da Vinci improves time to completion and quality of choledochojejunostomy over laparoscopy in an ex vivo bench model. This advantage is more pronounced in the hands of surgeons with less MIS experience. Conversely, robotics may allow less experienced surgeons to perform more complex operations without first developing advanced laparoscopic skills; however, there may be benefit to first obtaining fundamental skills.

Gas turbines operating on liquid fuels may produce higher NOx and soot emissions and may suffer from reduced combustion part durability, as compared to gas turbines operating on gaseous fuels. With some fuels, like diesel (aka light distillate), the NOx emissions increase is related to the liquid fuel spray atomization process, which plays a vital role in the combustion process. A promising technology for enhancing fuel atomization in a combustor is water-fuel emulsion technology. Injecting a water-fuel emulsion into a gas turbine combustor may lead to favorable effects. Since fuel atomization should be enhanced, combustion should occur at lower local equivalence ratio values, thus reducing the creation of NOx and soot emissions. Moreover, the presence of water in the combustion mixture decreases the average temperature of the combusting mixture due to the high latent heat of vaporization of water, which in turn should reduce NOx. In this study, a numerical investigation is conducted to quantify the impact of the water-fuel emulsion technology on gas turbine combustors operating on diesel fuel. The objective is to determine if NOx and soot emissions are improved, and if flame structure changes when the emulsion technology is utilized at different water to fuel ratios.

Tachycardia is a term used to describe any abnormally elevated heart rate exceeding or equal to 100 beats per minute (bpm), it can occur as the result of a wide array of pathologies. The majority of patients are symptomatic and typically present complaining of palpitations or chest discomfort. Patients may also have more dreadful presentations such as shock, hypotension, dyspnea, altered conscious level, myocardial infarction, and heart failure. Tachycardias are classically classified into narrow complex tachycardia (NCT) and wide complex tachycardia (WCT) based on the width of the QRS complex on Electrocardiography (ECG). Our objective was to look into the literature concerning the different types of tachycardia and their diagnosis along with their management. PubMed database was used for articles selection, papers afterward were obtained and reviewed accordingly. Clinical presentations of tachycardia can vary from simple palpitations or lightheadedness to severe shock or even sudden death. Diagnosis is mainly through the use of ECG or Holter monitor. The first step in the management of any type of tachycardia is assessing the hemodynamic stability of the patient, where if they were found to be unstable prompt use of cardioversion is warranted to prevent progression into cardiac arrest. In cases of stable NCT vagal maneuvers and IV, adenosine is considered to be the initial line of the therapy, other treatment options include radiofrequency or catheter ablation.