Waffling on the Internet: To Cap or Not

When I signed up to write a blog post on the decision this year by the New York Times and the Associated Press to stop capitalizing the term internet, I thought it would be a good way to come to terms with the decision by The JAMA Network to follow this style. My first thought had been, “Internet’s gotta be capitalized!” I’ve been capitalizing this word for a long time—since Google was invented and people could “surf” on it. I felt that it wasn’t right to use lowercase.

When the word is not initial capped, the wonder that is the internet seems somehow diminished. Reading about pros and cons, I discovered that feelings can run high on this subject, and people have very definite ideas about Internet vs internet. On the Grammarist’s website, people point out that there can be many internets—interconnected computers—but there is only 1 Internet, a kind of internet that would be hard to live without.

Alas, the internet is no longer a magical place—it’s something mundane, like radio or television or cable. But I am old enough to remember when it did feel magical. There weren’t many things to look up or opportunities to surf, but you just knew those days were coming.

On the one hand, as several Grammarist commenters pointed out, originally Internet referred to the internet delivered by the Internet Engineering Task Force and the Internet Corporation for Assigned Names and Numbers—it was a very specific institution. Its precursor was the ARPANET, which dates back to the 1960s. One the other hand, according to Wikipedia, “the designers of early computer networks used internet both as a noun and as a verb in shorthand form of internetwork or internetworking, meaning interconnecting computer networks.”

I see both sides of the argument. Although old habits die hard, ultimately, one has to has to go with the flow, especially in the workplace. The internet, if nothing else, is all about change and updates.—Karen Boyd



Questions From Users of the Manual

Q: If I have a title with a colon, is the first word after the colon capitalized or lowercased?

A: If you are speaking about title and subtitle on the manuscript itself, every major word in the title and subtitle, as well as the first word of title and subtitle, would begin with a capital letter.

Endless and Essential:  The Tug-of-War Over Off-Label Use

If you are speaking about the title and subtitle of a journal article as it appears in the reference list, only the first word of the title and any proper nouns would begin with a capital letter.

19. Incollingo J. Endless and essential:  the tug-of-war over off-label use. Cataract & Refractive Surgery Today. 2016;16(5):19-27.

More about capitalization of titles can be found in chapter 10.—Cheryl Iverson, MA

Questions From Users of the Manual

Q: I note in the manual that you do not require the use of the registered trademark symbol with brand names, as long as an initial capital letter is used (see 5.6.16, Use of Trademark Names in Publication).  Does this guideline apply to copy in medical books as well as medical journals?

A:  You are right that our manual does not encourage the use of the little “R” in a circle or the superscript TM to denote trademarks but rather relies on the initial cap to signify a trademark. As to what style would apply to books (medical or other), it really all comes down to what style the book publisher uses. The Chicago Manual of Style (section 8.152) states: “Although the symbols [cap R in a circle and superscript TM] for registered and unregistered trademarks, respectively) often accompany trademark names on product packaging and in promotional material, there is no legal requirement to use these symbols, and they should be omitted wherever possible.”

I think you would be fairly safe in zapping the symbol and just using the initial cap, unless the style guide you are following in editing a book dictates otherwise.

Q: What do you recommend re capitalization for something like the word “test” or “examination” or “questionnaire” in names of specific tests, examinations, or questionnaires?

A: Our style manual (section 10.3.8) advises the following regarding capping the “t” on “test” when it follows the name of a specific test. I would extrapolate from this to cover similar questions.

Tests.  The exact and complete titles of tests and subscales of tests should be capitalized.  The word test is not usually capitalized except when it is part of the official name of the test.  Always verify exact names of any tests with the author or with reference sources.

Examples where a cap would be correct include the Mini-Mental State Examination and the Minnesota Multiphasic Personality Inventory.—Cheryl Iverson, MA

Questions From Users of the Manual

Q: What is the source for the statement in section 11.10.5 that “The term sexual preference  should be avoided because it implies a voluntary choice of sexual orientation not supported by the scientific literature”?

A: The source is what is shown as reference 20:  Maggio’s Talking About People:  A Guide to Fair and Accurate Language. This was published by Oryx Press in 1997 and we are not aware of a newer edition.

Q: Is there a list in the manual, or in a source recommended by the manual, as to when it is appropriate to refer to an individual as “Dr”? It is sometimes difficult to know if a non-US degree is equivalent to an MD degree.

A: Great question. We do include a few of these in the manual (eg, MBBS), but you might try Google. It can provide helpful information on various degrees.

Q: Would you use “e-visit” or “E-visit” when it appears at the beginning of a sentence?

A: Based on the advice we give in 10.7 for “e-mail” (use “E-mail” if it appears at the beginning of a sentence), I would use “E-visit” at the start of a sentence.

Q: How do you cite the online AMA Manual of Style?

A:  I would recommend the following, based on 3.15.2 in the manual:

Iverson C, Christiansen S, Flanagin A, et al.  AMA Manual of Style:  A Guide for Authors and Editors.  10th ed.  New York, NY:  Oxford University Press; 2007.  www.amamanualofstyle.com.  Published online 2009.

Cheryl Iverson, MA

Questions From Users of the Manual

Q: If a product name appears in all caps in a company’s product literature (with or without a trademark symbol or registered symbol), must the editor retain the all caps in a journal article? Companies use caps for graphic impact or emphasis, but caps can be distracting and can make the text difficult to read. Would it be acceptable to substitute only an initial cap for an all-cap product name, particularly if the product is the main subject of the manuscript and occurs frequently?

A: Our journals do not require use of the trademark symbol (™) or the registered symbol (®) as the use of the initial cap frequently used on proprietary names indicates the proprietary nature of the name (see 5.6.16, Legal and Ethical Considerations, Intellectual Property:  Ownership Access, Rights, and Management, Trademark). There are exceptions to the use of the initial cap (eg, pHisoHex; see section 10.8, “Intercapped” Compounds) and in these cases, as in all others, we advise using the name according to the presentation of the legal trademark. To avoid a plethora of caps—which certainly can be distracting—we would suggest varying the way in which the product is referred to (eg, “this product,” “it”) as long as the meaning remains clear.

Q: Your manual indicates that references should be numbered consecutively with arabic numerals in the order in which they are cited in the text. But what about the distinction between references cited in a range and references cited individually? If an author cites references 1 through 5, does this count as only the citation of reference 1, as the first number in the range, or does it count as citation of all 5 references included in the range?

A: It matters not if the references are cited as part of a range or cited individually. Even if a reference is cited as part of a range, when any one of those references is cited later, it retains the same reference number.  This is not specifically stated in the Manual and, perhaps wrongly, we assumed that it would be understood. Thank you for allowing us to clarify this point.

Q: Convention seems to be to use the leading zero in P values, but why is this necessary since P cannot be greater than 1?

A: JAMA and the Archives Journals do not use a zero to the left of the decimal point, since statistically it is not possible to prove or disprove the null hypothesis completely when only a sample of the population is tested (P cannot equal 1 or 0, except by rounding). If convention dictates otherwise, we are unconventional!

Q: I have been unable to find specific rules on the use of nonbreaking hyphens and spaces. Do you have any suggestions for the correct and preferred use of nonbreaking hyphens and spaces?

A: You are right. We do not have any section devoted to this. However, there is information about line breaks scattered throughout the Manual. For example:

  • On page 29 (section 1.20.4), there is information on how to break an e-mail address. The same guidelines apply to breaking URLs.
  • On page 646 (section 15.6.4), there is information on breaking long karyotypes.
  • On page 910 (section 21.5), there is information on breaking long formulas.

There may be other instances like this scattered throughout the Manual where specific guidance is needed. However, individual publishers or clients may have their own preferences that require attention when editing material for their publications.

Q: I am working on a manuscript in which one of the authors has listed the degree MAS (Master of Advanced Studies). This abbreviation is not included in the Manual. Is it acceptable?

A:  This is a perfectly acceptable abbreviation. We simply did not have space to list all possible degrees and their abbreviations in the Manual and attempted to list some of the more common ones.—Cheryl Iverson, MA

Questions From Users of the Manual

Q: I am a medical writer (and writer, in general) and have always questioned the use of the lowercase “b” in the word “blacks.”  The “w” in “Whites” is normally capitalized when talking about that population.  Although this question is not limited to the AMA Manual of Style, how might I go about getting it changed so that the “b” in “blacks” is also capitalized, for consistency?

A: You will have noticed that in section 11.10.2 of the manual we do not use intial caps on either “white” or “black.”  Webster’s 11th seems to follow this policy also, as you will find definitions related to both races presented without initial caps. I also checked the Chicago Manual and, in section 8.39, they indicate a similar policy. “Common designation of ethnic groups by color are usually lowercased unless a particular publisher or author prefers otherwise.” So, there does seem to be consensus among this small sampling, but it is in the direction of using initial lowercase letters rather than initial caps for these terms.

Q: Are there courses that teach proper use of the AMA Manual of Style?

A: I know of one such course. It is the Medical Writing and Editing Certificate Program that is offered by the University of Chicago Graham School. See https://grahamschool.uchicago.edu/php/medicalwritingandediting/.

Q: I have been working as an APA style editor for nearly 3 years.  I would like to be able to work as an AMA style editor.  I need to learn the AMA style.  Which version of the manual do you recommend?  Is this manual available online?

A: You can visit the AMA Manual of Style Online site (www.amamanualofstyle.com) and you can see that you can purchase a book, an online subscription, or a “bundle” of both. You can also subscribe to the blog and sign up for tweets at no charge. Good luck to you!

Q: Does AMA have a preference for “versus” vs “vs”? If so, can you include the rationale behind the choice?

A: Yes, we prefer “vs” as an abbreviation for “versus” (except in the names of legal cases, where we use the conventional “v”). See the list of abbreviations (14.11) re our preference for how to abbreviate “versus” and also note that we do not require this abbreviation ever to be expanded.  Note too that the use of the lowercase italic “vee” is preferred in legal cases, per convention.  As to our rationale, we have been doing this for so long it is hard to recall exactly.  I suspect it was a combination of “vs” taking up less space than “versus” and being well recognized and understood by all/most.

Q: Is it 0.9 second or 0.9 seconds? The AMA Manual of Style doesn’t seem to address this particular question.

A: This question originally arose on the AMWA Editing-Writing Listserv. There was much good discussion and various sources were cited. After considering all the comments and polling our own staff, we come down on the side of Words Into Type and Edie Schwager’s Medical English Usage and Abusage (for print usage:  prefer the singular).  But when spoken, we prefer the advice of the Chicago Manual (section 10.68)—in general, prefer the plural.—Cheryl Iverson, MA

Quiz Bowl: To Capitalize or Not to Capitalize

Flipping through the table of contents of the most recent issues of JAMA and the Archives journals, I realize how challenging it can be to correctly capitalize article titles and subtitles. Do hyphenated compounds use initial capital letters on both terms? Are words of 2 letters or fewer capitalized? How do you capitalize genus and species names? Much like Hamlet’s “To Be or Not to Be” conundrum, I am often found muttering to myself “To Capitalize or Not to Capitalize.”

This month in the Archives of Internal Medicine, an article on hip fracture and increased short-term but not long-term mortality in healthy older women appears. But how should this be capitalized as a title? Is it “Hip Fracture and Increased Short-Term But Not Long-Term Mortality in Healthy Older Women,” “Hip Fracture and Increased Short-term But Not Long-term Mortality in Healthy Older Women,” or “Hip Fracture and Increased Short-term but Not Long-term Mortality in Healthy Older Women”?

This month’s JAMA contains an article on the need for critical reappraisal of intra-aortic balloon counterpulsation. But is it the “Need for Critical Reappraisal of Intra-Aortic Balloon Counterpulsation” or the “Need for Critical Reappraisal of Intra-aortic Balloon Counterpulsation”?

Finally, in the Archives of Otolaryngology–Head & Neck Surgery, an article on leiomyosarcoma of the head and neck: a population-based analysis is published. But did the authors perform “A Population-Based Study” or “A Population-based Study”?

Capitalizing titles can provide editors with a sea of troubles, which is why we have chosen the topic for this month’s quiz. Test your ability to correctly capitalize the title in the following example. For further explanation of the correct answer, refer to section 10.2 (pp 372-374 in print). Then check out this month’s quiz (which subscribers can find at http://www.amamanualofstyle.com/) for more titles and subtitles to capitalize.

tolcapone in patients with parkinson disease: a randomized, double-blind, placebo-controlled trial

Okay, back to the original question—to capitalize or not to capitalize? How did you handle this title and subtitle? Did you know that double-blind and placebo-controlled are treated differently? Here’s the answer (use your mouse to highlight the text box):

Tolcapone in Patients With Parkinson Disease: A Randomized, Double-blind, Placebo-Controlled Trial

The A should be capitalized because it is the first word of the subtitle (§10.2, Titles and Headings, p 372 in print). Double-blind is a hyphenated compound considered a single word (ie, it can be found as a single entry in Webster’s); therefore, blind should not be capitalized. Placebo and controlled are 2 separate terms operating together as a temporary compound; therefore, both parts of the hyphenated compound should be capitalized (§10.2.2, Hyphenated Compounds, pp 373-374 in print).

For the record, those titles I mentioned earlier should be capitalized as follows:

Hip Fracture and Increased Short-term but Not Long-term Mortality in Healthy Older Women
Need for Critical Reappraisal of Intra-aortic Balloon Counterpulsation
Leiomyosarcoma of the Head and Neck: A Population-Based Analysis

If you want more examples to help you solve the puzzle surrounding correct capitalization of titles and subtitles, take the Capitalization of Titles and Subtitles Quiz on the AMA Manual of Style online.—Laura King, MA, ELS