The 100 most influential articles in myopia: a bibliometric analysis

INTRODUCTION

Myopia (short-sightedness or near-sightedness) is becoming a major public health concern and is causing a huge economic burden. The prevalence of myopia has expanded greatly over the past 50-60y and has reached epidemic levels in young adults in East and Southeast Asia. With the increasing attention of myopia, a large volume of studies are published every year to provide new insights into the development of myopia, and treatment techniques have undergone a seismic revolution of the last decades.

Literature retrieval, screening and analysis follow the methods established in previously published articles. The Web of Science (WOS) Core Collectiondatabase was used for conducting a literature search on March 25, 2020. The index terms used for the search were “TOPIC:(myopia) OR TOPIC: (myopic) OR TOPIC: (nearsightedness)OR TOPIC: (shortsightedness) OR TOPIC: (near-sighted) OR TOPIC: (short-sighted) OR TOPIC: (high myopia) OR TOPIC:(pathological myopia)”, a year of publication ranging from 1975 until 2020. Languages, document type and the WOS category were not restricted in the search.

總體上正在向多樣化發(fā)展，四川、青海等省份制定了旅游產(chǎn)業(yè)發(fā)展大會申辦辦法，每年舉辦旅游節(jié)事活動和招商活動，中國醫(yī)療保健國際交流促進會開辟了多種國際交流途徑。涉外活動也越來越受到大眾關(guān)注，僅2018年以來，就先后舉行了多場與健康旅游相關(guān)的重量級活動，博鰲“一帶一路”與健康產(chǎn)業(yè)發(fā)展論壇在海南博鰲舉辦，國際中醫(yī)藥文化節(jié)首次登陸中國內(nèi)地，世界中醫(yī)藥學(xué)會聯(lián)合會首屆非物質(zhì)文化遺產(chǎn)高峰論壇在北京舉行。2020年，北京還將舉辦世界休閑大會，倡導(dǎo)休閑生活，發(fā)展健康旅游。與“引進來”形成對比的是，“走出去”推介的力度還顯不夠。

水利質(zhì)量檢測人員的專業(yè)能力直接影響著質(zhì)量檢測的結(jié)果，所以水利企業(yè)要重視質(zhì)量檢測人員的能力培訓(xùn)，定期的組織質(zhì)量檢測人員進行專業(yè)培訓(xùn)，這樣可以有效地提高他們的質(zhì)量檢測能力，還要對檢測人員進行職業(yè)素養(yǎng)教育，讓他們具備較高的社會責(zé)任心和職業(yè)素養(yǎng)，這樣才能在質(zhì)量檢測的過程中切實的負(fù)起責(zé)任，按照相關(guān)的標(biāo)準(zhǔn)要求規(guī)范檢測，保證質(zhì)量檢測的準(zhǔn)確性和真實性。另外，水利企業(yè)招聘質(zhì)量檢測人員的時候，要盡可能多招聘一些專業(yè)的質(zhì)量檢測人才，并且要質(zhì)量檢測經(jīng)驗豐富的，這樣更能保證質(zhì)量檢測的準(zhǔn)確性。

云計算作為一種全新的互聯(lián)網(wǎng)應(yīng)用模式，將成為未來人們獲取服務(wù)和信息的主導(dǎo)方式[5]。云計算是一種方便的使用方式和服務(wù)模式，通過互聯(lián)網(wǎng)按需訪問資源池模型(例如網(wǎng)絡(luò)、服務(wù)器、存儲、應(yīng)用程序和服務(wù))，可以快速地管理工作，為用戶提供服務(wù)[6]。云計算技術(shù)相關(guān)研究得到大力推動并繼續(xù)穩(wěn)步、快速、深入進行。與此同時，隨著新業(yè)務(wù)需求日益增長，基于云計算平臺的各種應(yīng)用不斷涌現(xiàn)。白酒行業(yè)在保留傳統(tǒng)工藝的基礎(chǔ)上，引入現(xiàn)代化云計算技術(shù)來提升白酒發(fā)酵的精細(xì)化水平，對提高成品酒質(zhì)量具有重要意義。基于云計算平臺的白酒發(fā)酵智能專家系統(tǒng)在此基礎(chǔ)上展開。

MATERIALS AND METHODS

In addition to the impact factor (IF) of journals, the number of citations of an article is also an important reflection of its contribution to that particular field. Bibliometric analysis can reveal the evolution of a field by objectively identifying seminal studies among a population of papers. Since Garfield published the first bibliometric study inin 1987, this field has been developed and more and more articles have been published.

在劃定的地下水資源開發(fā)區(qū)，科學(xué)勘察，合理布置井位，采用先進的機械設(shè)備和現(xiàn)代化的工藝鑿至含水層，用井管保護井壁，以獲取深層地下水來滿足飲水需求。

A total of 22 509 published articles were retrieved, and then these articles were sorted in descending order according to total citations (TCs). Articles conforming to the abovementioned conditions were evaluated and preliminarily analyzed by two independent readers (Wang XJ and Chou YY) to ensure its relation to myopia. The 100 most cited articles were determined by reviewing the titles and abstracts of these articles, and the full text if necessary. Articles focusing only on animals (, chickens and monkeys) were excluded from the screening process.

The 100 most cited articles that meet the screening criteria were then analyzed further. Article title, first and corresponding authors, journal, 2018 IF of Journal Citation Reports (JCR), IF of most recent 5-year, publication date,country of origin, institution, TCs, annual citations (ACs),citation number of most recent 5-year, research focus and study type were recorded for the top 100 most influential articles on myopia. The number of ACs was calculated by dividing TCs by the number of years since the manuscript was published.

The data were usually distributed in the form of mean and standard deviation, while the skewed data were presented in the form of median and range. The Shapiro-Wilk test was used to test the normality of the distribution of individual variables. Correlations among non-parametric variables were evaluated by Spearman’s correlation analysis.Mann-Whitneytest was used to compare the difference between non-parametric variables. Analyses were performed with SPSS v.25 (IBM Corp., NY, USA). A two-sided-value<0.05 was considered to be statistically significant.

RESULTS

A total of 22 509 papers related to myopia were published from the WOS Core Collection database. These papers were sorted by TCs, and the top 100 papers in the field of myopia were identified. The details of the top 100 most cited articles can be found in Supplementary Table 1.

The 100 most influential articles were published between 1983 and 2016. Most of them were published between 2000 to 2009 (=60), followed by 1990-1999 (=28) and 2010-2019 (=10), whereas only 2 articles were published between 1980 to 1989 and none before 1980.Figure 1 shows TCs for every paper in each year. Figure 2 shows the number of papers in each year. The TCs of an article was independent of its publication date (>0.05). However,the number of ACs and citations in recent 5y are significantly correlated with publication date (=0.774,<0.01;=0.597,<0.01).

Among the top 100 most-cited articles, 85 were original articles and 15 were review articles. Three of the 15 review articles were systematic reviews and Metaanalysis. The highest TCs and ACs articles among the 100 most-cited articles were both review articles from Australia.The original articles comprised 52 observational studies and 33 experimental studies, the latter covers 10 randomized controlled trials (RCTs). Observational studies consisted of 38 cross-sectional studies, 6 cohort studies, 5 case series, and 3

case‐control studies. According to the time logic classification,the original articles included 38 cross-sectional studies, 37 prospective studies, and 10 retrospective studies. There was no difference in the number of TCs between the original articles and the review articles (Mann-Whitneytest=0.141), while the number of ACs of review articles was significantly higher than that of original articles [Mann-Whitneytest<0.05,median=22, range (9-109)median=17, range (7-45)].

(2)專業(yè)知識。具體到客服人員涉及的行業(yè)與企業(yè)，專業(yè)知識主要體現(xiàn)在行業(yè)背景、業(yè)務(wù)流程、產(chǎn)品知識、營銷知識、心理學(xué)知識等。

A total of 28 772 citations were obtained for the top 100 most influential articles. The number of TCs was highest at 537 for Morganand lowest at 193 for Goh.The number of ACs was highest at 109 for Holden. The median number of TCs and ACs were 266 and 16. Ninety-one articles were cited more than 200 times and 14 papers were cited more than 400 times. Table 1 shows the top 10 articles ranked by ACs.

Spearman correlation analyses revealed a significant positive association between the trends of TCs and ACs (=0.572,<0.01). Five of the top 10 articles ranked by TCs were listed in the top 10 articles ranked by ACs. The numbers of ACs of articles published in recent 10y [median=44, range (21-109)] were significantly higher than that of the other mostcited articles [median=16, range (7-45); Mann-Whitneytest,<0.01]. Nevertheless, there was no such correlation for the average number of TCs (Mann-Whitneytest=0.667). The recent 5-year citation number was also positively correlated with TCs (=0.477,<0.01). We believe that the number of citations in the last 5y can reflect the current research hotspots and trends better than TCs.

With too many medical papers indexed in the database every day, it is difficult for clinicians and researchers to quickly find important articles in their fields of interest in the vast ocean of digital information. The bibliometric analysis can determine the most influential articles in a certain field of interest, and help clinicians and researchers grasp the changing pattern of clinical practice, current research priorities, and research trends in the future. We conducted a bibliometric analysis of articles in the field of myopia and identified the 100 most influential articles, aiming to systematically determine the research trend of myopia.

The top 100 most influential papers were published in 21 journals. The journals of publication, journal IF according to the 2018 JCR and TCs for each journal are listed in Table 2. Specialized journals published most (94%) of the top 100 articles, leading with(29 papers and 8122 citations) and(23 papers and 6531 citations). None of the specialized journals listed in Table 2 had an IF of more than 12. Generalized journals published 6 papers and the IFs were all greater than 12. Thehad the highest IF of 59.1, and its only article is also the article with the most TCs. The IF is not statistically correlated with TCs (>0.01).

Uncorrected or undercorrected myopia is the main cause of visual impairment, and it has become an increasingly serious public health problem worldwide. Myopia brings further vision challenges since high myopia multiplies the risk of pathologic changes such as glaucoma, cataract, and myopic macular degeneration. The global potential productivity loss in 2015 was estimated at $244 billion from uncorrected myopia and $6 billion from myopic macular degeneration.

Bibliometric analysis has been widely used in several medical fields, such as asthma, obesity, diabetes, orthopedics, liver cancer, and pituitary adenoma. A number of bibliometric studies have also been published in the field of ophthalmology,such as cataract surgery and dry eye. However, similar bibliometric studies have not been conducted in the field of myopia. In this study, we aimed to identify and characterize the basic characteristics of the 100 most cited articles in myopia in recent few decades. We also intend to identify factors that contribute to the increase in citations, such as journals and publication time.

CBTC(基于通信的列車控制)系統(tǒng)能夠確保列車靈活、高效運行。但近年來，采用CBTC系統(tǒng)的線路仍時有事故發(fā)生。2011年9月11日，上海軌道交通10號線發(fā)生列車追尾事故，造成295人受傷；2017年11月15日，新加坡地鐵發(fā)生列車碰撞事故，造成28人受傷。這些事故都造成了巨大的社會影響和經(jīng)濟損失。事故原因是，CBTC系統(tǒng)地面設(shè)備故障，事故列車無法識別其他列車，因而不能實施有效控制。那么，如果列車具有自主運行能力，并且各車之間能夠直接通信，就可有效避免列車追尾或碰撞事故的發(fā)生。這一技術(shù)將成為新一代CBTC系統(tǒng)的一個重要著力點。

DISCUSSION

The top 100 most cited articles were originated from 14 countries led by the United States (=43; Figure 4). The most productive institution with the highest TCs was the National Institutes of Health (NIH)of USA, which has published 12 articles and the TCs reached 3655. The top 7 institutes or academies contributing to the top 100 most-cited articles were listed in Table 3. Leon B.Ellwein’s from the National Eye Institute of NIH has published the largest number of most influential articles on myopia (=9)and was thus the most-cited author in this field. The authors with more than three articles were listed in Table 4.

水分是行鞭、孕筍的一個重要條件，當(dāng)夏季連續(xù)高溫干旱時，進行補水；補水應(yīng)選擇晚上溫度回落后進行，補水量以林地澆透即可。8月底至9月中下旬，如再遇連續(xù)干旱，可再行澆灌補水1次，用量與前次相當(dāng)。

Treatment (=27) and prevalence (=27)of myopia was the most widely studied topic, accounting for more than half of the top 100 papers. Figure 3 shows the topics of articles. Among 38 studies focused on treatment and surgical complications of myopia, 25 were related to laser in situ keratomileusis (LASIK) and excimer laser photorefractive keratectomy (PRK), 3 for femtosecond laser small incision lenticule extraction (SMILE) and 3 for orthokeratology. The geographical range of epidemiological research was vast,including China, USA, India, Nepal, Singapore, Australia,Japan, South Africa, Malaysia, Chile and Western Europe. Of the 15 articles that studied the etiology of myopia, 10 articles studied children or teenagers. The most studied risk factors were parental history, near work, outdoor activities and genes.

The number of citations of a paper has become a valuable indicator for evaluating the efforts made by authors and journals as a measure of its impact on a particular field. The TCs of the 100 most influential articles in myopia ranged from 193 to 537. This number is considerably higher than that in dry eye, for which the TCs ranged from 96 to 610, and cataractsurgery, for which the TCs ranged from 85 to 281. When the table is sorted in descending order according to ACs, the influence of year of publication on TCs can be reduced. The correlation between ACs and publication date indicated that the newer the literature, the more likely it is to cover the topics of the greatest concern among eye care professionals. The most-cited paper is “Myopia” by Morganpublished in Thein 2012. This is a comprehensive review article of the biological basis, definition, epidemiology, pathology, risk factors of myopia, as well as interventions to control myopia.IF can only represent the quality of the journal in a certain specialty and not enough for assessing the impact of specific articles. Spearman’s correlation analysis showed the correlation between the ⅠF and TCs is not statistically significant. This may due to that almost all of the 100 most influential papers were published by journals in the ophthalmology category, and the IF of these journals were not as high as that of comprehensive journals. Among all journal categories ranked by the number of journals in 2018 JCR (a total of 236 categories),ophthalmology ranks 126with 60 journals, with a median IF of 1.889 and aggregate IF 2.551.

Treatment of myopia is the most studied topic, with 38 articles published after 1990. From these articles, we can discern the various intervention to control myopia and the main evolution course of refractive surgery over the past decades. Most articles published around the 1990s were about PRK and LASIK. In 1991, Seiler and Wollensakproved PRK is an efficient procedure to correct or lower myopia up to -7.0 D. An RCT conducted by Pallikaris and Siganosin 1994 concluded LASIK was more effective than PRK in higher myopes. In 1999, Oshikafound PRK and LASIK increase the wavefront aberrations of the cornea and change the relative contribution of coma- and spherical-like aberrations. This finding attributed to the smaller transition zone of the laser ablation in the LASIK. The 3 articles about SMILE were published during 2008-2011. Sekundoconducted the first prospective clinical experiment in Germany to evaluate the feasibility of femtosecond lenticule extraction(FLEx) in 2008 and performed myopic FLEx through a small incision using SMILE procedure in 2011. He found SMILE was a promising new flapless minimally invasive refractive procedure to correct myopia. In 2008, Shahin India carried out the first clinical study outside Germany performing SMILE with a single incision, proving all-in-one femtosecond refractive correction using a small incision technique was safe, predictable, and effective in treating myopia and myopic astigmatism. In 2004, the FDA performed a prospective clinical trial of implantable collamer lens (ICL) surgery and results supported the safety, efficacy, and predictability to treat moderate to high myopia. In 2005 and 2012, Chopublished 2 studies confirming orthokeratology had both corrective and preventive/control effects in childhood myopia. In 2006, Chuaconducted an RCT and proved topical atropine was well tolerated and effective in slowing the progression of myopia and ocular axial elongation in Asian children.

Epidemiology is also a popular topic of myopia, with a total of 27 articles. The geographical range of epidemiological research was vast, with 8 articles from China and 5 articles from the United States, and also included India, Nepal,Singapore, Australia, Japan, South Africa, Malaysia, Chile and Western Europe. The U.S. NIH contributes 12 articles in the field of epidemiology of myopia. The article with the largest ACs, entitled “Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050”, is a systematic review and Meta-analysis published inin 2016, exerting far-reaching influences on the estimation of the prevalence trends of myopia. In this article, Holdenincluded data from 145 studies covering 2.1 million participants and predicted that by 2050, myopia will show a significant increase in prevalence globally, affecting almost 5 billion people (50% of the world population), of which nearly 1 billion are high myopia (9.8% of the world population). The prevalence of myopia in high-income countries in the Asia-Pacific region is much higher than in any other region, and all regions will increase year by year over time. In 2000, the most myopic patients were between 10 and 39 years old. However,the research showed that this distribution will expand in 2050 due to the cohort effect and age effect, and most myopic patients will last between the ages of 10 and 79.

These 100 citations are landmark articles that have inspired clinical and basic research in myopia over the past decades.Our research may be worthwhile for several reasons. First of all, we found that myopia is a booming research hotspot, and the exploration on its epidemiology and treatment is in the ascendant. Second, our study offers new and old generations hints about what makes an article a most frequently cited classic. The eye care professors and their groups have to propose a surgical or medical innovation, worldwide influential clinical description, or discovery that has a long‐lasting effect on clinical practice. Third, the top 100 articles reflect the major evolution of the treatment of myopia. In recent years,corrective treatment has shown a diversified trend, with treatment methods including PRK, SMILE, and ICL. Last but not least, our observations show that the authors of citation classics in myopia have produced more highly cited articles than many colleagues in other ophthalmology specialties.Of course, some limitations of this study cannot be ignored.First, we selected the WOS database that is most commonly used in bibliometrics research, which resulted in the neglect of documents from other databases. Second, due to the use of TCs for evaluation, the importance of recently published articles may be weakened. Finally, we did not analyze selfcitation, citations in textbooks, and lectures. Inappropriate selfcitations might influence the results of the analysis. Some of the authors may have cited articles from the journal in which they hoped to publish their research. There may be “snowball effect” which means the previously high‐cited articles may be cited more not because of their values but simply due to the tendency of complying with an established paradigm.In conclusion, we conducted a bibliometric analysis of studies in the field of myopia, and identified the 100 most influential articles that have had the greatest impact on myopia research in the past few decades. This study emphasizes significant contributions in the field of myopia research, from which we can explore the future perspectives of myopia research.

The authors would like to thank Dr. Bao Jin, MD., Department of Liver Surgery, Peking Union Medical College Hospital, for his kind help and advices regarding this article.

Zhong Y, Li Y, and Luo Y conceived the study; Wang XJ and Chou YY collected the data; Wang XJ, Chen D and Jiang Y participated in data analysis and interpretation; Wang XJ wrote the first draft; Zhong Y and Ma J revised the manuscript. All authors read and approved the final manuscript.

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