Comparing Robot-Assisted and Laparoscopic Inguinal Hernia Repair: A Systematic Review and Meta-Analysis.

Inguinal hernia repair is a common surgical intervention. Advancements in minimally invasive techniques, specifically laparoscopic (LR) and robot-assisted (RR) approaches, have reshaped the landscape of surgical options. This meta-analysis aimed to systematically assess and compare the effectiveness and safety of laparoscopic and robot-assisted inguinal hernia repair through a comprehensive review of the literature. A systematic search of databases was conducted to identify relevant studies published up to November 30, 2023. Fifteen studies, encompassing a total of 64,568 participants, met the inclusion criteria. Pooled estimates for key outcomes, including duration of operation, overall complications, and surgical site infection (SSI), were calculated using random-effects models. This meta-analysis revealed a statistically significant difference in the duration of surgery, favoring laparoscopic repair over robot-assisted techniques (mean difference: 26.85 minutes, 95% CI (1.16, 52.54)). Overall complications did not significantly differ between the two approaches (odds ratio: 1.54, 95% CI (0.83, 2.85)). However, a significantly greater risk of SSI was identified for robot-assisted procedures (odds ratio: 3.32, 95% CI (2.63, 4.19)). This meta-analysis provides insights into the comparative effectiveness of laparoscopic and robot-assisted inguinal hernia repair. While laparoscopy has shorter operative times and comparable overall complication rates, the increased risk of SSI during robot-assisted procedures necessitates careful consideration in clinical decision-making. Surgeons and healthcare providers should weigh these findings according to patient characteristics, emphasizing a personalized approach to surgical decision-making. The evolving landscape of inguinal hernia repair warrants ongoing research to refine techniques and optimize outcomes for the benefit of patients undergoing these procedures.

Tailoring the interfacial surfaces of tungsten and molybdenum tungsten disulfide electrodes for hybrid supercapacitors.

The layered structures of tungsten disulfide (WS2) and molybdenum tungsten disulfide (MoWS2) are considered as the most promising electrode materials for energy storage devices. Herein, MS (magnetron sputtering) is required for the deposition of WS2 and MoWS2 on the surface of the current collector to attain an optimized layer thickness. The structural morphology and topological behavior of the sputtered material were examined via X-ray diffraction and atomic force microscopy. Three-electrode assembly was used to start the electrochemical investigations to identify the most optimal and effective sample among WS2 and MoWS2. CV (cyclic voltammetry), GCD (galvanostatic charging discharging), and EIS (electro-impedance spectroscopy) techniques were employed to analyze the samples. After preparing WS2 with optimized thickness as the superior performing sample, a hybrid device was designed as WS2//AC (activated carbon). With a remarkable cyclic stability of 97% after 3000 continuous cycles, the hybrid supercapacitor generated a maximum energy density (Es) value of 42.5 W h kg-1 and 4250 W kg-1 of power density (Ps). Besides, the capacitive and diffusive contribution during the charge-discharge process and b-values were calculated by Dunn's model, which lay in the 0.5-1.0 range and the fabricated WS2 hybrid device was found to have a hybrid nature. The outstanding outcomes of WS2//AC make it suitable for future energy storage applications.

Merocel Surgicel Wrap Technique to Manage Diffuse Epistaxis in Patients with Comorbidities.

Epistaxis, or nasal bleeding, occurs in over half of the general population. It is caused by various etiological factors and affects both sexes and all age groups. The simplest treatment for a nosebleed is pinching of the ala nasi, referred to as the Hippocratic technique. In this study, we adopted different treatment protocols dependent on the severity of bleeding and assessed the etiology and efficacy of these modalities. This was a prospective study. We recruited 25 patients (24 adults and 1 child) who presented with epistaxis in the ENT departments of two tertiary care hospitals. We evaluated the cause of epistaxis and efficacy of the treatments used. All patients had experienced several episodes of epistaxis and were managed using anterior nasal packing with gauze and ointment or with Merocel packs alone. The incidence of epistaxis was more common in males than in females. It was effectively managed by anterior nasal packing with Surgicel-wrapped Merocel. Patients did not experience further episodes of bleeding following the removal of Merocel and retention of Surgicel in place.

Residential Solar PV Systems in the Carolinas: Opportunities and Outcomes.

This paper presents a first-order analysis of the feasibility and technical, environmental, and economic effects of large levels of solar photovoltaic (PV) penetration within the services areas of the Duke Energy Carolinas (DEC) and Duke Energy Progress (DEP). A PV production model based on household density and a gridded hourly global horizontal irradiance data set simulates hourly PV power output from roof-top installations, while a unit commitment and real-time economic dispatch (UC-ED) model simulates hourly system operations. We find that the large generating capacity of base-load nuclear power plants (NPPs) without ramping capability in the region limits PV integration levels to 5.3% (6510 MW) of 2015 generation. Enabling ramping capability for NPPs would raise the limit of PV penetration to near 9% of electricity generated. If the planned retirement of coal-fired power plants together with new installations and upgrades of natural gas and nuclear plants materialize in 2025, and if NPPs operate flexibly, then the share of coal-fired electricity will be reduced from 37% to 22%. A 9% penetration of electricity from PV would further reduce the share of coal-fired electricity by 4-6% resulting in a system-wide CO2 emissions rate of 0.33 to 0.40 tons/MWh and associated abatement costs of 225-415 (2015$ per ton).