Shanghai Electric Porcelain Works (SEPW), a subsidiary enterprise of the SEC (Group), is specialized in manufacturing highvoltage surge arresters and fuses as main products, as well as some high-voltage insulators, wa...Shanghai Electric Porcelain Works (SEPW), a subsidiary enterprise of the SEC (Group), is specialized in manufacturing highvoltage surge arresters and fuses as main products, as well as some high-voltage insulators, wall bushings and disconnecting switches for power transmission & distribution systems. In fact, SEPW is展开更多
Crimped ribbon flame arresters are important safety devices in the chemical industry, especially for the danger- ous situations. Although proper design of arresters by the numerical simulation method is promising, its...Crimped ribbon flame arresters are important safety devices in the chemical industry, especially for the danger- ous situations. Although proper design of arresters by the numerical simulation method is promising, its reliabil- ity and accuracy are dependent upon the mathematical model. In this work, an integrated mathematical model for the microchannel in the crimped ribbon flame attesters was set up; the fluid flow behavior and the sensitiv- ities of four chemical kinetics mechanisms of propane-air on the accuracy were analysed. It is shown that turbu- lence is predominant in the microchannel of the crimped ribbon flame arresters under the defiagration and detonation conditions, and a new quenching criterion for the numerical simulation is proposed. The kinetics mechanism of Mansouri et al. among the four ones is the most accurate due to the best agreement of the pre- dicted outlet temperature at the experimental flameproof velocity with the autoignition temperature of propane-air. The species mass fraction profiles and the temperature distribution, which are too difficult to mea- sure due to the tiny dimension of the microchannel in experiments, are captured. The fundamental insights into chemical reactions and heat loss are well portrayed. It can be concluded that the integrated mathematical model established in this work can be used as a reliable tool for modeling, selecting and designing such type of crimped ribbon flame attesters with the propane-air medium in the future.展开更多
Zinc Oxide (ZnO) surge arresters (SAs) experience thermal runaway when the temperature exceeds the acceptable limit. This phenomenon is associated with the increase in resistive leakage current due to degradation. Thi...Zinc Oxide (ZnO) surge arresters (SAs) experience thermal runaway when the temperature exceeds the acceptable limit. This phenomenon is associated with the increase in resistive leakage current due to degradation. This paper presents the electrical performance of ZnO SAs in 22 kV distribution systems using thermal image camera under the power frequency AC operating voltages. When ZnO surge arresters are installation takes a long time in distribution system over more than 5 years. For the experimental study, as ZnO installation takes a long time over 6 years the leakage current is 63.9 mA, temperature differences were measured over a period of time over 14 degree Celsius. This data will be useful as a guideline for solving problems and reducing power loss from leakage current. Moreover, it will be useful in predicting lifetime of ZnO SAs.展开更多
Due to important consideration of protection against lightning surge on electrical, electronic and telecommunication equipment, it was necessary to carry out a special study to look at the performance of protective de...Due to important consideration of protection against lightning surge on electrical, electronic and telecommunication equipment, it was necessary to carry out a special study to look at the performance of protective devices. The study was testing performance of arresters on low voltage system. The activity was testing of arresters using steady state and impulse voltages. The arresters consisted of gas tube, zener diode, varistor and spark gap arresters, then it was made a cascade circuit between the varistor and spark gap arresters with a decoupling element. The decoupling elements were used air, iron and ferrite. The test yielded data of current and voltage on the tables and oscilloscope waveforms. The arresters had cut voltages early different from each other, namely the gas tube, zener diode, spark gap and varistor arresters were at the voltages of 500 V, 250 V, 1,000 V and 565 V respectively. The iron core decoupling element cascade circuit had the least oscillation among remaining cores.展开更多
Global brain ischemia and neurological deficit are consequences of cardiac arrest that lead to high mortality.Despite advancements in resuscitation science,our limited understanding of the cellular and molecular mecha...Global brain ischemia and neurological deficit are consequences of cardiac arrest that lead to high mortality.Despite advancements in resuscitation science,our limited understanding of the cellular and molecular mechanisms underlying post-cardiac arrest brain injury have hindered the development of effective neuroprotective strategies.Previous studies primarily focused on neuronal death,potentially overlooking the contributions of non-neuronal cells and intercellular communication to the pathophysiology of cardiac arrest-induced brain injury.To address these gaps,we hypothesized that single-cell transcriptomic analysis could uncover previously unidentified cellular subpopulations,altered cell communication networks,and novel molecular mechanisms involved in post-cardiac arrest brain injury.In this study,we performed a single-cell transcriptomic analysis of the hippocampus from pigs with ventricular fibrillation-induced cardiac arrest at 6 and 24 hours following the return of spontaneous circulation,and from sham control pigs.Sequencing results revealed changes in the proportions of different cell types,suggesting post-arrest disruption in the blood-brain barrier and infiltration of neutrophils.These results were validated through western blotting,quantitative reverse transcription-polymerase chain reaction,and immunofluorescence staining.We also identified and validated a unique subcluster of activated microglia with high expression of S100A8,which increased over time following cardiac arrest.This subcluster simultaneously exhibited significant M1/M2 polarization and expressed key functional genes related to chemokines and interleukins.Additionally,we revealed the post-cardiac arrest dysfunction of oligodendrocytes and the differentiation of oligodendrocyte precursor cells into oligodendrocytes.Cell communication analysis identified enhanced post-cardiac arrest communication between neutrophils and microglia that was mediated by neutrophil-derived resistin,driving pro-inflammatory microglial polarization.Our findings provide a comprehensive single-cell map of the post-cardiac arrest hippocampus,offering potential novel targets for neuroprotection and repair following cardiac arrest.展开更多
The amplitude of switching overvoltages is a key factor for designing the insulation of UHV equipment. The effect of different arresters needs to be studied, since installing arresters is an important way to suppress ...The amplitude of switching overvoltages is a key factor for designing the insulation of UHV equipment. The effect of different arresters needs to be studied, since installing arresters is an important way to suppress switching overvoltages in UHV transmission lines. Switching overvoltages on the 1000 kV Huainan-Huxi double-circuit transmission line were simulated for different operating modes and different arrester designs using the electromagnetic transient program PSCAD/EMTDC. With parallel resistors, the switching overvoltages are less than 1.70 p.u. （1.0 p.u.=1100×√ 2 /√3 kV）. If the arrestors are better, the switching overvoltages can be reduced even lower to 1.55 p.u. Without parallel resistors, the arresters can reduce three-phase energizing overvoltages to 1.70 p.u, while the single-phase reclosing overvoltages still exceed the limit. The results show that the parallel resistors cannot be eliminated if the arresters are only installed at each end of the transmission line. Also, better quality arresters significantly lower the switching overvoltages.展开更多
Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological damage.Hypoxic preconditioning has been shown to impr...Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological damage.Hypoxic preconditioning has been shown to improve migration and survival of bone marrow–derived mesenchymal stem cells and reduce pyroptosis after cardiac arrest,but the specific mechanisms by which hypoxia-preconditioned bone marrow–derived mesenchymal stem cells protect against brain injury after cardiac arrest are unknown.To this end,we established an in vitro co-culture model of bone marrow–derived mesenchymal stem cells and oxygen–glucose deprived primary neurons and found that hypoxic preconditioning enhanced the protective effect of bone marrow stromal stem cells against neuronal pyroptosis,possibly through inhibition of the MAPK and nuclear factor κB pathways.Subsequently,we transplanted hypoxia-preconditioned bone marrow–derived mesenchymal stem cells into the lateral ventricle after the return of spontaneous circulation in an 8-minute cardiac arrest rat model induced by asphyxia.The results showed that hypoxia-preconditioned bone marrow–derived mesenchymal stem cells significantly reduced cardiac arrest–induced neuronal pyroptosis,oxidative stress,and mitochondrial damage,whereas knockdown of the liver isoform of phosphofructokinase in bone marrow–derived mesenchymal stem cells inhibited these effects.To conclude,hypoxia-preconditioned bone marrow–derived mesenchymal stem cells offer a promising therapeutic approach for neuronal injury following cardiac arrest,and their beneficial effects are potentially associated with increased expression of the liver isoform of phosphofructokinase following hypoxic preconditioning.展开更多
Severe fever with thrombocytopenia syndrome(SFTS)is a novel emerging acute infectious disease caused by severe fever with thrombocytopenia syndrome virus(SFTSV),characterized by high fever and thrombocytopenia.It has ...Severe fever with thrombocytopenia syndrome(SFTS)is a novel emerging acute infectious disease caused by severe fever with thrombocytopenia syndrome virus(SFTSV),characterized by high fever and thrombocytopenia.It has been proved that traditional Chinese medicine(TCM)has displayed definite therapeutic effects on viral hemorrhagic fever,indicating its potential to treat SFTS.In this study,SFTS-relative key targets were predicted via gene ontology(GO)analysis and kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis.Molecular docking was then used to select stable binders.Molecules matched TCMs were identified,and a new prescription,Qingqi Guxue decoction(QQGX),was formulated to clear heat and nourish blood,with a resulting drug composition network.We explored the optimal drug proportion for QQGX.Through an in-depth study of molecular mechanisms,we found that QQGX induces S phase arrest by promoting the degradation of cyclin A2(CCNA2)and cyclin-dependent kinase 2(CDK2),thereby inhibiting SFTSV replication.Finally,we verified the effectiveness and safety of QQGX based on the mouse liver bile duct organoid model infected with SFTSV.In summary,our study prepared a TCM decoction using the method of network pharmacology.This decoction has a significant inhibitory effect on the replication of SFTSV and provides a new treatment strategy for hemorrhagic fever with TCM.展开更多
BACKGROUND:Post-cardiac arrest brain injury remains the leading cause of mortality and longterm disability in patients following cardiac arrest(CA).However,optimizing clinical management strategies for bundled therapy...BACKGROUND:Post-cardiac arrest brain injury remains the leading cause of mortality and longterm disability in patients following cardiac arrest(CA).However,optimizing clinical management strategies for bundled therapy after CA still faces challenges.METHODS:For this literature review,we searched PubMed,Web of Science,and SpringerLink databases for high-quality studies published between December 1982 and July 1,2024.The search included randomized clinical trials,meta-analyses,systematic reviews,and observational studies.References in included studies were also checked to identify additional sources.RESULTS:Many studies have identified potential targets for interventions to mitigate brain injury and improve outcomes for post-resuscitated patients.To optimize clinical management strategies to minimize brain injury after CA,we developed the acronym “SOOTEST-ICU” bundle,which includes “SOOTEST” therapy to optimize peripheral oxygen delivery and “ICU” intervention to optimize the cerebral oxygen cascade.The order of the “SOOTEST” treatment was organized based on the severity and importance of brain oxygen aff ecting brain injury.It includes systolic blood pressure and mean arterial pressure management,oxygenation and ventilation management,original etiological treatment,temperature control,electrolytes and acid basic status,seizure control,and targeted substrate delivery.The acronym “ICU” intervention includes intracerebral oxygen delivery,cerebral oxygen diff usion,and oxygen utilization.CONCLUSION:The “SOOTEST-ICU” therapy is developed to optimize oxygen and substrate cascades to minimize brain injury after CA.展开更多
Brain plasticity-A universal tool with many variations:The study of brain plasticity has been gaining interest since almost a century and has now reached a huge amount of information(>80,000 results in PubMed).Over...Brain plasticity-A universal tool with many variations:The study of brain plasticity has been gaining interest since almost a century and has now reached a huge amount of information(>80,000 results in PubMed).Overall,different types of plasticity,including stem cell-driven genesis of new neurons(adult neurogenesis),cells in arrested maturation(dormant neurons),neuro-glial and synaptic plasticity,can coexist and contribute to grant plastic changes in the brain,from a cellular to system level(Benedetti and Couillard-Despres,2022;Bonfanti et al.,2023).展开更多
BACKGROUND Acute pancreatitis in pregnancy is a rare but serious condition that can lead to high maternal mortality and fetal loss.Instances of pregnancy complicated by severe acute pancreatitis,particularly with subs...BACKGROUND Acute pancreatitis in pregnancy is a rare but serious condition that can lead to high maternal mortality and fetal loss.Instances of pregnancy complicated by severe acute pancreatitis,particularly with subsequent respiratory and cardiac arrest,are rarely reported.CASE SUMMARY We present the case of a 35-year-old woman,at 36+5 weeks of gestation,who presented with paroxysmal epigastric pain accompanied by low back pain,nausea,and vomiting.According to the clinical symptoms,B-ultrasound imaging and biochemical indicators,the patient was diagnosed with acute pancreatitis and initially managed conservatively.However,3 hours after admission,the patient experienced respiratory and cardiac arrest,and the fetus died.In this case,the adverse outcomes occurred due to the lack of aggressive fluid resuscitation and an active surgical intervention.CONCLUSION Implementing aggressive fluid resuscitation to sustain tissue perfusion,alongside the proactive evaluation of pharmacological agents that suppress gastric acid secretion and inhibit pancreatic enzyme activity,may be beneficial in mitigating the risk of a severely adverse prognosis.Effective management of acute pancreatitis during pregnancy requires careful timing of surgical intervention,a thorough evaluation of the risks and benefits regarding the continuation or termination of pregnancy,and a focus on safeguarding both maternal and fetal health.展开更多
Cardiac arrest(CA)is a critical condition in the field of cardiovascular medicine.Despite successful resuscitation,patients continue to have a high mortality rate,largely due to post CA syndrome(PCAS).However,the inju...Cardiac arrest(CA)is a critical condition in the field of cardiovascular medicine.Despite successful resuscitation,patients continue to have a high mortality rate,largely due to post CA syndrome(PCAS).However,the injury and pathophysiological mechanisms underlying PCAS remain unclear.Experimental animal models are valuable tools for exploring the etiology,pathogenesis,and potential interventions for CA and PCAS.Current CA animal models include electrical induction of ventricular fibrillation(VF),myocardial infarction,high potassium,asphyxia,and hemorrhagic shock.Although these models do not fully replicate the complexity of clinical CA,the mechanistic insights they provide remain highly relevant,including post-CA brain injury(PCABI),post-CA myocardial dysfunction(PAMD),systemic ischaemia/reperfusion injury(IRI),and the persistent precipitating pathology.Summarizing the methods of establishing CA models,the challenges encountered in the modeling process,and the mechanisms of PCAS can provide a foundation for developing standardized CA modeling protocols.展开更多
BACKGROUND Cardiac arrest caused by acute pulmonary embolism(PE)is the most serious clinical circumstance,necessitating rapid identification,immediate cardiopulmonary resuscitation(CPR),and systemic thrombolytic thera...BACKGROUND Cardiac arrest caused by acute pulmonary embolism(PE)is the most serious clinical circumstance,necessitating rapid identification,immediate cardiopulmonary resuscitation(CPR),and systemic thrombolytic therapy.Extracorporeal CPR(ECPR)is typically employed as a rescue therapy for selected patients when conventional CPR is failing in settings where it can be implemented.CASE SUMMARY We present a case of a 69-year-old male who experienced a prolonged cardiac arrest in an ambulance with pulseless electrical activity.Upon arrival at the emergency department with ongoing manual chest compressions,bedside pointof-care ultrasound revealed an enlarged right ventricle without contractility.Acute PE was suspected as the cause of cardiac arrest,and intravenous thrombolytic therapy with 50 mg tissue plasminogen activator was administered during mechanical chest compressions.Despite 31 minutes of CPR,return of spontaneous circulation was not achieved until 8 minutes after initiation of Veno-arterial extracorporeal membrane oxygenation(ECMO)support.Under ECMO support,the hemodynamic status and myocardial contractility significantly improved.However,the patient ultimately did not survive due to intracerebral hemorrhagic complications,leading to death a few days later in the hospital.CONCLUSION This case illustrates the potential of combining systemic thrombolysis with ECPR for refractory cardiac arrest caused by acute PE,but it also highlights the increased risk of significant bleeding complications,including fatal intracranial hemorrhage.展开更多
Cardiac arrest(CA)is considered a state of clinical death in which the heart suddenly loses its ability to effectively expel blood,resulting in circulatory and respiratory arrest.CA is often catastrophic for patients,...Cardiac arrest(CA)is considered a state of clinical death in which the heart suddenly loses its ability to effectively expel blood,resulting in circulatory and respiratory arrest.CA is often catastrophic for patients,as it can cause serious long-term cardiovascular and cerebrovascular complications that affect their quality of life[1].Survey data indicate that the overall incidence rate of intraoperative CA in patients undergoing thoracic surgery in China is currently 0.138%[2].This rate is expected to increase because of the increasing proportion of older individuals(age>60 years)in the population,as well as the increasing pulmonary surgery rates.However,the incidence rate during the perianesthetic period in older patients undergoing thoracic surgery has not yet been comprehensively reported.展开更多
BACKGROUND:Post-cardiac arrest syndrome(PCAS) significantly contributes to mortality after initially successful cardiopulmonary resuscitation(CPR) in cardiac arrest(CA) patients.Effective cardiocerebral protection is ...BACKGROUND:Post-cardiac arrest syndrome(PCAS) significantly contributes to mortality after initially successful cardiopulmonary resuscitation(CPR) in cardiac arrest(CA) patients.Effective cardiocerebral protection is essential for improving post-resuscitation survival.This study investigated the mechanisms and common targets of myocardial dysfunction and brain injury after resuscitation.METHODS:The male Sprague-Dawley rats(10–12 weeks old,400–500 g) were divided into two groups:the control group(n=6),which received sham surgery,and the CA/CPR group(n=10),which received ventricular fibrillation(VF) followed by CPR.After 24 h,brain and heart tissues were collected for analysis.The sequencing was used to identify differentially expressed genes(DEGs) between control and CA/CPR rats.RESULTS:At 24 h after resuscitation,CA/CPR rats presented 217 DEGs in the hippocampus and 80 DEGs in the left ventricle(LV) compared to the control group.In the hippocampus,the most notable biological process was the positive regulation of tumor necrosis factor production,with key pathways related to inflammation and the immune response.In the LV,the Gene Ontology(GO)enrichment analysis revealed that gene alterations were primarily associated with amyloid-beta clearance,a pathway that was also relevant in the brain.Eleven common targets were identified in the DEGs of both heart and brain tissues.The reverse transcription-polymerase chain reaction(RTPCR) validation revealed significant differences in the mRNA expression of Timp1,Apln,Ccl7,and Lgals3 in both LV and hippocampus.CONCLUSION:This study identified possible key genes and underlying mechanisms involved in PCAS.The differential genes Timp1,Apln,Ccl7,and Lgals3 might serve as common biomarkers for myocardial and neurological injury following resuscitation.展开更多
Modern cardiopulmonary resuscitation(CPR)has been established for more than 60 years;however,its success rate remains low.Currently,the global incidence of out-of-hospital cardiac arrest(OHCA)is rising,ranging from 52...Modern cardiopulmonary resuscitation(CPR)has been established for more than 60 years;however,its success rate remains low.Currently,the global incidence of out-of-hospital cardiac arrest(OHCA)is rising,ranging from 52.5 to 97.1 per 100,000 population.[1,2]Survival-to-discharge rates for OHCA and in-hospital cardiac arrest(IHCA)are not satisfactory,with ranges of 1.2%-9.9%and 9.1%-19.1%,respectively.展开更多
BACKGROUND Cardiac arrest is a critical condition characterized by abrupt cessation of cardiac function,resulting in reduced oxygen delivery to vital organs and rapid progression to death if not timely treated.Despite...BACKGROUND Cardiac arrest is a critical condition characterized by abrupt cessation of cardiac function,resulting in reduced oxygen delivery to vital organs and rapid progression to death if not timely treated.Despite advances in medical science and resuscitation techniques,cardiac arrest remains a significant burden globally,with survival rates remaining low.Comprehensive research on cardiac arrest,particularly comparisons between in-hospital cardiac arrest(IHCA)and out-of-hospital cardiac arrest(OHCA),is limited.AIM To compare the survival rates,return of spontaneous circulation(ROSC),survival to discharge,and neurological outcomes after IHCA and OHCA in Arab Asian countries.METHODS We systematically searched PubMed,Medline,EMBASE and Google Scholar(2000-2024)using keywords(“IHCA”,“OHCA”,“cardiac arrest”,“Middle East”,“Arab”,“Asian”)in titles/abstracts.The inclusion criterion was observational studies on adults(≥18 years)in Arab Asian countries reporting relevant outcomes.The exclusion criteria were narrative reviews,non-Arab Asian studies,non-English publications,inaccessible full texts,pediatric-only populations,and studies lacking outcome data.RESULTS In total,44 observational studies from nine Arab Asian countries comprising 32535 participants were included.This review highlights the substantial variability in cardiac arrest outcomes in Asian countries.OHCA mortality rates were alarmingly high in several nations,with Kuwait(99%),Bahrain(98.8%),and Qatar(97.6%)reporting the highest figures.In contrast,the Kingdom of Saudi Arabia(KSA)had a markedly lower OHCA mortality rate(8.2%).The rates of ROSC also varied,with Qatar achieving the highest(34.4%)and Kuwait the lowest(3.3%).Survival to hospital discharge ranged from 1.2%in Bahrain to 18.7%in Kuwait,with Qatar also reporting favorable rates(17.5%).For IHCA,mortality was 73.6%in the United Arab Emirates(UAE)and 72.8%in KSA,whereas Lebanon and Iraq reported higher rates of 94.6%and 88%,respectively.ROSC rates were the highest in Lebanon(55.9%)and the UAE(51.3%).Neurological outcome reporting has been inconsistent,although Qatar reported a high rate(68.6%)for OHCA survivors.Comparative data showed generally better survival and neurological outcomes with IHCA than with OHCA.CONCLUSION This systematic review underscores the clear disparity in survival outcomes between IHCA and OHCA in Arab Asian countries,with IHCA demonstrating superior outcomes.Despite progress in some countries,outcomes remain suboptimal compared with international standards.Future multicenter studies with standardized methodologies are required to generate high-quality evidence and provide region-specific interventions for cardiac arrest management.展开更多
Morusin is a flavonoid compound isolated and extracted from the root bark of Morus alba L.Studies have reported that morusin exerts anti-tumor effects by inhibiting cancer cell invasion and proliferation,as well as in...Morusin is a flavonoid compound isolated and extracted from the root bark of Morus alba L.Studies have reported that morusin exerts anti-tumor effects by inhibiting cancer cell invasion and proliferation,as well as inducing tumor cell apoptosis.This article comprehensively reviews recent research on the anti-tumor effects of morusin and its related molecular mechanisms,aiming to provide theoretical support for further studies and new drug development of morusin.展开更多
Objective This systematic review and meta-analysis aimed to identify the main factors influencing the public’s willingness to participate in out-of-hospital emergency care.Methods Studies were searched in online data...Objective This systematic review and meta-analysis aimed to identify the main factors influencing the public’s willingness to participate in out-of-hospital emergency care.Methods Studies were searched in online databases,including PubMed,Embase,Web of Science,and the Cochrane Library.The articles included in this review were published from inception to July 31,2024.The Iain Crombie assessment tool was used to assess study quality.Meta-analysis was performed using RevMan(version 5.4)software.The review protocol has been registered with PROSPERO(CRD42024570491).Results A total of 1,434 research articles were initially identified,among which 18 were incorporated into this study,and all of the included studies were cross-sectional.Meta-analysis results demonstrated that gender(male;OR=1.37,95%CI:1.28–1.47),profession(healthcare provider;OR=0.17,95%CI:0.06–0.47),knowledge and skill level(OR=1.63,95%CI:1.25–2.11),willingness to undergo training(OR=2.68,95%CI:1.89–3.79),interest in first aid(OR=2.08,95%CI:1.60–2.69),previous training(OR=2.14,95%CI:1.49–3.08),and previous first-aid experience(OR=1.70,95%CI:1.37–2.11)were the principal influencing factors of the public’s willingness to engage in out-of-hospital cardiopulmonary resuscitation.Conclusion Demographic factors,knowledge,belief,and behavior are crucial in influencing public emergency decision-making.Medical personnel could create specialized training programs based on relevant factors to enhance the public's willingness to engage in out-of-hospital CPR.展开更多
Unheralded cardiac arrest among previously healthy young people without antecedent illness,months or years after coronavirus disease 2019(COVID-19)vaccination,highlights the urgent need for risk stratification.The mos...Unheralded cardiac arrest among previously healthy young people without antecedent illness,months or years after coronavirus disease 2019(COVID-19)vaccination,highlights the urgent need for risk stratification.The most likely underlying pathophysiology is subclinical myopericarditis and reentrant ventri-cular tachycardia or spontaneous ventricular fibrillation that is commonly preci-pitated after a surge in catecholamines during exercise or the waking hours of terminal sleep.Small patches of inflammation and/or edema can be missed on cardiac imaging and autopsy,and the heart can appear grossly normal.This paper reviews evidence linking COVID-19 vaccines to cardiac arrest where unfortu-nately the majority of victims have had no antecedent clinical evaluation.We propose a comprehensive strategy for evaluating cardiovascular risk post-vaccination,incorporating detailed patient history,antibody testing,and cardiac diagnostics in the best attempt to detect abnormalities before sudden cardiac death.This approach aims to identify individuals at higher risk of cardiac events after COVID-19 vaccination and guide appropriate clinical management.It is prudent for each primary care physician to have a pre-established plan when addressing this issue in their practice.展开更多
文摘Shanghai Electric Porcelain Works (SEPW), a subsidiary enterprise of the SEC (Group), is specialized in manufacturing highvoltage surge arresters and fuses as main products, as well as some high-voltage insulators, wall bushings and disconnecting switches for power transmission & distribution systems. In fact, SEPW is
基金Supported by the National Key Research and Development Program of China(2016YFB0301701)the National Natural Science Foundation of China(21706268+4 种基金9143411421376254)the Postdoctoral Science Foundation of Qingdao Municipal Government(Y7330419DM)the Instrument Developing Project of the Chinese Academy of Sciences(YZ201641)State Key Laboratory of Safety and Control for Chemicals of China
文摘Crimped ribbon flame arresters are important safety devices in the chemical industry, especially for the danger- ous situations. Although proper design of arresters by the numerical simulation method is promising, its reliabil- ity and accuracy are dependent upon the mathematical model. In this work, an integrated mathematical model for the microchannel in the crimped ribbon flame attesters was set up; the fluid flow behavior and the sensitiv- ities of four chemical kinetics mechanisms of propane-air on the accuracy were analysed. It is shown that turbu- lence is predominant in the microchannel of the crimped ribbon flame arresters under the defiagration and detonation conditions, and a new quenching criterion for the numerical simulation is proposed. The kinetics mechanism of Mansouri et al. among the four ones is the most accurate due to the best agreement of the pre- dicted outlet temperature at the experimental flameproof velocity with the autoignition temperature of propane-air. The species mass fraction profiles and the temperature distribution, which are too difficult to mea- sure due to the tiny dimension of the microchannel in experiments, are captured. The fundamental insights into chemical reactions and heat loss are well portrayed. It can be concluded that the integrated mathematical model established in this work can be used as a reliable tool for modeling, selecting and designing such type of crimped ribbon flame attesters with the propane-air medium in the future.
文摘Zinc Oxide (ZnO) surge arresters (SAs) experience thermal runaway when the temperature exceeds the acceptable limit. This phenomenon is associated with the increase in resistive leakage current due to degradation. This paper presents the electrical performance of ZnO SAs in 22 kV distribution systems using thermal image camera under the power frequency AC operating voltages. When ZnO surge arresters are installation takes a long time in distribution system over more than 5 years. For the experimental study, as ZnO installation takes a long time over 6 years the leakage current is 63.9 mA, temperature differences were measured over a period of time over 14 degree Celsius. This data will be useful as a guideline for solving problems and reducing power loss from leakage current. Moreover, it will be useful in predicting lifetime of ZnO SAs.
文摘Due to important consideration of protection against lightning surge on electrical, electronic and telecommunication equipment, it was necessary to carry out a special study to look at the performance of protective devices. The study was testing performance of arresters on low voltage system. The activity was testing of arresters using steady state and impulse voltages. The arresters consisted of gas tube, zener diode, varistor and spark gap arresters, then it was made a cascade circuit between the varistor and spark gap arresters with a decoupling element. The decoupling elements were used air, iron and ferrite. The test yielded data of current and voltage on the tables and oscilloscope waveforms. The arresters had cut voltages early different from each other, namely the gas tube, zener diode, spark gap and varistor arresters were at the voltages of 500 V, 250 V, 1,000 V and 565 V respectively. The iron core decoupling element cascade circuit had the least oscillation among remaining cores.
基金supported by the National Science Foundation of China,Nos.82325031(to FX),82030059(to YC),82102290(to YG),U23A20485(to YC)Noncommunicable Chronic Diseases-National Science and Technology Major Project,No.2023ZD0505504(to FX),2023ZD0505500(to YC)the Key R&D Program of Shandong Province,No.2022ZLGX03(to YC).
文摘Global brain ischemia and neurological deficit are consequences of cardiac arrest that lead to high mortality.Despite advancements in resuscitation science,our limited understanding of the cellular and molecular mechanisms underlying post-cardiac arrest brain injury have hindered the development of effective neuroprotective strategies.Previous studies primarily focused on neuronal death,potentially overlooking the contributions of non-neuronal cells and intercellular communication to the pathophysiology of cardiac arrest-induced brain injury.To address these gaps,we hypothesized that single-cell transcriptomic analysis could uncover previously unidentified cellular subpopulations,altered cell communication networks,and novel molecular mechanisms involved in post-cardiac arrest brain injury.In this study,we performed a single-cell transcriptomic analysis of the hippocampus from pigs with ventricular fibrillation-induced cardiac arrest at 6 and 24 hours following the return of spontaneous circulation,and from sham control pigs.Sequencing results revealed changes in the proportions of different cell types,suggesting post-arrest disruption in the blood-brain barrier and infiltration of neutrophils.These results were validated through western blotting,quantitative reverse transcription-polymerase chain reaction,and immunofluorescence staining.We also identified and validated a unique subcluster of activated microglia with high expression of S100A8,which increased over time following cardiac arrest.This subcluster simultaneously exhibited significant M1/M2 polarization and expressed key functional genes related to chemokines and interleukins.Additionally,we revealed the post-cardiac arrest dysfunction of oligodendrocytes and the differentiation of oligodendrocyte precursor cells into oligodendrocytes.Cell communication analysis identified enhanced post-cardiac arrest communication between neutrophils and microglia that was mediated by neutrophil-derived resistin,driving pro-inflammatory microglial polarization.Our findings provide a comprehensive single-cell map of the post-cardiac arrest hippocampus,offering potential novel targets for neuroprotection and repair following cardiac arrest.
基金Supported by the National Natural Science Foundation of China(No. 50737001)
文摘The amplitude of switching overvoltages is a key factor for designing the insulation of UHV equipment. The effect of different arresters needs to be studied, since installing arresters is an important way to suppress switching overvoltages in UHV transmission lines. Switching overvoltages on the 1000 kV Huainan-Huxi double-circuit transmission line were simulated for different operating modes and different arrester designs using the electromagnetic transient program PSCAD/EMTDC. With parallel resistors, the switching overvoltages are less than 1.70 p.u. （1.0 p.u.=1100×√ 2 /√3 kV）. If the arrestors are better, the switching overvoltages can be reduced even lower to 1.55 p.u. Without parallel resistors, the arresters can reduce three-phase energizing overvoltages to 1.70 p.u, while the single-phase reclosing overvoltages still exceed the limit. The results show that the parallel resistors cannot be eliminated if the arresters are only installed at each end of the transmission line. Also, better quality arresters significantly lower the switching overvoltages.
基金supported by the Natural Science Fund of Fujian Province,No.2020J011058(to JK)the Project of Fujian Provincial Hospital for High-level Hospital Construction,No.2020HSJJ12(to JK)+1 种基金the Fujian Provincial Finance Department Special Fund,No.(2021)848(to FC)the Fujian Provincial Major Scientific and Technological Special Projects on Health,No.2022ZD01008(to FC).
文摘Cardiac arrest can lead to severe neurological impairment as a result of inflammation,mitochondrial dysfunction,and post-cardiopulmonary resuscitation neurological damage.Hypoxic preconditioning has been shown to improve migration and survival of bone marrow–derived mesenchymal stem cells and reduce pyroptosis after cardiac arrest,but the specific mechanisms by which hypoxia-preconditioned bone marrow–derived mesenchymal stem cells protect against brain injury after cardiac arrest are unknown.To this end,we established an in vitro co-culture model of bone marrow–derived mesenchymal stem cells and oxygen–glucose deprived primary neurons and found that hypoxic preconditioning enhanced the protective effect of bone marrow stromal stem cells against neuronal pyroptosis,possibly through inhibition of the MAPK and nuclear factor κB pathways.Subsequently,we transplanted hypoxia-preconditioned bone marrow–derived mesenchymal stem cells into the lateral ventricle after the return of spontaneous circulation in an 8-minute cardiac arrest rat model induced by asphyxia.The results showed that hypoxia-preconditioned bone marrow–derived mesenchymal stem cells significantly reduced cardiac arrest–induced neuronal pyroptosis,oxidative stress,and mitochondrial damage,whereas knockdown of the liver isoform of phosphofructokinase in bone marrow–derived mesenchymal stem cells inhibited these effects.To conclude,hypoxia-preconditioned bone marrow–derived mesenchymal stem cells offer a promising therapeutic approach for neuronal injury following cardiac arrest,and their beneficial effects are potentially associated with increased expression of the liver isoform of phosphofructokinase following hypoxic preconditioning.
基金supported by the National Natural Science Foundation of China(32170144 and 32470146).
文摘Severe fever with thrombocytopenia syndrome(SFTS)is a novel emerging acute infectious disease caused by severe fever with thrombocytopenia syndrome virus(SFTSV),characterized by high fever and thrombocytopenia.It has been proved that traditional Chinese medicine(TCM)has displayed definite therapeutic effects on viral hemorrhagic fever,indicating its potential to treat SFTS.In this study,SFTS-relative key targets were predicted via gene ontology(GO)analysis and kyoto encyclopedia of genes and genomes(KEGG)enrichment analysis.Molecular docking was then used to select stable binders.Molecules matched TCMs were identified,and a new prescription,Qingqi Guxue decoction(QQGX),was formulated to clear heat and nourish blood,with a resulting drug composition network.We explored the optimal drug proportion for QQGX.Through an in-depth study of molecular mechanisms,we found that QQGX induces S phase arrest by promoting the degradation of cyclin A2(CCNA2)and cyclin-dependent kinase 2(CDK2),thereby inhibiting SFTSV replication.Finally,we verified the effectiveness and safety of QQGX based on the mouse liver bile duct organoid model infected with SFTSV.In summary,our study prepared a TCM decoction using the method of network pharmacology.This decoction has a significant inhibitory effect on the replication of SFTSV and provides a new treatment strategy for hemorrhagic fever with TCM.
基金supported by the High-Level Public Health Technical Talent Building Program (Discipline Leader-01-01)Capital’s Funds for Health Improvement and Research (CFH 2022-1-2032)+1 种基金National Natural Science Foundation of China (82072136)Beijing Hospitals Authority’s Ascent Plan (DFL20240302)。
文摘BACKGROUND:Post-cardiac arrest brain injury remains the leading cause of mortality and longterm disability in patients following cardiac arrest(CA).However,optimizing clinical management strategies for bundled therapy after CA still faces challenges.METHODS:For this literature review,we searched PubMed,Web of Science,and SpringerLink databases for high-quality studies published between December 1982 and July 1,2024.The search included randomized clinical trials,meta-analyses,systematic reviews,and observational studies.References in included studies were also checked to identify additional sources.RESULTS:Many studies have identified potential targets for interventions to mitigate brain injury and improve outcomes for post-resuscitated patients.To optimize clinical management strategies to minimize brain injury after CA,we developed the acronym “SOOTEST-ICU” bundle,which includes “SOOTEST” therapy to optimize peripheral oxygen delivery and “ICU” intervention to optimize the cerebral oxygen cascade.The order of the “SOOTEST” treatment was organized based on the severity and importance of brain oxygen aff ecting brain injury.It includes systolic blood pressure and mean arterial pressure management,oxygenation and ventilation management,original etiological treatment,temperature control,electrolytes and acid basic status,seizure control,and targeted substrate delivery.The acronym “ICU” intervention includes intracerebral oxygen delivery,cerebral oxygen diff usion,and oxygen utilization.CONCLUSION:The “SOOTEST-ICU” therapy is developed to optimize oxygen and substrate cascades to minimize brain injury after CA.
基金supported by Progetto Trapezio,Compagnia di San Paolo(67935-2021.2174)to LB,Fondazione CRT(Cassa di Risparmio di Torino,RF=2022.0618)to LB。
文摘Brain plasticity-A universal tool with many variations:The study of brain plasticity has been gaining interest since almost a century and has now reached a huge amount of information(>80,000 results in PubMed).Overall,different types of plasticity,including stem cell-driven genesis of new neurons(adult neurogenesis),cells in arrested maturation(dormant neurons),neuro-glial and synaptic plasticity,can coexist and contribute to grant plastic changes in the brain,from a cellular to system level(Benedetti and Couillard-Despres,2022;Bonfanti et al.,2023).
文摘BACKGROUND Acute pancreatitis in pregnancy is a rare but serious condition that can lead to high maternal mortality and fetal loss.Instances of pregnancy complicated by severe acute pancreatitis,particularly with subsequent respiratory and cardiac arrest,are rarely reported.CASE SUMMARY We present the case of a 35-year-old woman,at 36+5 weeks of gestation,who presented with paroxysmal epigastric pain accompanied by low back pain,nausea,and vomiting.According to the clinical symptoms,B-ultrasound imaging and biochemical indicators,the patient was diagnosed with acute pancreatitis and initially managed conservatively.However,3 hours after admission,the patient experienced respiratory and cardiac arrest,and the fetus died.In this case,the adverse outcomes occurred due to the lack of aggressive fluid resuscitation and an active surgical intervention.CONCLUSION Implementing aggressive fluid resuscitation to sustain tissue perfusion,alongside the proactive evaluation of pharmacological agents that suppress gastric acid secretion and inhibit pancreatic enzyme activity,may be beneficial in mitigating the risk of a severely adverse prognosis.Effective management of acute pancreatitis during pregnancy requires careful timing of surgical intervention,a thorough evaluation of the risks and benefits regarding the continuation or termination of pregnancy,and a focus on safeguarding both maternal and fetal health.
基金supported by the National Key Research and Development Program(2021YFC3002205)the Postgraduate Research and Innovation Program of Tianjin Municipal Education Commission(2022BKY113),China.
文摘Cardiac arrest(CA)is a critical condition in the field of cardiovascular medicine.Despite successful resuscitation,patients continue to have a high mortality rate,largely due to post CA syndrome(PCAS).However,the injury and pathophysiological mechanisms underlying PCAS remain unclear.Experimental animal models are valuable tools for exploring the etiology,pathogenesis,and potential interventions for CA and PCAS.Current CA animal models include electrical induction of ventricular fibrillation(VF),myocardial infarction,high potassium,asphyxia,and hemorrhagic shock.Although these models do not fully replicate the complexity of clinical CA,the mechanistic insights they provide remain highly relevant,including post-CA brain injury(PCABI),post-CA myocardial dysfunction(PAMD),systemic ischaemia/reperfusion injury(IRI),and the persistent precipitating pathology.Summarizing the methods of establishing CA models,the challenges encountered in the modeling process,and the mechanisms of PCAS can provide a foundation for developing standardized CA modeling protocols.
基金Supported by Scientific Research Projects from Wuhan Municipal Health Commission of China,No.WX23B42.
文摘BACKGROUND Cardiac arrest caused by acute pulmonary embolism(PE)is the most serious clinical circumstance,necessitating rapid identification,immediate cardiopulmonary resuscitation(CPR),and systemic thrombolytic therapy.Extracorporeal CPR(ECPR)is typically employed as a rescue therapy for selected patients when conventional CPR is failing in settings where it can be implemented.CASE SUMMARY We present a case of a 69-year-old male who experienced a prolonged cardiac arrest in an ambulance with pulseless electrical activity.Upon arrival at the emergency department with ongoing manual chest compressions,bedside pointof-care ultrasound revealed an enlarged right ventricle without contractility.Acute PE was suspected as the cause of cardiac arrest,and intravenous thrombolytic therapy with 50 mg tissue plasminogen activator was administered during mechanical chest compressions.Despite 31 minutes of CPR,return of spontaneous circulation was not achieved until 8 minutes after initiation of Veno-arterial extracorporeal membrane oxygenation(ECMO)support.Under ECMO support,the hemodynamic status and myocardial contractility significantly improved.However,the patient ultimately did not survive due to intracerebral hemorrhagic complications,leading to death a few days later in the hospital.CONCLUSION This case illustrates the potential of combining systemic thrombolysis with ECPR for refractory cardiac arrest caused by acute PE,but it also highlights the increased risk of significant bleeding complications,including fatal intracranial hemorrhage.
基金supported by the Regional Science Foundation Project of the National Natural Science Foundation of China(Project No:82160157)the Beijing High-Level Public Health Technology Talent Construction Project(Project No.:Leading Talents-03-10).
文摘Cardiac arrest(CA)is considered a state of clinical death in which the heart suddenly loses its ability to effectively expel blood,resulting in circulatory and respiratory arrest.CA is often catastrophic for patients,as it can cause serious long-term cardiovascular and cerebrovascular complications that affect their quality of life[1].Survey data indicate that the overall incidence rate of intraoperative CA in patients undergoing thoracic surgery in China is currently 0.138%[2].This rate is expected to increase because of the increasing proportion of older individuals(age>60 years)in the population,as well as the increasing pulmonary surgery rates.However,the incidence rate during the perianesthetic period in older patients undergoing thoracic surgery has not yet been comprehensively reported.
基金supported by the National High Level Hospital Clinical Research Funding (2022-NHLHCRF-YS-03)the National Natural Science Foundation of China (82272196)。
文摘BACKGROUND:Post-cardiac arrest syndrome(PCAS) significantly contributes to mortality after initially successful cardiopulmonary resuscitation(CPR) in cardiac arrest(CA) patients.Effective cardiocerebral protection is essential for improving post-resuscitation survival.This study investigated the mechanisms and common targets of myocardial dysfunction and brain injury after resuscitation.METHODS:The male Sprague-Dawley rats(10–12 weeks old,400–500 g) were divided into two groups:the control group(n=6),which received sham surgery,and the CA/CPR group(n=10),which received ventricular fibrillation(VF) followed by CPR.After 24 h,brain and heart tissues were collected for analysis.The sequencing was used to identify differentially expressed genes(DEGs) between control and CA/CPR rats.RESULTS:At 24 h after resuscitation,CA/CPR rats presented 217 DEGs in the hippocampus and 80 DEGs in the left ventricle(LV) compared to the control group.In the hippocampus,the most notable biological process was the positive regulation of tumor necrosis factor production,with key pathways related to inflammation and the immune response.In the LV,the Gene Ontology(GO)enrichment analysis revealed that gene alterations were primarily associated with amyloid-beta clearance,a pathway that was also relevant in the brain.Eleven common targets were identified in the DEGs of both heart and brain tissues.The reverse transcription-polymerase chain reaction(RTPCR) validation revealed significant differences in the mRNA expression of Timp1,Apln,Ccl7,and Lgals3 in both LV and hippocampus.CONCLUSION:This study identified possible key genes and underlying mechanisms involved in PCAS.The differential genes Timp1,Apln,Ccl7,and Lgals3 might serve as common biomarkers for myocardial and neurological injury following resuscitation.
文摘Modern cardiopulmonary resuscitation(CPR)has been established for more than 60 years;however,its success rate remains low.Currently,the global incidence of out-of-hospital cardiac arrest(OHCA)is rising,ranging from 52.5 to 97.1 per 100,000 population.[1,2]Survival-to-discharge rates for OHCA and in-hospital cardiac arrest(IHCA)are not satisfactory,with ranges of 1.2%-9.9%and 9.1%-19.1%,respectively.
文摘BACKGROUND Cardiac arrest is a critical condition characterized by abrupt cessation of cardiac function,resulting in reduced oxygen delivery to vital organs and rapid progression to death if not timely treated.Despite advances in medical science and resuscitation techniques,cardiac arrest remains a significant burden globally,with survival rates remaining low.Comprehensive research on cardiac arrest,particularly comparisons between in-hospital cardiac arrest(IHCA)and out-of-hospital cardiac arrest(OHCA),is limited.AIM To compare the survival rates,return of spontaneous circulation(ROSC),survival to discharge,and neurological outcomes after IHCA and OHCA in Arab Asian countries.METHODS We systematically searched PubMed,Medline,EMBASE and Google Scholar(2000-2024)using keywords(“IHCA”,“OHCA”,“cardiac arrest”,“Middle East”,“Arab”,“Asian”)in titles/abstracts.The inclusion criterion was observational studies on adults(≥18 years)in Arab Asian countries reporting relevant outcomes.The exclusion criteria were narrative reviews,non-Arab Asian studies,non-English publications,inaccessible full texts,pediatric-only populations,and studies lacking outcome data.RESULTS In total,44 observational studies from nine Arab Asian countries comprising 32535 participants were included.This review highlights the substantial variability in cardiac arrest outcomes in Asian countries.OHCA mortality rates were alarmingly high in several nations,with Kuwait(99%),Bahrain(98.8%),and Qatar(97.6%)reporting the highest figures.In contrast,the Kingdom of Saudi Arabia(KSA)had a markedly lower OHCA mortality rate(8.2%).The rates of ROSC also varied,with Qatar achieving the highest(34.4%)and Kuwait the lowest(3.3%).Survival to hospital discharge ranged from 1.2%in Bahrain to 18.7%in Kuwait,with Qatar also reporting favorable rates(17.5%).For IHCA,mortality was 73.6%in the United Arab Emirates(UAE)and 72.8%in KSA,whereas Lebanon and Iraq reported higher rates of 94.6%and 88%,respectively.ROSC rates were the highest in Lebanon(55.9%)and the UAE(51.3%).Neurological outcome reporting has been inconsistent,although Qatar reported a high rate(68.6%)for OHCA survivors.Comparative data showed generally better survival and neurological outcomes with IHCA than with OHCA.CONCLUSION This systematic review underscores the clear disparity in survival outcomes between IHCA and OHCA in Arab Asian countries,with IHCA demonstrating superior outcomes.Despite progress in some countries,outcomes remain suboptimal compared with international standards.Future multicenter studies with standardized methodologies are required to generate high-quality evidence and provide region-specific interventions for cardiac arrest management.
基金Supported by Heilongjiang Provincial Key Research and Development Program(Guided Category)(GZ20220039)Central Government Funds for Local University Reform and Development(Talent Cultivation Program)(2020GSP16).
文摘Morusin is a flavonoid compound isolated and extracted from the root bark of Morus alba L.Studies have reported that morusin exerts anti-tumor effects by inhibiting cancer cell invasion and proliferation,as well as inducing tumor cell apoptosis.This article comprehensively reviews recent research on the anti-tumor effects of morusin and its related molecular mechanisms,aiming to provide theoretical support for further studies and new drug development of morusin.
基金supported by Major Scientific Research Special Project for High-level Talents in Health and Wellness,Hunan Province(R2023072)Project of Hunan Provincial Department of Finance(2050205)Hunan Provincial Department of Finance Project(050205).
文摘Objective This systematic review and meta-analysis aimed to identify the main factors influencing the public’s willingness to participate in out-of-hospital emergency care.Methods Studies were searched in online databases,including PubMed,Embase,Web of Science,and the Cochrane Library.The articles included in this review were published from inception to July 31,2024.The Iain Crombie assessment tool was used to assess study quality.Meta-analysis was performed using RevMan(version 5.4)software.The review protocol has been registered with PROSPERO(CRD42024570491).Results A total of 1,434 research articles were initially identified,among which 18 were incorporated into this study,and all of the included studies were cross-sectional.Meta-analysis results demonstrated that gender(male;OR=1.37,95%CI:1.28–1.47),profession(healthcare provider;OR=0.17,95%CI:0.06–0.47),knowledge and skill level(OR=1.63,95%CI:1.25–2.11),willingness to undergo training(OR=2.68,95%CI:1.89–3.79),interest in first aid(OR=2.08,95%CI:1.60–2.69),previous training(OR=2.14,95%CI:1.49–3.08),and previous first-aid experience(OR=1.70,95%CI:1.37–2.11)were the principal influencing factors of the public’s willingness to engage in out-of-hospital cardiopulmonary resuscitation.Conclusion Demographic factors,knowledge,belief,and behavior are crucial in influencing public emergency decision-making.Medical personnel could create specialized training programs based on relevant factors to enhance the public's willingness to engage in out-of-hospital CPR.
文摘Unheralded cardiac arrest among previously healthy young people without antecedent illness,months or years after coronavirus disease 2019(COVID-19)vaccination,highlights the urgent need for risk stratification.The most likely underlying pathophysiology is subclinical myopericarditis and reentrant ventri-cular tachycardia or spontaneous ventricular fibrillation that is commonly preci-pitated after a surge in catecholamines during exercise or the waking hours of terminal sleep.Small patches of inflammation and/or edema can be missed on cardiac imaging and autopsy,and the heart can appear grossly normal.This paper reviews evidence linking COVID-19 vaccines to cardiac arrest where unfortu-nately the majority of victims have had no antecedent clinical evaluation.We propose a comprehensive strategy for evaluating cardiovascular risk post-vaccination,incorporating detailed patient history,antibody testing,and cardiac diagnostics in the best attempt to detect abnormalities before sudden cardiac death.This approach aims to identify individuals at higher risk of cardiac events after COVID-19 vaccination and guide appropriate clinical management.It is prudent for each primary care physician to have a pre-established plan when addressing this issue in their practice.
