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The hazards of festive foliage - and other research

Thursday December 16th 2021

It’s safe to rock around the Christmas tree – but be careful about the berries on holly, according to the latest annual round of quirky seasonal medical research.

Researchers in the Christmas issue of The BMJ have provided a guide to the potential dangers of plants traditionally associated with the festive season, examining each variety against the National Poisons Information Service (ToxBase) database.

They say Christmas trees are generally safe, except for a few cases of contact dermatitis from workers with unusually high exposure, and ivy is also a low risk plant, but holly needs to be hung more carefully because the berries contain saponins, which can cause stomach upsets and drowsiness.

They also warn against eating the seeds in a pear as they contain amygdalin, which is converted to cyanide in the gut. While there are no reports of human cyanide poisoning resulting from pear seed consumption, the authors warn the fruit of 12 pear trees may be sufficient.

Cliff Richard’s famous seasonal song Mistletoe and Wine is a particularly disastrous combination because the white-berried plant contains viscotoxins.

Even Christmas dinner can include some potentially injurious plant species: potatoes are a nightshade relation of the Christmas cherry, although the tuber holds the lowest concentrations of solanines, so are unlikely to cause any ill effects, while cooks should be careful to make sure they have parsnips because poisonous water hemlock has been mistaken for the vegetable by foragers, which has led to seizures and kidney failure.

Brussels sprouts are not poisonous, leading the authors to note: “Looks like you’ll have to endure them after all.”

The Christmas edition of The BMJ also publishes research from the USA-based Children's Hospital of Philadelphia's Center for Injury Research and Prevention and Minds Matter Concussion Program about nursery rhymes.

Declan Patton analysed seven popular nursery rhymes involving or suspected of involving fall-related head injuries.

He said Humpty Dumpty, who famously had a great fall, has inspired tests on chicken eggs to study the biomechanics of head injuries in humans “because of the similarities between the two in shape and physical properties”, while Jack and Jill might provide insights into sex-based differences in head injuries and the use of protective equipment to reduce skull fractures.

Rock-a-Bye Baby highlights the role of height and impact surface on the likelihood of head injury after a fall, while falls from standing height, as those described in Ring a Ring o’ Roses, comprise a quarter of fall-related head injuries in those younger than six years.

Patton says children singing and dancing to this rhyme, traditionally associated with the Great Plague, “should be at low risk of head injury, but they ought to perform it on energy absorbing surfaces for extra safety.”

He suggests that authors of future nursery rhymes “should bear in mind the risk factors associated with head injuries, especially when their characters might behave recklessly like jumping off a springy bed; might fall off a wall or down from a treetop; or are thrown down the stairs by unknown assailants”.

The Christmas edition also reveals how artificial intelligence (AI) technology can generate plausible, entertaining, and scientifically interesting titles for potential research articles.

A study of The BMJ’s most popular Christmas research articles found that AI-generated titles were as attractive to readers but that, as in other areas of medicine, performance was enhanced by human input.

As such, the researchers say AI could have a role in generating hypotheses or directions for future research.

They used the titles of the publication’s 13 most-read Christmas research articles of the past 10 years to prompt similar AI generated titles, which they scored for scientific merit, entertainment, and plausibility.

The results showed that AI-generated titles were rated at least as enjoyable (64% v 69%) and attractive (70% v 68%) as real titles, although the real titles were rated as more plausible (73% v 48%).

Of the AI-generated titles, among the highest for plausibility were “The clinical effectiveness of lollipops as a treatment for sore throats”, and “The effects of free gourmet coffee on emergency department waiting times: an observational study”.

The funniest AI-generated title was: “Superglue your nipples together and see if it helps you to stop agonising about erectile dysfunction at work”.

Huntingdon GR, Byrne ML. The holly and the ivy: a festive platter of plant hazards. BMJ 16 December 2021; doi: 10.1136/bmj-2021-066995 [abstract]

Patton DA. We all fall down: head injuries in nursery rhyme characters. BMJ 16 December 2021; doi: 10.1136/bmj-2021-068256 [abstract]

Marlow R, Wood D. Ghost in the machine or monkey with a typewriter—generating titles for Christmas research articles in The BMJ using artificial intelligence: observational study. BMJ 16 December 2021; doi: 10.1136/bmj-2021-067732 [abstract]

Tags: Child Health | Gastroenterology | General Health | North America | UK News

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