Getting to Zero: Achievement of 95-95-95 and Declining Hiv Incidence in Eswatini

Background: Achieving UNAIDS global 95 targets among people living with HIV (PLHIV) is key to HIV epidemic control. Eswatini, a country with one of the severest HIV epidemics, has implemented an aggressive national HIV response with comprehensive HIV prevention and treatment services. We assessed progress towards these targets in the high HIV disease burden setting of Eswatini. Method(s): We compared 95-95-95 indicators and HIV incidence from two sequential Population-based HIV Impact Assessment (PHIA) surveys conducted in Eswatini in 2016 and 2021. These PHIAs were similarly designed as nationally representative household surveys among individuals 15 years and older. Respondents completed interviews and provided blood samples for HIV rapid testing (Determine and Unigold), antiretrovirals (ARV) testing, and viral load (VL) measurement. The first 95 (diagnosed PLHIV) was assessed by self-report or detectable ARVs;second 95 (on treatment) by self-report or detectable ARVs among diagnosed PLHIV, and third 95 (VL suppression, VLS) as VL < 1,000 copies/mL among PLHIV on treatment. Annual HIV incidence was estimated from recent infections (classified by HIV-1 LAg avidity assay, VL and ARV detection) using the formula recommended by the World Health Organization Incidence Working Group. Survey weights accounting for sample selection probabilities and adjusted for nonresponse and noncoverage were applied. Result(s): The 11,199 adults in the 2021 PHIA were at 94-97-96, while the 10,934 adults in the 2016 PHIA were at 87-89-91, a statistically significant increase of 5-10% in all 95 indicators (see Table). Target achievement varied by sex, but all 95 indicators improved among men (92-96-97 in 2021 vs 80-90-91 in 2016) and women (95-98-96 in 2021 vs 91-88-91 in 2016). Overall annual HIV incidence declined by 45% from 1.13% in 2016 to 0.62% in 2021 (p = 0.055). Annual HIV incidence in 2021 was nearly seven times higher among women (1.11%) than among men (0.17%). Conclusion(s): These findings reflect substantial progress toward HIV epidemic control, a remarkable achievement in the context of health, social and economic disruptions and challenges associated with the COVID-19 era. The 2021 data highlight remaining gaps in knowledge of HIV status, particularly among men, and HIV incidence reduction, particularly among women.

Integrating Virtual Simulation into Nursing Education: A Roadmap

Background: Simulation education is needed to train a highly competent nursing workforce. In-person simulation requires many resources, such as faculty, space, and time, that can negatively affect its feasibility. These barriers have prompted educators to seek new technologies to provide experiential learning opportunities, such as virtual simulation (VS). The COVID-19 pandemic further highlighted the need for educators to investigate alternative learning opportunities.Methods: A quantitative cross-sectional study was conducted with pre-licensure and advanced practice nursing students. They participated in a VS learning experience that was evaluated using the System Usability Scale (SUS)(R), the Clinical Learning Environment Comparison Survey (CLECS 2.0), and the Simulation Effectiveness Tool-Modified (SET-M).Result: 197 pre-licensure and 11 advanced nursing practice students completed post-simulation eval-uations. The results from the SUS scale found the overall virtual system effective. Evaluating the CLECS tool found students' perceived experience was relatively similar for face-to-face simulation and screen-based simulation. The SET-M indicated students rated the VS simulation experience positively. Conclusion: VS for nursing education can be an effective experiential learning tool.

I am surprised that it works so well”: clinicians' views on delivering psychological assessments and therapy to young people in a fully-digital mental health service

Purpose: Many mental health clinicians have delivered services digitally in response to the COVID-19 pandemic. Emerging research suggests that, despite some initial discomfort, therapists appear to adjust to remote working. The purpose of this study is to explore the views of clinicians working within a fully digital organisation towards digital service provision. Design/methodology/approach: Clinicians (N = 52) providing digital mental health assessments and treatments at Healios anonymously completed a mixed-methods questionnaire. Findings: In all, 85% of participants enjoyed working remotely and 71% thought they would continue to work online over the next 5–10 years. Of the participants, 40% reported low confidence in online work's efficacy before working remotely, but 96% reported confidence at the time of questionnaire completion: suggesting confidence increased with experience. An exploratory "inverted” factor analysis generated a two-factor solution, grouping clinicians into two factors based on key views. Factor 1 was predominantly characterised by satisfaction with training received and factor 2 by quality of technical experiences (encountering problems less often and greater personal confidence in resolving them). Qualitative feedback described some benefits of, and barriers to, digital service provision. Clinicians reflected on a perceived change in cultural norms, with more openness to digital services following the COVID-19 pandemic. On a personal level, teletherapy was viewed more favourably with increased personal experience. Originality/value: Clinicians' confidence in providing services digitally is discussed, with reference to how this may be affected by extent of remote working experience and availability of technical support. Staff well-being within the digital workspace is also discussed. © 2023, Emerald Publishing Limited.

Impact of the Covid-19 Pandemic in Patients Attending Renal Clinic at Kingston Public Hospital, Jamaica

Introduction: Early in the pandemic various lockdown measures were implemented to decrease spreading of Covid-19. This resulted in many clinics and hospitals observing a decrease in the usual numbers of patients accessing care. Patients have also expressed fears and challenges with accessing care at health clinics and hospitals during this time. Since May 2020, there has been a gradual decrease in the restrictions and stay at home orders for Covid-19 by the government in Jamaica and more persons have begun to access care again at health facilities. The impact of the Covid-19 pandemic in patients with chronic kidney disease especially those who were not admitted with Covid-19 is limited. This study seeks to determine why patients were not accessing care early in the pandemic and the possible longer-term impact of the Covid-19 pandemic on the care and prognosis of patients with chronic kidney disease. Method(s): All patients who attended Renal clinic, Kingston Public Hospital (KPH) from April 20th to July 14th 2021 were eligible for inclusion in the study. Those who consented to participate in the study had an interview with the researcher at the Renal clinic where a questionnaire was administered. Demographic data was collected as well as whether they were a new or follow-up patient and number of appointments missed was noted. Their renal diagnosis and labs were obtained from their dockets by the researchers. The data was analysed using Microsoft excel and Epi info software Results: There were 185 participants. 45.7% of the participants were 51 to 70 years old. 61.1% were females and 38.9% were males. Follow-up patients accounted for 76.2% of the participants whilst 23.8% were new patients. 92.2% of the follow-up patients reported attending clinic in the past year. 15.1% of the participants reported missing at least one appointment in the past year. Most common reasons given for missing appointments were forgot date of appointment, afraid of coming to hospital, was sick at home or admitted to hospital. 2.7% of the participants reported having had Covid-19. Only 7.0% of the study participants were on dialysis. 76.9% of those receiving dialysis were started on haemodialysis since March 2020. 93.0% reported receiving all or most of their medications through the free public health care system during the pandemic. 44.3% of the participants reported working in the past year. Most common reasons given for not working in the past year were medical condition, receiving family support or retired. Only 3.6% reported being sent home by an employer due to the pandemic. The most common renal diagnoses were diabetic nephropathy and hypertensive nephrosclerosis followed by lupus nephritis and sickle cell nephropathy. 49.2% were CKD stage 3b to Stage 5. 14.6% of those who were CKD stage 3 near to March 2020 progressed to CKD stage 4 or 5 by a year later. Conclusion(s): During the pandemic, attendance of patients at Renal clinic, Kingston Public Hospital and their access to medications remained high. Approximately 15% of those with CKD stage 3 near the onset of the pandemic progressed to CKD stage 4 or 5 by a year later. This warrants further study. No conflict of interestCopyright © 2023

Conceptual Framework of Contact-Less Consumer Products Industry During and Post-pandemic Era

The COVID-19 era has reshaped the world regarding the contact-less economy, healthcare systems, remote work environment, people's lifestyle and their daily routines, etc. The consumer products (CP) industry is being impacted due to the behaviours of consumers during self-quarantine. This accelerates adopting digital transformation and upgrading the business models for the contact-less CP industry. Accordingly, this study provides a step toward the contact-less CP industry during and post-pandemic. First, we have proposed a conceptual framework for the contact-less CP industry that aims to bring together the key advanced technologies (e.g., Digital Twin (DT), blockchain, AI, cloud computing, 5G, and robots). The combination of the advanced technologies provides data monitoring, transparency, traceability, automation, and data sharing among consumers and CP partners. The proposed framework will enable a more contact-less personalized interaction that will work towards higher levels of consumer satisfaction while maintaining contact-less economy growth. Then, we have described how the proposed framework can be applied for contact-less delivery services for the CP industry during and post-pandemic. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

A Digital Health Initiative (COVIDsmart) for Remote Data Collection and Study of COVID-19's Impact on the State of Virginia: Prospective Cohort Study.

BACKGROUND: The COVID-19 pandemic has affected people's lives beyond severe and long-term physical health symptoms. Social distancing and quarantine have led to adverse mental health outcomes. COVID-19-induced economic setbacks have also likely exacerbated the psychological distress affecting broader aspects of physical and mental well-being. Remote digital health studies can provide information about the pandemic's socioeconomic, mental, and physical impact. COVIDsmart was a collaborative effort to deploy a complex digital health research study to understand the impact of the pandemic on diverse populations. We describe how digital tools were used to capture the effects of the pandemic on the overall well-being of diverse communities across large geographical areas within the state of Virginia. OBJECTIVE: The aim is to describe the digital recruitment strategies and data collection tools applied in the COVIDsmart study and share the preliminary study results. METHODS: COVIDsmart conducted digital recruitment, e-Consent, and survey collection through a Health Insurance Portability and Accountability Act-compliant digital health platform. This is an alternative to the traditional in-person recruitment and onboarding method used for studies. Participants in Virginia were actively recruited over 3 months using widespread digital marketing strategies. Six months of data were collected remotely on participant demographics, COVID-19 clinical parameters, health perceptions, mental and physical health, resilience, vaccination status, education or work functioning, social or family functioning, and economic impact. Data were collected using validated questionnaires or surveys, completed in a cyclical fashion and reviewed by an expert panel. To retain a high level of engagement throughout the study, participants were incentivized to stay enrolled and complete more surveys to further their chances of receiving a monthly gift card and one of multiple grand prizes. RESULTS: Virtual recruitment demonstrated relatively high rates of interest in Virginia (N=3737), and 782 (21.1%) consented to participate in the study. The most successful recruitment technique was the effective use of newsletters or emails (n=326, 41.7%). The primary reason for contributing as a study participant was advancing research (n=625, 79.9%), followed by the need to give back to their community (n=507, 64.8%). Incentives were only reported as a reason among 21% (n=164) of the consented participants. Overall, the primary reason for contributing as a study participant was attributed to altruism at 88.6% (n=693). CONCLUSIONS: The COVID-19 pandemic has accelerated the need for digital transformation in research. COVIDsmart is a statewide prospective cohort to study the impact of COVID-19 on Virginians' social, physical, and mental health. The study design, project management, and collaborative efforts led to the development of effective digital recruitment, enrollment, and data collection strategies to evaluate the pandemic's effects on a large, diverse population. These findings may inform effective recruitment techniques across diverse communities and participants' interest in remote digital health studies.

A comparative analysis exposes an amplification delay distinctive to SARS-CoV-2 Omicron variants of clinical and public health relevance.

Mutations in the SARS-CoV-2 genome may negatively impact a diagnostic test, have no effect, or turn into an opportunity for rapid molecular screening of variants. Using an in-house FDA Emergency Used Authorized RT-qPCR-based COVID-19 diagnostic assay, we combined sequence surveillance of viral variants and computed PCR efficiencies for mismatched templates. We found no significant mismatches for the N, E, and S set of assay primers until the Omicron variant emerged in late November 2021. We found a single mismatch between the Omicron sequence and one of our assay's primers caused a >4 cycle delay during amplification without impacting overall assay performance. Starting in December 2021, clinical specimens received for COVID-19 diagnostic testing that generated a Cq delay greater than 4 cycles were sequenced and confirmed as Omicron. Clinical samples without a Cq delay were largely confirmed as the Delta variant. The primer-template mismatch was then used as a rapid surrogate marker for Omicron. Primers that correctly identified Omicron were designed and tested, which prepared us for the emergence of future variants with novel mismatches to our diagnostic assay's primers. Our experience demonstrates the importance of monitoring sequences, the need for predicting the impact of mismatches, their value as a surrogate marker, and the relevance of adapting one's molecular diagnostic test for evolving pathogens.

High-Intensity, Occupation-Specific Physical Therapy for a Firefighter's Return to Work Following Critical Covid-19

BACKGROUND AND PURPOSE: Firefighting is a demanding and hazardous profession requiring optimal physical and cognitive health. Occupational risk factors associated with firefighting (contact with the public, pulmonary damage from repeated exposure to fire) may place firefighters at an increased risk of contracting SARSCoV-2 as well as for suffering complications resulting from fulminant COVID-191, which can result in impaired physical2 and cognitive3 performance. Current recommendations for rehabilitation following COVID-19 may be insufficient to address the unique physical and cognitive demands required to perform fire suppression tasks.4 The purpose of this case report is to describe the efficacy of a high-intensity, occupation-specific physical therapy (HIOS-PT)5 program to improve aerobic capacity, muscular strength, and cognitive performance sufficient to return a firefighter to full duty within 6 months following hospital discharge for critical COVID-19. CASE DESCRIPTION: A 36-year-old firefighter completed 30 sessions of HIOS-PT with hopes of returning to his strenuous occupation as a firefighter following a 70-day complicated hospitalization for critical COVID-19 pneumonia and acute respiratory distress syndrome requiring invasive mechanical ventilation. Initial evaluation revealed impaired aerobic capacity of less than the first percentile for age and sex on cardiopulmonary exercise testing6, impaired muscular strength on isokinetic testing, and impaired cognitive performance as assessed by an app-based information processing task (reaction time and accuracy). The HIOS-PT program was symptom-limited simulated real work activities based on previous literature describing the effect of similar programming with first responders in cardiac rehabilitation5, while improving strength, cognition, and aerobic capacity sufficient to meet fitness standards required to return to work. Additionally, the patient performed 3 simulated candidate physical ability tests each increasing in intensity which consisted of 9 fire suppression activities required by his department7. Followup assessments were performed after completion of 30 HIOS-PT sessions. OUTCOME(S): Aerobic capacity increased 54% from a VO2=25.4 mL/kg/min (7.3 METs) to VO2=39.2 mL/kg/min (11.2 METs). Muscular strength increased from 59% to >96% body weight. Cognitive performance on an information processing test increased 175% from a score of 556 to 1530. Upon discharge from the HIOS-PT program, the patient returned to full duty as a firefighter. DISCUSSION: HIOS-PT was well tolerated and effective in rehabilitating a firefighter to return to work following a prolonged hospitalization for critical COVID-19. Rehabilitation guidelines for occupational athletes, such as firefighters, following critical COVID-19 is limited and may be insufficient to adequately prepare these individuals for return to strenuous work duties. This case supports the exploration into using HIOS-PT for individuals required to perform heavy work following critical COVID-19.

Re-Imaging the Future in Urban Studies and Built Environment Discourse: A Neurourbanism Perspective

Neurological constructs are being applied in various fields;within urban studies and built environments, neurourbanism stands out. To understand this concept, this study seeks to conduct a scientometric analysis of the concept of neurourbanism. To do so, we gauged the intellectual structure and clarified the influencers and emerging themes while seeking to identify essential gaps in neurourbanism research in urban studies and the built environment. Data were sorted from Dimensions Artificial Intelligence platform because of its reliability in providing the needed dataset accurately, and the Citespace software was used to analyze the data. Our results suggest plurality in explaining the risk factors in urbanicity research, particularly regarding prevalence, incidence, and the general cause of psychosis in urban living. The study also shows that players in the construction sector, such as engineers, town planners, and developers, have not fully grasped how the built environment assists in improving well-being, reducing stress levels of urbanists, assisting migrants in settling into the community, and the general mental wellness of those who live in the city. The study also identified a correlation between urbanization and mental health and added that the main recipient of rapid urban transformation countries does not show leadership in neurourbanism studies.

A Universal 'Day Zero' Infectious Disease Testing Strategy Exploiting Crispr-Based Sample Depletion And Metagenomic Sequencing

Background. The lack of preparedness for detecting the highly infectious SARS-CoV-2 pathogen - the pathogen responsible for the COVID-19 disease - caused enormous harm to the public health, the economy and society as a whole. It took ~60 days for the first RT-PCR tests for SARS-CoV-2 infection developed by the United States Centers for Disease Control (CDC) to be made available. It then took >270 days to deploy 800,000 of these tests at a time when the estimated actual testing needs required over 6 million tests per day. Testing was therefore limited to only individuals with symptoms or individuals in close contact with confirmed positive cases. Testing strategies that can be deployed on a population scale at 'day zero' (i.e., at the time of the first reported case) are needed. Next Generation Sequencing (NGS) has such day zero capabilities with the potential to enable feasible and broad large-scale testing strategies, however it has limited detection sensitivity for low copy numbers of pathogens which may be present. Here we demonstrate that using CRISPR-Cas9 to remove abundant sequences that do not contribute to pathogen detection, NGS detection sensitivity is equivalent to RT-PCR. In addition, we show that this assay can be used for variant strain typing, co-infection detection, and individual human host response assessment - all in a single workflow using existing open-source analysis pipelines. This NGS workflow is pathogen agnostic, and therefore has the potential to radically transform how both very large-scale pandemic response and focused clinical infectious disease testing are pursued in the future. Methods. Covid positive samples with RT-PCR Ct values from 16-39 were processed through the CRISRP enhanced mNGS pipeline. Results. Sn/Sp compared to RT-PCR was 97%/100%. Strain calling concordance compared to amplicon sequencing was 100%. Co-infections from Covid positive samples were identified with high confidence. Host response signatures match the published literature. Conclusion. Applying CRISPR enhanced metagenomic NGS at Day Zero of the next pandemic can mitigate the time gap in developing approved diagnostics at population scale and potentially save lives.

Evaluation of immunogenicity and reactogenicity of COVID-19 vaccines in pregnant women.

OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy is associated with increased risk of adverse maternal and perinatal outcomes. Vaccines are highly effective at preventing severe coronavirus disease 2019 (COVID-19), but there are limited data on COVID-19 vaccines in pregnancy. This study aimed to investigate the reactogenicity and immunogenicity of COVID-19 vaccines in pregnant women when administered according to the 12-week-interval dosing schedule recommended in the UK. METHODS: This was a cohort study of pregnant women receiving COVID-19 vaccination between April and September 2021. The outcomes were immunogenicity and reactogenicity after COVID-19 vaccination. Pregnant women were recruited by phone, e-mail and/or text and were vaccinated according to vaccine availability at their local vaccination center. For immunogenicity assessment, blood samples were taken at specific timepoints after each dose to evaluate nucleocapsid protein (N) and spike protein (S) antibody titers. The comparator group comprised non-pregnant female healthcare workers in the same age group who were vaccinated as part of the national immunization program in a contemporaneous longitudinal cohort study. Longitudinal changes in serum antibody titers and association with pregnancy status were assessed using a two-step regression approach. Reactogenicity assessment in pregnant women was undertaken using an online questionnaire. The comparator group comprised non-pregnant women aged 18-49 years who had received two vaccine doses in primary care. The association of pregnancy status with reactogenicity was assessed using logistic regression analysis. RESULTS: Overall, 67 pregnant women, of whom 66 had received a mRNA vaccine, and 79 non-pregnant women, of whom 50 had received a mRNA vaccine, were included in the immunogenicity study. Most (61.2%) pregnant women received their first vaccine dose in the third trimester, while 3.0% received it in the first trimester and 35.8% in the second trimester. SARS-CoV-2 S-antibody geometric mean concentrations after mRNA vaccination were not significantly different at 2-6 weeks after the first dose but were significantly lower at 2-6 weeks after the second dose in infection-naïve pregnant compared with non-pregnant women. In pregnant women, prior infection was associated with higher antibody levels at 2-6 weeks after the second vaccine dose. Reactogenicity analysis included 108 pregnant women and 116 non-pregnant women. After the first dose, tiredness and chills were reported less commonly in pregnant compared with non-pregnant women (P = 0.043 and P = 0.029, respectively). After the second dose, feeling generally unwell was reported less commonly (P = 0.046) in pregnant compared with non-pregnant women. CONCLUSIONS: Using an extended 12-week interval between vaccine doses, antibody responses after two doses of mRNA COVID-19 vaccine were found to be lower in pregnant compared with non-pregnant women. Strong antibody responses were achieved after one dose in previously infected women, regardless of pregnancy status. Pregnant women reported fewer adverse events after both the first and second dose of vaccine. These findings should now be addressed in larger controlled studies. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

The impact of the SARS-COV-2 pandemic on surgical oncology cases at the University Hospital of the West Indies, Kingston, Jamaica

Objective: To evaluate the effect of the COVID-19 pandemic on prostatectomies, mastectomies, colectomies, and hysterectomies done at the University Hospital of the West Indies (UHWI). Design and Methods: Data was extracted from the records for the main operating theatre of the UHWI, for all cases done between January 1st, 2016, and September 30th, 2021. Patients who underwent any of these surgeries with a diagnosis of an associated cancer were included. The covid pandemic in Jamaica was considered to start March 1st, 2020, based on the detection of the first case in the island. Result(s): 921 cases were identified, 145 colectomies, 280 mastectomies, 114 prostatectomies and 382 hysterectomies. Comparisons were made of the mean number of cases done monthly pre and post pandemic. The rates pre and post were, 4.12 and 4.11 for mastectomies (p = 0.976), 2.20 and 2.0 for colectomies (p = 0.713), 5.65 and 5.74 for hysterectomies (p = 0.881) and 1.88 and 1.16 for prostatectomies (p = 0.012). The proportion of males in the population decreased from 20% to 15% (p = 0.155). The mean age for patients pre and post were, 55.8 and 56.1 for mastectomies (p = 0.842), 63.2 and 63.7 for colectomies (p = 0.82), 58.5 and 58.4 for hysterectomies (p = 0.91) and 63.7 and 61.2 for prostatectomies (p = 0.176). Conclusion(s): Except for prostatectomies, the pandemic has had little impact on the number of common oncological surgeries done at the UHWI. Investigation of the causes of the decreased number of prostatectomies is needed.

Evaluation of immunogenicity and reactogenicity of COVID‐19 vaccines in pregnant women

Objective SARS‐CoV‐2 infection in pregnancy is associated with increased risk of adverse maternal and perinatal outcomes including preterm birth, pre‐eclampsia, stillbirth, admission to intensive care unit and death. Vaccines are highly effective in preventing severe COVID‐19, however there are limited data on COVID‐19 vaccines in pregnancy. This study aimed to investigate the reactogenicity and immunogenicity of the COVID‐19 vaccine in pregnant women when given using the UK's extended 12‐week interval schedule. Methods This was a cohort study of pregnant women receiving COVID‐19 vaccination between January and September 2021. The primary outcome was immunogenicity and reactogenicity after COVID‐19 vaccination in pregnant women. Pregnant women were recruited by phone, email and text. They were vaccinated according to vaccine availability at their local vaccination hub and blood samples were taken at specific time points after each vaccine for nucleoprotein (N) and spike protein (S) antibodies. The comparator group comprised non‐pregnant female healthcare workers in the same age‐group who were vaccinated as part of the national immunization programme in a contemporaneous longitudinal cohort study. Association of variables with antibody levels was assessed using linear regression analysis after log‐transforming antibody levels. Reactogenicity assessment in pregnant women was undertaken using an online questionnaire. The comparator group comprised non‐pregnant women aged 18‐49 years who had received two vaccine doses in primary care. The association of pregnancy status with reactogenicity was assessed using logistic regression analysis. Results Overall 67 pregnant women including 66 who had received an mRNA vaccine and 50 non‐pregnant women were included in the immunogenicity study. Most pregnant women (61.2%) received the vaccine in the third trimester, while 3.0% received it in their first and 35.8% in the second trimesters. SARS‐CoV‐2 S‐antibody GMCs after mRNA vaccination were not significantly different at 2‐6 weeks after the first dose but were significantly lower at 2‐6 weeks after the second dose of vaccine in infection‐naïve pregnant compared to non‐pregnant women. In pregnant women, prior infection was associated with higher antibody levels compared to infection‐naïve women at 2‐6 weeks after both vaccine doses. The reactogenicity analysis included 108 pregnant women and 116 non‐pregnant women. After the first dose, tiredness and chills were reported less commonly in pregnant women when compared to non‐pregnant women (P=0.043 and P=0.029, respectively). After the second dose feeling generally unwell was reported less commonly (P=0.046) in pregnant women when compared to non‐pregnant women. Conclusions Using an extended 12‐week interval between vaccine doses, antibody responses after 2 doses of mRNA vaccine were found to be lower in pregnant women than in non‐pregnant women. However, Antibody responses to mRNA vaccination were lower in pregnant women when compared to non‐pregnant women. High antibody responses were achieved after one dose in previously infected women, regardless of pregnancy status. Pregnant women had fewer adverse effects after both the first and the second dose of the vaccine. These findings should now be addressed in larger controlled studies. This article is protected by copyright. All rights reserved.

Heliophysics Environmental & Radiation Measurement Experiment Suite (HERMES): A Small External Payload for Gateway with Big Challenges

Currently scheduled for liftoff in 2024, Gateway will be an outpost orbiting the moon for astronauts headed to and from the lunar surface and will serve as a staging point for deep space exploration. In January 2020, NASA Headquarters contacted Goddard Space Flight Center (GSFC) with a request that they provide a Heliophysics instrumentation package for Gateway. This package would later become known as the Heliophysics Environmental & Radiation Measurement Experiment Suite (HERMES). HERMES consists of four high-heritage instruments-a Miniaturized Electron pRoton Telescope (MERIT), an Electron Electrostatic Analyzer (EEA), a Solar Probe Analyzer-Ions (SPAN-I), and Noise Eliminating Magnetometer Instrument in a Small Integrated System (NEMISIS), which consists of one fluxgate and two magneto-inductive magnetometers. Launching HERMES with Gateway would provide an opportunity to conduct early science experiments on Gateway, but the plan to develop HERMES concurrently with Gateway and launch with the co-manifested vehicle brought numerous technical challenges for the pathfinder payload. HERMES was intended to be a low-cost, tailored Class-D mission, and maintaining that programmatic position proved difficult as the technical challenges grew. The effects of Coronavirus Disease 2019 (COVID-19) were not factored in from the beginning and also created programmatic challenges. This paper will discuss what's being done to overcome the technical and programmatic challenges to put HERMES on track for a 2024 Launch Readiness Date (LRD). © 2022 IEEE.

Heliophysics Environmental & Radiation Measurement Experiment Suite (HERMES): A Small External Payload for Gateway with Big Challenges

Currently scheduled for liftoff in 2024, Gateway will be an outpost orbiting the moon for astronauts headed to and from the lunar surface and will serve as a staging point for deep space exploration. In January 2020, NASA Headquarters contacted Goddard Space Flight Center (GSFC) with a request that they provide a Heliophysics instrumentation package for Gateway. This package would later become known as the Heliophysics Environmental & Radiation Measurement Experiment Suite (HERMES). HERMES consists of four high-heritage instruments – a Miniaturized Electron pRoton Telescope (MERIT), an Electron Electrostatic Analyzer (EEA), a Solar Probe Analyzer-Ions (SPAN-I), and Noise Eliminating Magnetometer Instrument in a Small Integrated System (NEMISIS), which consists of one fluxgate and two magneto-inductive magnetometers. Launching HERMES with Gateway would provide an opportunity to conduct early science experiments on Gateway, but the plan to develop HERMES concurrently with Gateway and launch with the co-manifested vehicle brought numerous technical challenges for the pathfinder payload. HERMES was intended to be a low-cost, tailored Class-D mission, and maintaining that programmatic position proved difficult as the technical challenges grew. The effects of Coronavirus Disease 2019 (COVID-19) were not factored in from the beginning and also created programmatic challenges. This paper will discuss what’s being done to overcome the technical and programmatic challenges to put HERMES on track for a 2024 Launch Readiness Date (LRD).