Because she works in the medical field, she decided to create a condition related to health and hit on the name bixonimania because it “sounded ridiculous”, she says. “I wanted to be really clear to any physician or any medical staff that this is a made-up condition, because no eye condition would be called mania — that’s a psychiatric term.”

If that wasn’t sufficient to raise suspicions, Osmanovic Thunström planted many clues in the preprints to alert readers that the work was fake. Izgubljenovic works at a non-existent university called Asteria Horizon University in the equally fake Nova City, California. One paper’s acknowledgements thank “Professor Maria Bohm at The Starfleet Academy for her kindness and generosity in contributing with her knowledge and her lab onboard the USS Enterprise”. Both papers say they were funded by “the Professor Sideshow Bob Foundation for its work in advanced trickery. This works is a part of a larger funding initiative from the University of Fellowship of the Ring and the Galactic Triad”.

Even if readers didn’t make it all the way to the ends of the papers, they would have encountered red flags early on, such as statements that “this entire paper is made up” and “Fifty made-up individuals aged between 20 and 50 years were recruited for the exposure group”.