Background: The aim of this post hoc analysis of a large cohort study was to evaluate the association between night-time surgery and the occurrence of intraoperative adverse events (AEs) and postoperative pulmonary complications (PPCs). Methods: LAS VEGAS (Local Assessment of Ventilatory Management During General Anesthesia for Surgery) was a prospective international 1-week study that enrolled adult patients undergoing surgical procedures with general anaesthesia and mechanical ventilation in 146 hospitals across 29 countries. Surgeries were defined as occurring during 'daytime' when induction of anaesthesia was between 8:00 AM and 7:59 PM, and as 'night-time' when induction was between 8:00 PM and 7:59 AM. Results: Of 9861 included patients, 555 (5.6%) underwent surgery during night-time. The proportion of patients who developed intraoperative AEs was higher during night-time surgery in unmatched (43.6% vs 34.1%; P<0.001) and propensity-matched analyses (43.7% vs 36.8%; P¼0.029). PPCs also occurred more often in patients who underwent night-time surgery (14% vs 10%; P¼0.004) in an unmatched cohort analysis, although not in a propensity-matched analysis (13.8% vs 11.8%; P¼0.39). In a multivariable regression model, including patient characteristics and types of surgery and anaesthesia, night-time surgery was independently associated with a higher incidence of intraoperative AEs (odds ratio: 1.44; 95% confidence interval: 1.09e1.90; P¼0.01), but not with a higher incidence of PPCs (odds ratio: 1.32; 95% confidence interval: 0.89e1.90; P¼0.15). Conclusions: Intraoperative adverse events and postoperative pulmonary complications occurred more often in patients undergoing night-time surgery. Imbalances in patients' clinical characteristics, types of surgery, and intraoperative management at night-time partially explained the higher incidence of postoperative pulmonary complications, but not the higher incidence of adverse events. Clinical trial registration: NCT01601223.

The purpose of this study was to evaluate the effectiveness of plagiarism detection software and penalty for plagiarizing in detecting and deterring plagiarism among medical students. The study was a continuation of previously published research in which second-year medical students from 2001/2002 and 2002/2003 school years were required to write an essay based on one of the four scientific articles offered by the instructor. Students from 2004/2005 (N = 92) included in present study were given the same task. Topics of two of the four articles were considered less complex, and two were more complex. One less and one more complex articles were available only as hardcopies, whereas the other two were available in electronic format. The students from 2001/2002 (N = 111) were only told to write an original essay, whereas the students from 2002/2003 (N = 87) were additionally warned against plagiarism, explained what plagiarism was, and how to avoid it. The students from 2004/2005 were warned that their essays would be examined by plagiarism detection software and that those who had plagiarized would be penalized. Students from 2004/2005 plagiarized significantly less of their essays than students from the previous two groups (2% vs. 17% vs. 21%, respectively, P < 0.001). Over time, students more frequently choose articles with more complex subjects (P < 0.001) and articles in electronic format (P < 0.001) as a source for their essays, but it did not influence the rate of plagiarism. Use of plagiarism detection software in evaluation of essays and consequent penalties had effectively deterred students from plagiarizing.

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Minimal invasive US-FPB provides sufficient anesthesia for ankle fracture. In comparison to the SA group, patients from the US-FPB group achieved significantly longer postoperative analgesia, while faster onset of anesthesia was noted in SA group.

Objectives. Sudden cardiac death is a major cause of death in today