Refractive features and amblyopia in Duane's Retraction Syndrome: A review of the 582 patients / Características refractivas y ambliopía en el síndrome de retracción de Duane: una revisión de los 582 pacientes

Purpose: To report the visual and refractive characteristics and the prevalence of amblyopia in patients with different types of Duane's Retraction Syndrome (DRS). Method: This retrospective study was performed on hospital records of 582 DRS patients at Farabi Hospital, Iran, from 2012 to March 2022. Results: The mean age of patients was 19.4 ± 11.9 (range, 3–70) years [335 (57.6 %) females and 247 (42.4 %) males (P < .001)]. DRS type I, II, III, and IV were presented in 347 (59.6 %), 148 (25.4 %), 82 (14.1 %), and 5 (0.9 %) patients, respectively. There were 530 (91.1 %) patients with unilateral and 52 (8.9 %) with bilateral involvement. In the unilateral patients, the DRS eyes' corrected distance visual acuity (CDVA) and astigmatism were significantly worse than the Non-DRS Eyes (P < .001). The mean amount of all refractive and visual parameters in bilateral patients' right or left eyes was significantly lower than in unilateral patients' non-DRS eyes (all P < .05). Anisometropia was observed in 75(12.9 %) of the patients. Amblyopia was observed in 18.5 % (98 patients) and 36.5 % (19 patients) of unilateral and bilateral DRS patients, respectively (P < .001). In unilateral patients, amblyopia was found in 57 (16.4 %) patients with Type I, 22 (14.9 %) patients with Type II, 16 (19.5 %) patients with Type III, and 3 (60 %) patients with Type IV. Forty-four (37.6 %) of patients with amblyopia had anisometropia. Conclusion: This large-scale study indicates that DRS types differ in terms of refractive error, visual acuity, and the prevalence of amblyopia and anisometropia. Clinicians should be aware of the clinical features associated with different types of DRS.(AU)

Rates of Reoperation in Duane Retraction Syndrome.

Purpose: To investigate the types of strabismus surgeries performed and the reoperation rate in patients with Duane retraction syndrome (DRS). Design: Retrospective cohort analysis. Participants: An insurance claims data set was used to identify patients diagnosed with DRS between 2007 and 2021. Methods: We recorded the type of strabismus surgery performed and the timing and frequency of reoperations. The hazard ratios (HRs) for reoperation were estimated according to the surgical methods using Cox regression analysis. Results: Of the 9435 patients diagnosed with DRS, 1023 (10.8%) underwent ≥ 1 strabismus operation. The median age at surgery was 5.0 years, and patients were followed for an average of 3.8 ± 3.0 years after their initial strabismus surgery. Most of the surgeries only involved horizontal muscle(s) (n = 734 [71.7%]). However, some patients underwent surgeries on vertical muscle(s) (n = 132 [12.9%]), vertical muscle(s) with transposition (n = 102 [10.0%]), and horizontal muscle with transposition (n = 51 [5.0%]). The estimated 5-year rate of reoperation was 18.2% (95% confidence interval [CI], 15.0%-22.2%). Compared with surgery on horizontal muscle(s) only, vertical muscle surgery (HR, 2.01; 95% CI, 1.30-3.11; P = 0.002) and vertical muscle surgery coupled with transposition (HR, 1.79; 95% CI, 1.06-3.02; P = 0.03) had an increased risk of reoperation. Conclusions: Strabismus surgery on ≥ 1 horizontal muscles is the most common type of strabismus surgery performed on patients with DRS. Approximately 1 in 7 patients with DRS who had strabismus surgery underwent a reoperation. Patients who underwent vertical muscle surgery had a higher risk of undergoing a reoperation. Financial Disclosures: Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

A Systematic Review of Retracted Publications in Clinical Orthopaedic Research.

BACKGROUND: Retracted publications are an often-overlooked issue affecting the scientific community; recent data confirms the overall number of retracted publications is rising. While this has previously been looked at within orthopaedic surgery, a contemporary understanding of retractions is required due to the rapid expansion in publications. Our study aimed to assess the retracted publications within clinical orthopaedic research to evaluate for characteristics and trends. METHODS: A systematic review was conducted on December 14, 2023, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. There were four databases that were queried to identify retracted publications in clinical orthopaedics that assessed operative and non-operative orthopaedic interventions (excluding basic science). Articles were independently screened by two reviewers; those meeting inclusion criteria were evaluated for various characteristics, including reasons for retraction based on Committee on Publication Ethics (COPE) guidelines. RESULTS: There were 233 studies that met inclusion criteria and were retracted between January 1, 1990, and December 14, 2023. Clinical orthopaedics represented 1.18% of all retracted publications identified through PubMed over this period. There were 87 articles that were retracted in 2023, up from 17 in 2022 (a 412% increase). Retracted studies were published in journals with 2022 impact factors up to 9.3, with an average of 3.1 (SD [standard deviation] 1.9). A total of 39.5% of the retracted studies were published in orthopaedic journals, and 60.9% of the retracted articles were published in exclusively open access journals. The mean time from electronic publication to retraction was 2.1 years (SD 2.2). Retracted articles have been cited up to 180 times (mean 8.6; SD 20). Reasons for retraction included misconduct (45.9%), plagiarism (11.6%), redundant publication (11.6%), unethical research (10.3%), error (9.4%), and others (10.7%). CONCLUSIONS: The prevalence of retractions in the clinical orthopaedic literature is increasing. Clinical research is the basis for clinical practice guidelines, the gold standard for informing medical decision making. Retractions may be one harbinger of lower-quality publications; researchers, institutions, and journals together play important roles in maintaining scientific integrity.

Various retraction techniques for laparoscopic pancreaticoduodenectomy.

The laparoscopic pancreaticoduodenectomy (LPD), introduced by Gagner and Pomp in 1994, is typically done in high-volume centers due to its technical demands. Our methods aim to provide effective traction, enabling efficient surgery despite limited staffing. A retrospective analysis of 29 patients undergoing LPD by a single surgeon between September 2021 and December 2022 showed promising outcomes: median intraoperative bleeding of 425 mL, operation time of 505 minutes, and postoperative hospital stay of 10 days. With only one case requiring open conversion, our external retraction techniques demonstrate efficacy in overcoming challenges associated with manpower constraints, highlighting potential utility for surgeons in similar settings. We share LPD external retraction techniques and outcomes.

An Evaluation of the Rate and Type of Orthodontic Tooth Movement When Injecting Platelet-Rich Plasma During Mini-Implant-Based Segmented en-Masse Retraction of Upper Anterior Teeth.

INTRODUCTION: The study aimed to determine the influence of palatal injection of platelet-rich plasma (PRP) on the rate and type of orthodontic tooth movement (OTM) during the en-masse retraction of upper anterior teeth. MATERIALS AND METHODS: Two-arm parallel-group trial, in which 30 class II division 1 adult patients (7 males and 23 females) aged 16 to 27 years were recruited. The sample was randomly divided into two groups: the experimental group, in which PRP was injected in the palatal mucosa of the maxillary six anterior teeth immediately before starting the en-masse retraction of upper anterior teeth, whereas in the control group, traditional treatment was employed. Following the first premolar extraction, space closure was accomplished using frictionless mechanics for the en-masse retraction of upper anterior teeth. In both groups, a rigid segmented arch made of stainless steel with a diameter of 0.021 x 0.025 inch and an 8-mm power arm was used for the upper anterior teeth, and mini-implants were inserted between the upper second premolar and first molar at 8 mm apical from the archwire line. NiTi coil springs were used for retraction. Measurements were recorded at the onset of space closure (T0) and every 40 days till the middle of the en-masse retraction of upper anterior teeth (T1). RESULTS: Thirty patients completed the trial, and no patients were lost to follow-up in both groups. The OTM rate in the PRP group was similar to that of the control group (P = 0.596). The upper anterior teeth in the two groups were retracted mostly by controlled tipping and partially by translation. Statistically insignificant differences were observed between the two groups regarding the rest of the cephalometric variables. No serious harms were observed in either group. CONCLUSIONS: PRP was ineffective in accelerating the OTM rate during the en-masse retraction of upper anterior teeth and it did not affect the type of tooth movement.

Identification of Retracted Publications and Completeness of Retraction Notices in Public Health.

OBJECTIVES: Retraction is intended to be a mechanism to correct the published body of knowledge when necessary due to fraudulent, fatally flawed or ethically unacceptable publications. However, the success of this mechanism requires that retracted publications be consistently identified as such and that retraction notices contain sufficient information to understand what is being retracted and why. Our study investigated how clearly and consistently retracted publications in public health are being presented to researchers. STUDY DESIGN AND SETTING: This is a cross-sectional study, using 441 retracted research publications in the field of public health. Records were retrieved for each of these publications from 11 resources, while retraction notices were retrieved from publisher websites and full-text aggregators. The identification of the retracted status of the publication was assessed using criteria from the Council on Publication Ethics (COPE) and the National Library of Medicine (NLM). The completeness of the associated retraction notices was assessed using criteria from COPE and Retraction Watch. RESULTS: 2841 records for retracted publications were retrieved, of which less than half indicated that the article had been retracted. Less than 5% of publications were identified as retracted through all resources through which they were available. Within single resources, if and how retracted publications were identified varied. Retraction notices were frequently incomplete, with no notices meeting all criteria. CONCLUSIONS: The observed inconsistencies and incomplete notices pose a threat to the integrity of scientific publishing and highlight the need to better align with existing best practices to ensure more effective and transparent dissemination of information on retractions.

Taking it back: A pilot study of a rubric measuring retraction notice quality.

The frequency of scientific retractions has grown substantially in recent years. However, thus far there is no standardized retraction notice format to which journals and their publishers adhere voluntarily, let alone compulsorily. We developed a rubric specifying seven criteria in order to judge whether retraction notices are easily and freely accessible, informative, and transparent. We mined the Retraction Watch database and evaluated a total of 768 retraction notices from two publishers (Springer and Wiley) over three years (2010, 2015, and 2020). Per our rubric, both publishers tended to score higher on measures of openness/availability, accessibility, and clarity as to why a paper was retracted than they did in: acknowledging institutional investigations; confirming whether there was consensus among authors; and specifying which parts of any given paper warranted retraction. Springer retraction notices appeared to improve over time with respect to the rubric's seven criteria. We observed some discrepancies among raters, indicating the difficulty in developing a robust objective rubric for evaluating retraction notices.

From low-rank retractions to dynamical low-rank approximation and back.

In algorithms for solving optimization problems constrained to a smooth manifold, retractions are a well-established tool to ensure that the iterates stay on the manifold. More recently, it has been demonstrated that retractions are a useful concept for other computational tasks on manifold as well, including interpolation tasks. In this work, we consider the application of retractions to the numerical integration of differential equations on fixed-rank matrix manifolds. This is closely related to dynamical low-rank approximation (DLRA) techniques. In fact, any retraction leads to a numerical integrator and, vice versa, certain DLRA techniques bear a direct relation with retractions. As an example for the latter, we introduce a new retraction, called KLS retraction, that is derived from the so-called unconventional integrator for DLRA. We also illustrate how retractions can be used to recover known DLRA techniques and to design new ones. In particular, this work introduces two novel numerical integration schemes that apply to differential equations on general manifolds: the accelerated forward Euler (AFE) method and the Projected Ralston-Hermite (PRH) method. Both methods build on retractions by using them as a tool for approximating curves on manifolds. The two methods are proven to have local truncation error of order three. Numerical experiments on classical DLRA examples highlight the advantages and shortcomings of these new methods.

Mini-Screw-Assisted Orthodontic Retraction of Class I Malocclusion in a Bimaxillary Protrusion Patient Using Sliding Mechanics: A Case Report.

A condition known as bimaxillary protrusion occurs when the front teeth protrude due to the forward positioning of the lower and upper jaws. Temporary anchorage devices (TADs) are utilized to provide anchorage and facilitate the controlled retraction of maxillary and mandibular protruding teeth, helping to correct the patient's bite and facial aesthetics. A 27-year-old female with bimaxillary protrusion reported to the Department of Orthodontics. On examination, the facial profile of the patient was convex. The clinical FMA was high. With a deep mentolabial sulcus and an acute nasolabial angle, lips were potentially competent. An intraoral examination revealed proclined incisors with spacing in the maxillary arch and proclined anterior teeth in the mandibular arch. Space closure was done using sliding mechanics with direct anchorage from a mini-screw after the extraction of all four first premolars. There was a significant improvement in the patient's profile posttreatment.

Triamcinolone injection in the treatment of lid retraction for thyroid-associated ophthalmopathy: A systematic review.

INTRODUCTION AND OBJECTIVES: Lid retraction is one of the most common symptoms of Thyroid-Associated Ophthalmopathy (TAO), which potentially precipitates various complications, such as dry eyes, exposure keratopathy, and cosmetic concerns. Local corticosteroid injections, such as triamcinolone, have been proposed as a choice of treatment for TAO. This approach may be a favorable alternative for patients intolerant to the systemic effects of high-dose methylprednisolone. However, the efficacy of this intervention remains unestablished. Hence, our review aims to evaluate the efficacy of triamcinolone injection in reducing lid retraction. METHODS: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and was conducted in three databases (PubMed, Science Direct, and ProQuest). This review included studies that use local triamcinolone injections for patients with thyroid-associated ophthalmopathy. The outcome of interest in this review is lid retraction parameters. RESULTS: From six studies, a total of 392 patients were included. All studies showed significant improvement in lid retraction in the patient who received triamcinolone (all p < 0.05) as shown by ΔMRD (-0.93 mm in 1 month and -1.38 mm in 3 months), ΔMLD (-1.98 mm at 6 months), and Δpalpebral fissure height (-1.68 in 1 month). The majority of studies showed rapid improvement in lid retraction in the first month of therapy. CONCLUSION: Triamcinolone injection is an effective therapy for lid retraction related to thyroid-associated ophthalmopathy.

Peritumoral Clefts in Basal Cell Carcinoma: Matrix Metabolism and Primary Cilium.

The phenomenon of tissue retraction, characterized by peritumoral spaces or clefts, is prominent in basal cell carcinoma (BCC) tumors, yet its underlying mechanisms remain unclear. Proposed factors include changes in cell structures, enzymatic activity, and alterations in the Hedgehog (Hh) signaling pathway. This article discusses these factors and proposes that structural changes in BCC cells' primary cilia may contribute to matrix alterations, leading to the formation of peritumoral clefts. Further research is needed to confirm these hypotheses and understand BCC's unique growth patterns.

The impact of affiliation naming proximity on the retrieval efficiency of Chinese universities-affiliated retractions in the Retraction Watch Database.

The Retraction Watch Database (RWDB) is widely used to retrieve retraction data. However, its lack of affiliation normalization hinders the retrieval efficiency of retraction data for specific research-performing organizations. A query for a university name in the RWDB may yield retraction data entries for other universities with similar names, giving rise to the issue of affiliation naming proximity. This study assessed the impact of this issue on the retrieval efficiency of retraction records for 2,692 Chinese university names in English. The analysis revealed that the retrieval efficiency of retraction records for 206 Chinese university names can be influenced by 408 university names. As of 2022, the retrieval efficiency of retraction records for 96 Chinese university names was compromised by the involvement of 402 university names, resulting in an overall retraction inflation rate of 37.9% and an average rate of 45.0%. The findings highlight the importance of curating retraction data through affiliation-specific queries in the RWDB, adhering to the official English names of Chinese universities for scholarly publishing, and adopting the Research Organization Registry system for affiliation disambiguation. Given the significance of this issue concerning the English names of universities in non-English-speaking countries, the identified causes of the problem and proposed solutions can offer valuable insights for improving the retrieval of retraction records for non-Chinese universities in the RWDB.

Transient sensorimotor projections in the developmental song learning period.

Memory recall and guidance are essential for motor skill acquisition. Like humans learning to speak, male zebra finches learn to sing by first memorizing and then matching their vocalization to the tutor's song (TS) during specific developmental periods. Yet, the neuroanatomical substrate supporting auditory-memory-guided sensorimotor learning has remained elusive. Here, using a whole-brain connectome analysis with activity-dependent viral expression, we identified a transient projection into the motor region, HVC, from neuronal ensembles responding to TS in the auditory forebrain, the caudomedial nidopallium (NCM), in juveniles. Virally induced cell death of the juvenile, but not adult, TS-responsive NCM neurons impaired song learning. Moreover, isolation, which delays closure of the sensory, but not the motor, learning period, did not affect the decrease of projections into the HVC from the NCM TS-responsive neurons after the song learning period. Taken together, our results suggest that dynamic axonal pruning may regulate timely auditory-memory-guided vocal learning during development.

Efficiency of a high-speed handpiece with anti-retraction adapter to minimize cross-contamination during the routine dental procedure: A clinical study.

Background: This study aimed to detect the efficiency of anti-retraction adapter (ARA) attached to a handpiece (HP). Materials and Methods: Two types of dental HP with and without the ARA were used in this study. A total of 30 sets of samples were obtained from two groups and were subjected to a real-time reverse transcriptase-polymerase chain reaction (RT-PCR) and microbial culture for quantitative analysis of total bacterial and Legionella count. Statistical Analysis Used: The data obtained were tabulated using the Statistical Package for the Social Sciences (SPSS, IBM version 26.0) for statistical analysis. Results: The water samples were analyzed using PCR, Legionella-specific PCR, and culture-based analysis. In Groups 1 and 2, there was no significant difference between bacterial load in the water samples taken from both HP and coupling of the Dental Unit Waterline (DUWL). Conclusions: The reduction in bacterial load in DUWLs analyzed using quantitative RT-PCR was similar in both experimental groups. Overall, the bacterial load was lower in the group with ARA when compared to the group without ARA but not statistically significant. ARA was not effective in reducing the Legionella species load in DUWLs.

Comparative evaluation of effectiveness of three versus four mini-implants for simultaneous intrusion and retraction of maxillary anterior teeth: A 3D FEM study.

OBJECTIVE: To evaluate and compare the displacement pattern of maxillary anterior teeth in the sagittal and vertical planes and evaluate the stress distribution in pdl, bone, teeth of the maxillary anterior region, and around the mini-implants during simultaneous en-masse retraction and intrusion using two, three, and four mini-implants combinations. METHODS: A three-dimensional FEM model of maxillary teeth and periodontal ligament housed in the alveolar bone with extracted first premolarswasgenerated. The models were broadly divided into three groups according to the number of mini-implants. Mini-implants were placed bilaterally between the second premolar and molar in group I, and along with bilateral implants, an additional mid-implant was placed between the central incisors as in group II, whereas in group III, anterior mini-implants were placed in between lateral incisors and canine bilaterally. RESULTS: The two mini-implant model showed the maximum amount of retraction in the sagittal plane followed by three and four mini-implant models. In the vertical plane, all six anterior teeth showed intrusion only in the four mini-implant model. The stress in cortical bone, cancellous bone, PDL, around the mini-implants, and in lateral incisor was maximum in the three mini-implant model, followed by four mini-implants with the least stress in the two mini-implant model. CONCLUSION: The four mini-implant model is better than the three and two mini-implants model as there is a more even distribution of force in the four mini-implants model as compared to the three mini-implants model.

Relationship between retraction and refraction values in patients with Duane's retraction syndrome.

PURPOSE: To evaluate refractive findings in patients with unilateral Duane's retraction syndrome (DRS). METHODS: This retrospective study included 40 patients followed for unilateral DRS. Detailed ophthalmological examinations of the patients were performed. The spherical and cylindrical refractive error, spherical equivalent, and type of refractive error in the eyes with DRS and the fellow eyes were determined. The patients were divided into three subgroups according to their type of DRS. The refractive properties of the eyes with DRS were examined in subgroup analyses. Eye movement limitation was graded between +1 and +4 and compared according to the refractive error type. RESULTS: The mean age of the patients was 16.8±12.6 (range, 1-60) years. Of the eyes with DRS, 11 (27.5%) were emmetropic, four (10%) were hyperopic, two (5%) were myopic, 11 (27.5%) were myopic astigmatic, and 12 (30.0%) were hyperopic astigmatic. There was no statistically significant difference between the eyes with DRS and fellow eyes in relation to the spherical or cylindrical refractive errors or spherical equivalent (P>0.05 for all). The refraction values for the patients with type 1, type 2 and type 3 DRS were similar between groups (P>0.05). No statistically significant difference was detected in the degree of eye movement limitation according to refractive status (P>0.05). CONCLUSION: In patients with unilateral DRS, there was no significant difference between the affected eyes and the fellow eyes in terms of refractive error values or types. Refractive status did not significantly differ according to the degree of eye movement limitation. Therefore, although extraocular muscles are affected by DRS, there may not be any significant refractive changes.

Patient-reported outcomes during accelerating the en-masse retraction of the upper anterior teeth using low-intensity electrical stimulation: a randomized controlled trial.

BACKGROUND: Low-intensity electrical stimulation (LIES) is considered a relatively recent technology that has received little attention in orthodontics as a method of acceleration. This study aimed to evaluate patient-reported outcome measures when LIES is used to accelerate the en-masse retraction of the upper anterior teeth. MATERIALS AND METHODS: The sample consisted of 40 patients (8 males, 32 females; mean age 21.1 ± 2.3 years), with Class II division I malocclusion who required extraction of the first premolars to retract upper anterior teeth. They were randomly assigned to the LIES group (n = 20) and the conventional en-masse retraction group (CER; n = 20). Patient responses regarding pain, discomfort, burning sensation, swelling, chewing difficulty, speech difficulty, and painkillers' consumption were recorded at these nine assessment times: 24 h (T1), 3 days (T2), and 7 days (T3) after force application, then in the second month after 24 h (T4), 3 days (T5), and 7 days (T6) of force re-activation, and finally after 24 h (T7), 3 days (T8), and 7 days (T9) of force re-activation in the third month. RESULTS: The mean values of pain perception were smaller in the LIES group than those in the CER group at all assessment times with no statistically significant differences between the two groups except during the second and third months (T5, T6, T8, and T9; P < 0.005). However, discomfort mean values were greater in the LIES group with significant differences compared to CER group during the first week of the follow-up only (T1, T2, and T3; P < 0.005). Burning sensation levels were very mild in the LIES group, with significant differences between the two groups at T1 and T2 only (P < 0.001). Speech difficulty was significantly greater in the LIES group compared to CER group at all studied times (P < 0.001). High levels of satisfaction and acceptance were reported in both groups, without any significant difference. CONCLUSION: Both the LIES-based acceleration of en-masse retraction of upper anterior teeth and the conventional retraction were accompanied by mild to moderate pain, discomfort, and chewing difficulty on the first day of retraction. These sensations gradually decreased and almost disappeared over a week after force application or re-activation. TRIAL REGISTRATION: ClinicalTrials.gov, ClinicalTrials.gov, NCT05920525. Registered 17 June 2023 - retrospectively registered, http://clinicaltrials.gov/study/NCT05920525?term=NCT05920525&rank=1 .

Rethinking the author name ambiguity problem and beyond: The case of the Chinese context.

The perennial problem of author name ambiguity has attracted increasing attention in the academic community. Drawing on the literature, this article first highlights the pervasiveness of the problem and discusses its adverse consequences. It then analyzes the behavioral causes of the problem in the Chinese context and attributes them to personal, cultural, and institutional factors. Informed by this analysis and recognizing ORCID as a promising solution, we propose an ORCID-based "Prevention plus Cure" campaign against author name ambiguity. The prevention objective relies on researchers' consistent use of ORCID, while the cure objective involves retrospectively integrating ORCIDs into backfile publications. We also outline the responsibilities of various stakeholders to ensure the success of the campaign. Furthermore, we argue that universal adoption of ORCID can help curb authorship-related misconduct, discern predatory journals and publishers, and track researchers' undesirable records of academic publishing. We then analyze the current status of ORCID adoption in China, identify potential challenges, propose tentative solutions to address them, and highlight ORCID as a tool that can be utilized to empower China's combat against research misconduct. In conclusion, we emphasize the importance of conducting empirical research to inform more effective promotion of ORCID adoption in China.

Eyelid retraction during smiling in a patient with monocular congenital ptosis: a case report.

BACKGROUND: Blepharoptosis is a common symptom in ophthalmology clinic, but eyelid retraction when smiling in a ptosis eye is a rare manifestation. Here we report a novel manifestation that eyelid retraction during smiling in a patient with monocular congenital ptosis. CASE DESCRIPTION: A 10-year-old girl with isolated and mild unilateral congenital ptosis showed eyelid retraction in ptotsis eye when smiling together with a lid lag on downgaze. She didn't have any systematic and ocular diseases other than myopia and astigmatism.Eyelid retraction during smiling is 5 mm, resulting in a significant difference in the height of bilateral palpebral fissures.As for ptosis, is mild.The margin to reflex distance 1 is 1.0 mm on the right eye(ptosis eye) and 3.0 mm on the left eye. A lid lag of 1.0 mm on downward gaze was noted on the right, she could close her eyes fully while sleeping.The ice pack test, laboratory test for thyroid function, whole-exome sequencing (WES) and magnetic resonance imaging(MRI) of the orbital and ocular motor nerves showed normal results.Her symptoms alleviated after 6 months, with the retraction of the right upper eyelid when smiling was approximately 3 mm, thus the difference in the palpebral fissure height when smiling was smaller than that at the initial presentation. CONCLUSION: Blepharoptosis may accompanied with abnormal innervation like eyelid retraction, this phenomenon can be alleviated with age.The results of the levator muscle function test should be carefully examined to determine whether it is ptosis in an impaired innervation eyelid.

Retracted papers originating from paper mills: a cross-sectional analysis of references and citations.

OBJECTIVES: The aims of this study are (1) to analyze the references cited by retracted papers originated from paper mills; (2) to analyze the citations received by retracted papers originated from paper mills; and (3) to analyze the potential relationships existing between paper mill papers and their references and their citations. STUDY DESIGN AND SETTING: This study was a cross-sectional study. All original papers retracted in 2022 identified as having originated from paper mills and had been published at least 12 months before their retraction (hereinafter "source-retracted papers") were included. The Retraction Watch database was used to identify the source-retracted papers and Web of Science was used to identify the references contained within them and the citations received by them. We described the characteristics of the papers and journals. Additionally, 2 networks of source-retracted papers mutually interconnected via their citations and references were built: 1 with only retracted references and retracted citations and the other with all references and citations (retracted or unretracted). RESULTS: A total of 416 paper mill papers retracted in 2022 (sourced retracted papers) were identified, with a median of 1247 (interquartilic range, 907.8-1673.5) days between publication and retraction. Of all authors identified, 92.3% were affiliated with Chinese institutions. There were 14,411 references contained in the source-retracted papers and 8479 citations received by them; the median number of references and citations was 35 (29-40) and 16 (9-25), respectively. In total, 473 references and citations had also been retracted for being paper mill papers. Among the 416 sourced-retracted papers, 169 (41.9%) and 178 (42.8%) were referenced or were cited by at least another retracted paper, the majority of which also originated from paper mills. The first network analysis, which included source-retracted papers along with their retracted references and citations, found 3 clusters of 53, 48, and 44 retracted papers that were mutually interconnected. The second network analysis, with all references and citations (retracted or unretracted) identified a large cluster of 2530 interconnected papers. CONCLUSION: Retracted papers originating from paper mills frequently reference and are cited by papers that are later retracted for having originated from paper mills, displaying inter-relationships. Detecting these inter-relationships can serve as an indicator for identifying potentially fraudulent publications.