...if the rigor, methodology and sample size is good, then it's a good study.
That's pretty naive. What about the effects of multiple publication, selective publication, and selective reporting - all common practice in the pharma industry.
Even if you're going to get 'routine' major surgery with general anaesthetic you should insist on a spinal block for pain. The anaesthetic blocks out frontal lobe consciousness and some memory formation, but other parts of the brain are going, "holy fuck, I'm being sawn in half!" which leads to major brain trauma and long-lasting problems.
Fortunately for those of us who've undergone major leg surgery with general anesthetic, I don't think there's much evidence out there of the occurrence of "major brain trauma and long-lasting problems" from not having also had a spinal block. I'd be interested to read any actual evidence you can provide to support your statement.
California’s democracy is not at all like America’s, as conceived by founders such as James Madison. The federal constitution is based on checks and balances within and among three and only three branches of government—executive, legislative and judicial. That is because Madison feared that popular “passions” would undo the republic, that majorities might “tyrannise” minorities, and that “minority factions” (ie, special interests) would take over the system. America’s was therefore to be a representative, not a direct, democracy. “Pure democracies have ever been spectacles of turbulence and contention,” Madison wrote, “and have in general been as short in their lives as they have been violent in their deaths.”
Be careful when a loop exits to the same place from side and bottom.