The following are questions from you, faithful AMA Manual of Style users, seeking clarification of AMA style guidelines or guidance on topics not covered in the current edition.

Q: I think I know the answer to this but want to be sure. Do you italicize “ad libitum” in “Animals were provided ad libitum access to standard chow”?

A: The manual (22.5.4: Specific Uses of Fonts, Typography) says this about italics:

[Use italics] for some non-English words and phrases that are not shown among English terms in the current edition of Merriam-Webster’s Collegiate Dictionary or in accepted medical dictionaries. Italics are not used if words or phrases are considered to have become part of the English language, eg, café au lait, in vivo, in vitro, en bloc.

Merriam-Webster’s online dictionary lists “ad libitum,” so there is no need to italicize it. Interestingly, the example is “rats fed ad libitum.”

Q:  I am wondering: How does one cite a clinical trial as a reference? Do we treat them like a PI, or like a website? Do we include the identifier?

A: It would look most like a website and yes, inclusion of the identifier is recommended:

1. Evaluation of phage therapy for the treatment of Escherichia coli and Pseudomonas aeruginosa wound infections in burned patients (PHAGOBURN). ClinicalTrials.gov identifier: NCT02116010. https://www.clinicaltrials.gov/ct2/show/NCT02116010. Updated July 23, 2015. Accessed October 13, 2018.

Q:  Hi, Should there be a comma between a last name and “Jr” in a byline? 

For example:  Krzysztof Goniewicz, PhD; Frederick M. Burkle, Jr, PhD

A: No, AMA style does not include a comma before Jr or Sr, or before III, IV, etc.

See the policy and examples in chapter 8.2.1, Punctuation, Comma.

Q:  Does the manual have any position on whether “24/7” or “24-7” are acceptable in formal prose, with the meaning “at all times”? Thanks!

A:  As far as formatting, it’s not in the current AMA manual, but the Chicago Manual of Style and AP stylebook both use “24/7.”

Merriam-Webster’s dictionary lists “24-7” as the primary entry, with “24/7” as a variant.

The JAMA Network journals have generally preferred “24/7” considering that the slash serves to indicate “per” (24 hours per 7 days). Numbers joined with a hyphen (24-7) could be confused for a range or expression of variability, although the context of the passage should alleviate that.

As to “24/7” being acceptable in formal prose, it’s clearer to say “all the time”  or something less jargony:

            The hospital has stroke expertise available 24/7.

            Rewrite: The hospital has stroke expertise always available.

            Rewrite: The hospital has stroke expertise available around-the-clock.

Q: I know you aren’t supposed to refer to patients by their diseases, eg, “asthmatics.” How does that apply to the following sentence:

 Of the 196 patients, 20.4% (40) were made comfort-focused care, and 79.6% (156) remained full codes. 

What is the alternative for “full code”? 

A: Stylebook committee member Phil Fontanarosa, MD, MBA, replied:

With advance directives, patients can choose to have any or none of these procedures and also can opt for “comfort care,” which usually involves pain control, perhaps some sedation, and other comfort measures.

For the sentence, you could revise as something like the following: “Of the 196 patients, 20.4% (40) decided to have comfort-focused care, and 79.6% (156) opted to receive full resuscitation efforts.” 

Q: Hi, I have 2 questions about authors’ initials:

1.  If the journal typically uses periods after middle initials in the byline and the author has 2 middle initials, should there be a space between them?

2. If the journal uses first and last author initials in the Disclosures section, should there be periods and spaces between them?

A: The answer to both questions is yes.  Here’s an example from the 11th edition (forthcoming later this year) re the second question:

Author Affiliations:  Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong (S. K. W. Chan, S. W. Y. Chan, Hui, Chang, Chen); The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong (S. W. K. Chan, Chang, Chen); School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong (Pang, Yan).

Have a question? Send it in to stylemanual@jamanetwork.org or tweet to @AMAManual.—Stacy L. Christiansen, MA