Author: amastyleinsider

Short Course for Manuscript Editors at the 2011 Council of Science Editors Annual Meeting

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Today in Baltimore, a group of 35 participants met to learn about and discuss topics relevant to manuscript editors in the Council of Science Editors Short Course for Manuscript Editors. The morning started with Jane Wiggs of the Mayo Clinic in Jacksonville, Florida, addressing the editing of abstracts. The session covered the importance of a well-written abstract, the elements of a good abstract, and how to edit an abstract to conform to a journal’s specifications. Wiggs emphasized that effective abstracts consist of clear, concise writing with limited use of abbreviations. She stated that abstracts should include number of observations (eg, the numbers of patients and controls), interventions (including dosages), identification of end points and how they were measured, results of end points in the same order as in the methods section, report of complications or adverse effects, and a conclusion based on data in the article. Her take-home message was that all the information listed in the abstract must appear and match the information in the text.

The next session was led by Trista Wagoner, a copy editor at Science, who addressed how to handle supplementary material. The group discussed the difficulties of editing (or not editing) and publishing supplementary material. Hot topics included whether supplementary material is being used by readers and how to handle authors who want to “dump” supplementary material on a journal’s Web site.

Stacy Christiansen then explored balancing patient confidentiality with dissemination of information. The group examined published photos and text of easily identifiable patients and brainstormed on ways to avoid these ethical and sometimes legal breaches. After lunch, Laura King, a freelance medical editor, led a discussion on levels of editing and how to use this system to communicate with authors and publishers. Participants discussed how they used different levels of editing in their daily work and other uses for the system in the field of publishing.

The course concluded with Elizabeth Blake of Inera Inc, who covered Word tips for editors. This practical session covered how manuscript editors can personalize Microsoft Word so it works effectively for instead of against the editor. Blake covered shortcuts, navigation, find and replace, and editing tables and concluded with a discussion on transitioning to Word 2010. The course was a great kick-off to the 2011 Council of Science Editors Annual Meeting.––Laura King, MA, ELS

Aggravate, Irritate

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Students are commonly taught that these words should be distinguished from one another, with aggravate used to mean “to make worse, more serious, or more severe”1(p24) and irritate to mean “to provoke impatience, anger, or displeasure in.”1(p663) However, aggravate has been used to mean irritate since at least 1611 (in a dictionary, no less: Randle Cotrave’s A Dictionairie of the French and English Tongues)2 and moreover has been used in that sense by such writers as Cheever, Cowper, Dickens, Melville, and Styron.3

Despite that sterling track record, by 1870 the use of aggravate to mean irritate had for some reason begun to provoke finger-wagging,1(p24) and currently such use is more acceptable in conversation and casual writing. (Perfectly understandable, really: who has time to stop and ponder which is correct, when one’s meaning seems clear enough using either word?) On the other hand, more formal writing—perhaps because the reader has the benefit of neither nonverbal cues nor personal acquaintance with the writer—often calls for more precision, and published writing commonly preserves the distinction between these words.1(p24) Hence, many guides to written English continue to maintain that aggravate should never be used to mean irritate; for example, regarding such usage, Bernstein pointedly maintains that “neither the commonness nor the long history of misuse makes it any better than inept.”4

However, even writers who freely use aggravate in place of irritate do so only when describing a mental state—specifically, when someone or something is getting on one’s last nerve. Descriptions of physical states are another matter: while aggravate was used at least as early as the 1800s to indicate physical irritation (“With stinging wood smoke aggravating the eyes”),2 precision mandates that that the distinction between the words be preserved in such contexts. For example, a patient with conjunctivitis does not have an “aggravation of the conjunctiva”; irritation, or a reaction to a stimulus, is the finding here, although the patient might be advised that environmental irritants such as smoke can further aggravate the irritation already present (see §11.1, Current and Preferred Usage of Common Words and Phrases, in the AMA Manual of Style, pp 381-405 in print).

The bottom line:

●Describing a physical finding or state? In casual as well as formal contexts, current usage calls for irritate, with aggravate used only to describe the worsening of the irritation.

●Describing the effects of irksome behavior or circumstances? The use of aggravate to mean irritate is usually acceptable in casual communications and is rapidly gaining acceptance in more formal contexts as well, but persons writing for publication might be wise to use aggravate only to refer to a worsening of one’s irritation. On this point, Bernstein again: “[t]hose who say they are aggravated are, most likely, the same persons who say that in the hospital they were diagnosed.”4—Phil Sefton, ELS

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

2. Aggravate. The Compact Oxford English Dictionary. 2nd ed. Oxford, England: Oxford University Press; 1991:28.

3. Aggravate. Merriam-Webster’s Dictionary of English Usage. Springfield, MA: Merriam-Webster Inc; 1994:49.

4. Aggravate. In: Bernstein TM. The Careful Writer: A Modern Guide to English Usage. New York, NY: Athaneum; 1985:30.

Questions From Users of the Manual

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Q:  Do you recommend end point or endpoint?  I have folks dying on their grammatical swords over this and thought you might have an opinion.

A:  We follow Dorland’s and use end point.  Replying quickly so as little blood as possible is shed.

Q:  I failed to find guidance in the Manual on correct use of the apostrophe with plural compound nouns, eg, the possessive of mothers-in-law.  What would you advise?

A:  You are quite right that we don’t include any examples that address this specifically and it would be helpful to do so.  (A thought for the next edition—or an annotation for section 8.7.3 if you are an online subscriber.)  I would recommend mothers-in-law’s, as in mothers-in-law’s first meeting.  The Chicago Manual of Style also recommends this (section 7.23):  my sons-in-law’s addresses.

Q:  Where is the style going on the treatment of Web site?  We use Web site but are seeing it more and more frequently as website, or web site, or Website.

A:  JAMA and the Archives Journals are still sticking with Web site, but the new edition of the Chicago Manual of Style is recommending website.  So, it appears that things are, indeed, shifting but we have not shifted yet!

Q:  We’re having a debate about the order of footnotes in a table.  Are they ordered left to right, top to bottom?  Or are they ordered by where they fall in terms of the table components (eg, title, column heading, row heading, field) and then left to right, top to bottom?

A:  There’s a great example in the Manual on on page 93 (Table 10).  In that table, which has a raft of footnotes, you’ll see that the order is basically from top to bottom and, within that, from left to right…as we expect readers would move through a table as they were reading it.  That said, there is nothing sacred about this and a publication could certainly establish a different policy (eg, with the table body, priority could be given to footnotes attached to table stubs, so that if you had footnotes a and b in stubs high up in the table and then footnotes c, d, and e in rows below this but NOT in the table stubs, and then footnote f in a later stub, you might decide to make the stub footnotes a through c [renaming f to c] and then the footnotes within the body of the table d through f. )—Cheryl Iverson, MA

A Healthy Discussion

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You’d think a nutritionist would know the correct usage of healthy vs healthful. Not so. At a recent nutrition educational meeting at the AMA, the nutritionist used the words interchangeably: healthful eating or healthy behavior. That’s a head-scratcher for me. I was hoping for clarification after a stinging rebuke—(I have been accused of being dramatic)—when my editing of healthy behavior to healthful behavior in a commentary had been reversed.

Shaken, I turned to the dictionary to confirm my position and found, as I thought, that healthful promotes health and healthy represents the state of good health. Yet, my editor’s complaint was that healthful seemed unnecessary. My attempts at persuasion fell short, so I had hoped the nutritionist’s discussion would help me gain my equilibrium.

Realizing her discussion placed her in my boat, I decided to see what the authorities who address it had to say.

Fowler’s Modern English Usage1 notes that the distaste for the use of healthful is particular to the United States, a “problem that hardly arises in Britain.” Comparing 3 dictionaries for non-English speakers, Editor R. W. Burchfield observes that one calls its use “old fashioned or literary”; a second, “formal.” The third omits it.

Webster’s Dictionary of English Usage2 says the confusion has existed since the 16th century and claims that the distinction between the terms was created as recently as 1881 by Alfred Ayers. Webster’s concludes that those who “observe the distinction between healthful and healthy … are absolutely correct, and in the minority.” Those who “ignore the distinction … are absolutely correct, and in the majority.”

The Chicago Manual3 hedges by making the distinction between the 2 words, but admits “But gradually healthy is taking over.”

As usual, it doesn’t really matter. But what should one do when making it an adverb? Healthfully or healthily? Hmmm.—Beverly Stewart, MSJ

1. Burchfield RW. Fowler’s Modern English Usage. 3rd rev ed. New York, NY: Oxford University Press; 2004.

2. Webster’s Dictionary of English Usage. Springfield, MA: Merriam-Webster Inc.

3. The Chicago Manual of Style. 16th ed. Chicago, IL: University of Chicago Press; 2010.

Duplicity, or the Dangers of Duplicate e-Publication

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The senior author of a paper has posted its entire contents, including additional data that do not appear in the version sent to your publication, on his academic department’s Web site. The author did not mention this online version to the journal editors. He has already signed the publisher’s copyright transfer form. Is this a problem? How do you proceed?

The Internet has opened many new doors for the dissemination of scientific information, but it has also created new dilemmas. Just because it’s easy to post or send information to more than one place does not mean that this practice is acceptable.

As noted in the AMA Manual of Style, duplicate publication is the simultaneous or subsequent reporting of essentially the same information, article, or major components of an article 2 or more times in 1 or more forms of media (either print or electronic format) (see 5.3, Duplicate Publication).1(p148)

JAMA’s Instructions for Authors notes that submissions are considered with the understanding that they have not been published previously in print or electronic format and are not under consideration by another publication or electronic medium.2 Copies of related or possibly duplicative materials (ie, those containing substantially similar content or using the same or similar data) that have been previously published or are under consideration elsewhere must be provided at the time of manuscript submission.

According to the recommendations of the International Committee of Medical Journal Editors (ICMJE), publication of complete manuscripts in proceedings of meetings in print or online may preclude consideration for publication in a primary-source journal.3

Thus, the answer to the first question above is yes, this is a problem. Duplicate submission/publication is an offense to the author–journal relationship and an affront to the ethical reporting of biomedical research. In addition, if the author has transferred copyright or a license to publish the manuscript to the journal, he/she also could violate copyright law. The type of Web site that has posted the article is not relevant; whether it’s another journal, an institutional site, or even a blog, online posting is publication.

To resolve the situation, it is important to know where in the publication process that manuscript is and to have a frank conversation with the corresponding author. One of the simplest options is for the journal to insist on the immediate removal of the content on the academic department’s Web site. Another approach is for the journal to reject the paper on the basis of previous publication, provided it has not published the manuscript already. In the worst-case scenario, the author refuses to take the paper off the Web site and the journal has already published it as well. This could lead to a notice of duplicate publication, consultation with the senior author’s institutional supervisor, and/or banning the author from publishing in that journal for a specified time.

After publication, some journals permit authors to post a copy of the published article (eg, a PDF) on their academic department or institutional Web site or establish toll-free links from these Web sites to the author’s article on the journal’s Web site. This is an acceptable form of secondary publication (see 5.3.1, Secondary Publication).

Extensive discussion of various examples and consequences of duplicate submission/publication appear in the AMA Manual of Style1 and the ICMJE guidelines.3 The new wrinkle is the ease (and speed) with which researchers can post information online. It may be easy to forget that the Internet, while seemingly ethereal, is a publication venue all the same.—Stacy L. Christiansen, MA

1. Iverson C, Christiansen S, Flanagin A, et al. The AMA Manual of Style: A Guide for Authors and Editors. 10th ed. New York, NY: Oxford University Press; 2007.

2. JAMA Instructions for Authors: Duplicate/Previous Publication or Submission. http://jama.ama-assn.org/site/misc/ifora.xhtml#DuplicatePreviousPublicationorSubmission. Updated March 15, 2011. Accessed April 13, 2011.

3. Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Publishing and Editorial Issues Related to Publication in Biomedical Journals—Overlapping Publications. ICMJE Web site. http://www.icmje.org/publishing_4overlap.html. Updated 2009. Accessed April 13, 2011.

What Are You Trying to Say?

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In his chapter, “An Approach to Style” in The Elements of Style, E. B. White states, “A careful and honest writer does not have to worry about style.” This statement guides me as an editor, and as a writer, when I become too mired in the frustrations of dangling modifiers, passive sentences, imperfect words. I try to remember, the point of any writing is to communicate. When I ask myself what I am communicating, and get back to the simplest idea of my purpose for an assignment, the editing becomes easier, and the intricacies of style seem less of an obstacle and more of a tool.

But what happens when an editor isn’t sure what he or she is communicating? Medicine is complex, full of specialized words and obscure concepts. What happens when we don’t realize that a word is being used incorrectly, because our understanding of the concept being communicated is limited? This is perhaps the most difficult challenge I face as an editor of medical journals, and the reason we track our changes when sending them to authors. What if my streamlining of a complex sentence detrimentally affects its meaning? It’s always my fear that, in attempting to improve a statement, I will cause the meaning to be changed.

This is why I’m grateful for the author-assisted editing process. Each author who carefully sorts through my myriad comments and questions, who assesses the edits I make and comments on them, is my ally in making sure any reader, regardless of their experience with English or level of medical expertise, can use our journals in their work. Physicians are busy people, and editing is not their job. Yet, this partnership allows us to make our journal as useful and far-reaching as possible. As a microbiology student, I regularly used medical journals in my research and school assignments. Reading these studies was challenging at best, and occasionally baffling. It’s this experience that I go back to—remembering that it’s not just myself and the author who will need to understand this work, that it affects all levels of medicine—and remembering my purpose, I turn the elements of style into my tools.—Roya Khatiblou, MA

Apostrophe

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In everyday usage, apostrophe denotes the punctuation mark used to form the possessive case of nouns, to form possessive adjectives, to indicate the omission of one or more letters in a contraction, and to form plurals of such items as letters, signs, or symbols. Simple, yes? Apparently not. Incorrect use of this seemingly innocuous little jot has become rampant. For example, writers frequently confuse the contraction “it’s” with the possessive “its” — it seems that users of the apostrophe have lost sight of it’s proper use, and its so sad. Another example is when writers use the apostrophe to form the plural of a noun — a usage termed the greengrocer’s apostrophe, presumably owing to its prevalence at one time in grocery signage advertising sale prices on, for example, apple’s, banana’s, and orange’s. While the rise of edited, corporation-issued supermarket signage has rendered use of the greengrocer’s apostrophe more rare in that context than it once was, it now enjoys a wide popularity in other written materials, most noticeably in do-it-yourself advertising copy hawking everything from car’s to hot dog’s to stereo’s — a burgeoning phenomenon that has given rise to another term, apostrophitis.

Apart from this everyday denotation, apostrophe also denotes a rhetorical figure of speech in which a speaker or writer suddenly breaks off narration to direct speech elsewhere, often to exclaim or to convey heightened emotion — as, for example, when a driver conversing with a passenger suddenly breaks into an impassioned aside directed to a recalcitrant automobile, a pedestrian, or the driver of another vehicle. In its original usage, an apostrophe was directed to a person present. However, over time, the meaning has broadened to include speech directed to a person or persons either present, absent, or deceased; to a personified material object; or to an idea or other abstract quality. In poetry or narrative prose, an apostrophe often begins with the word “O”: “O Romeo, Romeo! wherefore art thou Romeo?” (William Shakespeare, Romeo and Juliet, II.2); “O eloquent, just, and mighty Death!” (Sir Walter Raleigh, A Historie of the World). — Phil Sefton, ELS

See 8.7.2 (page 362 in the print book).

Deciphering the Alphabet Soup of Cardiac Imaging

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As medical technology expands, so does the lexicon of abbreviations, commonly used but indecipherable to anyone who is not “living” in that rarified world. Frequently, in professional and commercial publications, perhaps especially during February (or “heart month”), you may see advertisements encouraging people to get one of these “heart scans.” (Don’t!) All the more valuable is a tip for navigating the lexicon of cardiac testing.

One of the latest popular scans is a noninvasive way to look at the coronary arteries: CCTA or cardiac computed tomographic angiography. This scan requires intravenous (IV) injection of a contrast agent. As it requires an IV line it is most accurately described as “semi-invasive.” Additionally, there is some hazard associated with it because the contrast agent may be damaging to the kidneys. The CCTA is a variation of the more generic CT scan, which refers to any test done using a CT scanner on any body part. A CCTA is often done on a multidetector CT (MDCT) scanner. These tests are often preceded by the term 64-slice or 128-slice, which refers to the technology of the scanner. A “heart scan” commonly refers to another type of cardiac CT scan, which can be done on either an MDCT or an EBCT (electron-beam computed tomographic) scanner, an older technology. A coronary calcium scan is noninvasive as it does not use contrast enhancement. It is used to quantify coronary artery calcium (CAC).

Other newer cardiac imaging tests are PET scans—no animals here; it stands for positron emission tomographic scans. These sophisticated scans are done using various radioactive isotopes (and, you guessed it, they have various abbreviations as well). Old standbys for medical imaging are SPECT studies, or single-photon emission computed tomography and echocardiography (no abbreviations here).

To make sense out of the soup, it’s important to include an expansion for each abbreviation at first mention. Now you can be “nourished” by the soup you consume! —Rita F. Redberg, MD, MSc