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Questions From Users of the Manual

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Q: A colleague and I both remember seeing in a style manual that an en dash should be used between 2 words of equal weight. However, we checked the AMA Manual of Style and saw that this was not a supported use of the en dash. Did this guideline appear in a former edition of the AMA Manual, or did we just pick this idea up from another source?

A: No, I don’t believe we have ever recommended an en dash between 2 words of equal weight. It is the hyphen that we recommend between 2 words of equal weight. See the middle of page 346 of the 10th edition, with the examples of “blue-gray eyes” and “blue-black lesions.” We recommend use of the en dash when the items on either side are not of equal weight (eg, one element consists of 2 words or a hyphenated word or a compound). There are examples at the bottom of page 352 and the top of page 353.

Q: Is it appropriate to abbreviate echocardiography as ECHO or echo in documents that describe the use of echocardiography during the treatment of various types of cancer?

A: We would be unlikely to abbreviate echocardiography (or any related term, such as echocardiogram) to ECHO or echo. We would spell this term out. Only in cases in which there are serious space constraints would we consider abbreviating this term (eg, in a large table), and then we would recommend expanding the abbreviation in a table footnote.

Q: Do you use Web site or website? Traditionally it has always been “Web site,” but in the past few years I have noticed a change to the more informal “website” in many publications. What is your recommendation?

A: On the home page of the AMA Manual, in the navigation bar, there’s a listing for “Updates.” If you take a look there, you’ll see that a relatively recent update (January 18, 2012) indicates that, as of that date, we began to prefer website to Web site.  Check “Updates” periodically to see if there are other, newer updates on material in the manual.

Q: I have a style question I cannot find addressed in your manual. On a manuscript I plan to submit to a journal, the corresponding author has moved since the manuscript was written and this author wants to indicate both her current and her former affiliation. Can you advise on how to phrase this information?

A: The answer to your question is in section 2.3.3 of the manual. See the relevant excerpt below:

The affiliation listed, including departmental affiliation if appropriate, should reflect the author’s institutional affiliation at the time the work was done. If the author has since moved, the current affiliation also should be provided.

Author Affiliations: Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland. Dr Lloyd is now with the Department of Emergency Medicine, St Luke’s Hospital, Milwaukee, Wisconsin.

—Cheryl Iverson, MA

Illicit, Elicit, Solicit

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“I am the offspring of illicit love.”1(p814)

“Only suffering… can elicit the perfumes of the soul.”1(p503)

“Henry had been soliciting the pope for some time, in order to obtain a divorce from Catherine of Aragon, his queen.”1(p1822)

Illicit, elicit, solicit. The above examples make it abundantly clear that these words have distinctly different denotations; yet they are often confused or misused, even by careful writers. In medical contexts, it is especially important to preserve the distinctions between them.

Illicit, denoting simply “not permitted; unlawful”2(p618) (and sometimes used colloquially to indicate naughty, unseemly, or immoral), has limited use in medical writing. For example, written materials might convey the risks associated with use of illicit drugs, discuss illicit relationships between researchers and industry, or report on the illicit trade in human body parts. Beyond such instances, however, the word does not often come into play.

Elicit, however, is another story. Denoting “to call forth or draw out (as information or a response)” or “to draw forth or bring out (something latent or potential),”2(p404) the word occurs frequently in medical contexts. It might be used in both senses regarding a patient–physician encounter: for example, a physician evaluating a patient’s pain will ask questions to elicit information about the characteristics of the pain (eg, location, nature, duration, exacerbating factors). From the patient’s perspective, that is the easy part, and patients might well wish this were the end of the matter; however, having thus elicited mere information about the patient’s pain, the physician then embarks on maneuvers expressly designed to elicit the real thing. In written materials covering the basic sciences and their clinical applications, elicit is perhaps most frequently used in the second sense noted above. For example,a writer might report that a new vaccine elicits a given immune response, describe pathological mechanisms that elicit organ damage, or present a theory of how a treatment might elicit changes in gene expression.

Even accomplished writers sometimes confuse the homophones illicit and elicit. However, these terms are easily distinguished from each other: illicit is always an adjective, whereas elicit is—in current usage—always a verb. (It also can help to remember that illicit denotes illegal; for the temperance-minded, the illicit distillation of spirits might also come to mind.)

Troublesome as homophones can be, however, sometimes near-homophones can be more so, especially when they are similar in meaning. For example, elicit and solicit—the latter most frequently used in medical contexts in the sense of “to approach with a request or plea”2(p1187)—are often used interchangeably, with solicit perhaps more frequently used in place of elicit.3 However, such use obscures an important distinction. The Oxford Dictionary of American Usage and Style perhaps explains this distinction most succinctly: “To solicit a response is to request it. To elicit a response is to get it.”3 Thus, in the patient–physician encounter alluded to above, the physician solicits information regarding the patient’s pain and then performs a physical examination to elicit and evaluate actual pain. The Oxford resource also points out an ambiguity that can arise when elicit and solicit are confused: “‘Sentient representatives expect the core group to solicit [read elicit?] response from about 4,000 people.’”3 In other words, will the group solicit responses from 4000 persons, or will the group approach a larger number of persons to try and elicit 4000 responses, knowing that some persons approached might not reply? In medical contexts, the distinction has obvious implications for reports of survey studies and possibly for discussions of power calculations in reports of clinical trials.

Three quick tips:

* Looking for an adjective to describe something as immoral, forbidden, or illegal? Illicit (think illicit = illegal) might be the ticket.

* Looking for a verb to convey the requesting of information? Consider solicit.

* Looking for a verb to convey the obtaining of information or the drawing forth of a response or change? Consider elicit (think elicit = get).—Phil Sefton, ELS

1. The Compact Oxford English Dictionary. 2nd ed. Oxford, England: Oxford University Press; 1991.

2. Merriam-Webster’s Collegiate Dictionary. 11th ed. Springfield, MA: Merriam-Webster Inc; 2003.

3. Garner BA. The Oxford Dictionary of American Usage and Style. New York, NY: Oxford University Press; 2000:309.

Quiz Bowl: SI vs Conventional Units

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Welcome back, quiz bowl participants. Our very first quiz bowl, which appeared on this site on May 5, 2011, dealt with format, style, and punctuation of units of measure. Now we’re back to delve even further into the intriguing and ever-changing world of units of measure style. The following is a sample of one of the questions that appears in this month’s AMA Manual of Style quiz on SI vs conventional units (http://www.amamanualofstyle.com/). Answer the question based on your understanding of section 18.5 of the AMA Manual of Style.

The mean 2-dimensional area of the largest metastasis was 7.2 sq in.

So, what do you think? This one isn’t really too hard. Here’s the answer (use your mouse to highlight the text box):

The mean 2-dimensional area of the largest metastasis was 46.8 cm2.

Measurements of length, area, volume, and mass are reported in metric units rather than English units. To convert square inches to square centimeters, multiply by 6.5 (§18.5.1, Length, Area, Volume, Mass, pp 794-795 in print).

Let’s try a more challenging question.

Admission laboratory tests revealed the following: serum creatinine, 0.9 mg/dL; serum urea nitrogen, 11 mg/dL; serum albumin, 39 g/L; and prothrombin time, 11.5 seconds.

Yes, this one is definitely harder. Here’s the answer:

Admission laboratory tests revealed the following: serum creatinine, 0.9 mg/dL (to convert to micromoles per liter, multiply by 88.4); serum urea nitrogen, 11 mg/dL (to convert to millimoles per liter, multiply by 0.357); serum albumin, 3.9 g/dL (to convert to grams per liter, multiply by 10); and prothrombin time, 11.5 seconds.

For laboratory values, factors for converting conventional units to SI units should be provided in the article. In text, the conversion factor should be given once, at first mention of the laboratory value, in parentheses following the conventional unit (§18.5.10, Laboratory Values, pp 797-816 in print). Although the AMA Manual of Style recommends writing out units of measure when no numbers are reported (eg, micromoles per liter), some journals may prefer to use abbreviations when listing SI conversion factors (eg, mmol/L).

Need some more practice? Subscribe to the AMA Manual of Style online and take the full quiz. If you’re new to the site, check out some of our other quizzes as well.—Laura King, MA, ELS

Incidence

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In medical contexts, incidence is most often used in its epidemiologic sense, ie, the number of new cases of a disease occurring over a defined period among persons at risk for that disease. When thus used, incidence may be expressed as a percentage (new cases divided by number of persons at risk during the period) or as a rate (number of new cases divided by number of person-years at risk).

Reporting several incidence values in the same sentence can nearly always be accomplished using the singular form (eg, “the incidence of nonfatal myocardial infarction during follow-up was 10% at 6 months, 19% at 12 months, and 26% at 18 months” or “the incidence of clinical stroke decreased significantly, from 7.6 to 5.3 per 1000 person-years in men and from 6.2 to 5.1 per 1000 person-years in women). However, in rare instances, sentence construction may necessitate the use of the plural, which of course is… what, exactly? The understandable urge to simply add an “s” at the end of the word to form the plural results in incidences — a form not found in most dictionaries and a clunker of a word if ever there was one. Writers wishing for a more mellifluous plural sometimes use incidence rates, a valid term but one perhaps best reserved for reporting incidence values expressed as actual rates rather than simple percentages. Moreover, incidences is sometimes used when reporting values either as percentages or as rates, in the latter case missing a valuable opportunity to emphasize that rates rather than percentages are being reported.

Thus, it is perhaps best to use incidences, awkward as it may be, when reporting multiple incidence values as percentages and incidence rates when reporting such values as rates, eg, “at first follow-up, the incidences of falls resulting from frailty, neuromuscular disorders, or improper use of mobility devices were 15% (95% CI, 10%-20%), 12% (95% CI, 7%-17%), and 12% (5%-19%), respectively” or “the incidence rates for falls resulting from frailty, neuromuscular disorders, or improper use of mobility devices were 5.1, 6.3, and 4.6 per person-year, respectively.” Incidentally, these 2 examples report occurrences (falls) rather than diseases or conditions, and so represent 2 instances reporting the incidence of incidents.

To further muddy the waters, incidence is sometimes confused with prevalence, defined as the proportion of persons with a disease at any given time (ie, total number of cases divided by total population). Thus, whereas incidence describes how commonly cases are diagnosed, prevalence describes how widespread the disease already is; on a more personal level, incidence describes one’s risk of developing the disease, whereas prevalence describes the likelihood that one already has it. The confusion between the terms is perhaps attributable to the occasional use of prevalence in place of incidence in the study of rare, chronic diseases for which few newly diagnosed cases are available; however, this circumstance is unusual, and incidence and prevalence should always be distinguished from one another and used appropriately. (See also §20.9, Glossary of Statistical Terms, in the AMA Manual of Style, p 872 in print.)

Whereas prevalence is often used in general contexts to indicate predominance or general acceptance, the circumstances calling for the use of incidence in general contexts are quite few and become fewer still when one takes into account that incidence is often used when incidents (the simple plural of incident) or instance (again denoting an occurrence) would be the better choice. Perhaps incidents or instances was intended but never made it to the page — as is so often the case with homophones and near-homophones, even the careful writer who usually would not confuse incidence, incidents, and instance might one day look back over a hastily typed passage only to see that a wayward incidence has crept in; if the passage is hastily edited to boot, the error might well go unnoticed until the passage is in print and a discerning reader takes pains to point it out in a letter or e-mail. The plural form, incidences, has virtually no use outside of the epidemiologic discussed above, although it has been used to subtly disorienting effect by translators rendering the Kafkaesque works of Russian writer Daniil Kharms (1904-1942) into English, most notably when rendering the 1-word title of Incidences, Kharms’ 1934 collection of absurdist critiques on life in the Soviet Union under Stalin. However, writers who are not political dissidents aiming for absurdist effect — presumably all medical writers — would do well to proofread carefully and often. — Phil Sefton, ELS

Respective

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How much can one trust a curmudgeonly English composition teacher who terrorized his early 20th-century Cornell students? How relevant are his grammatical admonitions today? With little else to support my inclination to remove the word respective or its adverb partner respectively and unite the string of data points with what they modify, I find the barking rules of E. B. White’s college rhetoric teacher William Strunk Jr calming.

Based on White’s description of his teaching style in the introduction of Elements of Style,1 I can assert with some certainty that had Strunk found himself an adjunct English composition instructor today, “lean[ing] forward over his desk, grasp[ing] his coat lapels in his hands, and in a husky, conspiratorial voice, say[ing], ‘Rule Thirteen. Omit needless words! Omit needless words! Omit needless words!’” it might not go over so well with today’s sensitive students. The style of this widely emphatic man who barked writing rules during his lectures lasted a lifetime for White. Now about 100 years later, such barking would likely cause a rush to the dean’s office to do something about this brazen man’s approach to teaching. He would simply not be asked back the next semester because the trend today is for warm-hearted English comp teachers to create a safe environment in which students can write without becoming immobilized by gruff commands. So in as much as the style of teaching would end a career today, should one conclude that Strunk’s rules for writing have become as out of date as his approach to teaching them?

Several months ago, after reading White’s delightful 1972 homage to Strunk, I flipped through some of the commands and came upon a piece of advice that lifted me out of my self-doubt and emboldened me not to give up on eradicating the use of the word respective. Unlike the image of Strunk as confident, I am not so. I am one who will eventually cave on a rule, especially if I’m the only one defending it. For example, the use of healthful over healthy when describing behavior that leads to my good health—I have let it go. If a manuscript comes in describing eating fruit as healthy, I will let it stand and not change it to healthful.

Yet, when I see in almost every article that I edit a string of numbers followed by a list of items each number describes covered by respectively at the end of the sentence, my eyes cross. I become disheartened. As I push back my sleeves to match the experimental treatment groups with the values to describe the efficacy of a treatment, I sometimes wonder whether it is worth the effort to set up the parallel structure and the repletion of words to make the match. I sigh and do it, hoping not to offend the author.

Copyediting is a solitary experience that doesn’t often allow for consensus about the rules because, as they say, much of it is a matter of preference. But when one’s eyes land on a sure-footed confirmation about a problem that niggles and nags almost every day of my work life, I must rejoice, which is exactly what I did when my eyes fell to Strunk’s simple exhortation:

Respective, respectively. These words may usually be omitted with advantage.

My heart leaped. I am not alone! Strunk follows his simple rule with an example that justifies my applying it to scientific editing.

The mile run and the two-mile run were won by Jones and Cummings, respectively.

The mile run was won by Jones, the two-mile run by Cummings.

Look at that. The second example has fewer words.

The true purpose of writing is to be clear and not make the reader work too much. As the attention span of the reader decreases by the second, making them match numbers to words 3 lines down gives the reader little reason to continue. In light of today’s hot-footed race against time, I say Strunk is more relevant now than ever. White was right when he wrote in 1979:

“All through The Element of Style one finds evidences of the author’s deep sympathy for the reader. Will felt that the reader was in serious trouble most of the time, a man floundering in a swamp, and that it was the duty of anyone attempting to write English to drain this swamp quickly and get his man up on dry ground, or at least throw him a rope.”

—Beverly Stewart, MSJ

1. Strunk W Jr, White EB. Elements of Style, 2nd ed. New York, New York: Macmillan Publishing Co; 1972.

Questions From Users of the Manual

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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

Quiz Bowl: Fill in the Blank

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When is a girl really a woman? When is a boy a man? When do children stop being children and become adults? Okay, we are starting to sound like a style manual version of Bob Dylan—but these answers are not blowing in the wind, they are in an AMA Manual of Style quiz on age and sex referents. Below are some simple fill in the blank exercises to guide you when you take this quiz.

Use the following terms to fill in the blanks: woman, man, newborn, adolescent, and infant. (To see the answers, highlight the blank space with your mouse.)

A person from birth to 1 month of age is a(n) newborn.

A female person older than 18 years is a(n) woman.

A male person older than 18 years is a(n) man.

A person aged 1 month to 1 year is a(n) infant.

A person aged 13 through 17 years is a(n) adolescent.

For additional exercises on age and sex referent usage in medical publications, take this month’s quiz at www.amamanualofstyle.com.—Laura King, MA, ELS

Envy, Jealousy

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Words that convey similar meanings sometimes come to be used interchangeably. In the case of envy/envious and jealousy/jealous, though, the move seems to have been in one direction only; jealousy is often used in place of envy (“I’m so jealous of your new job”) but not vice-versa (one does not write, for example, “He was poisoned by his envious wife.”). Theodore Bernstein further points out that jealousy is sometimes used, not merely in place of envy, but as a stronger form: “‘There, within a stone’s throw of the sea, he makes his home, and his description of how he does this makes one move from envy to downright jealousy.’”1 A human, and perhaps all-too-familiar, state of affairs—anyone who denies having experienced such a progression of emotion is either hopelessly out of touch with his or her feelings or a liar.

However, although jealous has been used in place of envious since the late 1300s2 and using jealous as a more intense form of envious creates no confusion, it is often held that the words have distinct meanings and that this distinction should be maintained. Even authorities sometimes flounder around a bit when trying to nail the distinction,3 but in general envy is taken to convey a coveting of the wealth, possessions, or success of someone else,4 whereas jealousy is often taken to convey a state of “intolerance of a rival for the possession of a thing which one regards as peculiarly one’s own or for the winning of which one has set one’s heart….”4 Jealousy also can be used in a less grasping sense to indicate the understandable guarding of some possession or attribute, as in “new colonies were jealous of their new independence.”5 Both of the latter meanings highlight that jealousy concerns an attitude toward something that one has or believes one has. In this sense, envious and jealous are not interchangeable—one can jealously guard something, but one cannot enviously guard something.

However, jealous also often carries a frank note of hostility, “a strong implication of distrust, suspicion, enviousness, or sometimes anger.4 This might suggest why the person seeking a word with a bit more heft than envious will sometimes use jealous instead—quite simply, when casting about for a suitably malicious word in the heat of the moment, jealous is low-hanging fruit.

On the other hand, envy is not the innocuous little milquetoast that it at first seems. True, it can be used without malice; one can say, for example, “I don’t envy him his mother in law.” Equally true, it has in the past been used in a noble sense—Aristotle wrote of “good envy,” an admiration that drives one to emulate another3—although that usage has been rare since the 1600s and is now nearly obsolete.6 Certainly, envy carries less emotional charge than jealousy. But to assume that envy is simply a meek cousin of jealousy is to make a mistake.

If jealousy implies strong emotion that often is perhaps all too apparent to everyone involved, envy can imply something more clandestine; as Joseph Epstein puts it, “Malice that cannot speak its name, cold-blooded but secret hostility, impotent desire, hidden rancor, and spite all cluster at the center of envy.”3 Used in this sense, envy suddenly becomes a different animal altogether, and, as Epstein further points out, “The openness changes the nature of the game. Envy is almost never out in the open; it is secretive, plotting, behind the scenes.”3 Perhaps this is another reason that jealousy is often used, albeit subconsciously, in place of envy—after all, envy is one of the Seven Deadly Sins; jealousy is not.

In short, although envy and jealousy have long been used interchangeably and jealousy has come to be frequently used in place of envy, the words do denote different states, and the careful writer should take care to maintain the distinction between them. Both can be used in neutral ways (“She was jealous of her honor”; “I don’t envy him his workload”), but both also can carry weightier meanings; in choosing between them, one might keep in mind that “The real distinction is that one is jealous of what one has, envious of what other people have.”3

The bottom line:

● Looking for a word that expresses the coveting of what someone else has? Use envy.

● Looking for a word that expresses the guarding of what one has or believes one has? Use jealousy.

● Keep in mind that although jealousy is often used as a more intense form of envy, it might be better to use another word or to reword the sentence so as to retain envy.—Phil Sefton, ELS

 

1. Envy, jealousy. In: Bernstein TM. The Careful Writer: A Modern Guide to English Usage. New York, NY: Athaneum; 1985:166-167.

2. Jealous. The Compact Oxford English Dictionary. 2nd ed. Oxford, England: Oxford University Press; 1991:892.

3. Epstein J. The green-eyed monster: envy is nothing to be jealous of. Washington Monthly website. http://www.washingtonmonthly.com/features/2003/0307.epstein.html. July/August 2003. Accessed December 13, 2011.

4. Envious, jealous. Merriam-Webster’s Dictionary of Synonyms. Springfield, MA; Merriam-Webster Inc; 1984:295.

5. Jealous. Merriam-Webster’s Collegiate Dictionary. 11th ed. Springfield, MA: Merriam-Webster Inc; 2003:671.

6. Envy. The Compact Oxford English Dictionary. 2nd ed. Oxford, England: Oxford University Press; 1991:523.

Digital Object Identifiers (DOIs) for Electronic References

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Electronic references are widely used in scientific publications. Most people are familiar with the URL (uniform resource locator), the address for a page on the Internet. A serious problem with URLs is described by the slang term link rot, the tendency of URLs to fail over time because the content has been deleted or moved. Markwell and Brooks1 found that science education URLs went bad at a rate of more than 10% per year (63% were bad after 5 years 11 months).

The DOI was created in part to address this problem. At the time of publication, DOI names are assigned to content objects themselves; in contrast, URLs are assigned to locations of objects. DOIs are permanent; once assigned, they cannot be changed. Because of the DOI system’s technology, DOI links are persistent—an object’s DOI link continues to work even if its URL changes.

All DOI names have a prefix and a suffix, separated by a forward slash; for example, 10.1001/jama.2009.2. All DOI prefixes begin with the directory code 10, followed by a period and a number identifying the entity that registered the DOI (usually the publisher), in this case the American Medical Association. The DOI suffix is a unique identifier for the content object and is assigned by the entity that registers the DOI; the suffix does not have to have any meaning, although some publishers use the object’s bibliographic information or its ISBN. In this case the suffix comprises the journal abbreviation (jama), the year of editorial processing (2009), and a sequential number (2). By convention, when a DOI is cited, “doi:” precedes the DOI and is set closed up to it.

The process by which a DOI is used to link to a content object is called resolution. There are 2 easy ways to resolve DOIs:

• Any DOI can be converted to a URL by adding the prefix “http://dx.doi.org/”; for example, http://dx.doi.org/10.1001/jama.2009.2. Enter the URL in any Web browser’s address window.

• The International DOI Foundation provides a Web page that resolves DOIs, http://dx.doi.org/. Paste the DOI into the box on this Web page.

To find the correct DOI for an electronic reference:

• The DOI registration agency CrossRef’s simple text query page (http://www.crossref.org/SimpleTextQuery/) locates DOIs for references input as text. Paste the reference into the box on this Web page.

• CrossRef’s fielded search page (http://www.crossref.org/guestquery/) supports a more targeted search.

• Use the click-through link from the PubMed service of the National Library of Medicine (http://www.ncbi.nlm.nih.gov/pubmed/). There’s often a link at the top right of an article’s citation page on PubMed to the article on the publisher’s Web site, and the DOI usually appears there.

See §3.15, Electronic References in the AMA Manual of Style (pp 64-67 in print) for more information about the correct format for DOIs in electronic references.—Paul Frank

1. Markwell J, Brooks DW. Broken links: just how rapidly do science education hyperlinks go extinct? http://www-class.unl.edu/biochem/url/broken_links.html . Updated July 24, 2006. Accessed January 17, 2012.

Free-range Verbs

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“Patients in the intervention group received doses of study drug in the range of 80 to 325 mg.”

“Patients in the intervention group received doses of study drug ranging from 80 to 325 mg.”

Both of these sentences use forms of the verb range in the sense of “to change or differ within limits”1 or “to vary between certain limits; to form a varying set or series.”2 And both use the word correctly, yes?

The answer would at first seem to be a firm “perhaps.” Some language purists might suggest that range is a verb (at least when so used), and it is not possible for doses and other inanimate subjects to “range.” In this view, the second sentence above would be incorrect. On the other hand, the use of range with inanimate subjects seems quite widespread in everyday speech and writing (eg, “prices ranging from $1 to $15”; “topics ranging from A to Z”). So is this a case of language purists insisting on a distinction that has long since begun to evaporate or yet another case of language becoming more permissive with time?

When attempting to formulate an answer to this question, at least 3 concepts might come into play. First, it is important to note that, unlike some languages such as Japanese3 and the American Indian language Ojibwe (Anishinaabemowin),4 which have different verb forms for use with animate and inanimate subjects, English makes no such distinction. So perhaps those who insist that verbs may be used only with animate subjects are taking their cue from the grammars of other languages with which they might be familiar.

Second, English does distinguish between animate and inanimate subjects when it comes to selecting relative pronouns—who is used with animate subjects (eg, “Patients who received the study drug….”); that is used with groups or inanimate subjects (eg, “The group that best responded….”; “The drug that was administered first….”). Setting aside the questions of whether that constructions are always necessary in such sentences (“The drug administered first….”) and also of whether who should be used only when the subject is human and that used when the subject is nonhuman but animate, it seems possible that a distinction maintained for one part of speech has been analogously applied to another.

Third, there is some precedent in English for avoiding the possessive with inanimate subjects, although that precedent has been on the wane for some time. As early as 1965, Theodore Bernstein quoted American grammarian George O. Curme as saying that, to take the possessive, “‘the [subject] must usually have some sort of individual life like a living being, but this idea of life may be very faint. It is faintest when the name of a thing is used as the subject of a gerund, where it is often not felt at all.’”5 In his discussion Bernstein cites such common examples as “death’s door,” “sun’s warmth,” “ship’s propeller,” and “storm’s fury”; he further notes that inanimate subjects may take the possessive when poetic effect is desired, citing as examples “April’s breeze” and “river’s trembling edge.” However, Bernstein does also point out that the use of the possessive with inanimate subjects is a throwback to previously accepted usage: “Undoubtedly we are witnessing these days a reversion in part from the prepositional genitive—the specialty of the day—to the simple ‘s’ genitive of the older days—the day’s specialty.” So again, it seems entirely possible that over time a distinction maintained for one part of speech might have come to be analogously applied to another; moreover, if that is the case, the new distinction (verbs should be used only with animate subjects) seems to have been based on a distinction (only animate subjects can take the possessive) that superseded earlier usage (animate and inanimate subjects can both take the possessive) but that is once again in decline.

Certainly the use of verbs such as range with inanimate subjects has been accepted since at least the 1830s.2 When David Livingstone wrote in 1857 that “The thermometer early in the mornings ranged from 42° to 52°,”2 he surely meant that the temperature varied between those limits—but he nevertheless was using range in a manner already accepted and considered correct. In a discussion of which prepositions best follow range, Webster’s Dictionary of English Usage cites an example from 1973: “‘…ranging from a whisper to a bray.’”6 (Incidentally, it is pointed out in that same discussion that while Bernstein states that range should be followed only by the prepositions through, with, along, or between, in actual usage range is most commonly followed by from.) More recently still, the 10th edition of the AMA Manual of Style provides, in a discussion of an unrelated point, the example “The percentage of patients who reported gastrointestinal symptoms ranged from 20% to 30%.” (§19.7.2, Percentages, p 831 in print). However, it is worth keeping in mind that when using ranging or ranged with inanimate subjects and describing variation between set limits, those limits should be specified whenever possible (eg, “doses ranging from 80 to 325 mg”) to avoid imprecision.

So free up those verbs, and let those cases, diagnoses, doses, incidence rates, etc, range from X to Y. Just be certain that X and Y are defined when possible, and avoid constructions such as “widely ranging doses” or “incidence rates ranged widely.” —Phil Sefton, ELS

1. Range. Merriam-Webster’s Collegiate Dictionary. 11th ed. Springfield, MA; Merriam-Webster Inc; 2003:1030.
2. Range. The Compact Oxford English Dictionary. 2nd ed. Oxford, England: Oxford University Press; 1991:1508.
3. More verbs, Japanese grammar and the particle “ni.” All About Teaching English in Japan Web site. http://www.all-about-teaching-english-in-japan.com/Japanesegrammar.html. Accessed January 3, 2012.
4. Anishaabemowin grammar: verbs: transitivity and animacy. University of Wisconsin Letters and Science Learning and Support Services Web site. http://imp.lss.wisc.edu/~jrvalent/AIS/Grammar/InflMorphology/verbTransitivity.html. Accessed January 3, 2012.
5. Bernstein TM. The Careful Writer: A Modern Guide to English Usage. New York, NY: Atheneum; 1965:336-337.
6. Range. Webster’s Dictionary of English Usage. Springfield, MA: Merriam-Webster Inc; 1989:796.