Iron is required for hemoglobin production, and it plays a key role during erythropoiesis. Systemic iron homeostasis is mainly negatively regulated by the peptide hormone hepcidin, coded by the gene HAMP. Hepcidin excess may cause iron deficiency, iron-restricted erythropoiesis, and anemia. Conversely, hepcidin insufficiency leads to iron overload and oxidative damage in multiple tissues. During regulation of hepcidin synthesis, multiple promoter elements in the HAMP gene respond to variable signaling pathways corresponding to different extracellular situations. It has been reported that hepcidin expression can be suppressed by secreted erythroid factors, including GDF15, TWSG1, GDF11, and ERFE, thereby increasing iron availability for hemoglobin synthesis. These potential erythroid factors act via intricate mechanisms that remain controversial. However, it is clear that hepcidin affects erythropoiesis, and promising therapies targeting hepcidin have been developed to treat erythroid disorders. These therapeutic strategies include suppressing or activating HAMP gene expression, mimicking or activating hepcidin activity, and blocking the ability of hepcidin to bind to its target ferroportin.
COVID-19 significantly increased perioperative risks including mortality and complications. Currently, the Omicron variant is the dominant strain worldwide. Omicron variant is highly contagious with lower incidence of severe diseases. Therefore, it is necessary to update recommendations for managing perioperative anesthesia equipment and protecting perioperative healthcare providers. This article aims to describe perioperative risks, anesthesia equipemnt management, and personelll protection when caring for Omicron patients.
By evaluating the stability of coastal wetland ecosystems, health conditions of regional ecosystems can be revealed and the sustainable development of coastal wetlands can be promoted. Coastal wetlands have been scarcely involved in present ecosystem stability evaluation studies, these being performed with relatively simple evaluation data sources. Therefore, in this research, a comprehensive and representative ecosystem stability evaluation index system was constructed by using the pressure-state-response model and multi-source datasets from perspectives of internal and external environmental changes of the Yancheng coastal wetlands, Jiangsu, China. The analysis results indicated that: (1) The ecosystem stability of the Yancheng coastal wetlands was at an early warning stage, and all segments except the Binhai segment (relatively stable) were in an early warning state. (2) In the criterion layer, the Dafeng District and the whole Yancheng District were faced with the highest pressure, followed by the Dongtai, Xiangshui and Binhai segments, successively. The Sheyang segment reached the highest state level, followed by the Binhai, Xiangshui and Dafeng segments in succession. (3) In the factor layer, the whole Yancheng District was faced with high resource and socioeconomic double pressures, with a poor water quality state and relatively low environmental pressure; favorable soil, biological and landscape states; and positive response to wetland protection. Various factors varied from county to county. (4) In the index layer, the ecosystem stability of the Yancheng coastal wetlands was significantly influenced by the invasion of alien species, change rate of natural wetland area (D32), change rate of artificial wetland area, increment of aquafarm area, intensity of fertilizer application and coverage of dominant vegetations. The novel significance of this research lies in enriching global coastal wetlands ecosystem stability evaluation investigations by providing a typical case study.
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