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Countries use battle management systems (BMS) that enable commands to share digital situational awareness information. In the network of electronic warfighting platforms where military assets are classified as agents and where multiple subsystems interact, potential permutations and combinations of interactions can cause unpredictable negative or positive feedback loops, resulting in unpredictable or unwanted outcomes, which is referred to as emergence behaviour. [ABSTRACT FROM AUTHOR]

Many countries including Ukraine use battle management systems (BMS) like Delta that enable command to share situation awareness information; this study focuses on the distribution of information across a warfighting network. Similar to natural systems, where autonomous agents, such as ants and bees, follow a set of simple rules, a BMS is a network of bases and electronic warfighting platforms that have military assets as agents within the network, guided by the defense doctrine. The rationale for the workability of such a system is based on each subsystem being reliable when multiple subsystems interact. However, the potential permutations and combinations of interactions can cause unpredictable negative or positive feedback loops, resulting in unpredictable and unwanted outcomes. The results of emergent behavior are unexpected and sometimes unwanted in areas such as intelligence, and wireless networks. Understanding emergent behavior is imperative in understanding complex engineering systems, and to present new insights, and take practical steps toward improving complex systems design and analysis. This paper presents the BMS and networks with examples of user-defined system integration of the network soldier concept. We believe that Ukrainian and other armies can directly benefit from utilising meta cybernetics, meta metasystem model analysis to control emergence. [ABSTRACT FROM AUTHOR]

Background: Real‐world evidence is an essential component of evidence‐based medicine. The aim of the BICSTaR (BICtegravir Single Tablet Regimen) study is to assess effectiveness and safety of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in antiretroviral treatment‐naïve (TN) and treatment‐experienced (TE) people with HIV. Methods: BICSTaR is a prospective, observational cohort study. Participants (≥18 years) are being followed for 24 months. A pooled analysis is presented at 12 months, with the primary endpoint of effectiveness (HIV‐1 RNA <50 copies/mL) and secondary endpoints of safety and tolerability (as per protocol). An exploration of patient‐reported outcome measures using standardized questionnaires is included. Results: Between June 2018 and May 2021, 1552 people with HIV were enrolled across 12 countries. The analysed population comprised 1509 individuals (279 TN, 1230 TE); most were white (76%), male (84%) and had one or more comorbid conditions (68%). Median age was 47 years. After 12 months of B/F/TAF treatment, HIV‐1 RNA was <50 copies/mL in 94% (221/236) of TN participants and 97% (977/1008) of TE participants. Median CD4 cell count increased by 214 cells/μL (p < 0.001) in TN participants and 13 cells/μL (p = 0.014) in TE participants; median CD4/CD8 ratios increased by 0.30 and 0.03, respectively (both p < 0.001). Persistence was high at 12 months (TN, 97%; TE, 95%). No resistance to B/F/TAF emerged. Study drug‐related adverse events occurred in 13% of participants through 12 months, leading to B/F/TAF discontinuation in 6%. Conclusions: The findings of this study provide robust real‐world evidence to support the broad use of B/F/TAF in both TN and TE people with HIV. [ABSTRACT FROM AUTHOR]

The objective of this systematic literature review was to investigate the current understanding of the competencies needed by Engineering Asset Management personnel in local authorities within Australia. During the development of the search string for the literature review, it was found that there were no available peer-reviewed articles on Engineering Asset Management competencies through an Australian local authority lens between January 2010 and December 2019 within the searched databases. Based on this, the search string criteria was re-focused onto Engineer Asset Management competencies within Australia (in general), as the new frame. Using this updated string search, the authors searched several databases (EBSCOHost, Informit, Scopus Informit and Web of Science) for research published in English between January 2010 and December 2019 that detailed the competencies deemed necessary for personnel undertaking Engineering Asset Management activities within the Australian context. Additional records were searched for in relation to the topic, from a range of Engineering and Engineering Management Conferences held between 2010 and 2019. Two hundred and thirty publications were identified through database searches, while eight conference proceedings were identified from the additional conference search. These were initially checked for duplicates, and then subjected to the refinement stage against a detailed review criteria, as per the PRISMA framework checklist process. Four articles progressed through the full PRISMA framework process. Further in-depth reviews of the remaining four papers found that one article was principally focused on the Australian Quality Framework (AQF) certification training processes, while the remaining three papers contained data of competency requirements (and example subjects) for Engineering Asset Management personnel within Australia. This data was collated, and through a deductive qualitative content analysis, was coded into three common themes: (1) Technical skills, (2) Professional skills – internally focused and (3) Professional skills – externally focused. The review process undertaken within this research initially showed that there were no papers within the original search frame of Australian local authorities, while the updated search detailed limited available literature within the general Australian context. This highlights an apparent gap within the available literature for the research topic scope during the period within January 2010 and December 2019. [ABSTRACT FROM AUTHOR]

This paper analyses a fourteen-year period of Western Australian data from the client information system of the Department for Child Protection and Family Support. Western Australia saw a large increase in the number of children in state care similar to trends across Australia as a whole. The study shows the following trends: changes in response to ‘referrals' with particular increases in the number of findings of neglect and increasing proportions of these followed swiftly by entry to care; changes in patterns of entry to care with more children under one-year-old entering; increased length of stay of children in care; and, the high incidence of Aboriginal children entering and remaining in care. The data demonstrate unequivocally that increased ‘referrals’ are not associated with increased substantiations of harm or ‘acts of commission with dangerous intent’, but that neglect assessed early in the lives of children was the major precipitant for entry to care and particularly so for Aboriginal infants. [ABSTRACT FROM AUTHOR]

Introduction: BICSTaR (GS-EU-380-4472/GS-CA-380-4574/GS-IL-380- 5335) is an ongoing, multinational, observational cohort study evaluating real-world effectiveness and safety of B/F/TAF in ART naïve (TN) and ARTexperienced (TE) PLWH. Materials and Methods: This 12M pooled analysis included PLWH starting B/F/TAF in clinical practice from June 2018 to September 2020 (latterly during the COVID-19 pandemic) in Europe/Israel/Canada. Outcomes included virological effectiveness (HIV‐1 RNA <50 copies/ml [missing=excluded]), persistence, drug‐related adverse events (DRAEs), and laboratory parameters. Results: One-thousand one hundred thirty-five PLWH were included (Table 1). The TE group had older median age than TN. Of TE participants, 65%/20%/16% switched from INSTI/NNRTI/PI-based regimens (36% TDF/46% TAF/13% ABC); 12% had prior virologic failure. Baseline resistance was documented in 124/535 participants (NRTI/NNRTI/PI/ INSTI=6%/6%/3%/0.2%). Prevalence of comorbidities (47%/72% TN/TE) and concomitant medication usage was high. At 12M, 97% (149/154) of TN and 96% (771/800) of TE participants had HIV-1 RNA <50 copies/ml, and persistence on B/F/TAF was high [91% (1032/1135)]. In a multivariable analysis, TE participants with neuropsychiatric disorder ongoing at baseline had lower odds for viral suppression (odds ratio=0.45, 95% CI: 0.21-0.96). There was no emergence of resistance to the components of B/F/TAF. DRAEs occurred in 13% (148/1135) of participants; gastrointestinal and neuropsychiatric DRAEs were the most common (3% each). Discontinuations due to DRAEs were low (TN 4%; TE 6%). Serious DRAEs were rare (0.2%; 2 TE participants with depression). Lipidchanges are shown (Figure 1). Conclusion: B/F/TAF was associated with high levels of effectiveness and persistence after 12M in this large real-world cohort of TN and TE PLWH with a high comorbidity burden. Effectiveness was demonstrated across key subgroups (females, older participants, late presenters). Importantly, there were no new or unexpected safety findings. Collectively, these real-world data continue to support the use of B/F/TAF in clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: BICSTaR is an ongoing, multinational, observational cohort study evaluating B/F/TAF in ART therapy-naïve (TN) and ART-experienced (TE) PLWH. The BICSTaR population has a high baseline prevalence of comorbidities (particularly neuropsychiatric). PROs were prospectively collected. Materials and Methods: One hundred eighty TN/955 TE participants were considered for the 12M analysis (cut-off Feb 2021, including people enrolled from Jun 2018 to Sept 2020, i.e. partially during the COVID19 pandemic). PRO measures: Adherence [visual analogue scale (VAS)]; physical/mental health [short form 36 (SF-36) questionnaire: Aggregated physical/mental component summary (PCS/MCS) scores; HIV-symptom index (HIV-SI; symptoms dichotomised into bothersome/not bothersome); HIV treatment satisfaction questionnaire (HIVTSQ; TE only); physician visits. VAS/SF-36/HIV-SI: Analysis population restricted to participants with questionnaires completed at both baseline/12M. SF-36/HIV-SI/HIVTSQ were described for participants with/without prior/ongoing neuropsychiatric comorbidities (TE only as TN subgroup was small). Results: Adherence to treatment was high at baseline (TE) and was maintained at 12M after switch to B/F/TAF [Table 1 (T1)]. Statistically significant improvements in PCS/MCS scores were observed in TN participants at 12M (p<0.05); scores remained stable in TE participants (Figure 1). The medyan (Q1, Q3) number of bothersome symptoms in TN participants declined from 6 (2, 9) at baseline to 2 (0, 6) at 12M (p<0.001; T1); TE, no change in absolute count. Statistically significant reductions in the frequency of several bothersome symptoms were reported in TN participants (p<0.05) (TE: No statistically significant changes). Treatment satisfaction was high at baseline (TE), with improvements observed at 12M following switch to B/F/TAF (p<0.001) (T1). Physician visits are shown (T1). In TE participants with baseline prior/ongoing neuropsychiatric comorbidities [275/955 (29%)], similar PRO trends were seen. Conclusion: In this real-world cohort of PLWH with a high prevalence of comorbidities (and in the setting of a global pandemic), patient-reported adherence, physical/mental health, bothersome symptoms, and treatment satisfaction were maintained/showed improvements during 12M of B/F/ TAF treatment. [ABSTRACT FROM AUTHOR]

This 96-week, randomized, open-label study was designed to assess the efficacy and safety of two single-tablet regimens in treatment naïve HIV-1-infected adults: rilpivirine (RPV) + emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) and efavirenz (EFV) + FTC/TDF. Assessments included patient-reported Medication Adherence Self-Report Inventory, SF-12v2 Quality of Life assessment, HIV Treatment Satisfaction Questionnaire, and HIV Symptom Index Questionnaire through Week 48. Additional evaluations included study drug discontinuations due to treatment-emergent adverse events (TEAEs). A total of 786 participants (n=394 RPV/FTC/TDF, n=392 EFV/FTC/TDF) were included. Fewer RPV/FTC/TDF-treated than EFV/FTC/TDF-treated participants discontinued study drug due to TEAEs (2.5% vs. 8.7%), with 41% (14/34) TEAE-related discontinuations in the EFV/FTC/TDF group occurring within the first four weeks of treatment. Treatment adherence and satisfaction remained high through Week 48 and quality of life improved from baseline in both groups. There were no significant between-group differences in virologic success (HIV-1 RNA <50 copies/mL) regardless of adherence (<95% or ≥95%). Significant between-group differences favouring RPV/FTC/TDF were observed for the HIV SIQ symptoms of difficulty falling or staying asleep (p = .022) and diarrhea or loose bowel movements (p = .002). In conclusion, 48-week treatment with RPV/FTC/TDF or EFV/FTC/TDF was associated with high adherence, high treatment satisfaction, and improved quality of life. TEAE-related discontinuations and patient-reported symptoms indicate that RPV/FTC/TDF may be somewhat better tolerated than EFV/FTC/TDF. [ABSTRACT FROM PUBLISHER]

This article uses a comprehensive database about children in adversity collected over the 16-year period from 1990 to 2005 in the state of Western Australia. The focus of this interrogation is the effect of major changes in responses to information about children brought to the attention of the Western Australian statutory authority in a 10-year period during this 16 years. The initiative for these changes was termed New Directions , and its associated policy and practice changes were aimed at differentiating information expressing concerns about children and families from allegations of child maltreatment. They emphasized the provision of supportive and empowering services to families experiencing difficulties – a form of differential response to children in adversity. The article covers the period leading up to the policy and practice change and the 10 years during which these changes were implemented. It examines some effects of the new policy and comments on whether the changes resulted in missed opportunities to protect children from harm, which in turn, might have led to higher rates of re-reporting. The authors present an overall picture of the nature of the information accepted by the statutory authority and how the interpretation of that information might have affected subsequent outcomes for children. In doing so, it shows that the policy and consequential practice changes associated with a differential response mechanism had long lasting positive effects that, despite dire warnings, did not compromise the protection of the small group of children identified as requiring protective interventions. [ABSTRACT FROM AUTHOR]

Introduction: The ongoing observational BICSTaR study aims to demonstrate effectiveness, safety and tolerability of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in routine clinical practice in at least 1400 antiretroviral treatment (ART)-naive (TN) and ARTexperienced (TE) people living with HIV (PLHIV). Materials and Methods: This 12-month (12M) analysis of PLHIV receiving B/F/TAF in Europe and Canada assessed HIV 1-RNA (missing data=excluded analysis), drug-related (DR) adverse events (AEs), persistence and weight/body mass index (BMI) change. Results: At the time of data cut-off (March 2020), 513 participants (n=84 TN/n=429 TE) completed a 12M visit. Most were male (91%) and white (89%); the median age was 38 (TN) and 49 (TE) years. Prevalence of comorbidities at baseline was 76%; the most common were neuropsychiatric (28%), hyperlipidemia (18%) and hypertension (18%). 71%/18%/13% of TE participants switched from INSTI/NNRTI/PI-based regimens, respectively (26% TDF); 8% had a history of prior virologic failure. Baseline primary resistance prevalence by historical genotype was 9% [n=43/513; 5% had resistance mutations associated with NNRTIs, 3% PIs, 3% NRTIs (n=8 M184V/I, n=1 K65R) and 0.2% with INSTIs (n=1 G140S)]. At 12M, 100% of TN (n=74/74) and 96% (n=357/373) TE participants had viral load (VL) <50 copies/ml. Comparable and high effectiveness was observed in both male and female participants, including older individuals (Table 1). No major resistance substitutions to the components of B/F/TAF emerged. DRAEs occurred in 14% (n=12/84) of TN and 15% (n=64/429) of TE participants, with the most common being gastrointestinal (5%) and neuropsychiatric (4%); discontinuations due to DRAE were low (TN 3.6% and 7.2% TE) and 90% of study participants remained on B/F/TAF (n=462/513). Serious DRAEs were rare [0.4%; all in TE participants (n=2 depression)]. At 12M, median (Q1, Q3) weight change was +2.5 kg (0.5, 6.3) for TN (n=48) and +0.9 kg (-1.0, 3.0) for TE (n=269), with small changes in BMI of +0.8 kg/m² (0.1, 1.9) for TN and +0.3 kg/m² (-0.3, 1.0) for TE. Weight increase >10% was observed in 19% (n=9/48) and 5% (n=15/269) of TN and TE participants, respectively. Conclusion: The use of B/F/TAF in this real-world clinical cohort was associated with a high level of effectiveness and safety through 12M, inclusive of male, female and older PLHIV. [ABSTRACT FROM AUTHOR]