“…We have previously proposed that wrongly identified nucleotide sequences in the context of repetitive and superficially justified gene research could reflect the external involvement of organisations such as paper mills ( 8 , 13 , 24 , 26 ). Although researchers in different countries may use paper mills to meet publication targets or quotas ( 47 ), paper mills have been most widely discussed in the context of academics and medical doctors in China ( 25 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ). Stringent publication requirements may represent a particular challenge for hospital doctors in China, where some hospital doctors have described limited time, training and/or opportunities to undertake research ( 25 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ).…”