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Using data from the Louisiana Department of Public Health, we explored the spatial relationships between the Social Vulnerability Index (SVI) and COVID-19-related vaccination and mortality rates. Publicly available COVID-19 vaccination and mortality data accrued from December 2020 to October 2021 was downloaded from the Louisiana Department of Health website and merged with the SVI data; geospatial analysis was then performed to identify the spatial association between the SVI and vaccine uptake and mortality rate. Bivariate Moran's I analysis revealed significant clustering of high SVI ranking with low COVID-19 vaccination rates (1.00, p  < 0.001) and high smoothed mortality rates (0.61,  p  < 0.001). Regression revealed that for each 10% increase in SVI ranking, COVID-19 vaccination rates decreased by 3.02-fold (95% CI = 3.73-2.30), and mortality rates increased by a factor of 1.19 (95% CI = 0.99-1.43). SVI values are spatially linked and significantly associated with Louisiana's COVID-19-related vaccination and mortality rates. We also found that vaccination uptake was higher in whites than in blacks. These findings can help identify regions with low vaccination rates and high mortality, enabling the necessary steps to increase vaccination rates in disadvantaged neighborhoods., Competing Interests: Conflict of interestThe authors declare that the research was conducted without any commercial or financial relationships construed as a potential conflict of interest., (© The Author(s) 2022.)

Background: Vaccinating susceptible populations quickly and safely is vital during a pandemic. Mass vaccination programs using a drive-through method have been shown to reach large numbers of people efficiently during vaccine campaigns., Methods: We performed a quantitative, cross-sectional study analyzing data collected by the COVID-19 mass vaccination program conducted by Louisiana State University Health Shreveport (LSUSH)., Results: Between December 2020 and September 2021, the vaccination program administered 90,655 COVID-19 vaccines. Among those who received at least the first dose of the vaccine, there were 21,700 men and 28,269 women; 22,820 were ≥60 years of age; 28,031 identified as Caucasian, 19,249 as African American, 47,916 as non-Hispanic, and most of them reported that they had not tested positive for COVID-19 before vaccination., Discussion: The LSUHS vaccination center served people from different regions within Louisiana as well as those from outside Louisiana. Vaccination is a crucial public health measure in the fight against the COVID-19 pandemic., Conclusions: Our study showed that the mass vaccination program conducted by LSUHS had a considerable positive impact on communities in Northwest Louisiana. This drive-through method is an effective strategy with which to reach a significant number of people during a pandemic., Competing Interests: Conflicts of interest The authors declare that the research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest.

Unintentional injuries are among the ten leading causes of death in older adults; falls cause 60% of these deaths. Despite their effectiveness to improve balance and reduce the risk of falls, balance training programs have several drawbacks in practice, such as lack of engaging elements, boring exercises, and the effort and cost of travelling, ultimately resulting in low adherence. Exergames, that is, digital games controlled by body movements, have been proposed as an alternative to improve balance. One of the main challenges for exergames is to automatically quantify balance during game-play in order to adapt the game difficulty according to the skills of the player. Here we perform a multidimensional exploratory data analysis, using visualization techniques, to find useful measures for quantifying balance in real-time. First, we visualize exergaming data, derived from 400 force plate recordings of 40 participants from 20 to 79 years and 10 trials per participant, as heat maps and violin plots to get quick insight into the nature of the data. Second, we extract known and new features from the data, such as instantaneous speed, measures of dispersion, turbulence measures derived from speed, and curvature values. Finally, we analyze and visualize these features using several visualizations such as a heat map, overlapping violin plots, a parallel coordinate plot, a projection of the two first principal components, and a scatter plot matrix. Our visualizations and findings suggest that heat maps and violin plots can provide quick insight and directions for further data exploration. The most promising measures to quantify balance in real-time are speed, curvature and a turbulence measure, because these measures show age-related changes in balance performance. The next step is to apply the present techniques to data of whole body movements as recorded by devices such as Kinect., Competing Interests: The authors have declared that no competing interests exist.

Background: Exergames are becoming an increasingly popular tool for training balance ability, thereby preventing falls in older adults. Automatic, real time, assessment of the user's balance control offers opportunities in terms of providing targeted feedback and dynamically adjusting the gameplay to the individual user, yet algorithms for quantification of balance control remain to be developed. The aim of the present study was to identify movement patterns, and variability therein, of young and older adults playing a custom-made weight-shifting (ice-skating) exergame., Methods: Twenty older adults and twenty young adults played a weight-shifting exergame under five conditions of varying complexity, while multi-segmental whole-body movement data were captured using Kinect. Movement coordination patterns expressed during gameplay were identified using Self Organizing Maps (SOM), an artificial neural network, and variability in these patterns was quantified by computing Total Trajectory Variability (TTvar). Additionally a k Nearest Neighbor (kNN) classifier was trained to discriminate between young and older adults based on the SOM features., Results: Results showed that TTvar was significantly higher in older adults than in young adults, when playing the exergame under complex task conditions. The kNN classifier showed a classification accuracy of 65.8%., Conclusions: Older adults display more variable sway behavior than young adults, when playing the exergame under complex task conditions. The SOM features characterizing movement patterns expressed during exergaming allow for discriminating between young and older adults with limited accuracy. Our findings contribute to the development of algorithms for quantification of balance ability during home-based exergaming for balance training.

Exergames provide a challenging opportunity for home-based training and evaluation of postural control in the elderly population, but affordable sensor technology and algorithms for assessment of whole body movement patterns in the home environment are yet to be developed. The aim of the present study was to evaluate the use of Kinect, a commonly available video game sensor, for capturing and analyzing whole body movement patterns. Healthy adults (n=20) played a weight shifting exergame under five different conditions with varying amplitudes and speed of sway movement, while 3D positions of ten body segments were recorded in the frontal plane using Kinect and a Vicon 3D camera system. Principal Component Analysis (PCA) was used to extract and compare movement patterns and the variance in individual body segment positions explained by these patterns. Using the identified patterns, balance outcome measures based on spatiotemporal sway characteristics were computed. The results showed that both Vicon and Kinect capture >90% variance of all body segment movements within three PCs. Kinect-derived movement patterns were found to explain variance in trunk movements accurately, yet explained variance in hand and foot segments was underestimated and overestimated respectively by as much as 30%. Differences between both systems with respect to balance outcome measures range 0.3-64.3%. The results imply that Kinect provides the unique possibility of quantifying balance ability while performing complex tasks in an exergame environment., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Fall injuries are responsible for physical dysfunction, significant disability, and loss of independence among elderly. Poor postural control is one of the major risk factors for falling but can be trained in fall prevention programs. These however suffer from low therapy adherence, particularly if prevention is the goal. To provide a fun and motivating training environment for elderly, exercise games, or exergames, have been studied as balance training tools in the past years. The present paper reviews the effects of exergame training programs on postural control of elderly reported so far. Additionally we aim to provide an in-depth discussion of technologies and outcome measures utilized in exergame studies. Thirteen papers were included in the analysis. Most of the reviewed studies reported positive results with respect to improvements in balance ability after a training period, yet few reached significant levels. Outcome measures for quantification of postural control are under continuous dispute and no gold standard is present. Clinical measures used in the studies reviewed are well validated yet only give a global indication of balance ability. Instrumented measures were unable to detect small changes in balance ability as they are mainly based on calculating summary statistics, thereby ignoring the time-varying structure of the signals. Both methods only allow for measuring balance after the exergame intervention program. Current developments in sensor technology allow for accurate registration of movements and rapid analysis of signals. We propose to quantify the time-varying structure of postural control during gameplay using low-cost sensor systems. Continuous monitoring of balance ability leaves the user unaware of the measurements and allows for generating user-specific exergame training programs and feedback, both during one game and in timeframes of weeks or months. This approach is unique and unlocks the as of yet untapped potential of exergames as balance training tools for community dwelling elderly.

Background: Within the mental health care services for older persons there is a growing need for insight into and evaluation of the results of clinical treatment. The Health of the Nations Outcome Scales 65+ (honos65+) is a promising instrument for the assessment of mental, social and physical health in older persons, but it is not yet known whether it is valid for older persons in the Netherlands., Aim: To assess the reliability, validity and sensibility to change of the honos65+ when applied to older persons with psychiatric disorders., Method: The bio-psycho-social level of functioning of clients aged 60 and over (n=168) receiving mental health care was assessed by means of existing and validated measuring instruments and the results were compared with those obtained with the honos65+. Three months later the population sample was re-assessed in order to test the extent to which the honos65+ was sensitive to change., Results: The reliability and validity of the honos65+ could be ascertained for 168 clients aged 60 and over. After three months 116 clients were re-assessed so that the sensitivity of the honos65+ to change could be noted., Conclusion: The honos65+ is a reliable and valid instrument for assessing clients with affective disorders such as depression and anxiety and for detecting changes in clients’ problems and functioning. No conclusions could be reached regarding the reliability and validity of the honos65+ when used for clients with other psychiatric disorders because the clinical subgroups were too small for patterns to be detected.

The lipoxygenase product 15-hydroxyeicosatetraenoic acid (15-HETE) was shown to be the most important eicosanoid formed in the atherosclerotic rabbit aorta. The aim of the present study was to compare the effects of 15-HETE and its hydroperoxy precursor 15-HpETE with those of other vasoconstrictor and vasodilator agents in arteries from rabbits fed either a control or a cholesterol-rich diet for 16 and 30 weeks. 5-Hydroxytryptamine (5-HT) aggregated platelets and thrombin caused contractions of isolated rabbit aortas. The contractile responses elicited by platelets from control animals were similar to those evoked by platelets from atherosclerotic rabbits. After 16 weeks of hypercholesterolemia, the contractile responses were either augmented (5-HT), unchanged (platelets) or reduced (thrombin). After 30 weeks of hypercholesterolemia, the responses to all contractile agents used had decreased. In both aortas and pulmonary arteries the endothelium-dependent relaxations to the calcium ionophore, A23167, and to acetylcholine were progressively lost and the endothelium-independent relaxations to nitroglycerin were reduced by the progressing hypercholesterolemia. The 15-lipoxygenase metabolites contracted the isolated thoracic aorta and pulmonary artery from control rabbits and to a lesser extent those of the cholesterol-fed rabbits. After raising the tone in these vessels with prostaglandin F2 alpha PGF2 alpha) or noradrenaline, 15-HpETE induced relaxations which were not significantly influenced by the development of fatty streaks. Our data illustrate that the contractions of the blood vessel wall to 15-HETE, like those to other vasoconstrictors, are markedly reduced by developing atherosclerosis. In contrast, the relaxations to 15-HpETE in the rabbit arteries remain unaltered after 16 to 30 weeks of hypercholesterolemia. This is unlike the reactions to other vasodilators, which are markedly reduced.

In isolated canine saphenous veins, the contractions elicited by the 15-lipoxygenase metabolites 15-HETE and 15-HPETE were augmented by 5-hydroxytryptamine (5-HT) in a concentration-dependent way. This potentiation was not mediated by the endothelium nor was it influenced by the 5-HT2-antagonist ketanserin. Phentolamine, however, reduced both the contractions and the potentiation by 5-HT. These data provide evidence for a receptor-mediated potentiation by 5-HT which occurs independently of 5-HT2-receptors. The interaction between 5-HT or aggregating platelets and 15-HPETE was studied in isolated rabbit brachiocephalic arteries. Threshold concentrations of 5-HT and platelets markedly potentiated the contractions elicited by 15-HPETE. In brachiocephalic arteries obtained from cholesterol-fed rabbits, 15-HPETE, 5-HT and platelets caused contractions similar to those obtained in control rabbits. The potentiating effect of 5-HT and platelets on the 15-HPETE-induced contractions was also comparable to that observed in control rabbits. Moreover, no difference was found between control platelets and platelets obtained from hypercholesterolemic rabbits. Our findings demonstrate a positive interaction between 5-HT and 15-lipoxygenase metabolites of arachidonic acid in arteries and veins. This interaction persists in atherosclerotic arteries and could indicate that this mechanism is involved in the genesis of vasospasm.

In canine saphenous veins both the 15-hydroxy- and 15-hydroperoxy derivatives of arachidonic acid, 15HETE and 15HPETE, caused endothelium-independent contractions which were not affected by a variety of classical receptor antagonists. These contractions were markedly augmented by cyclooxygenase blockers; nifedipine, which did not influence the contractions induced by lipoxygenase products, inhibited the potentiating effect of indomethacin. In the veins, 15HETE and 15HPETE also induced spontaneous rhythmic contractions which persisted after several washings but could be blocked by inhibitors of cyclooxygenase. In coronary, splenic, renal and femoral arteries, 15HETE and 15HPETE caused contractions which were also augmented by indomethacin and were dependent on the influx of extracellular calcium as they were inhibited by verapamil. Both 15-lipoxygenase metabolites evoked relaxations during contractions induced by prostaglandin F2 alpha or the thromboxane-mimetic U46619. These relaxations were not endothelium-dependent but were inhibited by indomethacin; they did not occur when the initial contractions were caused by K+, norepinephrine or 5-HT. Our results illustrate multiple vascular actions of 15HETE and 15HPETE in dog blood vessels.