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[730] The Commission noted that the limited resources of many safety-net hospitals may make it difficult for them to compete with other hospitals for labor and technology, and observed that [t]his disadvantage, in turn, could lead to difficulty maintaining quality of care and even to hospital closure. [731] During the earlier phases of the COVID-19 pandemic, for example, studies showed higher rates of mortality among patients who received treatment at certain safety-net hospitals, with researchers citing understaffing and lack of access to advanced therapies as some of the factors that may have contributed to negative health outcomes

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These key mediators can activate signal transduction cascades as well as induce changes in transcription factors, such as nuclear factor kappa B (NF-B), signal transducer and activator of transcription 3 (STAT3), hypoxia-inducible factor-1 (HIF1-), activator protein-1 (AP-1), nuclear factor of activated T cells (NFAT) and NF-E2 related factor-2 (Nrf2), which mediate immediate cellular stress responses (Figure 2)

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Cell Death Differ 17 , 13731380 (2010)