One-hundred bloodstream isolates of C. parapsilosis complex from three hospitals in Rio de Janeiro city, Brazil, between 1998 and 2006 were analyzed. C. parapsilosis sensu stricto (61 %) was the predominant species, followed by C. orthopsilosis (37 %) and C. metapsilosis

(2 %). Most isolates were susceptible to the tested drugs. However, one C. parapsilosis sensu stricto isolate was considered resistant for amphotericin B. The essential agreement was 100 % between the methods, except for itraconazole (96.3 %). The categorical JNK inhibitors agreement varied for fluconazole and itraconazole by Etest and for amphotericin B and fluconazole by Vitek 2. This study reinforces the suitability of the commercial methods in routine clinical microbiology laboratories for antifungal susceptibility testing.”
“In assisted reproduction, there is strong evidence for some things done, but no or only very weak evidence for others. There are several reasons for Dorsomorphin research buy this. Most assisted reproduction procedures have small signal-to-noise ratios. This means that their treatment effect is sometimes only little better than the spontaneous conception rate, or the conception rate with traditional treatment. Hence, large trials are required. These demand complex multicentre logistics. The latter require substantial

funding and funding for reproductive medicine in most countries is notoriously difficult to obtain (as opposed, for example, to oncology research or cardiovascular research). Apart from these funding issues, the creation of embryos specifically for research is only allowed in a limited number of European countries, thus tempting clinicians to skip preclinical studies altogether and go directly for clinical application in their patients, raising an ethical issue. Introducing new treatments into the clinic without proper evidence, however, is perhaps even more of an ethical issue. Subfertile couples are very vulnerable and should not be exploited. (C) 2013, Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.”
“This review examines

the risk factors for the development of systemic lupus erythematosus (SLE) flares during pregnancy. In preconception, anti-DNA, hypocomplementemia, previous thrombosis, triple antiphospholipid (aPL) antibody positivity, active lupus nephritis and discontinuation of medications such as hydroxychloroquine and azathioprine selleck products are factors associated with pregnancy failure. During pregnancy, SLE flares are associated with aPL antibodies, synergic changes of pregnancy on Th1 and TH2 cytokines, other cytokines and chemokines that interact with hormones such as estrogen and prolactin that amplify the inflammatory effect. From the clinical point of view, SLE activity at pregnancy onset, thrombocytopenia, lupus nephritis, arterial hypertension, aPL syndromes, preeclampsia is associated with lupus flares and fetal complications. In puerperium, the risk factors of flares are similar to pregnancy.

Yet, both mechanisms could be differentiated based on alternative experiments and structural considerations.”
“From the anti-tumor active N-tryptophanyl-beta-carboline-3-carboxylic

acid benzyl ester and beta-carboline-3-carbonyltryptophan benzyl ester, a pharmacophore, Trp-Trp-OBzl, was drawn. Based on the DOCK scores amino acid residue was inserted into the C-terminus of Trp-Trp-OBzl and twenty Trp-Trp-AA-OBzls (AA = amino acid residues) were provided as DNA intercalators. On the in vitro and in vivo models seventeen Trp-Trp-AA-OBzls were anti-tumor active, and twelve Trp-Trp-AA-OBzls were more active than cytarabine. AR-13324 nmr In acute toxicity assay Trp-Trp-AA-OBzls did not damage the immunologic function and had an LD50 of more than 500 mg/kg. The relationships of structure and activity were analyzed with 3D QSAR The action mechanism studies revealed that the in vivo anti-tumor action of Trp-Trp-AA-OBzls was the result of DNA intercalation. (C) 2011 Elsevier Masson SAS. All rights STA-9090 research buy reserved.”
“This study was undertaken to define whether differences in the expression of Wnt pathway components are present between normal colonic mucosa, early (tubular) adenomas and villous adenomas which have

a higher malignant potential. Normal mucosa, tubular adenomas and villous adenomas were obtained from twelve patients. RNA was isolated and utilized for Wnt pathway-specific membrane array expression analysis. Quantitative real-time polymerase chain reaction (qRT-PCR) and fluorescent immunohistochemistry (IHC) were utilized for

confirmatory analyses. Fifteen Wnt pathway-related genes showed differential expression between villous adenomas and normal mucosa and villous click here and tubular adenomas at a significance level of p<0.01. Genes involved in canonical Wnt (B-catenin) signaling with increased expression in villous adenomas included wnt1, fz2, csnk2A2, pygo2, pygo1, frat2 and myc, the latter confirmed by qRT-PCR and IHC. Myc protein expression was confined primarily to stromal components of villous adenomas. Genes involved in non-canonical Wnt signaling with increased expression in villous adenomas included rho-u, daam1, damm2, cxxc4 and nlk. Successive increases in the expression of ctnnb1 (B-catenin) from normal to tubular adenomas to villous adenomas was seen. The Wnt pathway gene expression profile can differentiate between tubular and villous adenomas. These data suggest that Wnt signaling regulation changes during the progression from normal mucosa to tubular adenomas to villous adenomas. Expression of Myc in adenoma stroma suggests a dynamic signaling network within adenomas between mucosal and stromal elements. Inhibition of the Wnt pathway may provide a novel approach for cancer prevention in patients with benign tubular adenomas.”
“In evolutionary terms, IgG is the most recent addition to the human humoral immune response, the most recent of the 5 isotypes (classes).

Finally, the great morphologic plasticity of bivalves from rather distinct systematic entities is shown to result from different causes, thus demonstrating that careful studies of the involved species are a prerequisite to draw correct palaeoecological conclusions.”
“Borrelia miyamotoi, a member of the relapsing fever group borreliae, was

first isolated in Japan and subsequently found JNJ-26481585 inhibitor in Ixodes ticks in North America, Europe and Russia. Currently, there are three types of Borrelia miyamotoi: Asian or Siberian (transmitted mainly by lxodes persulcatus), European (Ixodes ricinus) and American (Ixodes scapularis and Ixodes pacificus). Despite the great genetic distances between Borrelia miyamotoi types, isolates within a type are characterised by an extremely low genetic variability. In particular, strains of Borrelia miyamotoi of Asian type, isolated in Russia from the Baltic sea to the Far East, have been shown to be identical based on the analysis of several conventional genetic markers, such as 16S rRNA, flagellin, outer membrane protein p66 and glpQ genes. Thus, protein or rRNA – coding genes were shown not to be informative enough in studying genetic diversity of Borrelia miyamotoi within a type. In the present paper, we have attempted to design a new multilocus technique based on eight non-coding inter-genic spacers (3686 bp in total) and have applied it to the analysis of intra-type genetic

variability of Borrelia miyamotoi detected in different regions of Russia and from two tick species, I. persulcatus and Ixodes pavlovskyi. However, even though potentially the most variable loci were selected, SCH727965 supplier no genetic variability between studied DNA samples was found, except for one nucleotide substitution in two of them. The sequences obtained were identical to those of the reference strain FR64b. Analysis of the data obtained with the GenBank sequences

indicates a highly homogeneous genetic background of Borrelia miyamotoi from the Baltic LOXO-101 Sea to the Japanese Islands. In this paper, a hypothesis of clonal expansion of Borrelia miyamotoi is discussed, as well as possible mechanisms for the rapid dissemination of one Borrelia miyamotoi clone over large distances. (C) 2015 Elsevier B.V. All rights reserved.”
“Background An improved understanding of the characteristics, treatment, and outcome of patients with “Stage D” heart failure (HF) may improve patient outcomes. We conducted an analysis of the ADHERE LM to enhance this understanding.\n\nMethods ADHERE LM is a multicenter registry designed specifically to prospectively collect observational data on chronic Stage D HF. The findings were analyzed and compared to data from ADHERE CM, a multicenter registry designed to prospectively collect data on the entire spectrum of acute decompensated HF. Descriptive statistics and Kaplan-Meier analysis were used to evaluate data from all 1433 patients in ADHERE LM.

Almost all the compounds in HEK cells heterogeneously expressed TRPV1 or TRPA1, increased the intracellular Ca(2+) concentration ([Ca(2+)](i)) in a concentration-dependent manner. Among these, piperine, isopiperine, isochavicine, piperanine, pipernonaline, dehydropipernonaline, retrofractamide C, piperolein A, and piperolein B relatively strongly activated TRPV1. The EC(50) values of these compounds for TRPV1 were 0.6-128 mu m. Piperine, isopiperine,

isochavicine, piperanine, piperolein A, piperolein B, and N-isobutyl-(2E,4E)-tetradeca-2,4-diamide also relatively strongly activated TRPA1, the EC50 values of these compounds for TRPA1 were 7.8-148 mu M. The Ca(2+) responses of these compounds for TRPV1 and TRPA1 were significantly suppressed by co-applying each antagonist.

We identified in this study new transient receptor potential (TRP) PF-03084014 mouse agonists present Selleck Bafilomycin A1 in black pepper and found that piperine, isopiperine, isochavicine, piperanine, piperolein A, and piperolein B activated both TRPV1 and TRPA1.”
“Fed-batch cultivations of Streptomyces coelicolor, producing the antibiotic actinorhodin, were monitored online by multiwavelength fluorescence spectroscopy and off-gas analysis. Partial least squares (PLS), locally weighted regression, and multilinear PLS (N-PLS) models were built for prediction of biomass and substrate (casamino acids) concentrations, respectively. The effect of combination of fluorescence and gas analyzer data as well as of different variable selection methods was investigated. Improved prediction models were obtained by combination of data from the two sensors and by

variable selection using Selleckchem QNZ a genetic algorithm, interval PLS, and the principal variables method, respectively. A stepwise variable elimination method was applied to the three-way fluorescence data, resulting in simpler and more accurate N-PLS models. The prediction models were validated using leave-one-batch-out cross-validation, and the best models had root mean square error of cross-validation values of 1.02 g l(-1) biomass and 0.8 g l(-1) total amino acids, respectively. The fluorescence data were also explored by parallel factor analysis. The analysis revealed four spectral profiles present in the fluorescence data, three of which were identified as pyridoxine, NAD(P)H, and flavin nucleotides, respectively.”
“Flow-mediated dilation (FMD) assesses the health of the vascular endothelium. Despite widespread adoption of scaling practices in cardiac research, scaling for body size or composition has not been used for FMD. The present study investigated the relationships between brachial FMD and body composition in 129 children aged 9-10 (75a (TM) Euro, 54a (TM),), and 50 men aged 16-49.

This conditional expectation is computed from estimates of the probability density function of the light collection process and a model of the kinetics of photon interactions in the detector module. Our algorithm is capable of handling coincidences where each annihilation photon interacts any number of times within the detector module before being completely absorbed or escaping. In the case of multiple interactions, our see more algorithm estimates the position of the first interaction for each of the coincidence photons. This LOR estimation algorithm is developed

for a high-resolution PET detector capable of providing depth-of-interaction information. Depth of interaction is measured by tailoring the light shared between two adjacent detector elements. These light-sharing crystal pairs are referred to as dMiCE and are being developed in our lab. Each detector element in the prototype system has a 2 x 2 mm(2) cross section and is directly coupled to a micro-pixel avalanche photodiode (MAPD). In this set-up, the distribution of the ratio of light shared between two adjacent detector

elements can be expressed as a function of GDC-0994 manufacturer the depth of interaction. Monte Carlo experiments are performed using our LOR estimation algorithm and compared with Anger logic. We show that our LOR estimation algorithm provides a significant improvement over Anger logic under a variety of parameters.”
“The aim of this study was to apply a behavioural stress paradigm for studying the neural mechanisms underlying stress-induced arrhythmias, and to test whether such arrhythmias could be suppressed by systemic administration of 8-OH-DPAT, a 5-HT1A agonist possessing central

sympatholytic properties. The study was conducted on adult male rats instrumented for telemetric recordings of ECG, body temperature and locomotor activity. In the first experiment, P505-15 research buy rats were subjected to social defeat after either 8-OH-DPAT (100 mu g/kg s.c.) or vehicle injection. In the second experiment, prior to vehicle/8-OH-DPAT administration, animals were pre-treated with zatebradine, a blocker of the pacemaker current. 8-OH-DPAT caused prolongation of basal RR interval, increase in locomotion and hypothermia. Subjecting vehicle-treated animals to social defeat caused shortening in RR interval, increase in locomotor activity and hyperthermia, and provoked the occurrence of premature ventricular and supraventricular beats; all these effects were substantially attenuated by 8-OH-DPAT. Zatebradine caused prolongation of RR interval, In zatebradine/vehicle-treated rats, the incidence of ventricular and supraventricular premature beats during defeat increased 2.5-fold and 3.5-fold, respectively. 8-OH-DPAT administered after zatebradine significantly reduced these stress-induced arrhythmias.

The robot is a nearly-buoyant

bi-component system consisting of a carrier, in which the therapeutic agent is embedded, and a piston. The piston, by exploiting magnetic effects, docks with the carrier and compresses a drug-loaded hydrogel, thus activating the release mechanism. External magnetic fields are exploited to propel the robot towards the target region, while intermagnetic forces are exploited to trigger drug release. After designing and fabricating the robot, the system has been tested in vitro with an anticancer drug (doxorubicin) embedded in the carrier. The efficiency of the drug release mechanism has been demonstrated by both quantifying the amount of drug released and by assessing the efficacy of this therapeutic procedure on human bladder cancer cells.”
“Successful find more implantation and long-term survival of engineered tissue grafts hinges on adequate vascularization of the implant. Endothelial cells are essential for patterning vascular structures, but they require supportive mural cells such as pericytes/mesenchymal stem cells (MSCs) to generate stable, functional blood vessels. While there is evidence that the angiogenic effect of MSCs is mediated via the secretion of paracrine signals, the identity of these MI-503 cost signals is unknown. By utilizing two functionally distinct human MSC clones,

we found that so-called “pericytic” MSCs secrete the pro-angiogenic vascular guidance molecule SLIT3, which guides vascular development by directing ROBO4-positive endothelial cells to form networks in engineered tissue. In contrast, “non-pericytic” MSCs exhibit reduced activation of the SLIT3/ROBO4 pathway and do not support vascular networks. Using live cell imaging of organizing 3D vascular networks, we show that siRNA knockdown of SLIT3 in MSCs leads to disorganized clustering of ECs. Knockdown of its receptor ROBO4 in ECs abolishes the generation of functional human blood vessels in an in vivo xenogenic implant. These data suggest that the SLIT3/ROBO4 pathway is required for MSC-guided vascularization AZD9291 cell line in engineered tissues. Heterogeneity of SLIT3

expression may underlie the variable clinical success of MSCs for tissue repair applications. (C) 2013 The Authors. Published by Elsevier Ltd. All rights reserved.”
“Objective: To evaluate peritoneal carcinomatosis inpatients with gastrointestinal and gynecologic malignancies and to assess the diagnostic role for 18-FDG-PET and MDCT alone in comparison to the diagnostic accuracy of fused 18F-FDG-PET/MDCT by using surgical and histopathological findings as the standard of reference.\n\nMethods and subjects: Sixty-two patients (13 males, 49 females; age range 43-81; mean age, 62 years with suspected peritoneal carcinomatosis were reviewed for the presence of peritoneal lesions on 18F-FDG-PET/MDCT scans (Discovery LS, GE Medical Systems). The results were compared with the histological findings at laparatomy.

Otherwise, the distribution of clinical and biological risk factors including stage, ferritin, initial treatment, grade of NB differentiation, MKI, 11q, 1p, and 17q were similar between patients with GNBn and check details the overall INRG cohort. EFS and OS were 54% +/- 5% and 68% +/- 5%, respectively. A cohort with superior outcome was identified: OS for GNBn patients younger than 18 months was 95% +/- 5% (n = 39) and for GNBn

patients with stage 1, 2, 3, 4s was 95% +/- 3% (n = 125). Conversely, a poor outcome sub-group could also be identified: OS for stage 4 was 35% +/- 7% (n = 107).\n\nConclusions: Patients with GNBn tumours are rare and have a very heterogeneous outcome. Except for LDH and MKI, the factors prognostic in the overall NB cohort are also prognostic in patients with GNBn. Similar to the overall NB cohort, patients with GNBn older than 18 months of age, with stage 4 disease represent a high-risk sub-group and should be considered for aggressive treatment upfront. (C) mTOR inhibitor 2011 Elsevier Ltd. All rights reserved.”
“Background: Left ventricular hypertrabeculation/noncompaction is mainly detected by echocardiography. Left ventricular hypertrabeculation/noncompaction is commonly associated with cardiac and extra-cardiac disorders, preferentially neuromuscular disorders.

Left ventricular hypertrabeculation/noncompaction is mainly located within the left ventricular apex, lateral, posterior and anterior wall but only rarely in the medial and basal portions of the interventricular septum. Aim of the present review is to summarize the knowledge about septal affection in left ventricular hypertrabeculation/noncompaction.\n\nResults and conclusions: Septal affection in DUB inhibitor left ventricular hypertrabeculation/noncompaction is a finding in predominantly children and adolescents.

Septal left ventricular hypertrabeculation/noncompaction occurs more in females than in males. Patients with septal left ventricular hypertrabeculation/noncompaction have a poor prognosis. Septal left ventricular hypertrabeculation/noncompaction is most likely congenital. The association of septal left ventricular hypertrabeculation/noncompaction with extracardiac abnormalities and neuromuscular disorders remains unclear. Presumably left ventricular hypertrabeculation/noncompaction affecting the septum does not represent a cardiac manifestation of a neuromuscular disorder. (C) 2008 Published by Elsevier Ireland Ltd.”
“This is a novel study aimed at exploring possible tissue engineering (TE) options for fabricating middle ear ossicle replacements. Alternatives to prosthetic replacements currently used in ossiculoplasty are desirable, considering that current devices are known to suffer from a persistent rejection phenomenon, known as extrusion.

fourth rib methods. The current study tests Hartnett’s revised methods as well as the original Suchey-Brooks and Iscan etal. methods on a modern sample from the William Bass Skeletal Collection (N=313, mean age=58.5, range 19-92). Results show that the Suchey-Brooks and Iscan etal. methods assign individuals

to the correct phase 70.8% and 57.5% of the time compared with Hartnett’s revised methods at 58.1% and 29.7%, respectively, with correctness scores based on one standard deviation of 3-Methyladenine supplier the mean rather than the entire age range. Accuracy and bias scores are significantly improved for Hartnett’s revised pubic symphysis method and marginally better for Hartnett’s revised fourth rib method, suggesting that the revised mean ages at death of Hartnett’s phases better reflect this modern Napabucasin population. Overall, both Hartnett’s revised methods are reliable age estimation methods. For the pubic symphysis, there are significant improvements in accuracy and bias scores, especially for older individuals; however, for the fourth rib, the results are comparable to the original Iscan etal. methods, with some improvement for older individuals.”
“Directing spatial attention to a location inside the classical receptive field (cRF) of a neuron in macaque medial temporal area (MT) shifts the center of the cRF toward the attended location. Here

we investigate the influence of spatial attention on the profile of the inhibitory surround present in many MT neurons. Two monkeys attended to the fixation point or to 1 of 2 random dot patterns (RDPs) placed inside or next to the cRF, whereas a third RDP (the probe) was briefly presented in quick succession across the

cRF and surround. The probe presentation responses were used to compute a map of the excitatory receptive field and its inhibitory surround. Attention systematically reshapes the receptive ZD1839 nmr field profile, independently shifting both center and surround toward the attended location. Furthermore, cRF size is changed as a function of relative distance to the attentional focus: attention inside the cRF shrinks it, whereas directing attention next to the cRF expands it. In addition, we find systematic changes in surround inhibition and cRF amplitude. This nonmultiplicative push-pull modulation of the receptive field’s center-surround structure optimizes processing at and near the attentional focus to strengthen the representation of the attended stimulus while reducing influences from distractors.”
“Background & Aims: IL-17 secreting CD4 (Th17) and CD8 (Tc17) T cells have been implicated in immune-mediated liver diseases, but the molecular basis for their recruitment and positioning within the liver is unknown.\n\nMethods: The phenotype and migratory behaviour of human liver-derived Th17 and Tc17 cells were investigated by flow cytometry and chemotaxis and flow-based adhesion assays. The recruitment of murine Th17 cells to the liver was studied in vivo using intra-vital microscopy.

“
“Objective. To identify key determinants of patient satisfaction.\n\nDesign. Data used were obtained through a self-administered, post-visit questionnaire by random sampling during the period of January 2009 to September 2009.\n\nSetting. Thirty-nine hospitals in Germany.\n\nParticipants. A total of 8428 patients.\n\nMain Outcome Measure. Global patient satisfaction was measured by a single item question. Attributes of medical aspects of care were measured using 12 items, performance of service using 3 items and different dimensions of patient expectations

using 12 items. Medical aspects of care and performance of service items were entered into logistic regression analysis to identify determinants of patient satisfaction.\n\nResults. The results of the analysis

showed that there are 10 determinants of global Stem Cell Compound Library cell line patient satisfaction. The outcome of treatment was overall, the most salient predictor followed by nursing kindness as the second most important component. Items reflecting information receiving about the undergoing treatment do not have a major influence on patient satisfaction.\n\nConclusion. The analysis identified key determinants that should BMS-777607 manufacturer be altered first in order to improve global patient satisfaction. The results also indicate that some aspects of the hospital stay are not seen as relevant by patients and therefore are unrelated to satisfaction ratings. The findings suggest that variables measuring patients’ perceptions of care are more important determinants of global patient satisfaction in comparison to demographics and visit characteristics. Results of the present study have implications for health providers

aiming at improving the service quality and quality of care.”
“Systemic lupus erythematosus (SLE) is a prototypical autoimmune disease with strong genetic and environmental components. Previous studies have shown increased levels of several chemokines in active SLE. C-C chemokine receptor type 5 (CCR5) is involved in the recruitment of inflammatory cells into tissues, and mechanisms modulating CCR5 expression and function may interfere in SLE development, influencing the clinical course of the Selleckchem Adriamycin disease. The aim of this study was to evaluate the possible association between the CCR532 base-pair deletion polymorphism and SLE disease in a group of Portuguese patients. A total of 219 patients with SLE and 205 healthy individuals were studied. The frequency of CCR5/32 heterozygotes was lower in patients with SLE than in controls (8% vs. 15% OR=0.5162; P=0.0319), suggesting a protective association between CCR532 allele and SLE. These results highlight the protective role of Th1 cells that express CCR5 in SLE pathogenesis.”
“The electrical impedance of samples of mouse brain cortex has been measured between 4.7 kHz and 2.0 MHz.

It has been shown that the sedimentable slightly charged HA-BSA complexes are the most efficient to compete with HAase and release it. All the HA-BSA complexes are hydrolysable by HAase. The HA-BSA binding site shows that one BSA molecule

is associated with 85-170 HA carboxyl groups, depending on pH. Similar results have been obtained for lysozyme over an extended pH domain, including the neutrality. (C) 2011 Elsevier Ltd. All rights reserved.”
“Ovar-DRB1 is one of the most important response genes in the major histocompatibility complex (MHC) class II region of sheep. Gene polymorphism in the second exon of Ovar-DRB1 in three different Iranian fat-tailed sheep breeds (Lori-Bakhtiari, Shaul and Zandi) XMU-MP-1 was analyzed by either restriction fragment length polymorphisms (RFLP) or direct sequencing. A total of 92 Lori-Bakhtiari, 40 Shaul, and 47 Zandi sheep were examined. PCR-RFLP identified 17 genotypes in Lori-Bakhtiari sheep, 12 in Shaul sheep and 11 in Zandi sheep. Collectively, 24 different

genotypes could be found for Iranian fat-tailed sheep. Using direct sequencing, seven new sequences in exon 2 of the Ovar-DRB1 gene were identified. Generalized linear modeling with a multinomial error structure showed that the sheep populations had significantly different allele frequencies. (C) 2011 Elsevier Ltd. All rights reserved.”
“Background: Although CPAP is a highly efficacious treatment for obstructive sleep apnea (OSA), low adherence presents a significant challenge for sleep medicine clinicians. The present study aimed to evaluate the relationship between insomnia check details symptoms and CPAP use. We hypothesized that pre-treatment insomnia complaints would be associated with poorer CPAP adherence at clinical follow-up.\n\nMethods: This was a retrospective chart review of 232 patients (56.5% men,

mean age = 53.6 +/- 12.4 years) newly diagnosed with OSA (mean AHI = 41.8 +/- 27.7) and prescribed CPAP in the Johns Hopkins Sleep Disorder Center. Difficulty initiating sleep, difficulty maintaining sleep, and early morning awakening were measured via three self-report items. CPAP use was measured via objective electronic monitoring cards.\n\nResults: Thirty-seven percent of the sample reported at least one frequent insomnia complaint, with 23.7% reporting difficulty maintaining sleep, 20.6% reporting early morning awakening and 16.6% reporting difficulty click here initiating sleep. After controlling for age and gender, sleep maintenance insomnia displayed a statistically significant negative relationship with average nightly minutes of CPAP use (p < .05) as well as adherence status as defined by the Centers for Medicaid and Medicare Services (p < .02).\n\nConclusions: To our knowledge, these are the first empirical data to document that insomnia can be a risk factor for poorer CPAP adherence. Identifying and reducing insomnia complaints among patients prescribed CPAP may be a straightforward and cost-effective way to increase CPAP adherence.