criticism moderated the relation between a child's history of SI and their HF-HRV reactivity to the discussions. Specifically, while most children exhibited the typical pattern of HF-HRV suppression from baseline to both interactions, the highest risk children (i.e., children with a history of SI who also had highly critical parents) did not display any change in HF-HRV across the tasks, suggesting a failure to engage a typical psychophysiological response during emotional contexts., Conclusions: These results suggest a specific physiological mechanism that may place these children at risk for suicidal thoughts and behaviors in the future., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Attentional biases, particularly difficulty inhibiting attention to negative stimuli, are implicated in risk for major depressive disorder (MDD). The current study examined a neural measure of attentional bias using a continuous index of visuocortical engagement (steady-state visual evoked potentials [SSVEPs]) before and after a negative mood induction in a population at high-risk for MDD recurrence due to a recently remitted MDD (rMDD) episode. Additionally, we examined working memory (WM) capacity as a potential moderator of the link between rMDD and visuocortical responses., Methods: Our sample consisted of 27 women with rMDD and 28 never-depressed women. To assess attentional inhibition to emotional stimuli, we measured frequency-tagged SSVEPs evoked from spatially superimposed task-relevant stimuli and emotional distractors (facial displays of emotion) oscillating at distinct frequencies. WM capacity was assessed during a visuospatial memory task., Results: Women with rMDD, relative to never-depressed women, displayed difficulty inhibiting attention to all emotional distractors before a negative mood induction, with the strongest effect for negative distractors (sad faces). Following the mood induction, rMDD women's attention to emotional distractors remained largely unchanged. Among women with rMDD, lower WM capacity predicted greater difficulty inhibiting attention to negative and neutral distractors., Conclusions: By exploiting the phenomenon of oscillatory resonance in the visual cortex, we tracked competition in neural responses for spatially superimposed stimuli differing in valence. Results demonstrated that women with rMDD display impaired attentional inhibition of emotional distractors independent of state mood and that this bias is strongest among those with lower WM capacity., Competing Interests: Financial Disclosures The authors report no biomedical financial interests or potential conflicts of interest.

Peritoneal malignancies are a rare occurrence in children, often metastatic and rarely originating primarily in the peritoneum. The imaging findings of these entities in the pediatric age have not been recently reviewed or they have been previously described or depicted mostly as part of articles discussing each entity separately. This is a review of the most relevant peritoneal malignancies in childhood emphasizing imaging features. Knowledge of these appearances may facilitate diagnosis and staging of these neoplasms., (Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.)

Objectives: Probiotics act as a unique approach to maintaining oral health by supplementing the endogenous oral bacteria with additional naturally occurring beneficial microbes to provide defense against pathogens harmful to teeth and gingiva. The aim of this pilot study was to clinically evaluate the effects of probiotics on plaque accumulation and gingival inflammation in subjects with fixed orthodontics., Methods: The pilot study was comprised of 15 healthy patients, aged 11 to 18 years, undergoing fixed orthodontic treatment. Patients used an all-natural, dissolving lozenge containing six proprietary probiotic strains (Dentaq® Oral and ENT Health Probiotic Complex)for 28 days. Gingival Index (GI) according to Löe-Silness and Plaque Index (PI) according to Quigley-Hein for all teeth were measured at baseline (Day Zero) and at the end of the probiotic regimen (Day 28)., Results: The mean baseline GI and PI scores within each patient decreased by 28.4% and 35.8%, respectively, by Day 28. Patients reported decreased tooth and gingival pain, decreased oral bleeding, and increased motivation to maintain proper oral hygiene over the course of the study., Conclusions: This pilot study provided preliminary support for the use of Dentaq Oral and ENT Health Probiotic Complex as a safe and effective natural health product for the reduction of plaque accumulation and gingival inflammation. The results demonstrate its potential therapeutic value and open the door for larger scale placebo-controlled clinical studies to verify these findings., Competing Interests: The authors do not declare any serious conflicts of interest. K.M.J. is an employee of Integra Medical Inc., but did not participate in clinical data collection. K.M.J. performed data analysis and manuscript drafting.

Oral candidiasis is a disease caused by opportunistic species of Candida that normally reside on human mucosal surfaces. The transition of Candida from budding yeast to filamentous hyphae allows for covalent attachment to oral epithelial cells, followed by biofilm formation, invasion and tissue damage. In this study, combinations of Lactobacillus plantarum SD5870, Lactobacillus helveticus CBS N116411 and Streptococcus salivarius DSM 14685 were assessed for their ability to inhibit the formation of and disrupt Candida albicans biofilms. Co-incubation with probiotic supernatants under hyphae-inducing conditions reduced C. albicans biofilm formation by >75 % in all treatment groups. Likewise, combinations of live probiotics reduced biofilm formation of C. albicans by >67 %. When live probiotics or their supernatants were overlaid on preformed C. albicans biofilms, biofilm size was reduced by >63 and >65 % respectively. Quantitative real-time PCR results indicated that the combined supernatants of SD5870 and CBS N116411 significantly reduced the expression of several C. albicans genes involved in the yeast-hyphae transition: ALS3 (adhesin/invasin) by 70 % (P < 0.0001), EFG1 (hyphae-specific gene activator) by 47 % (P = 0.0061), SAP5 (secreted protease) by 49 % (P < 0.0001) and HWP1 (hyphal wall protein critical to biofilm formation) by >99 % (P < 0.0001). These findings suggest the combination of L. plantarum SD5870, L. helveticus CBS N116411 and S. salivarius DSM 14685 is effective at both preventing the formation of and removing preformed C. albicans biofilms. Our novel results point to the downregulation of several Candida genes critical to the yeast-hyphae transition, biofilm formation, tissue invasion and cellular damage.

Background: Infants with lower respiratory tract infections (LRTIs) are at an increased risk of developing childhood wheezing illnesses (including asthma), but it is not currently possible to predict those at risk for these long-term outcomes. The current objective was to examine whether urine levels of club cell 16-kDa secretory protein (CC16) at the time of an infant LRTI are associated with the development of childhood wheezing illnesses. Methods: Prospective study of 133 previously healthy infants enrolled during a healthcare visit for a LRTI and followed longitudinally for childhood wheezing illnesses. Urine levels of CC16 at the time of enrollment were measured after validating a commercially available enzyme-linked immunosorbent assay kit for serum. The outcome of interest was parental report of subsequent childhood wheeze (defined as ≥1 episode of wheezing following the initial LRTI) at the 1-year follow-up visit. Logistic regression was used for the main analysis. Results: The median (interquartile range) urine levels of CC16 (ng/mg of creatinine) at the time of an infant LRTI were 11.1 (7.7-20.1) for infants with subsequent childhood wheeze and 13.4 (8.3-61.1) for those without ( p  = 0.11). In the main multivariate analysis using a logarithmic transformation of the urine levels of CC16, a twofold increase in urine levels of CC16 was associated with ∼30% decreased odds (OR = 0.74 [95% confidence interval (CI) 0.56-0.98], p  = 0.04) of subsequent childhood wheeze after adjustment for potential confounders. Conclusions: An inverse association was found between urine levels of CC16 at the time of an infant LRTI and the odds of subsequent childhood wheeze. Urine CC16 may be a useful biomarker of the development of childhood wheezing illnesses after LRTIs in infancy.

Unlabelled: The adenovirus E1A gene is the first gene expressed upon viral infection. E1A remodels the cellular environment to maximize permissivity for viral replication. E1A is also the major transactivator of viral early gene expression and a coregulator of a large number of cellular genes. E1A carries out its functions predominantly by binding to cellular regulatory proteins and altering their activities. The unstructured nature of E1A enables it to bind to a large variety of cellular proteins and form new molecular complexes with novel functions. The C terminus of E1A is the least-characterized region of the protein, with few known binding partners. Here we report the identification of cellular factor DREF (ZBED1) as a novel and direct binding partner of E1A. Our studies identify a dual role for DREF in the viral life cycle. DREF contributes to activation of gene expression from all viral promoters early in infection. Unexpectedly, it also functions as a growth restriction factor for adenovirus as knockdown of DREF enhances virus growth and increases viral genome copy number late in the infection. We also identify DREF as a component of viral replication centers. E1A affects the subcellular distribution of DREF within PML bodies and enhances DREF SUMOylation. Our findings identify DREF as a novel E1A C terminus binding partner and provide evidence supporting a role for DREF in viral replication., Importance: This work identifies the putative transcription factor DREF as a new target of the E1A oncoproteins of human adenovirus. DREF was found to primarily localize with PML nuclear bodies in uninfected cells and to relocalize into virus replication centers during infection. DREF was also found to be SUMOylated, and this was enhanced in the presence of E1A. Knockdown of DREF reduced the levels of viral transcripts detected at 20 h, but not at 40 h, postinfection, increased overall virus yield, and enhanced viral DNA replication. DREF was also found to localize to viral promoters during infection together with E1A. These results suggest that DREF contributes to activation of viral gene expression. However, like several other PML-associated proteins, DREF also appears to function as a growth restriction factor for adenovirus infection., (Copyright © 2014, American Society for Microbiology. All Rights Reserved.)

Background and Objectives: Elderly patients require tunneled central vein dialysis catheters more often than younger patients. Little is known about the risk of catheter-related bloodstream infection in this population., Design, Setting, Participants, & Measurements: This study identified 464 patients on hemodialysis with tunneled central vein dialysis catheters between 2005 and 2007 and excluded patients who accrued <21 catheter-days during this period. Outpatient and inpatient catheter-related bloodstream infection data were collected. A Cox proportional hazards regression analysis adjusting for sex, ancestry, comorbidites, dialysis vintage, dialysis unit, immunosuppression, initial catheter site, and first antimicrobial catheter lock solution was performed for risk of catheter-related bloodstream infection between nonelderly (18-74 years) and elderly (≥ 75 years) patients., Results: In total, 374 nonelderly and 90 elderly patients with mean (SD) ages of 54.8 (12.3) and 81.3 (4.9) years and dialysis vintages of 1.8 (3.3) and 1.5 (2.9) years (P=0.47), respectively, were identified. Mean at-risk catheter-days were 272 (243) in nonelderly and 318 (240) in elderly patients. Between age groups, there were no significant differences in initial catheter site, type of catheter lock solution, or microbiology results. A total of 208 catheter-related bloodstream infection events occurred (190 events in nonelderly and 18 events in elderly patients), with a catheter-related bloodstream infection incidence per 1000 catheter-days of 1.97 (4.6) in nonelderly and 0.55 (1.6) in elderly patients (P<0.001). Relative to nonelderly patients, the hazard ratio for catheter-related bloodstream infection in the elderly was 0.33 (95% confidence interval, 0.20 to 0.55; P<0.001) after multivariate analysis., Conclusion: Elderly patients on hemodialysis using tunneled central vein dialysis catheters are at lower risk of catheter-related bloodstream infection than their younger counterparts. For some elderly patients, tunneled central vein dialysis catheters may represent a suitable dialysis access option in the setting of nonmaturing arteriovenous fistulae or poorly functioning synthetic grafts.

Background: Little is known about how U.S. physicians’ political affiliations, specialties, or sense of social responsibility relate to their reactions to health care reform legislation., Objective: To assess U.S. physicians’ impressions about the direction of U.S. health care under the Affordable Care Act (ACA), whether that legislation will make reimbursement more or less fair, and examine how those judgments relate to political affiliation and perceived social responsibility., Design: A cross-sectional, mailed, self-reported survey., Participants: Simple random sample of 3,897 U.S.physicians., Main Measures: Views on the ACA in general, reimbursement under the ACA in particular, and perceived social responsibility., Key Results: Among 2,556 physicians who responded (RR2: 65 %), approximately two out of five (41 %) believed that the ACA will turn U.S. health care in the right direction and make physician reimbursement less fair (44 %). Seventy-two percent of physicians endorsed a general professional obligation to address societal health policy issues, 65 % agreed that every physician is professionally obligated to care for the uninsured or underinsured, and half (55 %) were willing to accept limits on coverage for expensive drugs and procedures for the sake of expanding access to basic health care. In multivariable analyses, liberals and independents were both substantially more likely to endorse the ACA (OR 33.0 [95 % CI, 23.6–46.2]; OR 5.0 [95 % CI, 3.7–6.8], respectively), as were physicians reporting a salary (OR 1.7 [95 % CI, 1.2–2.5])or salary plus bonus (OR 1.4 [95 % CI, 1.1–1.9)compensation type. In the same multivariate models, those who agreed that addressing societal health policy issues are within the scope of their professional obligations (OR 1.5 [95 % CI, 1.0–2.0]), who believe physicians are professionally obligated to care for the uninsured / under-insured (OR 1.7 [95 % CI,1.3–2.4]), and who agreed with limiting coverage for expensive drugs and procedures to expand insurance coverage (OR 2.3 [95 % CI, 1.8–3.0]), were all significantly more likely to endorse the ACA. Surgeons and procedural specialists were less likely to endorse it (OR 0.5 [95 % CI, 0.4–0.7], OR 0.6 [95 %CI, 0.5–0.9], respectively)., Conclusions: Significant subsets of U.S. physicians express concerns about the direction of U.S. health care under recent health care reform legislation. Those opinions appear intertwined with political affiliation,type of medical specialty, as well as perceived social responsibility.

Background: The quality of communication in medical care has been shown to influence health outcomes. Cancer patients, a highly diverse population, communicate with their clinical care team in diverse ways over the course of their care trajectory. Whether that communication happens and how effective it is may relate to a variety of factors including the type of cancer and the patient's position on the cancer care continuum. Yet, many of the routine needs of cancer patients after initial cancer treatment are often not addressed adequately. Our goal is to identify areas of strength and areas for improvement in cancer communication by investigating real-time cancer consultations in a cross section of patient-clinician interactions at diverse study sites., Methods/design: In this paper we describe the rationale and approach for an ongoing observational study involving three institutions that will utilize quantitative and qualitative methods and employ a short-term longitudinal, prospective follow-up component to investigate decision-making, key topics, and clinician-patient-companion communication dynamics in clinical oncology., Discussion: Through a comprehensive, real-time approach, we hope to provide the fundamental groundwork from which to promote improved patient-centered communication in cancer care.

Introduction: Physicians vary in their moral judgments about health care costs. Social intuitionism posits that moral judgments arise from gut instincts, called "moral foundations." The objective of this study was to determine if "harm" and "fairness" intuitions can explain physicians' judgments about cost-containment in U.S. health care and using cost-effectiveness data in practice, as well as the relative importance of those intuitions compared to "purity", "authority" and "ingroup" in cost-related judgments., Methods: We mailed an 8-page survey to a random sample of 2000 practicing U.S. physicians. The survey included the MFQ30 and items assessing agreement/disagreement with cost-containment and degree of objection to using cost-effectiveness data to guide care. We used t-tests for pairwise subscale mean comparisons and logistic regression to assess associations with agreement with cost-containment and objection to using cost-effectiveness analysis to guide care., Results: 1032 of 1895 physicians (54%) responded. Most (67%) supported cost-containment, while 54% expressed a strong or moderate objection to the use of cost-effectiveness data in clinical decisions. Physicians who strongly objected to the use of cost-effectiveness data had similar scores in all five of the foundations (all p-values > 0.05). Agreement with cost-containment was associated with higher mean "harm" (3.6) and "fairness" (3.5) intuitions compared to "in-group" (2.8), "authority" (3.0), and "purity" (2.4) (p < 0.05). In multivariate models adjusted for age, sex, region, and specialty, both "harm" and "fairness" were significantly associated with judgments about cost-containment (OR = 1.2 [1.0-1.5]; OR = 1.7 [1.4-2.1], respectively) but were not associated with degree of objection to cost-effectiveness (OR = 1.2 [1.0-1.4]; OR = 0.9 [0.7-1.0])., Conclusions: Moral intuitions shed light on variation in physician judgments about cost issues in health care.

The broad diversity in physicians' judgments on controversial health care topics may reflect differences in religious characteristics, political ideologies, and moral intuitions. We tested an existing measure of moral intuitions in a new population (U.S. physicians) to assess its validity and to determine whether physicians' moral intuitions correlate with their views on controversial health care topics as well as other known predictors of these intuitions such as political affiliation and religiosity. In 2009, we mailed an 8-page questionnaire to a random sample of 2000 practicing U.S. physicians from all specialties. The survey included the Moral Foundations Questionnaire (MFQ30), along with questions on physicians' judgments about controversial health care topics including abortion and euthanasia (no moral objection, some moral objection, strong moral objection). A total of 1032 of 1895 (54%) physicians responded. Physicians' overall mean moral foundations scores were 3.5 for harm, 3.3 for fairness, 2.8 for loyalty, 3.2 for authority, and 2.7 for sanctity on a 0-5 scale. Increasing levels of religious service attendance, having a more conservative political ideology, and higher sanctity scores remained the greatest positive predictors of respondents objecting to abortion (β = 0.12, 0.23, 0.14, respectively, each p<0.001) as well as euthanasia (β = 0.08, 0.17, and 0.17, respectively, each p<0.001), even after adjusting for demographics. Higher authority scores were also significantly negatively associated with objection to abortion (β = -0.12, p<0.01), but not euthanasia. These data suggest that the relative importance physicians place on the different categories of moral intuitions may predict differences in physicians' judgments about morally controversial topics and may interrelate with ideology and religiosity. Further examination of the diversity in physicians' moral intuitions may prove illustrative in describing and addressing moral differences that arise in medical practice.

Importance: Physicians' views about health care costs are germane to pending policy reforms., Objective: To assess physicians' attitudes toward and perceived role in addressing health care costs., Design, Setting, and Participants: A cross-sectional survey mailed in 2012 to 3897 US physicians randomly selected from the AMA Masterfile., Main Outcomes and Measures: Enthusiasm for 17 cost-containment strategies and agreement with an 11-measure cost-consciousness scale., Results: A total of 2556 physicians responded (response rate = 65%). Most believed that trial lawyers (60%), health insurance companies (59%), hospitals and health systems (56%), pharmaceutical and device manufacturers (56%), and patients (52%) have a "major responsibility" for reducing health care costs, whereas only 36% reported that practicing physicians have "major responsibility." Most were "very enthusiastic" for "promoting continuity of care" (75%), "expanding access to quality and safety data" (51%), and "limiting access to expensive treatments with little net benefit" (51%) as a means of reducing health care costs. Few expressed enthusiasm for "eliminating fee-for-service payment models" (7%). Most physicians reported being "aware of the costs of the tests/treatments [they] recommend" (76%), agreed they should adhere to clinical guidelines that discourage the use of marginally beneficial care (79%), and agreed that they "should be solely devoted to individual patients' best interests, even if that is expensive" (78%) and that "doctors need to take a more prominent role in limiting use of unnecessary tests" (89%). Most (85%) disagreed that they "should sometimes deny beneficial but costly services to certain patients because resources should go to other patients that need them more." In multivariable logistic regression models testing associations with enthusiasm for key cost-containment strategies, having a salary plus bonus or salary-only compensation type was independently associated with enthusiasm for "eliminating fee for service" (salary plus bonus: odds ratio [OR], 3.3, 99% CI, 1.8-6.1; salary only: OR, 4.3, 99% CI, 2.2-8.5). In multivariable linear regression models, group or government practice setting (β = 0.87, 95% CI, 0.29 to 1.45, P = .004; and β = 0.99, 95% CI, 0.20 to 1.79, P = .01, respectively) and having a salary plus bonus compensation type (β = 0.82; 95% CI, 0.32 to 1.33; P = .002) were positively associated with cost-consciousness. Finding the "uncertainty involved in patient care disconcerting" was negatively associated with cost-consciousness (β = -1.95; 95% CI, -2.71 to -1.18; P < .001)., Conclusion and Relevance: In this survey about health care cost containment, US physicians reported having some responsibility to address health care costs in their practice and expressed general agreement about several quality initiatives to reduce cost but reported less enthusiasm for cost containment involving changes in payment models.