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Instead of ice packs, they use polymer crystals that activate with water

However, under pathological conditions, abnormal mechanical stress disrupts cardiac Ca 2+ homeostasis[48], thereby enhancing Ca 2+ influx through L-type Ca 2+ channels and stretch-activated ion channels, as well as facilitating Ca 2+ release from the sarcoplasmic reticulum via the ryanodine receptor (RyR)

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Gentle swirling (not shaking) until powder dissolved