Case Report: Molecular autopsy underlie COVID-19-associated sudden, unexplained child mortality.

Herein, we report a child with COVID-19 and seemingly no underlying disease, who died suddenly. The autopsy revealed severe anemia and thrombocytopenia, splenomegaly, hypercytokinemia, and a rare ectopic congenital coronary origin. Immunohistochemical analysis demonstrated that the patient had acute lymphoblastic leukemia of the B-cell precursor phenotype (BCP-ALL). The complex cardiac and hematological abnormalities suggested the presence of an underlying disease; therefore, we performed whole-exome sequencing (WES). WES revealed a leucine-zipper-like transcription regulator 1 (LZTR1) variant, indicating Noonan syndrome (NS). Therefore, we concluded that the patient had underlying NS along with coronary artery malformation and that COVID-19 infection may have triggered the sudden cardiac death due to increased cardiac load caused by high fever and dehydration. In addition, multiple organ failure due to hypercytokinemia probably contributed to the patient's death. This case would be of interest to pathologists and pediatricians because of the limited number of NS patients with LZTR1 variants; the complex combination of an LZTR1 variant, BCP-ALL, and COVID-19; and a rare pattern of the anomalous origin of the coronary artery. Thus, we highlight the significance of molecular autopsy and the application of WES with conventional diagnostic methods.

Measures to Ensure the Sustainability of Information Systems in the COVID-19 Environment

National defense requires uninterrupted decision-making, even under direct or indirect impacts of non-traditional threats such as infectious diseases. Since all work utilizes information systems, it is very important to ensure the sustainability and availability of information systems. In particular, in terms of security management, defense work is being performed by dividing the network into a national defense network and a commercial Internet network. This study suggests a work execution plan for sustainability that takes into account the efficiency of work performed on the Internet and the effectiveness of security through effective defense information system operation. It is necessary to minimize the network contact points between the national defense network and the commercial Internet and to select high-priority tasks from various tasks and operate them efficiently. For this purpose, actual cases were investigated for an institution, "Organization A”, and characteristics were presented. Through the targeted tasks and operation plans presented in this paper to improve the effectiveness of defense tasks and ensure security, it will be possible to increase the sustainability and availability of task performance even under non-traditional threats such as infectious diseases. © 2022 by the authors.

Collective Knowledge and Experience for Resource-Focused Business Continuity Plans Foundation: Survey on How Home-Visit Nursing Operators in Japan Coped with the COVID-19 Pandemic

This paper presents a nationwide survey about how Japanese home-visit nursing stations prepared and coped with the coronavirus disease 2019 COVID-19 pandemic. This study also aimed to provide a practical foundation and guide to develop business continuity plans (BCPs) for home-visit nursing stations and nursing care facilities to cope with pandemics. We applied a resource-focused BCP framework to efficiently collect and summarize knowledge and experiences from many facilities about the responses and countermeasures based on the three fundamental purposes to keep resources: prevent loss, promote increase, and utilize limited resources. We conducted a survey during Japan's third wave of the COVID-19 pandemic and analyzed the responses using a qualitative and inductive content analysis method. We could develop categories to summarize various responses and countermeasures in a consistent and comprehensive manner. Based on the analysis results, we proposed six fundamental sub-plans to reorganize resource-focused BCP. The categorization and sub-plans are not special or innovative;however, since they focus only on resources and explain what we need to consider in BCPs in terms of action plans for resources, we expect that it is easier for BCP non-experts to understand the concept and utilize it for developing practical responses and countermeasures. © Fuji Technology Press Ltd.

Designing Business Continuity Plan for It Organizations: A Systematic Literature Review and Meta-Analysis

With the recent pandemic due to COVID-19 and several other uncertain events (due to human error or natural disaster), designing and implementation of Business Continuity Plan (BCP) has become a vital part of any organization. The organizations must prepare in advance and identify all possible uncertain events which may cause hindrance in their services. They must also access the consequences due to such events, which helps them devise such a plan that their operations do not pause even in such a disaster. This research explores the possibilities and finds a standard set of steps that must be taken care of while designing, testing, and implementing BCP. In this research paper, a systematic literature review has been performed on a previous research paper in the area of Business Continuity Plan to explore various options that an organization may adopt during a disaster. The studies were of moderate quality and had a low chance of being skewed by publishing prejudice. Subgroup analyses were not possible due to the heterogeneity of outcome tests, follow-up durations, and research forms. The new research should be used to help create and evaluate executive training strategies that facilitate long-term adaptive coping with PSP and reduce PT-SIs. The aim of this systematic review and metanalysis is to assess PSP coping effects over time. The number of patients born with congenital heart disease need to be monitored for the rest of their lives. Discontinuity of treatment, on the other hand, is a well-known issue that tends to be worsening at the time of transition to adulthood.

FLOOD CONTROL MEASURES OF CORE MEDICAL INSTITUTION: LESSONS LEARNED FROM FLOODS IN KUMA RIVER IN 2020

Recordable heavy rainfall hit and caused severe floods from the Kuma River in Hitoyoshi and Kuma regions in July, 2020 due to an active frontal rain system. This paper aims to clarify challenges and issues in measures taken by core medical institutions against large-scale floods, which have been identified in the flood event in Kuma River in July 2020, based on the interview with the core medical institution in those regions. The paper then discusses directions for effective flood countermeasures of core medical institutions in order to have more robust Business Continuity Plan (BCP) for large-scale flood disasters.抄録　令和2年7月豪雨災害では，九州地方や東北地方などで大規模な出水となり，中でも九州地方では人的被害を含む甚大な被害が生じた．一方で，本災害は，新型コロナウイルス感染症（COVID-19）が全国的に流行する中で発生した最初の大規模水害であり，特殊な感染症への対応を継続しつつも，大規模な水害が発生した場合に地域の医療機能をどのように維持していくかが大きく問われた災害でもあった．本稿では，人吉・球磨地方における地域医療の拠点病院に対して令和2年7月豪雨災害での球磨川の氾濫に伴う浸水時の状況と対応についてヒアリングを行った結果を報告するとともに，これを踏まえた拠点医療機関の水害対策の課題と方向性について述べる．

Ergonomic exposures and control measures associated with mass fatality decedent handling in morgues and body collection points in a New York healthcare system during COVID-19: A case series.

INTRODUCTION: In April 2020, novel coronavirus SARS-CoV-2 (COVID-19) produced an ongoing mass fatality event in New York. This overwhelmed hospital morgues necessitating emergent expansion of capacity in the form of refrigerated trucks, trailers, and shipping containers referred to as body collection points (BCPs). The risks for musculoskeletal injury during routine and mass fatality mortuary operations and experiences of decedent handlers throughout the "first wave" of COVID-19 are presented along with mitigation strategies. METHODS: Awareness of the high rates of musculoskeletal injury among health care workers due to ergonomic exposures from patient handling, including heavy and repetitive manual lifting, prompted safety walkthroughs of mortuary operations at multiple hospitals within a health system in New York State by workforce safety specialists. Site visits sought to identify ergonomic exposures and ameliorate risk for injury associated with decedent handling by implementing engineering, work practice, and administrative controls. RESULTS: Musculoskeletal exposures included manual lifting of decedents to high and low surfaces, non-neutral postures, maneuvering of heavy equipment, and push/pull forces associated with the transport of decedents. DISCUSSION: Risk mitigation strategies through participatory ergonomics, education on body mechanics, development of novel handling techniques implementing friction-reducing aides, procurement of specialized equipment, optimizing BCP design, and facilitation of communication between hospital and system-wide departments are presented along with lessons learned. After-action review of health system workers' compensation data found over four thousand lost workdays due to decedent handling related incidents, which illuminates the magnitude of musculoskeletal injury risk to decedent handlers.

Ecosystem-centric business continuity planning (eco-centric BCP): A post COVID19 new normal.

This article views the COVID-19 pandemic as an opportunity leading to a significant reduction in pollution levels, clean waters in rivers, improved visibility, and other tangible benefit to humanity and the environment. In Post-COVID scenario, to restore the margins and regain the lost production, industries are likely to increase their production leading to a quantum jump in the pollution levels. Having precedence of such a scenario in 2008-09, this article looks at what are the possible avenues to engage the city government and business houses through an a new normal ECO-BCP concept for long term sustainability. All economic stimulus needs to be tied down with the stringent reduction in the emission norms. The Ten Principles for the Eco-centric BCP guide the reopening of MSMEs after lockdown period called to check the spread of the COVID-19 pandemic. The Eco-centric BCP model will help the MSMEs to adopt the new-normal business strategies to align with the country-specific commitments to SDGs, SFDRR and Paris declaration.