A smile is formed primarily by flexing the muscles at the sides of the mouth. Some smiles include a contraction of the muscles at the corner of the eyes, an action known as a Duchenne smile. Among humans, a smile expresses delight, sociability, happiness, joy or amusement. It is distinct from a similar but usually involuntary expression of anxiety known as a grimace. Although cross-cultural studies have shown that smiling is a means of communication throughout the world, there are large differences among different cultures, religions and societies, with some using smiles to convey confusion or embarrassment.