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Objectives: Social isolation imposes risks to an individual's psychological well-being. However, few studies have examined the role of resilience on these associations among older Chinese Americans, the fastest-growing aging population across all racial/ethnic groups in the United States. We aim to examine the associations of social isolation with indicators of psychological well-being and the mediating role of resilience in these associations.Methods: Data were derived from 398 Chinese older adults aged over 55 residing in Honolulu, Hawaii, in 2018. Psychological well-being was measured by psychological distress, life satisfaction, and happiness. Multivariate linear regressions and ordered logistic regressions were conducted.Results: Social isolation was positively associated with psychological distress and negatively associated with life satisfaction and happiness (all p < 0.05). By contrast, resilience was associated with lower levels of psychological distress and higher levels of life satisfaction and happiness (all p < 0.05). Moreover, the findings supported our hypothesis that resilience mediated the association between social isolation and psychological well-being. With regard to social isolation, resilience contributed to 32.0% of its association with distress, 24.9% of the association with life satisfaction, and 16.3% of the association with happiness.Conclusion: Our findings revealed a significant association between social isolation and psychological well-being and the mediating role of resilience in the association of older Chinese Americans in Hawaii. The study findings expand our understanding of psychological resources in older Chinese Americans and emphasize the importance of developing intervention programs to foster social connection and resilience among an understudied population. [ABSTRACT FROM AUTHOR]

High‐amplitude ridges can enforce heat‐trapping systems that persist through an entire season, contributing to drought events. However, the impacts of day‐to‐day weather system changes at the meso‐ and synoptic‐scale are also important, albeit less well studied. We identify five weather types (WTs) from 500‐hPa geopotential height anomalies. These categories include WT4, which represents ridges and associated dry and warm anomalies, and WT3, which characterizes troughs and associated wetter‐ and colder‐than‐normal conditions and is the largest contributor to precipitation in the western U.S. While no discernable trend is evident for WT4 conditions, WT3 conditions have undergone a distinctive decrease in frequency at both annual and seasonal scales, thus a general drying trend across the west during this time period may be more significantly associated with fewer troughs rather than more ridges. Attribution analysis reveals that this decrease in wetter and colder weather is a likely result of anthropogenic forcing. Plain Language Summary: While it is well known that large, persistent areas of high pressure can trap heat in a region for an entire season, contributing to droughts, the impacts of day‐to‐day weather system changes at smaller scales have remained less studied. In this study, we learned that dry‐ and hot‐weather‐inducing ridge conditions did not significantly change during a period of generalized drying between 1980 and 2018. What did change during those years was the pattern of troughs, which are associated with wetter‐ and colder‐than‐normal conditions; these conditions became less common during those years. This trend is likely to have occurred in response to human‐caused factors. Key Points: No discernable trend is evident for dry‐ and warm‐weather‐inducing ridge conditionsTrough conditions‐the largest contributor to annual precipitation in the western U.S.‐have undergone a distinctive decrease in frequencyThe decreasing trend in western troughs is likely to have occurred in response to external forcing rather than natural forcing alone [ABSTRACT FROM AUTHOR]

While major advances have been made toward understanding flooding across the central United States, little is known about the linkage between heat stress, characterized by high temperature and humidity, and flooding during the summer in this area. Here, we focus on a compound event that relates these two hazards; we find that a high percentage of floods are preceded by a heat stress event. The potential impacts are significant, leading to overwhelming the current infrastructure (e.g., damaged roads, hospitals, and power grid) and to a high number of fatalities and economic damage. We show that heat stress is tied to high surface temperatures, sensible heat flux, and humidity, which all tend to enhance convective available potential energy (CAPE) and stormy weather, frequently resulting in flooding. Given that heat stress is projected to become more frequent and intense, our findings point to an associated enhanced risk of flooding throughout this area. Key Points: Summer floods in the central United States are often preceded by a heat stress eventHeat stress is tied to high temperatures, sensible heat flux, and humidity, which all tend to enhance convective available potential energyThe conditions associated with heat stress lead to storm weather, heavy precipitation, and then flooding [ABSTRACT FROM AUTHOR]

To profile hospitals by survival rates of colorectal cancer patients in multiple periods after initial treatment. California Cancer Registry data from 50,544 patients receiving primary surgery with curative intent for stage I-III colorectal cancer in 1994-1998, supplemented with hospital discharge abstracts. We estimated a single Bayesian hierarchical model to quantify associations of survival to 30 days, 30 days to 1 year, and 1-5 years by hospital, adjusted for patient age, sex, race, stage, tumor site, and comorbidities. We compared two profiling methods for 30-day survival and four longer-term profiling methods by the fractions of hospitals with demonstrably superior survival profiles and of hospital pairs whose relative standings could be established confidently. Interperiod correlation coefficients of the random effects are (95 percent credible interval 0.27, 0.85), (0.20, 0.76), and (0.19, 0.82). The three-period model ranks 5.4 percent of pairwise comparisons by 30-day survival with at least 95 percent confidence, versus 3.3 percent of pairs using a single-period model, and 15-20 percent by weighted multiperiod methods. The quality of care for colorectal cancer provided by a hospital system is somewhat consistent across the immediate postoperative and long-term follow-up periods. Combining mortality profiles across longer periods may improve the statistical reliability of outcome comparisons. [ABSTRACT FROM AUTHOR]

Objective: To analyze variation in medical care use attributable to Medicare's decentralized claims adjudication process as exemplified in home hemodialysis (HHD) therapy.Data Sources/study Setting: Secondary data analysis using 2009-2012 paid Medicare claims for HHD and in-center hemodialysis (IHD).Study Design: We compared variation across Medicare administrative contractors (MACs) in predicted paid treatments per standardized patient-month for HHD and IHD patients. We used ordinary least-squares regression to determine whether higher paid HHD treatment counts expanded HHD programs' presence among dialysis facilities.Data Collection: We identified HHD and IHD treatments using procedure, revenue center, and claim condition codes on type 72x claims.Principal Findings: MACs varied persistently in predicted HHD treatments per patient-month, ranging from 14.3 to 21.9 treatments versus 10.9 to 12.4 IHD treatments. The presence of facilities' HHD programs was uncorrelated with average HHD payment counts.Conclusions: Medicare's claims adjudication process promotes variation in medical care use, as we observe among HHD patients. MACs' discretionary decision making, while potentially facilitating innovation, may admit inefficiency in care practice as well as inequitable access to health care services. Regulators should weigh the benefits of flexibility in local coverage decisions against those of national standards for medical necessity. [ABSTRACT FROM AUTHOR]

A compact planar microstrip ultra-wideband (UWB) bandpass filter (BPF) with notched band has been proposed and implemented in this letter for the use in UWB wireless communication applications set by Federal Communications Commission (FCC). Three coupled lines and quarter-wave short-circuited shunt stubs are used to realize a high selectivity filtering characteristic. By employing embedding open stubs, the narrow notched band was introduced to reject the undesired wireless local-area network (WLAN) radio signals. The bandwidth of the notched filter can be controlled by adjusting the width or length of the slot. The proposed component has been designed, simulated, and fabricated for verification. Simulation results are confirmed via experiment, showing good wideband filtering performance with notched band. The measured insertion loss is less than 1.2 dB, the return loss is more than 18 dB, and the variation of group delay is lessthan 0.4 ns throughout the passband except for the notched band. © 2009 Wiley Periodicals, Inc. Microwave Opt Technol Lett 52: 280–283, 2010; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/mop.24934 [ABSTRACT FROM AUTHOR]

The article asserts that the rise of a global middle class in countries such as China and India will not be sustainable if it translates to the demotion of the middle class in the U.S. in 2007. It also includes an analysis of the American middle class' role as the core of the U.S. consumption engine that has brought economic development to the global trade partners of the U.S.