Christmas research

As 2023 wraps up, just for fun we thought we would look at some of the best of the light-hearted ‘research’ articles published during the Christmas period in medical journals over the last twenty years.

2023
•    Workload and the mysterious law of karma
•    Effect of chair placement on physicians’ behavior and patients’ satisfaction: randomized deception trial
•    Efficacy of cola ingestion for oesophageal food bolus impaction: open label, multicentre, randomised controlled trial
•    Jingle bots: turbocharge your Christmas card creativity with AI
•    Rudolph, the kids’ ward reindeer: a scoping review of the effects of support animals on the well-being of healthcare staff

2022
•    Everything causes cancer? Beliefs and attitudes towards cancer prevention among anti-vaxxers, flat earthers, and reptilian conspiracists: online cross sectional survey
•    Quantifying the benefits of inefficient walking: Monty Python inspired laboratory based experimental study
•    Can artificial intelligence pass the Fellowship of the Royal College of Radiologists examination? Multi-reader diagnostic accuracy study
•    “Harry Potter and the Multitudinous Maladies”: a retrospective population‐based observational study of morbidity and mortality among witches and wizards

2021
•    A guide to the management of atrial fibrillation in Santa Claus
•    The CRECHE study: testing the urban myth that chocolate Santa Clauses are re‐wrapped Easter Bunnies
•    We all fall down: head injuries in nursery rhyme characters
•    Garlic as a vampire deterrent: fact or fiction?
•    Ghost in the machine or monkey with a typewriter—generating titles for Christmas research articles in The BMJ using artificial intelligence: observational study

2020
•    What the forks? A longitudinal quality improvement study tracking cutlery numbers in a public teaching and research hospital staff tearoom

2019
•    Symbolic sexism: superficial or serious bias? An investigation into images on patient call bells

2018
•    The emergence and characteristics of the Australian Mamil
•    Licence to swill: James Bond’s drinking over six decades
•    Everything is awesome: Don't forget the Lego

2017
•    The Specialty and Naughty/Nice Tendency Audit (SANTA): which medical specialists can be trusted to follow recipes?
•    The science behind “man flu”

2016
•    The razor’s edge: Australian rock music impairs men’s performance when pretending to be a surgeon
•    What’s in your hot dog? A histological comparative analysis

2015
•    The psychopathology of James Bond and its implications for the revision of the DSM-(00)7

2014
•    The Darwin Awards: sex differences in idiotic behaviour
•    What proof is in your Christmas pudding? Is caring under the influence possible?
•    The surprising benefit of passive–aggressive behaviour at Christmas parties: being crowned king of the crackers

2013
•    The survival time of chocolates on hospital wards: covert observational study

2012
•    Why Rudolph’s nose is red: observational study

2011
•    Orthopaedic surgeons: as strong as an ox and almost twice as clever? Multicentre prospective comparative study
•    Is 27 really a dangerous age for famous musicians? Retrospective cohort study

2010
•    Effect on gastric function and symptoms of drinking wine, black tea, or schnapps with a Swiss cheese fondue: randomised controlled crossover trial
•    A shopping list of doctors

2008
•    Head and neck injury risks in heavy metal: head bangers stuck between rock and a hard bass

2006
•    Sword swallowing and its side effects
•    The hazards of watching football — are Australians at risk?

2005
•    The case of the disappearing teaspoons: longitudinal cohort study of the displacement of teaspoons in an Australian research institute

2004
•    The perils of pet ownership: a new fall-injury risk factor
•    A precious case from Middle Earth

2002
•    Evidence-based physicians’ dressing: a crossover trial

_________________________________________________________________________________
2023
Workload and the mysterious law of karma
If good deeds beget good consequences, why do you always get the toughest shifts? BMJ 18 December 2023

Effect of chair placement on physicians’ behavior and patients’ satisfaction: randomized deception trial
Chair placement is a simple, no cost, low tech intervention that increases a physician’s likelihood of sitting during a bedside consultation and resulted in higher patients’ scores for both satisfaction and communication. BMJ 15 December 2023

Efficacy of cola ingestion for oesophageal food bolus impaction: open label, multicentre, randomised controlled trial
In this study, cola consumption did not lead to a higher rate of improvement of complete oesophageal food bolus impaction. Given the lack of adverse events in the treatment group and some events of resolution after treatment, cola might be considered as a first line treatment, but should not delay any planning of endoscopic management. BMJ 11 December 2023

Jingle bots: turbocharge your Christmas card creativity with AI
Use ChatGPT to enhance festive cheer for your colleagues with personalised greetings. BMJ 13 December 2023

Rudolph, the kids’ ward reindeer: a scoping review of the effects of support animals on the well-being of healthcare staff
Relevant positive effects and avenues of research are identified. Our review suggests that, but not exactly how, animal assisted activity benefits staff. Study evidence is limited with most studies being cross-sectional, descriptive, having low participant numbers, and mostly only involving dogs. Nonetheless, the evidence is mostly positive. The potential of animal assisted activities impacting positively on staff well-being warrants systematic research. Gaps in hard-fact-evidence should not deter us – especially at the festive season – to encourage work with, and systematic research regarding, support animals that provide warmth, empathy, comfort, and more in healthcare settings. Journal of occupational medicine and toxicology 12 December 2023
_________________________________________________________________________________

2022
Everything causes cancer? Beliefs and attitudes towards cancer prevention among anti-vaxxers, flat earthers, and reptilian conspiracists: online cross sectional survey
Almost half of the participants agreed that “It seems like everything causes cancer,” which highlights the difficulty that society encounters in differentiating actual and mythical causes owing to mass information. People who believed in conspiracies, rejected the covid-19 vaccine, or preferred alternative medicine were more likely to endorse the mythical causes of cancer than their counterparts but were less likely to endorse the actual causes of cancer. These results suggest a direct connection between digital misinformation and consequent erroneous health decisions, which may represent a further preventable fraction of cancer. BMJ 21 December 2022

Quantifying the benefits of inefficient walking: Monty Python inspired laboratory based experimental study
For adults with no known gait disorder who average approximately 5000 steps/day, exchanging about 22%-34% of their daily steps with higher energy, low efficiency walking in Teabag style—requiring around 12-19 min—could increase daily EE by 100 kcal. Adults could achieve 75 minutes of vigorous intensity physical activity per week by walking inefficiently for about 11 min/day. Had an initiative to promote inefficient movement been adopted in the early 1970s, we might now be living among a healthier society. Efforts to promote higher energy—and perhaps more joyful—walking should ensure inclusivity and inefficiency for all. BMJ 21 December 2022

Can artificial intelligence pass the Fellowship of the Royal College of Radiologists examination? Multi-reader diagnostic accuracy study
When special dispensation for the artificial intelligence candidate was provided (that is, exclusion of non-interpretable images), the artificial intelligence candidate was able to pass two of 10 mock examinations. Potential exists for the artificial intelligence candidate to improve its radiographic interpretation skills by focusing on musculoskeletal cases and learning to interpret radiographs of the axial skeleton and abdomen that are currently considered “non-interpretable.” BMJ 21 December 2022

“Harry Potter and the Multitudinous Maladies”: a retrospective population‐based observational study of morbidity and mortality among witches and wizards
Morbidity and, in particular, mortality were very high and predominantly caused by magical means. Further investigation into the safety at Hogwarts School of Witchcraft and Wizardry is warranted. The few treatments used had high success rates; rapid recovery was the rule, and hospital stays generally brief. Efforts should be undertaken to identify the magical therapies and interventions used and to introduce these novel remedies into Muggle medicine. MJA 12 December 2022
_________________________________________________________________________________
2021
A guide to the management of atrial fibrillation in Santa Claus
In view of his advanced age and risk factors, Santa Claus is at high risk of developing atrial fibrillation. Despite this, no guidelines exist on the subject. Following a review of the literature, we present our position on the management of atrial fibrillation in Santa Claus, and propose the use of the SANTA CLAUS mnemonic to aid clinicians: Screen for atrial fibrillation; Anticoagulate; Normalise heart rate; Treat comorbidities; Anti‐arrhythmic drugs; Cardioversion; Lifestyle measures; Ablation treatment; Understand emotional and psychological impact; Save Santa Claus. MJA 13 December 2021

The CRECHE study: testing the urban myth that chocolate Santa Clauses are re‐wrapped Easter Bunnies
Although about one‐third of our survey respondents did not rule out the possibility of seasonal sweets being re‐used, Whole body computed tomography (WBCT) imaging found no similarity between chocolate foil‐wrapped Easter and Christmas figurines, providing solid evidence against this urban myth. Chocolate Santa Clauses are unlikely to pose a significant threat to hospital food hygiene requirements. MJA 13 December 2021

We all fall down: head injuries in nursery rhyme characters
Nursery rhymes might aim to teach children morals and good behaviour, but Declan Patton examines several that involve or are suspected of involving fall related head injuries and wonders if they convey the correct message.  BMJ 15 December 2021

Garlic as a vampire deterrent: fact or fiction?
We believe we have summarised the available evidence for the efficacious use of garlic as a protective measure against vampires and conclude that both the science and historical evidence support the use of garlic as a public health intervention. Faced with ongoing environmental (biodiversity loss, climate change) and medical (COVID‐19 pandemic) disasters, populations globally are increasingly vulnerable to additional assaults on their wellbeing. Removing as many stressors as possible is good public health practice under such circumstances, if only to render the population more resilient to assaults on the public health by possible threats, such as vampires, over which we have little control. For these reasons, we recommend that all individuals increase their use of garlic as a preventive measure to minimise the risks of a “vampiregeddon” event. BMJ 13 December 2021

Ghost in the machine or monkey with a typewriter—generating titles for Christmas research articles in The BMJ using artificial intelligence: observational study
AI can generate plausible, entertaining, and scientifically interesting titles for potential Christmas research articles in The BMJ; as in other areas of medicine, performance was enhanced by human intervention. BMJ 15 December 2021
_________________________________________________________________________________
2020
What the forks? A longitudinal quality improvement study tracking cutlery numbers in a public teaching and research hospital staff tearoom
Teaspoon disappearance is a more substantial problem than fork migration in a multidisciplinary staff tearoom, and may reflect different kleptomaniacal or individual appropriation tendencies. If giving cutlery this Christmas, give teaspoons, not forks. The symbolism of fork rebirth or resurrection is appropriate for both Christmas and Easter, and forks are also mighty useful implements for eating cake! BMJ 14 December 2020
__________________________________________________________________________________
2019
Symbolic sexism: superficial or serious bias? An investigation into images on patient call bells
The known: Sexism persists in health care despite policies and procedures that require gender equality. Patient call bells in our hospital include female images, but gender‐specific symbols are unnecessary and inappropriate.
The new: Most call bells in our international sample bore female images. This is an example of widespread and probably unconscious bias.
The implications: Sexism is manifested both subtly and overtly in health care. Hospitals need to actively identify unconscious bias to achieve equitable workplaces. MJA 9 December 2019
________________________________________________________________________________
2018
The emergence and characteristics of the Australian Mamil
The known Middle-aged men in Lycra (Mamils) are often described in the media, but little is known about the extent of the phenomenon.
The new We found that Mamils do exist, evidenced by increases in the proportion of middle-aged men who cycle at least weekly. However, more regular cycling and commuting to work by bicycle have not increased. The habitat of the Mamil is predominantly in affluent suburbs of major cities, often near water.
The implications Mamils provide mutual midlife support for each other and engage in challenging cycling on expensive machines, but may not contribute to increasing overall physical activity levels among adult Australians. MJA 10 December 2018

Licence to swill: James Bond’s drinking over six decades
The known James Bond exhibited problematic alcohol consumption in the Bond books, but their content often deviates from that of the movies.
The new Bond showed a consistent pattern of heavy drinking in all 24 movies over six decades (109 drinking events). His peak binge involved 24 units of alcohol (6 vespers), enough to kill some people. His hazardous activities after drinking included fights, vehicle chases, contact with dangerous animals, and sex with enemies, sometimes with guns or knives in the bed.
The implications Bond should seek professional help and find alternatives to drinking for managing on-the-job stress. MJA 10 December 2018

Everything is awesome: Don't forget the Lego
What is already known on this topic:
•    Children frequently ingest foreign objects.
•    Parents worry about transit times and complications from ingestion.
What this paper adds
•    A predefined object passes through adult patients in 1–3 days.
•    There were no complications in our subjects.
•    Parents should be counselled not to search for the object in stools as it is difficult to find.
Journal of paediatrics and child health 22 November 2018
_________________________________________________________________________________
2017
The Specialty and Naughty/Nice Tendency Audit (SANTA): which medical specialists can be trusted to follow recipes?
The known Personality is thought to influence choice of medical specialty; it is also likely to influence whether a doctor tends to follow recipes or not. Santa expects food offerings beside the Christmas tree.
The new Most doctors do not follow recipes, despite admitting that the results are often less than desired.
The implications Santa will be disappointed by the quality of food offerings beside the Christmas trees of medical practitioners.
MJA 11 December 2017

The science behind “man flu”
This research explores whether men are wimps or just immunologically inferior. BMJ 11 December 2017
_________________________________________________________________________________
2016
The razor’s edge: Australian rock music impairs men’s performance when pretending to be a surgeon
Rock music impairs the performance of men but not women when undertaking complex surgical procedures in the board game Operation, increasing the time taken to operate and showing a trend towards more surgical mistakes. In addition, classical music was associated with lower perceived distraction during the game, but this effect was attenuated when factoring in how much people liked the music, with suggestions that only people who particularly liked the music of Mozart found it beneficial. Conclusions: Rock music (specifically Australian rock music) appears to have detrimental effects on surgical performance. Men are advised not to listen to rock music when either operating or playing board games. MJA 12 December 2016

What’s in your hot dog? A histological comparative analysis
The contents of hot dogs (also known as street meat, tube steaks, frankfurters, wieners, etc) have been a source of speculation in popular culture. However, a search of published literature did not identify any studies analysing the histological composition of these products. The oral mucosa from the vermillion border and anuses of large mammalian domesticated animals has been postulated. We sought to not only determine the varieties of tissues that make up hot dogs, but also to do a comparative analysis of various brands of hot dogs to study the amount of skeletal muscle (which most people consider to represent meat) within each type. MJA 12 December 2016
_______________________________________________________________________________
2015
The psychopathology of James Bond and its implications for the revision of the DSM-(00)7
The proposed DSM-(00)7 has benefits for both patients and clinicians. Patients will experience reduced stigma, as most individuals will meet the criteria for Normality Disorder. This parsimonious diagnostic approach will also mean clinicians have more time to focus on patient management. MJA 14 December 2015
_________________________________________________________________________________
2014
The Darwin Awards: sex differences in idiotic behaviour
Sex differences in risk seeking behaviour, emergency hospital admissions, and mortality are well documented. However, little is known about sex differences in idiotic risk taking behaviour. This paper reviews the data on winners of the Darwin Award over a 20 year period (1995-2014). Winners of the Darwin Award must eliminate themselves from the gene pool in such an idiotic manner that their action ensures one less idiot will survive. This paper reports a marked sex difference in Darwin Award winners: males are significantly more likely to receive the award than females (P<0.0001). We discuss some of the reasons for this difference. BMJ 11 December 2014

What proof is in your Christmas pudding? Is caring under the influence possible?
Christmas puddings contain ethanol that does not all evaporate during the cooking process. However, the rise in blood alcohol content (BAC) after ingestion of a typical slice of Christmas pudding was negligible and unlikely to affect work performance or safety or impair a health care worker's ability to make complex decisions. MJA 14 December 2014

The surprising benefit of passive–aggressive behaviour at Christmas parties: being crowned king of the crackers
he passive–aggressive strategy of failing to pull has a high rate of success at winning Christmas crackers; however, excessive adoption of this approach will result in a complete failure, with no winners at all. MJA 15 December 2014
_________________________________________________________________________________
2013
The survival time of chocolates on hospital wards: covert observational study
From this observational study, chocolate survival in a hospital ward was relatively short, and was modelled well by an exponential decay model. Roses chocolates were preferentially consumed to Quality Street chocolates in a ward setting. Chocolates were consumed primarily by healthcare assistants and nurses, followed by doctors. Further practical studies are needed. BMJ 13 December 2013
_________________________________________________________________________________
2012
Why Rudolph’s nose is red: observational study
he nasal microcirculation of reindeer is richly vascularised, with a vascular density 25% higher than that in humans. These results highlight the intrinsic physiological properties of Rudolph’s legendary luminous red nose, which help to protect it from freezing during sleigh rides and to regulate the temperature of the reindeer’s brain, factors essential for flying reindeer pulling Santa Claus’s sleigh under extreme temperatures. BMJ 12 November 2012
_________________________________________________________________________________
2011
Orthopaedic surgeons: as strong as an ox and almost twice as clever? Multicentre prospective comparative study
Male orthopaedic surgeons have greater intelligence and grip strength than their male anaesthetic colleagues, who should find new ways to make fun of their orthopaedic friends. BMJ 11 December 2011

Is 27 really a dangerous age for famous musicians? Retrospective cohort study
The authors identified three deaths at age 27 amongst 522 musicians at risk, giving a rate of 0.57 deaths per 100 musician years. Similar death rates were observed at ages 25 (rate=0.56) and 32 (0.54). There was no peak in risk around age 27, but the risk of death for famous musicians throughout their 20s and 30s was two to three times higher than the general UK population. The 27 club is unlikely to be a real phenomenon. Fame may increase the risk of death among musicians, but this risk is not limited to age 27. BMJ 20 December 2011
_________________________________________________________________________________
2010
Effect on gastric function and symptoms of drinking wine, black tea, or schnapps with a Swiss cheese fondue: randomised controlled crossover trial
Gastric emptying after a Swiss cheese fondue is noticeably slower and appetite suppressed if consumed with higher doses of alcohol. This effect was not associated with dyspeptic symptoms. BMJ 10 December 2010

A shopping list of doctors
The season of dietary indulgence seems a good time to celebrate doctors whose names have become linked with items of food and drink. From antiquity to the present, doctors have attempted to influence the diet of their patients. Some have developed foods that became so popular that they have achieved lasting commercial success. Although many are forgotten as doctors, their names remain well known to the public, becoming famous brand names and trademarks. BMJ 10 December 2010
_________________________________________________________________________________
2008
Head and neck injury risks in heavy metal: head bangers stuck between rock and a hard bass
To minimise the risk of head and neck injury, head bangers should decrease their range of head and neck motion, head bang to slower tempo songs by replacing heavy metal with adult oriented rock, only head bang to every second beat, or use personal protective equipment. BMJ 18 December 2008
________________________________________________________________________________
2006
Sword swallowing and its side effects
Sword swallowers run a higher risk of injury when they are distracted or adding embellishments to their performance, but injured performers have a better prognosis than patients who suffer iatrogenic perforation. BMJ 21 December 2006

The hazards of watching football — are Australians at risk?
Australians appear to be resistant to acute stressors associated with watching sporting events, possibly due to higher rates of motivational deficiency disorder (MoDeD) than in European populations. MJA 4 December 2006
________________________________________________________________________________
2005
The case of the disappearing teaspoons: longitudinal cohort study of the displacement of teaspoons in an Australian research institute
56 (80%) of the 70 teaspoons disappeared during the study. The half life of the teaspoons was 81 days. The half life of teaspoons in communal tearooms (42 days) was significantly shorter than for those in rooms associated with particular research groups (77 days). The rate of loss was not influenced by the teaspoons' value. The incidence of teaspoon loss over the period of observation was 360.62 per 100 teaspoon years. At this rate, an estimated 250 teaspoons would need to be purchased annually to maintain a practical institute-wide population of 70 teaspoons. BMJ 22 December 2005
_________________________________________________________________________________
2004
The perils of pet ownership: a new fall-injury risk factor
Pets are a potential environmental hazard in the occurrence of fall-related injuries in older people, with dogs and cats most likely to be involved. Women appear more likely than men to be injured. MJA 6 December 2004

A precious case from Middle Earth
Tolkien’s character Gollum is certainly disturbed, but is he physically or mentally ill? Gandalf the Wizard provides the history BMJ 18 December 2004
_________________________________________________________________________________
2002
Evidence-based physicians’ dressing: a crossover trial
Formal attire was correlated with higher patient confidence and trust. Nose rings were particularly deleterious to patients’ reported trust and confidence. A minimum threshold of two items of formal attire (dress pants, dress shirt, tie, or white coat) were necessary to inspire a reasonable amount of confidence; this is the NND (number needed to dress). MJA 16 December 2002

_________________________________________________________________________________