Corrigendum: Development of sandwich dot-ELISA for specific detection of Ochratoxin A and its application on to contaminated cereal grains originating from India.

[This corrects the article DOI: 10.3389/fmicb.2015.00511.].

A comparative study on electrochemical performance of KOH activated carbons derived from different biomass sources - Musa acuminata stem, Pongamia pinnata seed oil extract cake, cajanus cajan stem and Asclepias syriaca floss.

In the present scenario of research, the recycling of inexpensive widely available agricultural waste/biowaste to activate carbon (AC) and procurement of value-added product has significant impact on energy storage systems, particularly in Electrochemical double layer capacitors (EDLCs). Herein, we report the production of KOH activated carbons from different biomass sources such as Musa Acuminata stem (MAC), Pongamia pinnata seed oil extract cake (PPC), Cajanus Cajan stem (CCC) and Asclepias syriaca floss (ASC) for the said purpose. Initially, the biomass materials were pyrolyzed at 550 °C and then activated with KOH at 800 °C. All the carbon materials were characterized for their physico-chemical properties by various analytical techniques and compared. Further, these materials were studied for their electrochemical performance using suitable electro-analytical techniques in 1 M KOH solution. ACs (Activated carbons) derived from MAC, PPC, CCC & ASC were estimated in three electrode system and were found to exhibit a specific capacitance (Cs) of 358, 343, 355 & 540 F/g at a scan rate of 2 mV/s and 102, 188, 253 & 256 F/g at a current density of 2.5 A/g respectively. The main novel objective of this work is to correlate the morphological and surface properties of these ACs obtained from different biomass sources with electrochemical performance. A symmetric coin cell constructed with ASC material exhibited Cs of 67 F/g at a current density of 2.5 A/g with maximum energy & power densities (ED & PD) of 37.2 W h/kg and 19.9 kW/kg respectively. Further the cell showed 25,000 cycles stability with 86% Cs retention and 100% coulombic efficiency.

Determining the best anti-microbial properties of dental cements used for pulp capping procedures using deep dentinal carious material.

Introduction: The exposure of the healthy pulp in cases of deep dentinal caries (DDC) that contain carious microorganisms can be prevented by placing a layer of pulp capping agent on the affected dentin. The cements used for pulp-capping should also ensure good anti-microbial properties. The present study was carried out to detect the antimicrobial efficacy of the commonly used cements by culturing the samples directly from DDC. Aims: To determine the efficacy of dental cements in the growth inhibition of microorganisms involved in DDC using direct contact anaerobic culture test. Method: 100 samples of DDC were collected in RTF. Ten microliters of the specimen containing RTF was incubated in thioglycolate broth consisting of 1 mm3 cement blocks of GIC, CaOH2, ZnOE and MTA anaerobically for 24 hours. This was further sub-cultured using selective media for streptococcus mutans, lactobacillus and bifidobacterium. Growth inhibition was measured by calculating the number of CFUs and statistically analysed using ANOVA and Tukey's post-hoc tests. Results: Tests showed variation in the anti-microbial effects of the cements and was highly significant at P < 0.001. Bifidobacterium showed most number of CFUs. MTA was the most effective pulp capping agent exhibiting 87.13% reduction in microbial growth, followed closely by ZnOE (84.6%). Conclusion: A conservative approach to treat DDC is the need of the hour which calls for the use of pulp capping cements of good antimicrobial efficacy. The current study revealed bifidobacterium to be the most prevalent in DDC and the cement that would best inhibit the mixed culture growth was MTA followed closely by ZnOE.

MedDRA Labeling Groupings to Improve Safety Communication in Product Labels.

The granularity and structure of the International Council for Harmonisation's (ICH) Medical Dictionary for Regulatory Activities (MedDRA) are useful for precise coding of adverse events (AEs) for data analysis. In product labeling for healthcare practitioners, however, the granularity of MedDRA Preferred Terms (PTs) can obscure the communication of adverse reactions (ARs). Driven by a focus on patient safety, business needs, and regulatory guidance, many sponsors and regulators have begun to develop institution-specific approaches to clustering similar AR terms in medical product prescribing information on a product-by-product basis. However, there are no agreed upon conventions that describe which AR terms may be appropriate to group together. In order to improve safety communication to patients and healthcare providers, there is an urgent need for a harmonized international approach to the creation and use of groups of MedDRA PTs which we refer to as "MedDRA Labeling Groupings (MLGs)" in medical product prescribing information. Given its long-standing contributions towards the design of Standardised MedDRA Queries (SMQs), the Council for International Organizations of Medical Sciences (CIOMS) convened an Expert Working Group (EWG) with involvement of multiple major stakeholders to produce a consensus document on principles and points to consider in the development of MLGs. The CIOMS MLG EWG identified variations in grouping of MedDRA PTs in product labels, and in the current document, proposes a strategy for improving the communication of drug safety labeling. It is envisaged that the use of these consensus recommendations would be voluntary and applied to product labels in a manner that is consistent with existing regulatory frameworks.

Quantifying the impact of immune history and variant on SARS-CoV-2 viral kinetics and infection rebound: A retrospective cohort study.

Background: The combined impact of immunity and SARS-CoV-2 variants on viral kinetics during infections has been unclear. Methods: We characterized 1,280 infections from the National Basketball Association occupational health cohort identified between June 2020 and January 2022 using serial RT-qPCR testing. Logistic regression and semi-mechanistic viral RNA kinetics models were used to quantify the effect of age, variant, symptom status, infection history, vaccination status and antibody titer to the founder SARS-CoV-2 strain on the duration of potential infectiousness and overall viral kinetics. The frequency of viral rebounds was quantified under multiple cycle threshold (Ct) value-based definitions. Results: Among individuals detected partway through their infection, 51.0% (95% credible interval [CrI]: 48.3-53.6%) remained potentially infectious (Ct <30) 5 days post detection, with small differences across variants and vaccination status. Only seven viral rebounds (0.7%; N=999) were observed, with rebound defined as 3+days with Ct <30 following an initial clearance of 3+days with Ct ≥30. High antibody titers against the founder SARS-CoV-2 strain predicted lower peak viral loads and shorter durations of infection. Among Omicron BA.1 infections, boosted individuals had lower pre-booster antibody titers and longer clearance times than non-boosted individuals. Conclusions: SARS-CoV-2 viral kinetics are partly determined by immunity and variant but dominated by individual-level variation. Since booster vaccination protects against infection, longer clearance times for BA.1-infected, boosted individuals may reflect a less effective immune response, more common in older individuals, that increases infection risk and reduces viral RNA clearance rate. The shifting landscape of viral kinetics underscores the need for continued monitoring to optimize isolation policies and to contextualize the health impacts of therapeutics and vaccines. Funding: Supported in part by CDC contract #200-2016-91779, a sponsored research agreement to Yale University from the National Basketball Association contract #21-003529, and the National Basketball Players Association.

Clear cell adenomatoid odontogenic tumour and dentigerous cyst: an uncommon hybrid combination - case and review.

Odontogenic tumours and cysts have a characteristic presentation, histopathologically and clinically. The diagnostic criteria and nomenclature are distinct as elaborated in 2017 WHO classification. But one can occasionally and infrequently find an association between different odontogenic tumours and cysts, like calcifying epithelial odontogenic tumour (CEOT) and adenomatoid odontogenic tumour (AOT), CEOT and ghost cell tumour. Some of the odontogenic tumours and cysts share the site of occurrence, intraosseous location, teeth involved/quadrant involved and histopathology too. Hence these lesions are considered for differential diagnoses in most cases. But some instances report hybrid or associated tumours and cyst cases. Here we present a case of dentigerous cyst in association with AOT that showed variation in cell type, pattern and induction pattern.

Viral dynamics and duration of PCR positivity of the SARS-CoV-2 Omicron variant

BackgroundThe combined impact of immunity and SARS-CoV-2 variants on viral kinetics during infections has been unclear. MethodsWe characterized 2,875 infections from the National Basketball Association occupational health cohort identified between June 2020 and January 2022 using serial RT-qPCR testing. Logistic regression and semi-mechanistic viral RNA kinetics models were used to quantify the effect of variant, symptom status, age, infection history, vaccination and antibody titer to founder SARS-CoV-2 strain on the duration of potential infectiousness and overall viral kinetics. The frequency of viral rebounds was quantified under multiple cycle threshold (Ct) value-based definitions. ResultsAmong individuals detected partway through their infection, 51.0% (95% credible interval [CrI]: 48.2-53.6%) remained potentially infectious (Ct<30) five days post detection, with small differences across variants and vaccination history. Only seven viral rebounds (0.7%; N=999) were observed, with rebound defined as 3+ days with Ct<30 following an initial clearance of 3+ days with Ct[≥]30. High antibody titers against the founder SARS-CoV-2 strain predicted lower peak viral loads and shorter durations of infection. Among Omicron BA.1 infections, boosted individuals had lower pre-booster antibody titers and longer clearance times than non-boosted individuals. ConclusionsSARS-CoV-2 viral kinetics are partly determined by immunity and variant but dominated by individual-level variation. Since booster vaccination protects against infection, longer clearance times for BA.1-infected, boosted individuals may reflect a less effective immune response, more common in older individuals, that increases infection risk and reduces viral RNA clearance rate. The shifting landscape of viral kinetics underscores the need for continued monitoring to optimize isolation policies and to contextualize the health impacts of therapeutics and vaccines. FundingSupported in part by CDC contract 200-2016-91779, Emergent Ventures at the Mercatus Center, the Huffman Family Donor Advised Fund, the MorrisSinger Fund, the National Basketball Association, and the National Basketball Players Association.

Peripheral adenomatoid odontogenic tumour.

The Adenomatoid Odontogenic Tumour (AOT) is more than 100 years old, known by different names and the term AOT was coined in 1969 by Philipsen and Birn. AOT frequently occurs in intra-osseous location in gnathic skeleton and rarely seen in peripheral forms. These are rare odontogenic tumours, accounting for 2.2--7.1% of all odontogenic tumours, whereas the central or intraosseous variant of AOT in follicular and extra-follicular presentation, accounts for 95.6% of all AOTs. The peripheral variant presents as a gingival mass, which may cause slight saucerization of alveolar bone or might not affect the bone at all. These peripheral variants constitute 4.4% or less, of all AOTs of the gnathic skeleton. Here, we present a rare case of a peripheral variant of AOT in a 35-years-old female, 1.5 to 2 cm in dimension seen on the labial gingiva in right canine-premolar area. The lesion showed marked bone loss in 13 and 14 teeth region, causing mobility of 13. Histopathology showed a well encapsulated tumour mass with metaplastic bone in the capsule. A conventional AOT with ductal and rosette pattern was seen with tumour droplets and amyloid like material. The case clinically presented a moderately aggressive behaviour.

Severe Acute Respiratory Syndrome Coronavirus 2 Reinfection: A Case Series From a 12-Month Longitudinal Occupational Cohort.

Findings are described in 7 patients with severe acute respiratory syndrome coronavirus 2 reinfection from the National Basketball Association 2020-2021 occupational testing cohort, including clinical details, antibody test results, genomic sequencing, and longitudinal reverse-transcription polymerase chain reaction results. Reinfections were infrequent and varied in clinical presentation, viral dynamics, and immune response.

Case of labial sclerosing polycystic adenoma with ductal carcinoma in situ (DCIS).

Minor salivary gland tumours are enigmatic in their behaviour and presentations. Histopathological diagnosis of these tumours encompasses a large spectrum. Conventionally, small nodular tumours of the upper lip or the labial mucosa are generally adenomas, frequently pleomorphic adenomas. Here, we describe a case of a solitary nodular tumour, occurring in the upper labial mucosa, diagnosed as sclerosing polycystic adenoma (SPA) with intraductal epithelial proliferation of high grade. This is a rare lesion, which has entered into the category of salivary gland tumours recently in the 2017 WHO categorisation. We report a case of paucicystic SPA with intraductal epithelial proliferations in the labial minor salivary gland of a 56-year-old woman, which might be the first report of a case occurring in the upper labial mucosa.

Comparative Study of Sexual Side Effects in Female Patients With Schizophrenia Receiving Risperidone or Olanzapine.

Objective: To determine the prevalence of sexual dysfunction in female patients with schizophrenia receiving olanzapine or risperidone and to understand its relationship with other psychosocial variables.Methods: This cross-sectional descriptive study evaluated 57 female stabilized schizophrenia outpatients receiving risperidone (n = 28) or olanzapine (n = 29) in the psychiatric departments of a tertiary care hospital in South India from January to May 2019. Sexual dysfunction was assessed with the Changes in Sexual Functioning Questionnaire, severity of psychosis with the Brief Psychiatric Rating Scale, and level of improvement with the Clinical Global Impressions-Improvement and Severity scales.Results: Among the subjects, 93% of women receiving risperidone experienced sexual dysfunction compared to 83% in the olanzapine group. Sexual responses such as pleasure, frequency of sexual contacts, desire, arousal, and orgasm were significantly low in both drug groups (P < .05). Logistic regression of sexual dysfunction as dependent variable with other important variables found no significant relationship.Conclusions: This study suggests that sexual dysfunction is an important undetected problem in the majority of female schizophrenia patients. Risperidone was associated with more sexual dysfunction. Sexual dysfunction is an understudied yet important consideration in the treatment of schizophrenia.

A Low-Sodium Diet Boosts Ang (1-7) Production and NO-cGMP Bioavailability to Reduce Edema and Enhance Survival in Experimental Heart Failure.

Sodium restriction is often recommended in heart failure (HF) to block symptomatic edema, despite limited evidence for benefit. However, a low-sodium diet (LSD) activates the classical renin-angiotensin-aldosterone system (RAAS), which may adversely affect HF progression and mortality in patients with dilated cardiomyopathy (DCM). We performed a randomized, blinded pre-clinical trial to compare the effects of a normal (human-equivalent) sodium diet and a LSD on HF progression in a normotensive model of DCM in mice that has translational relevance to human HF. The LSD reduced HF progression by suppressing the development of pleural effusions (p < 0.01), blocking pathological increases in systemic extracellular water (p < 0.001) and prolonging median survival (15%, p < 0.01). The LSD activated the classical RAAS by increasing plasma renin activity, angiotensin II and aldosterone levels. However, the LSD also significantly up-elevated the counter-regulatory RAAS by boosting plasma angiotensin converting enzyme 2 (ACE2) and angiotensin (1-7) levels, promoting nitric oxide bioavailability and stimulating 3'-5'-cyclic guanosine monophosphate (cGMP) production. Plasma HF biomarkers associated with poor outcomes, such as B-type natriuretic peptide and neprilysin were decreased by a LSD. Cardiac systolic function, blood pressure and renal function were not affected. Although a LSD activates the classical RAAS system, we conclude that the LSD delayed HF progression and mortality in experimental DCM, in part through protective stimulation of the counter-regulatory RAAS to increase plasma ACE2 and angiotensin (1-7) levels, nitric oxide bioavailability and cGMP production.

A Preliminary Study of Real-time Capturing and Sharing of Routine Health Data among the Public Health Professionals.

CONTEXT: Electronic health record (EHR) has the potential to make available the real-time data of the patient to the healthcare professionals by connecting all levels of the public health system, irrespective of their geographical boundaries. AIM: This study aims to test the capturing and sharing of real-time patient data at primary, secondary, and the tertiary level. SETTINGS AND DESIGN: The cloud-based EHR system developed earlier was used to capture real-time data of the patient visiting a primay health center (PHC) in Udupi District of Karnataka. SUBJECTS AND METHODS: About 100 patient records including laboratory and pharmacy data have been captured into the EHR system. The confidentiality of patient data is assured. RESULTS: The result of the study indicated no errors while capturing and sharing the patient data in real time. The system also evidenced the availability of vital statistics about the patient visiting PHCs. The system also allowed the professionals at referral level to view patient data for providing quality healthcare. CONCLUSION: EHR plays a vital role in capturing, storing, and sharing patient data for providing quality healthcare and it should be made mandatory by the central health agencies in the provision of patient care and reporting of notifiable communicable diseases at all levels.

In Experimental Dilated Cardiomyopathy Heart Failure and Survival Are Adversely Affected by a Lack of Sexual Interactions.

Nearly one in three people in the U.S. will develop heart failure (HF), characterized by fluid retention (edema) in the lungs and elsewhere. This leads to difficult breathing, deterioration of physical capacity, restriction of normal activities and death. There is little data about the safety and effects of sexual interactions in patients with HF. We tested whether a lack of sexual interactions affected pathophysiological outcomes in a pre-clinical mouse model of dilated cardiomyopathy that recapitulates the progressive stages of human HF. Male mice were randomly given access to, or deprived from, sexual interactions with female mice, which were confirmed by videography and generation of offspring. Cohousing with access to sexual interactions markedly prolonged survival, while cohousing without access to sexual activity did not. Sexual interactions improved systolic function, reduced HF-associated edema, altered transcription of heart contractile protein genes and decreased plasma testosterone levels. To determine whether testosterone levels contributed to survival, testosterone levels were experimentally reduced. Reduction of testosterone levels significantly prolonged survival. Taken together, in mice with dilated cardiomyopathy, sexual activity altered cardiac contractile gene transcription, improved systolic function, reduced edema and prolonged survival which may be in part due to lower testosterone levels.

ZAP-X: A Novel Radiosurgical Device for the Treatment of Trigeminal Neuralgia.

Introduction The treatment of trigeminal neuralgia (TN) is one of the most demanding of all radiosurgery procedures, requiring accurate delivery and sharp dose fall off. ZAP-X®, a new, innovative frameless radiosurgical device, maybe an attractive platform for the treatment of TN and other functional brain disorders. Here, we compared the dosimetry of ZAP-X plans for a single patient to that generated by a well-established dedicated radiosurgery device, the CyberKnife. Methods Radiosurgery plans that delineated the cranial nerve from a single patient's fused computed tomography and magnetic resonance imaging (CT-MR) data set were planned on both the ZAP-X and CyberKnife, with the latter serving as a validated benchmark. The same target and treatment planning constraints were applied. Plans were evaluated by a physician with experience treating TN and a medical physicist. The ZAP-X treatment plan used two isocenters delivered through 4-mm collimators based on a non-isocentric plan that delivered 29,441 MU through 81 beams. The CyberKnife plans used a 5-mm collimator for a non-isocentric plan that delivered 17,880 MU through 88 beams. Results Based on visual inspection, the isodose volumes covered by ZAP-X and CyberKnife were similar at the prescription isodose (70% and 80%, respectively, with a maximum dose (Dmax) of 7500 cGy. The conformality index was better for the CyberKnife as compared to ZAP-X. However, the irradiated volumes were smaller at the 50%, 20%, and 10% isodoses for ZAP-X (0.12 cc, 0.57 cc, and 1.69 for ZAP-X; 0.18 cc, 0.91 cc, and 3.41 cc for CyberKnife). In particular, the 20% and 10% isodose volumes were much smaller for ZAP-X, especially on the axial and sagittal planes. Conclusions ZAP-X treatment planning for TN compares favorably with equivalent planning on CyberKnife. The brain volumes containing the 20% and 10% isodoses are smaller using ZAP-X, thus relatively sparing critical structures close to the target, including the Gasserian ganglion and brainstem. This feature could be of clinical relevance by potentially reducing treatment-related complications.

Intra-observer and inter-observer variability in two grading systems for oral epithelial dysplasia: A multi-centre study in India.

BACKGROUND: The presence and grading of oral epithelial dysplasia (OED) are considered the gold standard for predicting the malignant risk of oral potentially malignant disorders. However, inter-observer and intra-observer agreement in the context of reporting on OED grading has been reputedly considered unreliable. METHODS: We undertook a multi-centre study of six Indian oral pathologists to assess variations in reporting OED using the World Health Organization (WHO; 2005) system and also the recently introduced binary system. The observer variability was assessed with the use of kappa statistics. RESULTS: The weighted kappa intra-observer agreement scores improved (κw  = 0.5012) on grouping by two grades as no and mild dysplasia versus moderate and severe dysplasia compared to binary grading system (κ = 0.1563) and WHO grading system (κw  = 0.4297). Poor to fair inter-observer agreement scores were seen between the principal investigator (PI) and the other five observers using the WHO grading system (κ = 0.051-0.231; κw  = 0.145 to 0.361; 35% to 46%) and binary grading system (κ = 0.049 to 0.326; 50 to 65%). CONCLUSIONS: There is considerable room for improvement in the assessment of OED using either system to help in standardised reporting. The professional pathology organisations in India should take steps to provide external quality assessment in reporting OED among oral and general pathologists who are engaged in routine reporting of head and neck specimens.

Southern African Lesbian and Bisexual Women Responses to Symptoms of Sexually Transmitted Infections.

Sexually transmitted infection (STI) in lesbian and bisexual women is a relatively unexplored topic, particularly for women from low- and middle-income countries. Despite perceptions that women who have sex with women (WSW) are at negligible risk of contracting STI, existing research demonstrates that WSW do become infected with STI. Given the opposition between assumptions of invulnerability and the observed risks, we explored how WSW would respond to symptoms of STI (i.e., wait until symptoms passed, see a medical doctor, and inform sexual partners). We used data collected as part of a collaboration between academic researchers and community-based LGBTQ organizations in Botswana, Namibia, South Africa, and Zimbabwe. Chi-squared tests were used to test whether participants' responses to hypothetical STI symptoms varied in relation to several intrapersonal, interpersonal, and structural factors. Multivariable logistic regression (backward) was used to assess whether these variables were independently associated with women's responses. Most women would be proactive in response to potential STI symptoms and would see a medical doctor. However, most women would not inform their sexual partner of symptoms of STI. Findings demonstrate several intrapersonal, interpersonal, and structural factors that influence WSW's health agency, and show a clustering of high-risk factors among women who would not be proactive about their health. Our findings suggest the need for improved health and health care of WSW in Southern Africa.

"SKILL TO KILL" - Oral cancer and potentially premalignant oral epithelial lesions (PPOELs): A survey approach. Emerging of a new system and professionals.

BACKGROUND: Oral cancer is said to be the 6th most common cancer in men and 12th in women. Potentially malignant disorders/potentially premalignant oral epithelial lesion (PMDs/PPOELs) have shown an increased risk of progressing to cancer. In this regard, lack of awareness about identification of oral PMDs among healthcare providers in general and oral pathologists in particular is said to be responsible for the diagnostic delay. Oral cancer is said to be the most common cancer in men and 3rd most common in women in the Indian subcontinent. PMDs have shown an increased risk of progressing to cancer. The various rates of conversion include 14%-51% for erythroplakia, 60%-100% for proliferative verrucous leukoplakia and 7%-26% for oral submucous fibrosis (OSMF). In this regard, early detection at PPOEL level will lead to prevention of malignant transformation. AIMS AND OBJECTIVES: The purpose of this survey was: 1. To determine if awareness among professionals is essential/key to challenge the progression of PMDs of the oral cavity. 2. To examine and/ordiscern if oral pathologists felt enough was being done to address the issue of early detection and prevention and how the scenario could be improved further. MATERIALS AND METHODS: A survey was designed to assess the interest, zeal, knowledge and skill of healthcare providers in general and oral pathologists in particular in careful examination of the oral cavity and early detection of PMDs. A questionnaire with 18 questions was designed to address these issues/points and distributed among post-graduate students and practicing oral pathologists on online platforms. RESULTS: The results of the esurvey were collected, analyzed and the results discussed question wise. The validity and reliability of the questionnaire was assessed and confirmed with Aiken's index for validity and Cronbach's alpha for reliability. Inferential statistical analysis was performed using Chi square test with P = 0.05 being statistically significant. CONCLUSION: On evaluation of the survey, we found that 85% of the surveyees are on agreement that PPOELs should be registered in a standard format and should be included in the list of recognizable diseases. 89.2% and 87.8% of the respondents would like to be part of an active body for early detection and diagnosis and for Cancer screening in our country respectively. In conclusion, the oral pathology fraternity is eager to work for and tackle these PPOELs head on, provided the right opportunities and training are meted out to them.

Normalizing Plasma Renin Activity in Experimental Dilated Cardiomyopathy: Effects on Edema, Cachexia, and Survival.

Heart failure (HF) patients frequently have elevated plasma renin activity. We examined the significance of elevated plasma renin activity in a translationally-relevant model of dilated cardiomyopathy (DCM), which replicates the progressive stages (A-D) of human HF. Female mice with DCM and elevated plasma renin activity concentrations were treated with a direct renin inhibitor (aliskiren) in a randomized, blinded fashion beginning at Stage B HF. By comparison to controls, aliskiren treatment normalized pathologically elevated plasma renin activity (p < 0.001) and neprilysin levels (p < 0.001), but did not significantly alter pathological changes in plasma aldosterone, angiotensin II, atrial natriuretic peptide, or corin levels. Aliskiren improved cardiac systolic function (ejection fraction, p < 0.05; cardiac output, p < 0.01) and significantly reduced the longitudinal development of edema (extracellular water, p < 0.0001), retarding the transition from Stage B to Stage C HF. The normalization of elevated plasma renin activity reduced the loss of body fat and lean mass (cachexia/sarcopenia), p < 0.001) and prolonged survival (p < 0.05). In summary, the normalization of plasma renin activity retards the progression of experimental HF by improving cardiac systolic function, reducing the development of systemic edema, cachexia/sarcopenia, and mortality. These data suggest that targeting pathologically elevated plasma renin activity may be beneficial in appropriately selected HF patients.