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Popular Belief Meets Surgical Reality: Impact of Lunar Phases, Friday the 13th and Zodiac Signs on Emergency Operations and Intraoperative Blood Loss

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The influence of superstition, moon calendars, and popular belief on evidence-based medicine is stunning. More than 40% of medical staff is convinced that lunar phases can affect human behavior. The idea that Friday the 13th is associated with adverse events and bad luck is deep-rooted in the population of Western industrial countries. The aim of the present study was to test the hypothesis that these myths are transferable to real-life surgery. We analyzed the extent to which moon phases, zodiac signs, and Friday the 13th influence blood loss, emergency frequency, and intestinal perforations by evaluating the operation records of all 27,914 consecutive patients of our institution undergoing general, visceral, or vascular surgery between August 2001 and August 2010. Dates of surgery were allocated to lunar phases and to zodiac signs, as well as to Friday the 13th. A total of 111 lunar cycles and 15 Fridays the 13th occurred within the 3,281-day observation period. Patients' characteristics did not differ in lunar phases, zodiac signs, or Fridays the 13th. Full moon phases, the presence of Friday the 13th, and zodiac signs influenced neither intraoperative blood loss nor emergency frequency. No statistical peaks regarding perforated aortic aneurysms and gastrointestinal perforations were found on full moon or Friday the 13th. Scientific analysis of our data does not support the belief that moon phases, zodiac signs, or Friday 13th influence surgical blood loss and emergency frequency. Our data indicate that such beliefs are myths far beyond reality.
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ORIGINAL SCIENTIFIC REPORTS
Popular Belief Meets Surgical Reality: Impact of Lunar Phases,
Friday the 13th and Zodiac Signs on Emergency Operations
and Intraoperative Blood Loss
Jochen Schuld Jan E. Slotta Simone Schuld
Otto Kollmar Martin K. Schilling
Sven Richter
Published online: 29 June 2011
ÓSocie
´te
´Internationale de Chirurgie 2011
Abstract
Background The influence of superstition, moon calen-
dars, and popular belief on evidence-based medicine is
stunning. More than 40% of medical staff is convinced that
lunar phases can affect human behavior. The idea that
Friday the 13th is associated with adverse events and bad
luck is deep-rooted in the population of Western industrial
countries. The aim of the present study was to test the
hypothesis that these myths are transferable to real-life
surgery.
Methods We analyzed the extent to which moon phases,
zodiac signs, and Friday the 13th influence blood loss,
emergency frequency, and intestinal perforations by eval-
uating the operation records of all 27,914 consecutive
patients of our institution undergoing general, visceral, or
vascular surgery between August 2001 and August 2010.
Dates of surgery were allocated to lunar phases and to
zodiac signs, as well as to Friday the 13th.
Results A total of 111 lunar cycles and 15 Fridays the
13th occurred within the 3,281-day observation period.
Patients’ characteristics did not differ in lunar phases,
zodiac signs, or Fridays the 13th. Full moon phases, the
presence of Friday the 13th, and zodiac signs influenced
neither intraoperative blood loss nor emergency frequency.
No statistical peaks regarding perforated aortic aneurysms
and gastrointestinal perforations were found on full moon
or Friday the 13th.
Conclusions Scientific analysis of our data does not
support the belief that moon phases, zodiac signs, or Friday
13th influence surgical blood loss and emergency fre-
quency. Our data indicate that such beliefs are myths far
beyond reality.
Introduction
In ancient and modern cultures, the moon is regarded as a
factor influencing human fate and health. The term
‘lunacy’’ is derived from Luna, the Roman goddess of the
moon, and from the belief that the power of the moon can
cause disorders of the mind [1,2]. The lunar phase and
the position of the moon in the zodiac is especially
claimed to be relevant for the risk of emergency opera-
tions or intraoperative complications in surgery. More
than 10% of the German population believe in a rela-
tionship between lunar phase and diseases [3]. 43% of
health professionals believe that lunar effects can affect
human individual behavior [4]. The belief that lunar
phases can influence illness may be based on Galen and
Hippocrates, but no documents exist to prove that myth.
In recent years many articles assessing the influence of
lunar phases on suicide [57], mental health [8], and
various accident events [9,10] have been published.
Other forms of superstition, such as signs of the zodiac
may affect human behavior in various ways. A belief in
Friday the 13th as an ill-fated day is deep-rooted in the
population [11,12]. To the best of our knowledge, there
is only one study dealing with the zodiac and its influence
on emergency cases [13].
Jochen Schuld and Jan E. Slotta contributed equally to this study.
J. Schuld J. E. Slotta O. Kollmar M. K. Schilling
S. Richter (&)
Department of General-, Visceral-, Vascular- and Paediatric
Surgery, University of Saarland, 66421 Homburg/Saar, Germany
e-mail: sven.richter@uks.eu
S. Schuld
Department of Anaesthesiology and Intensive Care Medicine,
University of Saarland, 66421 Homburg/Saar, Germany
123
World J Surg (2011) 35:1945–1949
DOI 10.1007/s00268-011-1166-8
The aim of our retrospective study over 9 years was to
evaluate if there were any statistically significant peaks of
intraoperative blood loss or frequency of emergency cases
that could be linked to lunar phenomena, Friday the 13th,
or zodiac signs.
Patients and methods
The database was comprised of all consecutive patients
admitted and undergoing general, visceral, or vascular
surgery between August 29, 2001 and August 23, 2010.
However, pediatric surgery and all other surgical special-
ities (e.g., orthopedic and trauma surgery, neurosurgery,
thoracic surgery, etc.) were excluded from the evaluation.
Collective operative records were evaluated using the
hospital information system SAP/i.s.h.med (SAP, St. Leon-
Rot, Germany). Intraoperative documentations of estimated
surgical blood loss were analyzed.
One lunar phase was defined as 29.53 days (29 days,
12 h, 44 min, 2.9 s). Friday the 13th occurs when the
thirteenth day of a month falls on a Friday. In the Grego-
rian calendar, this occurs at least once, but at most three
times a year. Any month’s thirteenth day will fall on a
Friday whenever the month starts on a Sunday. Calculation
of patient’s zodiac signs, lunar phases, and zodiac signs at
time of the operation, as well as identification of Friday the
13th, were performed using VBA scripts in Microsoft
Excel (Microsoft, Unterschleissheim, Germany) based on
the date of the operation. All values are expressed as
mean ±SEM. After proving the assumption of normality
and homogeneity of variance across groups, differences
between the groups were calculated with the Student’s t-
test. In case of non-normal distribution of data, the Mann–
Whitney U-test was performed. Comparison between
groups of categorical data was performed with Fisher’s
exact test or the chi-square test. Overall statistical signifi-
cance was set at P\0.05. Statistical analysis was per-
formed with SPSS 15 software package (SPSS, Chicago,
IL).
Results
A total of 111 lunar phases over 3,281 days were evaluated
regarding operations of 27,914 patients (16,310 men,
58.4%; 11,604 women 41.6%) with an average age of
58.8 ±0.1 (16–99) years. At least one operation was
performed at 3,153 of the 3,281 days within the observa-
tion period (96.1%). Mean estimated blood loss was
161.7 ±2.8 ml, ranging from 1 ml to 12,000 ml. In 865
procedures (3.1%), an intraoperative blood transfusion was
mandatory.
Of all the operations analyzed, 7,309 (26.2%) were
performed as emergency operations; all others were plan-
ned. Most operations were performed during waxing moon
and waning moon; 912 operations were performed during a
new moon, and 916 operations were performed during a
full moon (Table 1). Friday the 13th occurred 15 times
within the observation period, with overall 170 operations
on these days. A little more than 50% (51.8%; n=88) of
these operations were performed during the waning moon;
48.2% (n=82) were done during the waxing moon. The
‘worst case scenario’’—a combination of a full moon and
Friday the 13th—never occurred. Estimated blood loss and
emergency frequency did not correlate with lunar phases,
the presence of Friday the 13th (Table 2), or zodiac signs at
the time of the operations (Table 3). During the zodiac
signs of Capricorn (Dec 22–Jan 20), Aries (March 21–April
20), and Gemini (May 22–June 21), the rate of emergency
Table 1 Distribution of 27,914 operations to lunar phases and
patient’s characteristics from August 29 2001 to August 23 2010
Lunar phase nPercentage Age, years
Waning moon 13,019 46.6 58.8 ±0.1
New moon 912 3.3 58.6 ±0.5
Full moon 916 3.3 58.6 ±0.5
Waxing moon 13,067 46.8 58.6 ±0.1
Overall 27,914 100.0 58.8 ±0.1
Table 2 Emergency frequency and estimated blood loss in relation to
lunar phases and Friday the 13th
Time
point or
lunation
phase
Emergency
rate (%)
Chi
square
Pvalue Estimated
blood
loss, ml
Pvalue
Friday
the
13th
20.0 3.384 0.069 203.0 ±34.8 0.245
Normal
day
26.2 161.5 ±2.8
Friday
the
13th
20.0 0.955 0.356 203.0 ±34.8 0.079
Every
other
Friday
23.2 148.8 ±5.6
Waning
moon
26.5 2.115 0.549 160.6 ±4.0 0.676
New
moon
25.8 151.98 ±13.6
Full
moon
27.4 149.69 ±15.4
Waxing
moon
25.8 164.40 ±4.16
1946 World J Surg (2011) 35:1945–1949
123
operations significantly differed from the mean emergency
rate during the rest of the evaluation period, but whereas
estimated blood loss was comparable (Table 3). A total of
128 severe vascular (0.5 % overall) cases and 448 (1.7%
overall) severe gastrointestinal emergency cases were
found with a peak for perforated aortic aneurysms in the
zodiac sign Aries (0.7%) and a peak for gastrointestinal
perforations in Capricorn and Scorpio (2.1% each); how-
ever, neither reached statistical significance. The distribu-
tion of both entities was independent of lunar phases and
zodiac signs, as shown in Tables 4and 5.
Discussion
Moon and lunar cycles played an important role in all
ancient human civilizations, the earliest reports dating to
Sumerian and Egyptian high cultures [14]. The idea that
stars and planets may influence human health and behavior
can be traced to at least Roman times [15]. Research
suggests that a high proportion of health professionals
continue to hold this belief [4]. The fear of Friday the 13th
is called Paraskavedekatriaphobia and was first mentioned
by Coriat in 1911 [16]. A number of publications sup-
porting the hypothesis of a lunar influence [17], Friday 13th
[11,18,19], and zodiac signs alternate with a larger
number of publications rejecting any such correlation [3,8,
10,2022]. When analyzing mentally ill people, only the
Table 5 Association between zodiac signs and operations for gas-
trointestinal perforation (P=0.398) and operations for perforated
aortic aneurysm (P=0.562)
Zodiac sign Gastrointestinal
perforation
Perforated aortic
aneurysm
Pisces 1.3%
30/2,347
0.5%
12/2,347
Virgo 1.9%
43/2,307
0.3%
8/2,307
Cancer 1.6%
42/2,572
0.5%
13/2,572
Leo 2.0%
47/2,363
0.4%
10/2,363
Sagittarius 1.3%
30/2,313
0.6%
14/2,313
Scorpion 2.1%
51/2,461
0.5%
12/2,461
Capricorn 2.1%
39/1,877
0.6%
11/1,877
Taurus 2.0%
46/2,307
0.3%
6/2,307
Libra 1.5%
36/2,333
0.6%
13/2,333
Aquarius 1.8%
42/2,399
0.3%
8/2,399
Aries 1.9%
41/2,134
0.7%
14/2,134
Gemini 1.6%
41/2,501
0.3%
7/2,501
Table 4 Correlation between lunar phases and operations for gas-
trointestinal perforation (v
2
=1.179, P=0.758) and lunar phases
and operations for perforated aortic aneurysm (v
2
=2.231,
P=0.526)
Lunar phase Gastrointestinal
perforation
Perforated aortic
aneurysm
Waning moon 1.7%
225/13,019
0.4%
57/13,019
New moon 1.4%
13/912
0.2%
2/912
Full moon 2.1%
19/916
0.3%
3/916
Waxing moon 1.8%
231/13,067
0.5%
66/13,067
Table 3 Influence of zodiac signs on emergency operations and
estimated intraoperative blood loss
Zodiac sign Emergency rate Estimated blood loss, ml
Capricorn 32.5%
610/1,877
156.3 ±9.4
Aries 29.1%
621/2,134
168.0 ±9.3
Gemini 28.3%
708/2,501
158.5 ±9.3
Leo 26.6%
629/2,363
154.1 ±9.5
Taurus 26.5%
612/2,307
149.9 ±8.7
Cancer 26.3%
676/2,572
181.1 ±10.8
Scorpio 25.5%
628/2,461
161.7 ±9.1
Libra 25.3%
590/2,333
163.4 ±9.6
Sagittarius 24.8%
574/2,313
144.6 ±9.4
Pisces 24.1%
566/2,347
173.3 ±10.3
Virgo 24.1%
555/2,307
162.2 ±9.9
Aquarius 22.5%
540/2,399
164.8 ±9.7
World J Surg (2011) 35:1945–1949 1947
123
mental health of patients with schizophrenia has been
shown to be affected by moon phases [8]. Kredel et al.
report that postoperative nausea and vomiting are not
influenced by lunar cycles [20]. The first medical doctor
scientifically dealing with the problem of bleeding and
lunar phases was Andrews in 1960 [18]. In his original
publication, only a pseudo-coincidence of postoperative
bleeding complications after tonsillectomy was found [23].
The myth that moon phases influence long term follow-up
in oncological surgery was broken by May et al. [22], as
well as by Kuehnl et al. [21]. As there are no studies
evaluating moon effects, zodiac signs, or Friday the 13th
on intraoperative blood loss and emergency frequency, we
have evaluated almost 28,000 patient records in 111 lunar
cycles representing the biggest cohort dealing with this
question to our knowledge. When analyzing big cohorts for
cyclical aspects or trends—as given by moon phases and
zodiac signs—the number of investigated cycles is more
important than the overall number of investigated subjects.
The results of our study are in line with most previously
published studies dealing with the influence of folk belief
on surgical complications [3,23,24]. The fact that emer-
gency cases are more frequent during the zodiac signs of
Capricorn, Aries, and Gemini is easy to explain because the
religious Christian holidays (Christmas, Easter, and Whit-
sun) cumulate in these periods. By definition, all operations
performed on holidays were classified as emergencies. It is
important to note that the emergency cases investigated in
our study are not influenced by human behavior as
described in previous studies [11,19]. This potential bias is
unmistakably excluded in our discipline, as emergency
cases in general, visceral, and vascular surgical occur only
due to internal patient characteristics and therefore repre-
sent unpredictable, stochastic events.
Admittedly, some shortcomings of the present study
have to be faced. First, one could argue that there may be
some systematic error as the data represent only a single-
center experience with 3,000 patients treated per year.
However, our database comprises all patients treated in
general, visceral, and vascular surgery at a tertiary referral
centre for 1 million people. Second, our study is limited
insofar that the statistical power for both perforated aortic
aneurysm and gastrointestinal perforation is 0.125 and
0.203, respectively. To reach a desired power level of 0.8,
this study would require 135,025 perforated aortic aneu-
rysm patients and 255,395 gastrointestinal perforation
patients. Such large cohorts can only be evaluated in
population-based registries [25,26] but are not available
for surgical patients. To our knowledge, however, no study
dealing with the problem of superstition in medicine to date
has provided a detailed power and sample size calculation.
Third, recent studies dealing with the influence of the full
moon on medical emergency cases may face a large degree
of beta error because of small patient cohorts and rare
events [3,17,21,24,27]. To overcome the problem of
analyzing rare events in a cyclical context within a limited
number of patients, some of the recent studies have not
clearly defined the event of ‘‘full moon’’ or allocated this
event to a time period of several days [22,27]. Fourth, the
estimation of intraoperative blood loss is strongly biased by
surgeons’ tendency to underestimate blood loss systemat-
ically [28,29]. At this point, the single-center approach
may provide an advantage by reporting standardized
measurements and correct documentation of intraoperative
blood loss. A final criticism of the present study may be
that 128 days are lacking in our investigation because
neither emergency cases nor elective surgeries were per-
formed on those days. However, the proportion of lunar
phases and zodiac signs in these lacking days was com-
parable to the rest, so that no statistical bias should occur.
Looking back, numerous studies have dealt with myths
and popular belief in modern medicine. Although most
publications deny any influence of superstition, some
studies still support this view [17,30], and evidence is
weak. Therefore, further research in the context of rare
unpredictable events—especially when dealing with cyclic
phenomena (e.g., moon phases, weather conditions, sea-
sons)—will require large databases of patients, which can
be recruited preferably from multicentric settings. In view
of the fact that trauma- and orthopedic surgery have been
excluded from the data set reported here, we finally want to
state that the impact of lunar phases and other influences on
human behavior that would have an impact on risk taking
and injury or trauma cannot be answered by the present
study.
Taken together, our results support the evidence that
operation scheduling according to lunar phases and zodiac
signs, as well as avoiding Friday the 13th for elective
surgical procedures is nothing more than medical nonsense.
Consequently, on the one hand, there is no reason for
patients to fear adverse health effects by scheduling oper-
ations during full moon phases or on Friday the 13th. On
the other hand there is no reason for health professionals in
emergency services to avoid Friday the 13th or full moon
phases on the staff roster. Finally, we want to highlight that
the current investigation is more than a humorous analysis
of a popular belief. The possible effect of these factors on
operation scheduling would be quite relevant for personal
and resource planning.
Conclusions
The hypothesis that lunar phases, zodiac signs, and Friday
the 13th influence blood loss and emergency operations is
not valid and only myth. So far, however, studies with
1948 World J Surg (2011) 35:1945–1949
123
adequate power and sample size calculation rejecting any
association between superstition and medicine are under-
represented in the medical literature.
Acknowledgments The authors greatly appreciate the help of Ms.
Catherine Black, University of Manchester, for proofreading and
substantive contributions concerning language and style of the
manuscript.
Conflict of interest None.
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... The lunar cycle is characterized by a periodic change in the visible side of the moon from the earth and is typically 29.53 days long [4]. The cycle has four distinct phases: first quarter, full moon, last quarter, and new moon [4][5][6]. The first quarter is seen one week after the new moon and happens when the moon is at a 90-degree angle with respect to the earth and sun. ...
... Lunatic has been used to refer to insanity related to the lunar cycle since the 13th century. Throughout history, sleepwalking, insanity, and epilepsy have all been connected with lunar effects [4][5][6]. In relevant literature, significant seasonal impacts on panic and anxiety disorders were reported [7]. ...
... The medical community has also been interested in the effects of lunar cycles on patients. Around 40% of healthcare professionals believe that lunar phases have effects on human behavior [5]. In a survey conducted by Vance et al., 43% of the 325 participants in New Orleans stated that lunar phases can change personal behavior. ...
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Aim: Suicide is when a person intentionally ends his or her own life. Today, it is considered a global concern. It is important to address the underlying causes leading to suicides. In this study, we aimed to investigate the relationship between the lunar cycle and suicide attempts. Material and Method: This multicenter study was done retrospectively between January 1, 2012 and December 31, 2012. The records of patients who presented to emergency departments (EDs) with attempted suicide at nine different hospitals across the country were evaluated retrospectively. The lunar phases of the days when patients presented to the hospitals were also evaluated. Results: As determined by an investigation of the days of presentation of the 5,647 patients who were investigated, 25.28% of the patients presented during the first quarter, 25.71% during the full moon, 25.03% during the last quarter, and 23.68% during the new moon. There is, therefore, no significant difference observed between the lunar phases and suicidal attempts (P <0.05). Discussion: The results of the present study and the literature findings do not support the hypothesis of the lunar cycle having any effect on suicide attempts.
... The lunar cycle is characterized by a periodic change in the visible side of the moon from the earth and is typically 29.53 days long [4]. The cycle has four distinct phases: first quarter, full moon, last quarter, and new moon [4][5][6]. The first quarter is seen one week after the new moon and happens when the moon is at a 90-degree angle with respect to the earth and sun. ...
... Lunatic has been used to refer to insanity related to the lunar cycle since the 13th century. Throughout history, sleepwalking, insan- ity, and epilepsy have all been connected with lunar effects [4][5][6]. In relevant literature, significant seasonal impacts on panic and anxiety disorders were reported [7]. ...
... The medical community has also been interested in the effects of lunar cycles on patients. Around 40% of healthcare profes- sionals believe that lunar phases have effects on human be- havior [5]. In a survey conducted by Vance et al., 43% of the 325 participants in New Orleans stated that lunar phases can change personal behavior. ...
... One study found a significant increase in emergency room visits for dogs and cats on fuller moon days (waxing gibbous to waning gibbous) compared with all other days (Wells et al., 2007). However, other veterinary and human research has failed to find an association with phases of the moon or temporal variation and emergency service caseload, intracranial aneurysm rupture, or cardiac arrest (Alves et al., 2003;Wells et al., 2007;Drobatz et al., 2009;Schuld et al., 2011;Bunevicius et al., 2017). Additionally, research in both human and animal populations has not identified an association between emergency service traffic, surgical blood loss, or occurrence of cardiac arrest with signs of the zodiac or Friday the 13th (Drobatz et al., 2009;Schuld et al., 2011;Lo et al., 2012). ...
... However, other veterinary and human research has failed to find an association with phases of the moon or temporal variation and emergency service caseload, intracranial aneurysm rupture, or cardiac arrest (Alves et al., 2003;Wells et al., 2007;Drobatz et al., 2009;Schuld et al., 2011;Bunevicius et al., 2017). Additionally, research in both human and animal populations has not identified an association between emergency service traffic, surgical blood loss, or occurrence of cardiac arrest with signs of the zodiac or Friday the 13th (Drobatz et al., 2009;Schuld et al., 2011;Lo et al., 2012). One of the most well-known superstitions is that uttering the word, Quiet will quickly make the emergency service busier and increase the number of hospital admissions. ...
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This study aims to determine whether the use of the word, Quiet increases veterinary emergency service triage traffic or hospital admissions. Days were randomized to be a control or test phrase day. On control days, the phrase, Have a nice day! was announced to the entire hospital staff. On test days, the phrase, Have a quiet day! was announced. No statistical difference in mean number of the patients presenting to the emergency service for triage (test phrase 30.1 ± 10.4 cases vs control phrase 30.3 cases ± 10.5, p = 0.91) or hospital admissions (test phrase 3.5 ± 1.9 cases vs control phrase 4.3 ± 2.4 cases, p = 0.13) was found for 24-h following phrase utterance. No statistical difference in mean number of patients presenting to the emergency service for triage (test phrase 2.7 ± 1.4 cases vs control phrase 2.6 ± 1.9 cases, p = 0.84) or hospital admissions (test phrase 0.3 ± 0.5 cases vs control phrase 0.5 ± 0.8 cases, p = 0.08) was found in the 2-h window immediately following phrase announcement. Despite popular myth, using the word, Quiet does not increase veterinary emergency service triage traffic or hospital admissions.
... The belief in significant times of the year or specific dates can be traced back to early man's relationship with the environment, seeing patterns in nature and agriculture related to phases of the moon and, in turn, imbuing the lunar cycle with supernatural qualities, in the form of gods or goddesses. The origins of these beliefs can be traced back to ancient times as described in several studies (Lo et al., 2012;Schuld et al., 2011). ...
... Radun and Summala (2004) used 14 years of Finnish vehicle accident data and found no significant differences in road injury accidents amongst Fridays, once they had controlled for holidays. In addition, no increase in incidents has been found on Friday the 13th for post-tonsillectomy haemorrhage (Kumar et al., 2009), intraoperative blood loss (Schuld et al., 2011), relationship between a Friday the 13th birthdate and lifetime economic measures (Fidrmuc and Tena, 2014) and the number of hospital admission rates and emergency department visits (Lo et al., 2012). ...
Article
Purpose It is a well held belief that the full moon period and the date Friday 13th has an impact on the number of emergency call outs for emergency services. The purpose of this paper is to critically explore that belief. It also examines the versatility and richness of response records, and demonstrates the effectiveness of combining data sets. Design/methodology/approach The work takes four varied data sets, from four rescue agencies along with the International Search and Rescue Database and compared the average number of calls on a full moon night, non-full moon and full moon period (the full moon night, the day before and day after). The average number of incidents on Friday 13th was also investigated. It uses a statistical approach to test the difference between “normal” dates and those dates traditionally believed to be busier. Findings Although there were differences between Friday 13th, full moon nights, full moon periods and “normal” days, the differences were in general extremely small, not significantly significant and in most cases actually dropped during the supposedly unlucky period. The exception to this is a very small increase in the average number of responses during full moons for most data sets, although this was not statistically significant. This paper concludes that there is no evidence in the data for any impact of the full moon upon rescue teams’ activities. Research limitations/implications This research deals with a small set of responses, from the UK only, and addresses an issue that is clearly not the most pressing. However, it does demonstrate evidenced-based management in practice, in that resources have incorrectly been assigned in the past to these dates. Practical implications This work shows that preconceptions exist within the emergency services and that, without evidence-led management, resources can be allocated on hearsay. This shows that widely available software and techniques can be applied to organisational data and used to make management decisions more appropriate. Social implications Rescue organisations are almost exclusively charity or public sector organisations, meaning that their budgets are sourced from donations or the tax-payer. Putting to bed misconceptions over resources for certain dates will ultimately benefit society in those terms. Originality/value There has been very little work on this phenomenon, although some works on A&E department admissions have taken place. This is the only work to date to combine data in this way for this purpose.
... For instance, the operation records were analyzed in 27,914 consecutive patients who underwent general, visceral, or vascular surgery: moon phases, zodiac signs, and Friday the 13 th were not associated with poor surgical outcomes, specifically blood loss or emergency frequency. 1 Another series of 452 patients with invasive bladder cancer treated with radical cystectomy demonstrated no predictable influence of zodiac signs or lunar phases on survival of patients nor on surgical complications. 2 Having an acute coronary syndrome on Friday the 13 th did not influence the 13-year mortality rate compared to other dates of the year. 3 To note, a study done in Japan in 1998 has shown that the belief in Taian (lucky day)-Butsumetsu (unlucky day), which is a superstition based on the six-day lunar calendar, influenced the decision of patients leaving the hospitals. ...
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We encounter in our everyday clinical practice many beliefs about the relationship between workload, disease type, and complexity of cases on one hand, and the calendar (e.g. Friday 13th), moon cycle, or identity of the physician on duty (a surgeon who always “attracts” complex cases) on the other hand. Although apparently implausible, these questions are sufficiently common to have intrigued many researchers, and the accuracy of many of these myths was investigated in the literature.
... 3 Likewise, Shuld et al concluded there was no evidence to show that moon phases, zodiac signs or Friday the 13th influence surgical blood loss and emergency frequency. 4 Similarly, Eisenburger et al found that lunar phases do not appear to correlate with acute coronary events leading to myocardial infarction or sudden cardiac death. 5 The frequency of births and related complications also seemed to have no relationship to the lunar cycle. ...
... Several investigations/studies have been carried out with regard to the effects of different phases of the lunar month on animals and humans, but there is a controversy about those effects (Bauer and Hornick 1968;Nalepka et al. 1983;Wolfe and Summerlin 1989;Raison et al. 1999;Ponce-Diaz et al. 2003;Biermann et al. 2005;McLay et al. 2006;Polychronopoulos et al. 2006;McAlees and Anderson 2007;Wells et al. 2007;Hanson et al. 2008;Voracek et al. 2008;Bueno et al. 2010;Mann and Kaufman 2010;Packer et al. 2011;Riva et al. 2011;Schuld et al. 2011;Chakraborty 2014). The aim of this review is to assess the relation of different phases of the lunar month on different activity of living organisms, like the activity pattern of marine organisms, animals, birds, insects and humans. ...
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The illumination and the gravitational pull of the moon on the earth are not same in all the prominent position of the moon during the lunar month, i.e. new moon (NM), first quarter (FQ), full moon (FM) and third quarter (TQ), and the amplitude of ocean tides also varies among those lunar phases. A huge number of investigations have shown the relation of lunar phases with the different activity of living organisms, like the activity pattern of marine and other animals, birds, insects and humans. These alterations of activity pattern may be due to the changes of lunar gravitational force on the earth surface and changes of “biological tide” or the alteration of electromagnetic field of the earth and lunar illumination. The altered autonomic neural activity and cardiovascular activity of higher vertebrates and light/dark cycle in different lunar phases are probably the fundamental causes of the changes of activity of other living organisms.
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The purpose of this study was to investigate the influence of lunar phases on fasting plasma glucose, heart rate, and blood pressure in type 2 diabetic patients. The present cross-sectional study was carried out during four phases, i.e., full moon (FM), first quarter (FQ), new moon (NM), and third quarter (TQ), of the lunar month. The study was conducted on 42 randomly selected patients (22 males and 20 females) from the Diabetes Clinic of Calcutta Medical College. Fasting plasma glucose (FPG) of each subject was determined and heart rate (HR) and blood pressure (BP) were measured at rest and during static exercise conditions, i.e., performance of a standard handgrip dynamometer test. The FPG level during the NM and FM was significantly higher (p < .001) than during the TQ and FQ for both males and females, respectively. The mean HR during static exercise during the NM and FM for both males and females was significantly higher than that during the FQ (p < .05) and TQ (p < .01). It appears from the present study that lunar phases may affect fasting plasma glucose level and cardiovascular functions of aged type 2 diabetic patients both at rest and during exercise.
Article
Purpose Assessment of the superstitious belief that saying the word “quiet” during an on-call period in Oral and Maxillofacial surgery (OMFS) causes a disproportionate increase in work-load. Methods A 2-armed, single centre randomised trial was performed in a single-blinded fashion within the OMFS department at Addenbrookes hospital, Cambridge. Duty on-call OMFS SHO's were assigned to a “quiet group” and “Non-quiet group”. Former group actively told on-call period would be quiet whilst this word was refrained from use in all contexts in the latter. Results Data was collected from 8am to 7pm from a period spanning a total of 40 week-day on-calls. Total number of bleeps encountered was 491, average bleep count per day irrespective of treatment was 12.3 (SD 4.6). Bleep count for the control group and 13.1 (4.9) bleeps for the quiet (treatment) group. Welches independent-sample T test identified no significant difference in the mean number of bleeps encountered between treatment and control groups. Moreover, ANOVA identified no significant difference in mean number of bleeps between days (F(4,35) = 0.086, p = 0.986). Statistical analysis was performed using R version 3.6.2 Conclusion Our study refutes the central dogma of all of medicine that suggests saying the word quiet increases clinician workload during the working day. We identified no significant difference in bleep number between different days of the week. OMFS sees a large breadth of presentations within the head & neck arena requiring a diverse set of skills to manage the varying presentations on-call.
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Introduction Risk management and patient safety are closely related, following this premise some industries have adopted measures to omit number 13. Healthcare is not left behind, in some hospital the day of surgery's or bed numbering avoid number 13. The objective was to assess whether it is necessary to redesign the safety policies implemented in hospitals based on avoiding 13 in the numbering of rooms/beds. Methods A retrospective cohort study was conducted. Mortality and the number of adverse events suffered by patients admitted to rooms/beds numbering 13 (bad chance) or 7 (fair chance) over a two-year period to Intensive Care Unit, Medicine, Gastroenterology, Surgery, and Paediatric service were registered and compared. Results A total of 8553 admissions were included. They had similar length-of-stay and Charlson Index scores (p-value = 0.435). Mortality of bed 13 was 268 (6.2%, 95% CI 5.5–6.9) and 282 in bed 7 (6.7%, 95% CI 5.9–7.5) (p-value = 0.3). A total of 422 adverse events from 4342 admissions (9.7%, 95% CI 8.9–10.6) occurred in bed 13, while in bed 7 the count of adverse events was 398 in 4211 admissions (9.4%, 95% CI 8.6–10.4) (p-value = 0.6). Odds Ratio for mortality was equal to 0.9 (95% CI 0.8–1.1) and suffering adverse events when admitted to bed 13 versus bed 7 was 1.03 (95% CI 0.9–1.2). Conclusions Bed 13 is not a risk factor for patient safety. Hospitals should pay attention to causes and interventions to avoid adverse events based on evidence rather than beliefs or myths.
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Tagtäglich werden in allen OP-Sälen Deutschlands Blutverluste visuell geschätzt, da Messungen (OP-Sauger, Auswiegen der Tücher) nur teilweise möglich sind. Uns interessierte daher: Wie genau ist visuelles Schätzen und wovon hängt die Genauigkeit ab? In einem OP-Saal wurden typische Blutverluste mit insgesamt 8245 ml Vollblut aus Eigenblutspenden simuliert. Mit Lagerungskissen wurde eine Patientenattrappe geformt und wie zum operativen Hüftgelenkersatz abgedeckt. Blut wurde millilitergenau abgemessen und verteilt. Nacheinander betraten 36 Klinikmitarbeiter den Saal und gaben an 22 Schätzpositionen ihre Schätzungen ab. Wir fanden große Schwankungen der Schätzwerte sowie große Abweichungen von den wahren Werten. Über- und Unterschätzungen um Faktor 2 und 3 waren keine Seltenheit, wobei Unterschätzungen häufiger waren. Mit zunehmender Verdünnung wurde immer stärker überschätzt, obwohl die Tatsache der Verdünnung bekannt war. Vollgesogene Bauchtücher und Kompressen wurden ebenso wie der simulierte “OP-Situs” deutlich unterschätzt. Geschlecht und Alter der Teilnehmer zeigten keinen Einfluss, weder auf den zufälligen (Präzision) noch auf den systematischen Schätzfehler (Genauigkeit). Mit zunehmender Berufserfahrung wurden die Schätzungen nicht besser. Dagegen zeigte sich eine Abhängigkeit des Schätzverhaltens von der Berufsgruppe: Anästhesisten schätzten im Mittel signifikant mehr als die Operateure (Chirurgen und Orthopäden). Unsere Fähigkeit, Blutverluste visuell zu schätzen, wird durch berufsgruppenspezifische Einstellungen offenbar stärker beeinflusst als durch die Berufserfahrung. Verdünntes Blut wird häufig überschätzt, andere typische Positionen werden notorisch unterschätzt. Simulationen wie diese könnten einen Beitrag zur Mitarbeiterschulung leisten und damit helfen, die Qualität der Patientenversorgung zu verbessern.
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Nine years of traffic accidents involving damage to property (n = 246,926 accidents) and involving nonfatal injury (n = 50,492) in Saskatchewan were examined by regression and spectral analyses. Both calendar and seasonal periodicities were found in both sets of data. After data were adjusted for calendar effects, no relationship was found with the total or half synodic and anomalistic lunar cycles or between the waxing and waning synodic cycle. No sudden change on the day of the full moon or surrounding days was found.
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Superstition is common and causes discomfiture or fear, especially in patients who have to undergo surgery for cancer. One superstition is, that moon phases influence surgical outcome. This study was performed to analyse lunar impact on the outcome following lung cancer surgery. 2411 patients underwent pulmonary resection for lung cancer in the past 30 years at our institution. Intra- and postoperative complications as well as long-term follow-up data were entered in our lung-cancer database. Factors influencing mortality, morbidity and survival were analyzed. Rate of intra-operative complications as well as rate of post-operative morbidity and mortality was not significantly affected by moon phases. Furthermore, there was no significant impact of the lunar cycle on long-term survival. In this study there was no evidence that outcome of surgery for lung cancer is affected by the moon. These results may help the physician to quiet the mind of patients who are somewhat afraid of wrong timing of surgery with respect to the moon phases. However, patients who strongly believe in the impact of moon phase should be taken seriously and correct timing of operations should be conceded to them as long as key-date scheduling doesn't constrict evidence based treatment regimens.
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Zusammenfassung - In der landläufigen Folklore werden Einflüsse des Mondes auf die menschliche Gesundheit angenommen. Insbesondere wird die Mondphase und die Stel- lung des Mondes in den Tierkreiszeichen als relevant für die Blutungsgefahr und andere Komplikationsrisiken bei chirurgischen Eingriffen angesehen. Wir diskutieren die Ent- stehung und Entwicklung solcher Glaubenssysteme in der Geschichte der Medizin und präsentieren einen Literaturüberblick zu empirischen Studien, die solche Behauptungen überprüften. In diesem Rahmen nehmen wir auch eine Reanalyse der oft zitierten Unter- suchung von Andrews (1960) vor. Um die Thesen von Andrews (1960), Paungger und Poppe (1994) auf den Prüfstand zu stellen, führten wir eine Studie mit 228 Patienten durch, die am Landeskrankenhaus Kirchdorf / Krems (Oberösterreich) Knie- oder Hüftprothesen-Erstimplantationen er- hielten. Um die relativen Effekte des Lebensalters, des Geschlechts, der Art der Opera- tion, der Mondphase sowie der Stellung des Mondes in den Tierkreiszeichen zu bestim- men - in Bezug auf perioperativ auftretende Komplikationen verschiedener Art, Blutver- brauch (in Zahl der Blutkonserven) als Reaktion auf überstarke Blutungen, sowie die postoperative Aufenthaltsdauer im Spital (in Tagen) -, wurden multiple Regressions- und Klassifikationsmodelle gerechnet. Während es einige Effekte des Lebensalters, des Ge- schlechts sowie des Operationstypus gibt, scheint die Mondphase oder die Stellung des Mondes in den Tierkreiszeichen kein Einflussfaktor zu sein. Diese Resultate stehen in Übereinstimmung mit anderen empirischen Studien, einschließlich einer kritischen Re- analyse der Veröffentlichung von Andrews. Es gibt gegenwärtig keine empirischen Belege, die die Auffassung stützten, die Mondphase oder die Stellung des Mondes in den Tier- kreiszeichen korreliere mit wie auch immer gearteten Komplikationen bei Operationen. Schlüsselbegriffe: Chirurgie - Geschichte der Medizin - Mond - Tierkreiszeichen - Volksglaube - Blutungen - Komplikationsrisiko bei Operationen Is there a lunar effect on perioperative hemorrhage and other forms of surgical and perisurgical complications? Abstract - In popular folklore the moon is regarded as an influencing factor on human health. The lunar phase and the position of the moon in the zodiac is especially claimed to be relevant for the risk of hemorrhage and other complications in surgery. We discuss the emergence and development of such belief systems in the history of medicine, and present a literature review on empirical tests to validate such claims, including a re-analysis of the often-cited study of Andrews (1960).
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Previous studies suggest that suicide occurrence varies by month and day of the week, but not by lunar phase. Variation by time of day has never before been adequately examined; to our knowledge, all previous studies have failed to obtain time-of-death information for a large percentage of cases. We examined suicide occurrence among residents of Sacramento County, CA, during the period from 1925 to 1983. Data were abstracted from coroner's autopsy and investigative reports. In contrast to previous studies, data on time of death were available for a large percentage of cases. 4,190 suicide deaths were identified during the study period. Suicide occurrence varied substantially by time of day; for both sexes and for ages under 65 years, the fewest suicide deaths occurred during the early morning hours, from 0401 to 0800. For recent years of the study, suicides occurred most frequently on Monday for both males and females and for most age groups. Variation by month followed no consistent pattern by gender, age, years of the study, or combinations of these factors. Contrary to popular belief, suicide occurrence did not vary by lunar phase.
Article
The potential influence of lunar phases on human life has been widely discussed by the lay press. The purpose of this study was to find out whether the timing of surgery during particular lunar phases influences the survival of breast cancer patients. It has been postulated that breast cancer surgery performed during the waxing moon, or particularly at full moon, is associated with a poorer outcome. We tested this hypothesis by evaluating the overall survival for 3,757 consecutive patients with invasive breast cancer. All patients underwent either modified radical mastectomy or breast conserving surgery plus radiotherapy, followed by adjuvant cytotoxic or hormonal therapy. The date of definitive surgery was allocated to the lunar phases. 1,904 (50.7%) patients were operated on during the waxing moon and 1,853 (47.3%) during the waning moon. The median follow-up was 74 months (range 1–372 months). The mean age at primary surgery did not differ significantly in the two groups 58.39 (SD 13.14) versus 58.34 (12.75) (p>0.05, t-test). Breast cancer stages at initial diagnosis were evenly distributed according to the lunar phases (p=0.325; chi-square). Survival curves were plotted according to the method of Kaplan–Meier. No significant differences were observed when timing of surgery was allocated to the lunar phases (p=0.4841, log-rank). Subgroup analysis of premenopausal patients revealed similar results (p=0.2950, log-rank; n=1072). Using multivariate Cox modelling, we found a significant association between the patient's age, stage of disease and survival, whereas no association with survival was observed for the timing of surgery (RR=1.062; 95% CI, 0.970–1.163; p=0.1937). No significant differences in overall survival of breast cancer patients were observed when timing of breast cancer surgery during the lunar cycle was considered. Although this was not a prospective randomized trial, the statistical magnitude of the results do not support any recommendations for scheduling patients for surgery at any particular day of the lunar phase.
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BACKGROUND: It has been claimed by non-scientific sources that operations carried out at waxing moon are associated with a higher risk of complications. We aimed to evaluate if the lunar cycle influenced the incidence of postoperative haemorrhage (PH) after thyroid surgery in our large database. METHODS: We retrospectively evaluated 424 patients requiring surgery for thyroid disease and suffering from PH from the years 1979 to 2006 for whom the precise operation date and hour were known. The lunar phase at the time of skin incision was calculated with an online-calculator. RESULTS: PH was somewhat less prevalent in the waning phase (54.7% waxing, 45.3% waning moon; p = 0.052). If the incidence of PH is plotted for each day of the lunar cycle only a random fluctuation was observed: A linear regression does not yield any significant correlation (r 2 = 0.0046). CONCLUSIONS: Patients need not worry about the lunar cycle when deciding on elective surgery.
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Collectively the daily, seasonal, lunar and tidal geophysical cycles regulate much of the temporal biology of life on Earth. The increasing isolation of human societies from these geophysical cycles, as a result of improved living conditions, high-quality nutrition and 24/7 working practices, have led many to believe that human biology functions independently of them. Yet recent studies have highlighted the dominant role that our circadian clock plays in the organisation of 24 hour patterns of behaviour and physiology. Preferred wake and sleep times are to a large extent driven by an endogenous temporal program that uses sunlight as an entraining cue. The alarm clock can drive human activity rhythms but has little direct effect on our endogenous 24 hour physiology. In many situations, our biology and our society appear to be in serious opposition, and the damaging consequences to our health under these circumstances are increasingly recognised. The seasons dominate the lives of non-equatorial species, and until recently, they also had a marked influence on much of human biology. Despite human isolation from seasonal changes in temperature, food and photoperiod in the industrialised nations, the seasons still appear to have a small, but significant, impact upon when individuals are born and many aspects of health. The seasonal changes that modulate our biology, and how these factors might interact with the social and metabolic status of the individual to drive seasonal effects, are still poorly understood. Lunar cycles had, and continue to have, an influence upon human culture, though despite a persistent belief that our mental health and other behaviours are modulated by the phase of the moon, there is no solid evidence that human biology is in any way regulated by the lunar cycle.
Article
The authors have studied the seasonal, weekly and lunar rhythms which could characterize deliveries, based on 12,035,680 french births, between January 1, 1968 and December 31, 1982. The seasonal rhythm is the most remarkable. It is characterized by a maximum of newborn in May and a minimum in November; there is an increased number of births during the month of September. The weekly rhythm is characterized by a drop in the number of births especially on Sundays, but also on Saturdays, with a maximum on Tuesday. The number of births also fluctuate according to the lunar cycle. Their amplitude is low. They are however significant. From that standpoint, these results confirm other studies already conducted in France and the USA, in a much smaller scale.