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ABSTRACT Neisseria meningitidis serogroup B (NmB) strains have diverse antigens, necessitating methods for predicting meningococcal serogroup B (MenB) vaccine strain coverage. The genetic Meningococcal Antigen Typing System (gMATS), a correlate of MATS estimates, predicts strain coverage by the 4-component MenB (4CMenB) vaccine in cultivable and non-cultivable NmB isolates. In Taiwan, 134 invasive, disease-causing NmB isolates were collected in 2003–2020 (23.1%, 4.5%, 5.2%, 29.8%, and 37.3% from individuals aged ≤11 months, 12–23 months, 2–4 years, 5–29 years, and ≥30 years, respectively). NmB isolates were characterized by whole-genome sequencing and vaccine antigen genotyping, and 4CMenB strain coverage was predicted using gMATS. Analysis of phylogenetic relationships with 502 global NmB genomes showed that most isolates belonged to three global hyperinvasive clonal complexes: ST-4821 (27.6%), ST-32 (23.9%), and ST-41/44 (14.9%). Predicted strain coverage by gMATS was 62.7%, with 27.6% isolates covered, 2.2% not covered, and 66.4% unpredictable by gMATS. Age group coverage point estimates ranged from 42.9% (2–4 years) to 66.1% (≤11 months). Antigen coverage estimates and percentages predicted as covered/not covered were highly variable, with higher estimates for isolates with one or more gMATS-positive antigens than for isolates positive for one 4CMenB antigen. In conclusion, this first study on NmB strain coverage by 4CMenB in Taiwan shows 62.7% coverage by gMATS, with predictable coverage for 29.8% of isolates. These could be underestimated since the gMATS calculation does not consider synergistic mechanisms associated with simultaneous antibody binding to multiple targets elicited by multicomponent vaccines or the contributions of minor outer membrane vesicle vaccine components.IMPORTANCEMeningococcal diseases, caused by the bacterium Neisseria meningitidis (meningococcus), include meningitis and septicemia. Although rare, invasive meningococcal disease is often severe and can be fatal. Nearly all cases are caused by six meningococcal serogroups (types), including meningococcal serogroup B. Vaccines are available against meningococcal serogroup B, but the antigens targeted by these vaccines have highly variable genetic features and expression levels, so the effectiveness of vaccination may vary depending on the strains circulating in particular countries. It is therefore important to test meningococcal serogroup B strains isolated from specific populations to estimate the percentage of bacterial strains that a vaccine can protect against (vaccine strain coverage). Meningococcal isolates were collected in Taiwan between 2003 and 2020, of which 134 were identified as serogroup B. We did further investigations on these isolates, including using a method (called gMATS) to predict vaccine strain coverage by the 4-component meningococcal serogroup B vaccine (4CMenB).

Objectives: Budgetary constraints force healthcare authorities to set priorities for optimal vaccine interventions. A comprehensive decision-making tool would help inform the best combination and sequence of introduction of vaccines within constrained budgets. Methods: Looking at available vaccines against pneumococcal infections in Taiwan (10/13-valent pneumococcal conjugate vaccines [PCV10, PCV13] and 23-valent pneumococcal polysaccharide vaccine [PPV23]), a constrained optimization (CO) model was used to assess the optimal combination of vaccines in children and older adults that would maximize the quality-adjusted life years under predefined budget constraints. Scenario analyses were carried out to evaluate the impact of vaccine efficacy (VE) on the optimized solution. Results: The CO model demonstrated that the optimal sequence of vaccine introduction was PPV23 in older adults and PCV10 in children. The optimal solution was mostly driven by the potential to reduce disease burden in the older adult population. The VE of PPV23 in older adults and the VE of PCV vaccines against serotype 19A invasive pneumococcal disease had little impact on the optimal solution. Conclusions: The CO approach can be used to set priorities for introducing new vaccines while maximizing health gains per age group within the constrained National Vaccine Fund for the prevention of pneumococcal disease in Taiwan.

Background: This study was conducted to establish the minimal detectable change (MDC) and clinically important differences (CIDs) of the physical category of the Stroke-Specific Quality of Life Scale in patients with stroke. Methods: MDC and CIDs scores were calculated from the data of 74 participants enrolled in randomized controlled trials investigating the effects of two rehabilitation programs in patients with stroke. These participants received treatments for 3 weeks and underwent clinical assessment before and after treatment. To obtain testretest reliability for calculating MDC, another 25 patients with chronic stroke were recruited. The MDC was calculated from the standard error of measurement (SEM) to indicate a real change with 95% confidence for individual patients (MDC95). Distribution-based and anchor-based methods were adopted to triangulate the ranges of minimal CIDs. The percentage of scale width was calculated by dividing the MDC and CIDs by the total score range of each physical category. The percentage of patients exceeding MDC95 and minimal CIDs was also reported. Results: The MDC95 of the mobility, self-care, and upper extremity (UE) function subscales were 5.9, 4.0, and 5.3 respectively. The minimal CID ranges for these 3 subscales were 1.5 to 2.4, 1.2 to 1.9, and 1.2 to 1.8. The percentage of patients exceeding MDC95 and minimal CIDs of the mobility, self-care, and UE function subscales were 9.5% to 28.4%, 6.8% to 28.4%, and 12.2% to 33.8%, respectively. Conclusions: The change score of an individual patient has to reach 5.9, 4.0, and 5.3 on the 3 subscales to indicate a true change. The mean change scores of a group of patients with stroke on these subscales should reach the lower bound of CID ranges of 1.5 (6.3% scale width), 1.2 (6.0% scale width), and 1.2 (6.0% scale width) to be regarded as clinically important change. This information may facilitate interpretations of patient-reported outcomes after stroke rehabilitation. Future research is warranted to validate these findings. [ABSTRACT FROM AUTHOR]

This research examined how retrospective self-assessments of performance are affected by major depression. To test the validity of the depressive realism versus the selective processing hypotheses, aggregate posttest performance estimates (PTPEs) were obtained from clinically depressed patients and an age-matched comparison group across 4 decision tasks (object recognition, general knowledge, social judgment, and line-length judgment). As expected on the basis of previous findings, both groups were underconfident in their PTPEs, consistently underestimating the percentage of questions they had answered correctly. Contrary to depressive realism, and in partial support of the selective processing account, this underconfidence effect was not reduced but modestly exacerbated in the depressed patients. Further, whereas the PTPEs of the comparison group exceeded that expected on the basis of chance alone those of the depressed individuals did not. The results provide no support for the depressive realism account and suggest that negative biases contribute to metacognitive information processing in major depression. [ABSTRACT FROM AUTHOR]

Researchers have repeatedly demonstrated that women continue to be underrepresented in publication output in the sciences. This is true even in female-rich fields such as archaeology. Since most gender-related publication studies rely on data from peer-reviewed journals, it would be instructive, though challenging, to also track publication output in non-refereed and professional or industry venues, which tend to be more accessible to those working in extra-academic settings. This comparison is important in fields such as archaeology in which the vast majority (approximately 90%) of practitioners in the USA work for private sector cultural resource management firms and federal and state agencies. To understand the dynamics of who publishes where, we compiled a new dataset tracking over 40 years of peer-reviewed versus non-peer-reviewed publications that publish articles on the archaeology of California (an American Indian cultural area including southwest Oregon, most of the state of California, and Baja Mexico) and the Great Basin culture area (spanning eight western USA states). Historic gender differences in the publishing output of authors identified as men versus those identified as women were revealed by articles published between 1974 and 2016 in two refereed journals, the Journal of California Anthropology/ Journal of California and Great Basin Anthropology and California Archaeology, and in one un-refereed venue, the Society for California Archaeology Proceedings. Although multiple independent measures indicate that women are contributing and active members of the discipline, publishing records yield more variable results. Specifically, while women have historic and increasingly robust levels of participation in the non-peer-reviewed Proceedings, they remain vastly underrepresented in the two peer-reviewed journals, which are widely regarded as more prestigious and influential. We argue that this "peer review gap" is influenced by variation in the costs (largely time investment) and benefits of publication for people working in different professional roles (e.g., agency professionals, private/cultural resource management firm personnel, tenure-track faculty, adjunct faculty, etc.). We also argue that these cost and benefit variations may ultimately influence the decisions of people of all genders and backgrounds, but, because of the current structure of our discipline-including the fact that women and minorities lag in positions where costly peer-reviewed publication is a rewarded and supported activity-overwhelmingly affect these groups. We recognize that non-refereed publications such as Proceedings provide an important means of bridging the peer review gap and give voice to individuals from diverse backgrounds and perspectives.