The United States is experiencing a renaissance in interest in space due to the advent of new lowercost small spacecraft. New launch entrants, such as Interorbital Systems, promise to lower launch cost levels. Many developers also benefit from free-to-developer launch services from NASA or the ESA. Unfortunately, existing commercial off the shelf (COTS) CubeSat hardware is priced based on amortization of design costs across low-sales volume. A lack of trained staff in any one of the numerous disciplines required for spacecraft design or other resources required for in-house development restricts entry into the small satellite industry to those who can afford expensive COTS hardware or pay for significant design expenses. With entry-level satellite hardware still priced in the six-figure range, limited market growth is expected even as the average CubeSat launch cost continues to decline. A new archetype could lower barriers to entry for building small satellites. A free, public-domain architecture for building a small satellite could allow low-cost, in-house satellite development. Under this paradigm, the expenses for initiating a small satellite program are limited to component and launch vehicle costs. The proposed framework allows for broad access to small satellite hardware, greatly increasing the size of the small satellite developer community. In the context of the small satellite market, freely offering plans to construct an entry-level satellite will court new non-traditional actors into building space hardware for launch on commercial and government small satellite launchers. The low-cost, high flight rate possible with the next generation of launch systems affords operators the freedom to experiment and innovate in a risktolerant environment. Successfully demonstrating products and services utilizing low-risk, publicdomain plans will stimulate demand for mature and more capable flight systems in the retail marketplace. If technical schools, community colleges, universities, small businesses and even amateurs can enter into the small satellite ecosystem, at an affordable entrance price, a positive spiral of increasing demand and decreasing cost may be created over time. A free, public domain satellite architecture may, thus, open the door to sustained growth and commercial opportunity for the small satellite industry. A. K. Nervold et al.15

OBJECTIVES:To perform a systematic review and meta-analysis to generate estimates of mortality in patients with COVID-19 that required hospitalization, ICU admission, and organ support.DATA SOURCES: A systematic search of PubMed, Embase, and the Cochrane databases was conducted up to December 31, 2021.STUDY SELECTION: Previously peer-reviewed observational studies that reported ICU, mechanical ventilation (MV), renal replacement therapy (RRT) or extracorporeal membrane oxygenation (ECMO)-related mortality among greater than or equal to 100 individual patients.DATA EXTRACTION: Random-effects meta-analysis was used to generate pooled estimates of case fatality rates (CFRs) for in-hospital, ICU, MV, RRT, and ECMO-related mortality. ICU-related mortality was additionally analyzed by the study country of origin. Sensitivity analyses of CFR were assessed based on completeness of follow-up data, by year, and when only studies judged to be of high quality were included.