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Background: Hiatal hernia (HH) is routinely reported in 40% of bariatric surgery patients. Left unrepaired, HH can lead to post-surgical reflux, regurgitation, and vomiting. Objectives: We hypothesize that patients with pre-operative reflux symptoms and a higher body mass index (BMI) will receive hiatal hernia repairs (HHR) more often. The study aim was to analyze the variables that drive HHR decision by operating surgeons. Methods: The records of 551 patients who underwent endoscopy in preparation for bariatric surgery were analyzed. Prevalence of HH was derived based on esophagogastroduodenoscopy (EGD) findings performed by a bariatric surgeon during patients’ bariatric surgery. The relationship between categorical participant attributes was calculated using a significance level of 0.05. Results: The groups consisted of 295 Roux-en-Y gastric bypass (RYGB) and 264 sleeve gastrectomy (SG) patients with preoperative HH identified in 310 patients. SG and a decreased BMI were significant for receiving a HHR. Type II diabetes (T2D), duodenitis found on EGD and pathology report, esophagitis, and Roux-en-Y gastric bypass (RYGB) were significant for not receiving a HHR. Only duodenitis, RYGB, and SG were found to be significant factors after multivariate analysis. Conclusions: While some pre-operative patient characteristics may not impact a surgeon's HHR decision in the bariatric population, our study suggests that duodenitis, SG, and RYGB may influence a surgeon's HHR decision.

The Cluster fleet offers the first possibility of comparing non-thermal terrestrial continuum radiation from similarly equipped nearby observation points. A very rich data set has already been acquired on the Cluster polar orbit, between 4 and 19 Earth radii geocentric distances, and preliminary analysis has been carried out on these emissions. We focus in this paper on direction finding performed from all four spacecraft as a means to locate the position of the sources of this continuum radiation. Directions are derived from spin modulation properties, under the usual analysis assumptions of the wave vector of the radiation lying in the plane containing the spin axis and the antenna position at electric field minimum. All the spin axes of the four Cluster spacecraft are aligned perpendicular to the ecliptic, thus the aligned spacecraft antenna spin planes provide redundant 2-D views of the propagation path of the radiation and source location. Convincing 2-D triangulation results have been obtained in the vicinity of the source region. In addition, the out of spin plane component of the wave vector reveals itself to a certain extent through directivity characteristics compared at different distances of the spin plane to the ecliptic. The four case events studied (two of them taken near apogee, the other two near perigee) have confirmed general properties derived from previous observations: trapping in the lower frequency range, radiation escaping into the magnetosheath region in the higher frequency range. All propagation directions are compatible with source positions in the plasmapause region, however, at a significant distance from the equator in one case. Our observations have also revealed new properties, like the importance of small-scale density irregularities in the local amplification of continuum radiation. We conclude that more detailed generation and propagation models are needed to fit the observations.