Effect of Poverty Level on the Relationship Between Hyperlipidemia and Cardiorenal Syndrome

Purpose. Elevated cholesterol is known to be associated with chronic kidney disease (CKD) and cardiovascular disease (CVD) independently. Cardiorenal syndrome (CRS), a recently defined syndrome, is characterized by renal failure that is closely interrelated to cardiac dysfunction. The effect of socioeconomic status on cardiorenal syndrome has not been explored in a multi-ethnic population. In this retrospective secondary analysis, the hypothesis was tested if socioeconomic status modifies the effect of hyperlipidemia on CRS. Methods. The National Health and Nutrition Examination Survey (NHANES) is a cross sectional survey done on the non-institutionalized population of the United States. All patients from the NHANES study, 20 years and older between the years 1999-2010 were included in the analysis. CRS was determined using a standard GFR equation and history of CVD. Analysis was performed using complex samples logistic regression to determine the relationship of hyperlipidemia on CRS. Results. Data on CRS status was available for 24,625 individuals (48.9% males & 51.1% females) and was representative of 173,805,863 individuals. The overall unadjusted odds ratio of CRS for hyperlipidemia to no hyperlipidemia was 3.01 (95% confidence interval [CI], 2.62-3.47, p \u3c 0.001). The adjusted OR was elevated, 2.20 (CI 1.20-4.05, p \u3c 0.01), among individuals living below poverty threshold but close to 1.0 (1.63 CI 1.31-2.03, p \u3c 0.001) among patients above poverty threshold, after the results were controlled for medical risk factors and demographic risk factors. Conclusions. Hyperlipidemia is strongly associated with CRS in a nationally representative multi-ethnic population and must be taken into special consideration when treating underprivileged patients. Longitudinal studies should further examine this association and demonstrate how socioeconomic status plays a role

Nonprofit governance: Improving performance in troubled economic times

Nonprofit management is currently pressured to perform effectively in a weak economy. Yet, nonprofit governance continues to suffer from unclear conceptions of the division of labor between board of directors and executive directors. This online survey of 114 executive directors aims to provide clarification and recommendations for social administration

Ab initio calculations for bromine adlayers on the Ag(100) and Au(100) surfaces: the c(2x2) structure

Ab initio total-energy density-functional methods with supercell models have been employed to calculate the c(2x2) structure of the Br-adsorbed Ag(100) and Au(100) surfaces. The atomic geometries of the surfaces and the preferred bonding sites of the bromine have been determined. The bonding character of bromine with the substrates has also been studied by analyzing the electronic density of states and the charge transfer. The calculations show that while the four-fold hollow-site configuration is more stable than the two-fold bridge-site topology on the Ag(100) surface, bromine prefers the bridge site on the Au(100) surface. The one-fold on-top configuration is the least stable configuration on both surfaces. It is also observed that the second layer of the Ag substrate undergoes a small buckling as a consequence of the adsorption of Br. Our results provide a theoretical explanation for the experimental observations that the adsorption of bromine on the Ag(100) and Au(100) surfaces results in different bonding configurations.Comment: 10 pages, 4 figure, 5 tables, Phys. Rev. B, in pres

Characterization of 30 76^{76}Ge enriched Broad Energy Ge detectors for GERDA Phase II

The GERmanium Detector Array (GERDA) is a low background experiment located at the Laboratori Nazionali del Gran Sasso in Italy, which searches for neutrinoless double beta decay of $^{76}$Ge into $^{76}$Se+2e$^-$. GERDA has been conceived in two phases. Phase II, which started in December 2015, features several novelties including 30 new Ge detectors. These were manufactured according to the Broad Energy Germanium (BEGe) detector design that has a better background discrimination capability and energy resolution compared to formerly widely-used types. Prior to their installation, the new BEGe detectors were mounted in vacuum cryostats and characterized in detail in the HADES underground laboratory in Belgium. This paper describes the properties and the overall performance of these detectors during operation in vacuum. The characterization campaign provided not only direct input for GERDA Phase II data collection and analyses, but also allowed to study detector phenomena, detector correlations as well as to test the strength of pulse shape simulation codes.Comment: 29 pages, 18 figure

Background free search for neutrinoless double beta decay with GERDA Phase II

The Standard Model of particle physics cannot explain the dominance of matter over anti-matter in our Universe. In many model extensions this is a very natural consequence of neutrinos being their own anti-particles (Majorana particles) which implies that a lepton number violating radioactive decay named neutrinoless double beta ($0\nu\beta\beta$) decay should exist. The detection of this extremely rare hypothetical process requires utmost suppression of any kind of backgrounds. The GERDA collaboration searches for $0\nu\beta\beta$ decay of $^{76}$Ge (^{76}\rm{Ge} \rightarrow\,^{76}\rm{Se} + 2e^-) by operating bare detectors made from germanium with enriched $^{76}$Ge fraction in liquid argon. Here, we report on first data of GERDA Phase II. A background level of $\approx10^{-3}$ cts/(keV$\cdot$kg$\cdot$yr) has been achieved which is the world-best if weighted by the narrow energy-signal region of germanium detectors. Combining Phase I and II data we find no signal and deduce a new lower limit for the half-life of $5.3\cdot10^{25}$ yr at 90 % C.L. Our sensitivity of $4.0\cdot10^{25}$ yr is competitive with the one of experiments with significantly larger isotope mass. GERDA is the first $0\nu\beta\beta$ experiment that will be background-free up to its design exposure. This progress relies on a novel active veto system, the superior germanium detector energy resolution and the improved background recognition of our new detectors. The unique discovery potential of an essentially background-free search for $0\nu\beta\beta$ decay motivates a larger germanium experiment with higher sensitivity.Comment: 14 pages, 9 figures, 1 table; ; data, figures and images available at http://www.mpi-hd.mpg/gerda/publi

Flux Modulations seen by the Muon Veto of the GERDA Experiment

The GERDA experiment at LNGS of INFN is equipped with an active muon veto. The main part of the system is a water Cherenkov veto with 66~PMTs in the water tank surrounding the GERDA cryostat. The muon flux recorded by this veto shows a seasonal modulation. Two effects have been identified which are caused by secondary muons from the CNGS neutrino beam (2.2 %) and a temperature modulation of the atmosphere (1.4 %). A mean cosmic muon rate of $I^0_{\mu} = (3.477 \pm 0.002_{\textrm{stat}} \pm 0.067_{\textrm{sys}}) \times 10^{-4}$/(s$\cdot$m$^2$) was found in good agreement with other experiments at LNGS at a depth of 3500~meter water equivalent.Comment: 7 pages, 6 figure

Limits on uranium and thorium bulk content in GERDA Phase I detectors

Internal contaminations of $^{238}$U, $^{235}$U and $^{232}$Th in the bulk of high purity germanium detectors are potential backgrounds for experiments searching for neutrinoless double beta decay of $^{76}$Ge. The data from GERDA Phase~I have been analyzed for alpha events from the decay chain of these contaminations by looking for full decay chains and for time correlations between successive decays in the same detector. No candidate events for a full chain have been found. Upper limits on the activities in the range of a few nBq/kg for $^{226}$Ra, $^{227}$Ac and $^{228}$Th, the long-lived daughter nuclides of $^{238}$U, $^{235}$U and $^{232}$Th, respectively, have been derived. With these upper limits a background index in the energy region of interest from $^{226}$Ra and $^{228}$Th contamination is estimated which satisfies the prerequisites of a future ton scale germanium double beta decay experiment.Comment: 2 figures, 7 page