Mechanics of Writing

Abstract

Articles that are easy for readers to understand are more likely to be read thoroughly and so more likely to influence fellow scientists and contribute to the global scientific conversation. Authors can take several steps to improve the clarity of their writing including by avoiding acronyms, avoiding writing in all capital letters, and using commas in large numbers consistent with scientific practice. Authors require the feedback of busy co-authors and reviewers to further develop their manuscripts. Authors build goodwill among these key stakeholders and enhance the efficiency of the review process by providing easy-to-review drafts that have been spell-checked, that have paragraphs clearly demarcated by indentation, and that align text to the left, use consistent fonts, and deploy informative document names.

1 Using Nonstandard Acronyms

A great barrier to communication is overuse of TLAs. When you work on a specific topic, you become quite comfortable with a TLA. You make it up or hear others in your project or area use it, and pretty soon, you are using it. When the time comes to write, instead of using words that people understand, you use TLAs throughout your manuscript. A TLA is a three-letter acronym. An acronym is a type of abbreviation where a new word is formed from the first letters of a series of words. It is annoying to read a passage that is written in code.

While acronyms have meaning to those who use them every day, as soon as a document is shared with outsiders, acronyms become an obstacle to understanding. Using acronyms requires readers to learn a new vocabulary. Indeed, scientific authors commonly expect readers to learn several new complex multisyllabic phrases simply to understand the article. Most people do not learn new language quickly. A reader may need to go back to the manuscript and review how the acronym was defined. Perhaps the reader highlights the acronym in another color so they can more quickly decode the work. Asking the reader to exert cognitive attention to try to learn and remember a new acronym leaves less attention available to the substance of the manuscript. Readers may skip over the acronyms or guess what they mean from context because they do not have the time or inclination to go back through the manuscript and figure out what it stands for.

Writers often assume that readers are similar to themselves. This is a flawed assumption. It is best to avoid all acronyms all the time. Using the replace feature of any word processor, you can remove them from your text. This means more people can understand your writing, including, for example, journal editors and journalists who are not topic experts in your area and staff who work for policy makers. An article that can be understood without decoding will be understood by more people. A more understandable article is more likely to influence global understanding.

Authors demonstrate respect for readers by avoiding insider abbreviations. Using words removes the burden from readers of requiring them to refer back to the first use of the abbreviation to decode meaning.

When journalists report on scientific work, they rarely use acronyms. Why not? Because they are experts in textual communication. They want people to understand what they write.

The few exceptions to this rule pertain to acronyms that are so standard that the general population would understand them (e.g., HIV, CDC). However, even for these, the acronym should be spelt out the first time it is used in the manuscript. The Editor of the American Journal of Public Health states this succinctly, “We frown on all acronyms but those in universal use.” The editors of the American Journal of Tropical Medicine and Hygiene maintain, “Abbreviations are commonly overused, compromising the clarity of manuscripts. Authors are advised to keep abbreviations to a minimum, using them when they are clearer than long terms (e.g., PCR, DNA), but avoiding them when possible when they are non-standard and idiosyncratic.” The “Uniform Requirements for Manuscripts submitted to Biomedical Journals” (www.icmje.org) recommends, “Avoid abbreviations in the title and the abstract.”

Examples of the error		Alternative, better options
✗	The NTCP has not been evaluated.	✓	The National Tuberculosis Control Program has not been evaluated.
✗	The CSF is scheduled to begin at 12 noon every Monday.	✓	The Centre for Scientific Forum is scheduled to begin at 12 noon every Monday.

2 Using Nonstandard Spaces

This error is particularly common among authors who draft their manuscripts using justified alignment where the text falls flush on both the right and left margin rather than left justification (Error 4.8). All the squeezing and spreading of spaces required by justification makes it more difficult for the author to detect spacing errors.

You can avoid irritating reviewers and journal editors with this distracting error by checking your document before sending it. Use the “Find and Replace” feature of your word processer. Search for two spaces and replace them with one. If you click on the replace all button, this removes all the double spaces in the document. You may have to repeat this process a couple of times if you also have some triple or larger series of spaces within your document. If you take this simple step after you spell-check and before circulating the document, then you can consistently avoid this error.

Nonstandard spacing includes:

• 1. The absence or too many spaces before or after parentheses.

• Example: To evaluate compliance with current World Health Organization(WHO) guidelines of postexposure rabies treatment(PET), we interviewed all animal bite victims. One-hundred-nine(76%) bites were category III and 33(23%) were category II.

• This is incorrect. There should be a space after “Organization” and before “(WHO).” Similarly, there should be a space after ‘treatment” and before “(PET)”. There should be a space after “nine” and before “(76%).” There should be a space after “33” and before “(23%).”

• 2. The absence of spaces following a comma.

• Example: On average the workers completed five household interviews,three child assessment,and one structured observation per day.

• This is incorrect. There should be a space after the word interviews and after the word assessment.

• 3. Inserting more than one space between words.

• Example: Approximately 6 million people annually undergo postexposure treatments worldwide, most in Third World states as a consequence of failure of canine rabies control programs or strategies.

• This is incorrect. There should be only one space after the word “undergo” and only one space after the word “as.” There should also be one space between sentences, not two.

• 4. Inserting a space within a numeral > 1,000

• Example: Field workers collected samples from 12, 456 patients.

• This is incorrect. There should be no space after the comma (Error 4.11). The numeral should be written as 12,456.

3 Improper Spelling

Improper spelling is distracting and unnecessary with the advent of spell-checking. Be sure to thoroughly spell-check any document you ask others to review.

Some journals prefer British English spelling. Others prefer US spelling. Set the spell-checker in your word processor to be consistent with the spelling specified in the Instructions to Authors for your target journal. If the Instructions to Authors does not specify a preference, review recent published articles from the journal to see what they use. Use the spell-checker to align spelling for the narrative elements of the manuscripts. Also check titles, legends, and contents of figures and tables. However, do not change the spelling in references or in the proper names of institutions.

Example of the error		Alternative, better option
✗	Mixture of United States English and United Kingdom English	✓	Harmonize spelling in article to meet the requirement of the journal.
✗	Centres for Disease Control and Prevention	✓	Centers for Disease Control and Prevention

4 Capitalization Problems

4.1 Using All Capital Letters

Look at an article in your target journal. Is the title of the article written in all capital letters? Are the titles of the tables and figures in all capitals? Are the words that are column and row headings in all capitals?

The reason that portions of journal articles are not written in all capitals is that reading text that is written in all capital letters is annoying. Indeed, research has demonstrated that people read all capital letters more slowly than they read standard sentence case. Thus, prepare your draft in accordance with the standards of the literature.

To learn more, navigate to Google Scholar (http://scholar.google.com/). Input the search terms “Reading speed all capitals,” and review the nearly 100-year history of research demonstrating the reduced readability of all capital lettering.

Take a lesson from the clarity of scientific findings. Avoid all capitals. If you want to emphasize a title or a heading, use a larger font or bold.

4.2 Capitalizing Non-proper Nouns

Although you may commonly use the acronym IEC to refer to information, education, and communication, that does not make these words proper nouns requiring capitalization. A proper noun refers to a specific person or place. Barak Obama and the Director General of Health are proper nouns requiring capitalization but not acquired immune deficiency syndrome (AIDS).

Example of the error		Alternative, better option
✗	In low-income countries, Information, Education, and Communication (IEC) should focus on high-risk sexual behavior.	✓	In low-income countries, information, education, and communication should focus on high-risk sexual behavior.

5 Failure to Spell Out an Isolated Numeral < 10

The International Committee of Medical Journal Editors (www.icmje.org) used to suggest that numbers < 10 should be spelled out in the text (“four” instead of 4). However, since 2010, they no longer make this recommendation. Different journals have different preferences on this issue. Unless journal copy editors recommend otherwise, we recommend you present numerals if you have a direct comparison or multiple numbers in a sentence, some less than ten and some more than ten, but write out numbers less than ten if they stand alone.

Example of the error		Alternative, better option
✗	The field team identified 6 community residents with fever and mental status changes.	✓	The field team identified six community residents with fever and mental status changes.
✗	Following the intervention, five of the 45 health centers were observed to have adequate practices.	✓	Following the intervention, 5 of the 45 health centers were observed to have adequate practices.

6 Starting a Sentence with a Numeral

Example: 43 individuals (56%) tested positive to more than one dengue serotype. 24 of them were reactive to type 1 and 2.

Historically, many journal and copy editors have considered this incorrect and not permitted it. Others argue that we should present numbers so they can be easily assimilated and compared. Trying to compare a number that is spelled out in English to a number that is numerically presented in the same sentence is an unnecessary chore—much like trying to read material that is in all capitals.

If you look in leading scientific journals, for example, Lancet and Science, you can find examples of articles with numerals beginning a sentence and numerals less than 10 presented numerically.

What should a writer do? The first goal of a writer is to provide clarity and quick understanding. If it is reasonable to initiate a sentence with a number, then do so. If editors do not permit it, then alternative strategies include:

• Write out the numeral in words.

• Recast the sentence so that it doesn’t begin with a numeral though be careful not to make the sentence too awkward.

• String sentences together with semicolons because the next word following a semicolon does not need to be capitalized; thus, numerals are permitted.

Examples of the error		Alternative options
✗	50 respondents did not complete the survey.	✓	Fifty respondents did not complete the survey.
✗	24 study participants (45%) correctly recalled the health education message that they had received.	✓	Of the respondents, 24 study participants (45%) correctly recalled the health education message that they had received.
✗	43 (56%) individuals tested positive to more than one dengue serotype. 24 of them were reactive to type 1 and 2.	✓	Forty-three individuals (56%) tested positive to more than one dengue serotype; 24 were reactive to type 1 and 2.

7 Not Indenting Paragraphs

To make it clearer to your readers, how your paper is organized into different ideas and/or sections, it is important to indicate when one paragraph ends and when another begins. The standard format is to indent the first word of each paragraph one tab width (0.25–0.5 inch).

An alternative form is to skip a line between paragraphs. If you do skip a line between paragraphs, it is still best to indent the first word. This way, when a new page starts with a new sentence, it is clear to the reader whether or not this also starts a new paragraph.

8 Not Aligning Text to the Left

Setting your word processor so that it aligns text to both the left and right margin (justify) distorts the space between letters and makes it more difficult for the reader to read the text. Although it creates a clean look along the left and right side of the page, it makes it difficult to identify spacing errors. Leave such text alignment to the journal that will finally format your article. For drafts that you send for review, you want to make these as easy on your co-authors and reviewers as possible. Align all text to the left.

9 Problems with Parentheses

Using parenthetical phrasing to qualify statements with additional verbiage should be avoided in the narrative portion of a manuscript. If you initially draft a sentence that deploys parenthetical clarification or qualification, consider revising the sentence to communicate your ideas without parentheses. This allows the reader to understand your ideas without backtracking and revising their understanding of your meaning.

• 1. Using parentheses to clarify language.

• Incorrect example: Personal harm (physical injury) of a friend was reported by 10%.

• Alternative: Ten percent of students reported that a friend was physically injured.

• Incorrect example: Most (but not all) respondents agreed that the community benefited from the new water pump.

• Alternative: Seventy-five percent of respondents agreed that the community benefited from the new water pump.

• Incorrect example: Children whose parents were employed in an informal industry (e.g., garbage picking, lead acid battery recycling, brick manufacturing) were less likely to be immunized against measles than children whose parents owned their own business or were employed in the formal sector.

• Alternative: 30% of parents were employed in informal industries including garbage picking, lead acid batter recycling, and brick manufacturing. Children whose parents were employed in an informal industry were less likely to be immunized against measles than children whose parents owned their own business or were employed in the formal sector.

• 2. Putting numbers and percentages in parentheses.

Parentheses are helpful in adding specific numbers to support a narrative claim.

• Incorrect examples:

  • The majority (64, 92%) of women reported associated symptoms.

• Correct examples:

  • The majority (n=64, 92%) of women reported associated symptoms.

  • The majority (64, [92%]) of women reported associated symptoms.

  • Women were 2.2 times (95% confidence interval 1.8, 2.6) more likely to develop illness than men.

10 Not Recognizing When an Abbreviation Has Become a Name

Institutions often begin with one name, but as they evolve, the original name no longer describes the institution and so the name changes. For example, AT&T used to be the American Telephone and Telegraph Company. IBM used to be International Business Machines. BRAC used to be the Bangladesh Rural Assistance Committee. Sometimes, institutions have an official name (Leland Stanford Junior University), but a different name that the institution actually uses as its regular name and brand (Stanford University).

The acronym for the International Centre for Diarrhoeal Disease Research, Bangladesh, was a communications nightmare: It was neither simple nor easy to understand. It failed to accurately describe what the institution did. Beginning in 2010, the institution rebranded and, like AT&T and BRAC, now wants its former acronym to be its formal name, icddr,b. Note that with this rebranding, the institution’s name is not capitalized.

Journal editors or reviewers will often assume that icddr,b is an acronym (as it was in the past) and request that it be in all capital letters and spelled out. When responding to this request, it may be helpful to use examples of other acronyms that have become names, for example, AT&T, IBM, or BRAC.

11 Misplaced Commas in Large Numbers

The standard placement of commas in numbers greater than 999 in international communication is with a comma after every three digits from the right and no spaces between digits or between the comma and the digits. The comma is optional, but it can be particularly helpful to readers to understand numbers especially when they exceed five digits. The placement of commas and the use of spaces are often different in the Asian subcontinent, but for scientific writing, or anytime you are writing for an international audience, large numbers should be recorded in standard international form.

Examples of the error		Alternative, better options
✗	7, 51,842	✓	751,842
✗	51, 00,000 doses of vaccine	✓	5,100,000 doses of vaccine

12 Varying Fonts Within the Narrative

The font used for narrative text of the manuscript should be a consistent size and style. If the first paragraph is Times New Roman 12 point, then so should each of the subsequent paragraphs. Sometimes during copying, pasting, or other editing variable, font sizes or types are introduced. Consistency avoids distracting the reader.

13 Using Bulleted Lists Rather Than Sentences

A list of phrases or words with preceding bullets works well for outlining, for quickly communicating a list on a website summary, or, if not overused, on slides that accompany an oral presentation. Although we are quite accustomed to communicating ideas in this format, this is not the standard technique for communicating in a scientific manuscript. Scientific manuscripts use sentences that flow together in paragraphs. There is a long history of written English language that uses sentences and paragraphs. Indeed, the complexity and nuance that characterizes scientific ideas makes this traditional format work quite well. Moreover, it is what editors and readers expect.

Examples of the error		Alternative, better options
✗	The field team also conducted spot checks to observe the following: • Latrine status (hygienic or unhygienic) • Presence of open feces (both human and animal) within the courtyard • Raw food remnants (food waste produced during food preparation) or leftover food within the courtyard • Food storage practices	✓	The field team also conducted spot checks within the household compound to observe the type and cleanliness of the latrine(s), presence of animal or human feces and food waste within the courtyard, and food storage practices.
✗	The defining features of all of these permutations of a District-Based Approach to intervening in the water and sanitation sector are: • A commitment by an intervening organization to work for a period of time longer than that needed for single projects within a specific subnational administrative district, such as a municipality or county (but smaller than a state or equivalent) • Sets a goal of achieving universal access to water and sanitation services within that district • Explicitly working with the local government • Develop capacity in the local government/public sector for planning and maintaining water and sanitation services • Align with the country’s national water and sanitation policy, while engaging, to varying degrees, with national government	✓	The defining features of the district-based approach appear to include an institutional commitment to work long term in a specific subnational administrative district, a goal of achieving universal access to water and sanitation services within that district, explicitly working with the local government, and alignment with the country’s national water policy while engaging.

14 Uninformative Document Names

The scientific document that you create will be shared with your co-authors, many of whom are likely to be co-authors on many other scientific documents. It helps your co-authors and reviewers keep track of your work if you create names for your document that are specific. The clearest document names include a description of the document and a version number. It also can be helpful to include your name and possibly a date.

Examples of the error	Alternative, better options
✗ Manuscript.docx	✓ Simple Soap Man v13.docx
✗ Review response.doc	✓ Response to Ecohealth Reviewers v3.doc
✗ Concept note.docx	✓ Detecting_lead_in_spices_Concept_note_Jenna v2.docx