Hiatoplasty with crura buttressing versus hiatoplasty alone during laparoscopic sleeve gastrectomy

Introduction. In obese patients with hiatal hernia (HH), laparoscopic sleeve gastrectomy (LSG) with cruroplasty is an option but use of prosthetic mesh crura reinforcement is debated. The aim was to compare the results of hiatal closure with or without mesh buttressing during LSG. Methods. Gastroesophageal reflux disease (GERD) was assessed by the Health-Related Quality of Life (GERD-HRQL) questionnaire before and after surgery in two consecutive series of patients with esophageal hiatus ≤ 4 cm2. After LSG, patients in group A (12) underwent simple cruroplasty, whereas in group B patients (17), absorbable mesh crura buttressing was added. Results. At mean follow-up of 33.2 and 18.1 months for groups A and B, respectively (p = 0 006), the mean preoperative GERD-HRQL scores of 16.5 and 17.7 (p = 0 837) postoperatively became 9.5 and 2.4 (p = 0 071). In group A, there was no difference between pre- and postoperative scores (p = 0 279), whereas in group B, a highly significant difference was observed (p = 0 002). The difference (Δ) comparing pre- and postoperative mean scores between the two groups was significantly in favor of mesh placement (p = 0 0058). Conclusions. In obese patients with HH and mild-moderate GERD, reflux symptoms are significantly improved at medium term follow-up after cruroplasty with versus without crura buttressing during LSG.Introduction. In obese patients with hiatal hernia (HH), laparoscopic sleeve gastrectomy (LSG) with cruroplasty is an option but use of prosthetic mesh crura reinforcement is debated. The aim was to compare the results of hiatal closure with or without mesh buttressing during LSG. Methods. Gastroesophageal reflux disease (GERD) was assessed by the Health-Related Quality of Life (GERD-HRQL) questionnaire before and after surgery in two consecutive series of patients with esophageal hiatus ≤ 4 cm2. After LSG, patients in group A (12) underwent simple cruroplasty, whereas in group B patients (17), absorbable mesh crura buttressing was added. Results. At mean follow-up of 33.2 and 18.1 months for groups A and B, respectively (p = 0 006), the mean preoperative GERD-HRQL scores of 16.5 and 17.7 (p = 0 837) postoperatively became 9.5 and 2.4 (p = 0 071). In group A, there was no difference between pre- and postoperative scores (p = 0 279), whereas in group B, a highly significant difference was observed (p = 0 002). The difference (Δ) comparing pre- and postoperative mean scores between the two groups was significantly in favor of mesh placement (p = 0 0058). Conclusions. In obese patients with HH and mild-moderate GERD, reflux symptoms are significantly improved at medium term follow-up after cruroplasty with versus without crura buttressing during LSG

Analysis of Thunderstorms Producing Terrestrial Gamma Ray Flashes With the Meteosat Second Generation

Up to now, only few works focused on the meteorological context leading to the production of Terrestrial Gamma ray Flashes (TGFs). In this study, we carry out, for the first time, an analysis on large scale of the meteorological scenario linked to 278 TGFs detected by RHESSI, AGILE, and Fermi, by using the Meteosat Second Generation geostationary satellites. These satellites are useful as they continuously monitor the same geographic region in time, allowing investigations on thunderstorms' development; moreover, they are endowed with channels and products that provide information about the meteorological context under analysis, such as the cloud top temperature and altitude, the cloud extension, the drop effective radius and the cloud phase. Our work confirms what previously found in other studies about the TGF‐associated thunderstorms, by using a different approach and by using for the first time the Meteosat satellites: we find TGFs mostly linked to the development phase of deep convective thunderstorm systems, exhibiting typical characteristics of tropical storms, and providing a first picture on large scale of the TGF‐associated thunderstorm systems.publishedVersio

The First AGILE Solar Flare Catalog

We report the Astrorivelatore Gamma ad Immagini LEggero (AGILE) observations of solar flares, detected by the on board anticoincidence system in the 80-200 keV energy range, from 2007 May 1st to 2022 August 31st. In more than 15 yr, AGILE detected 5003 X-ray, minute-lasting transients, compatible with a solar origin. A cross-correlation of these transients with the Geostationary Operational Environmental Satellites (GOES) official solar flare database allowed to associate an intensity class (i.e., B, C, M, or X) to 3572 of them, for which we investigated the main temporal and intensity parameters. The AGILE data clearly revealed the solar activity covering the last stages of the 23rd cycle, the whole 24th cycle, and the beginning of the current 25th cycle. In order to compare our results with other space missions operating in the high-energy range, we also analyzed the public lists of solar flares reported by RHESSI and Fermi Gamma-ray Burst Monitor. This catalog reports 1424 events not contained in the GOES official dataset, which, after statistical comparisons, are compatible with low-intensity, short-duration solar flares. Besides providing a further dataset of solar flares detected in the hard X-ray range, this study allowed to point out two main features: a longer persistence of the decay phase in the high-energy regime, with respect to the soft X-rays, and a tendency of the flare maximum to be reached earlier in the soft X-rays with respect to the hard X-rays. Both these aspects support a two-phase acceleration mechanism of electrons in the solar atmosphere.Comment: 22 pages, 10 figure

Time evolution of storms producing terrestrial gamma-ray flashes using era5 reanalysis data, gps, lightning and geo-stationary satellite observations

In this article, we report the first investigation over time of the atmospheric conditions around terrestrial gamma-ray flash (TGF) occurrences, using GPS sensors in combination with geostationary satellite observations and ERA5 reanalysis data. The goal is to understand which characteristics are favorable to the development of these events and to investigate if any precursor signals can be expected. A total of 9 TGFs, occurring at a distance lower than 45 km from a GPS sensor, were analyzed and two of them are shown here as an example analysis. Moreover, the lightning activity, collected by the World Wide Lightning Location Network (WWLLN), was used in order to identify any links and correlations with TGF occurrence and precipitable water vapor (PWV) trends. The combined use of GPS and the stroke rate trends identified, for all cases, a recurring pattern in which an increase in PWV is observed on a timescale of about two hours before the TGF occurrence that can be placed within the lightning peak. The temporal relation between the PWV trend and TGF occurrence is strictly related to the position of GPS sensors in relation to TGF coordinates. The life cycle of these storms observed by geostationary sensors described TGF-producing clouds as intense with a wide range of extensions and, in all cases, the TGF is located at the edge of the convective cell. Furthermore, the satellite data provide an added value in associating the GPS water vapor trend to the convective cell generating the TGF. The investigation with ERA5 reanalysis data showed that TGFs mainly occur in convective environments with unexceptional values with respect to the monthly average value of parameters measured at the same location. Moreover, the analysis showed the strong potential of the use of GPS data for the troposphere characterization in areas with complex territorial morphologies. This study provides indications on the dynamics of con-vective systems linked to TGFs and will certainly help refine our understanding of their production, as well as highlighting a potential approach through the use of GPS data to explore the lightning activity trend and TGF occurrences.publishedVersio

The AGILE real-time analysis software system to detect short-transient events in the multi-messenger era

AGILE is a space mission launched in 2007 to study X-ray and gamma-ray phenomena through data acquired by different instruments on board the satellite. In the multi-messenger era, the fast detection of transient sources is one of the main goals of space and ground-based gamma-ray observatories. When an observatory detects a transient event, it usually sends science alerts to other facilities through networks such as the General Coordinates Network (GCN), enabling follow-up observations. To achieve this task, real-time analysis (RTA) pipelines are required. This manuscript presents the RTA system developed for the AGILE space mission to detect transient sources on timescales from seconds to one hour. Two types of pipelines are presented. One pipeline executes automated analyses as soon as data are available, sharing the detection of sources with the community; more than 90 automated notices have been sent to the GCN since May 2019. The other pipeline reacts to external science alerts from neutrinos, gravitational waves (GW), etc., to search for electromagnetic counterparts in the AGILE data. The AGILE Team can visualize the results of these analyses using a web platform. The pipelines hereby presented can be a starting point for the development of RTA systems of the next generation of space-based gamma-ray observatories

The Gamma-Flash data acquisition system for observation of terrestrial gamma-ray flashes

Gamma-Flash is an Italian project funded by the Italian Space Agency (ASI) and led by the National Institute for Astrophysics (INAF), devoted to the observation and study of high-energy phenomena, such as terrestrial gamma-ray flashes and gamma-ray glows produced in the Earth's atmosphere during thunderstorms. The project's detectors and the data acquisition and control system (DACS) are placed at the "O. Vittori" observatory on the top of Mt. Cimone (Italy). Another payload will be placed on an aircraft for observations of thunderstorms in the air. This work presents the architecture of the data acquisition and control system and the data flow.Comment: 4 pages, 1 figure, Astronomical Data Analysis Software and System XXXII (2022

LIGO/Virgo S200208q : upper limits from AGILE/GRID observations

In response to the LIGO-Virgo GW event S200208q at T0 = 2020-02-08 13:01:17.991 (UTC) a preliminary analysis of the AGILE exposure at T0 shows that the Gamma-Ray Imaging Detector (GRID) exposure covered the 37% of the 90% c.l. localization region (LR). We performed an analysis of the GRID data in the energy range 50 MeV - 10 GeV on T0, where good exposure of the S200208q 90% c.l. LR was available. No candidate gamma-ray transient was detected. The following preliminary GRID values of 3-sigma upper limit (UL) are obtained: from 7.0e-08 to 7.4e-06 erg cm^-2 s^-1, with exposure of about 72% of the LR over the time interval ( T0s ; T0 + 100s ); These measurements were obtained with AGILE observing a large portion of the sky in spinning mode. Additional analysis of AGILE data is in progress

AGILE Observations of the LIGO-Virgo Gravitational-wave Events of the GWTC-1 Catalog

We present a comprehensive review of AGILE follow-up observations of the Gravitational Wave (GW) events and the unconfirmed marginal triggers reported in the first LIGO-Virgo (LV) Gravitational Wave Transient Catalog (GWTC-1). For seven GW events and 13 LV triggers, the associated 90% credible region was partially or fully accessible to the AGILE satellite at the T 0; for the remaining events, the localization region was not accessible to AGILE due to passages into the South Atlantic Anomaly, or complete Earth occultations (as in the case of GW170817). A systematic search for associated transients, performed on different timescales and on different time intervals about each event, led to the detection of no gamma-ray counterparts. We report AGILE MCAL upper limit fluences in the 400 keV-100 MeV energy range, evaluated in a time window of T 0 ± 50 s around each event, as well as AGILE GRID upper limit (UL) fluxes in the 30 MeV-50 GeV energy range, evaluated in a time frame of T 0 ± 950 s around each event. All ULs are estimated at different integration times and are evaluated within the portions of GW credible region accessible to AGILE at the different times under consideration. We also discuss the possibility of AGILE MCAL to trigger and detect a weak soft-spectrum burst such as GRB 170817A

LIGO/VIRGO S200213t: upper limits from AGILE/MCAL observations

In response to the LIGO/Virgo GW event S200213t at T0 = 2020-02-13 04:10:40.238 (UTC), a preliminary analysis of the AGILE mini calorimeter (MCAL) triggered data found no event candidates within a time interval covering -/+ 15 sec from the LIGO/Virgo T0. At the T0, about 96% of the S200213t 90 % c.l. localization region was accessible to the AGILE MCAL.Three-sigma upper limits (ULs) are obtained for a 1 s integration time at different celestial positions within the accessible S200213t localization region, from a minimum of 1.6E-06 erg cm^-2 to a maximum of 7.5 E-06 erg cm^-2 (assuming as spectral model a single power law with photon index 1.5). The AGILE-MCAL detector is a CsI detector with a 4 pi FoV, sensitive in the energy range 0.4-100 MeV. Additional analysis of AGILE data is in progress