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Our childrens hospital (besides the ICU that uses a phillips solution on windows, which integrates with the monitoring and anesthesia equipment) runs linux, however they do this in a virtual environment on windows, the reasoning I am not sure about, potentially to sandbox the electronic system they are using.
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Its almost exclusively to do with the software they need, it often wont run on linux or will have limited support.
You can with extensions. Tree Style Tabs, I dont even have a top tab bar.