For many editors, the “After Deadline” column of the New York Times is a must read. In this section, one finds a critique of language, usage, and style. In a similar fashion, I will try to address some language and punctuation mark usage that seems to often confuse our authors. In an era when most of our published articles come from non-native English language speakers, I have found that the items discussed below are often the source of confusion and misuse.
“ie” versus “eg”
No, “ie” does not mean Internet Explorer. In writing, ie is meant as an abbreviation for the Latin phrase id est. If you are not sure when to use ie, it is better to say “that is.” Ie also means “in other words” or “it is.” Ie is used to specify or make an expression more clear. Ie can be used to clarify a preceding statement by restating the idea. Although in the last sentences I have capitalized the expression (because it started the sentences), ie (as well as “eg”) is more commonly found in the middle of sentences and does not need to be capitalized. “Ie” actually looks weird, doesn't it? Similarly, both expressions are so well known that italicization is no longer used (it was, long ago). Because both expressions are located midsentence, they tend to be framed by commas, for example, “Eurasia is a large land mass encompassing 2 continents, ie, Europe and Asia.”
“Eg” means exempli gratis (a free example of what you are talking about). Eg is used when you want to clarify a thought by providing the reader with an example. An important thing to remember about eg is that you are giving some examples, not all of them! Whatever you list after eg is assumed to be only partial, and thus “etc” should not be used after it. Here is a phrase using eg: “Europe is a large continent formed by many countries (eg, France, Spain, Germany, and Italy).” Note that in this sentence, eg is found at the end and between parentheses. When located in the middle of a sentence, it may look like this: “Europe is formed by many countries, eg, France, Spain, Germany, and Italy, which make its population very diverse.” Still confused? Then forget the Latin phrases and use only “that is” and “for example”!
“Affect” versus “Effect”
A single letter can make a world of difference. “Affect” (a verb) generally means “to influence.” Here is an example: “Current chemotherapy agents affect the way postcontrast MR images look.” This is the most common scientific usage of the word “affect.” With respect to human behavior, it can also be used to mean “acting in a way you do not feel.” We have all been guilty of affecting a behavior when we feel threatened, for example, “He affected an air of nonchalance despite knowing that he was wrong.”
As used in scientific writing, “effect” (a noun) generally signifies “the result” of something as in “The effect of the drug is to diminish tumor vascularity.” If all of this sounds too easy, let's make it a bit more confusing. “Affect” may occasionally become a noun when you are referring to someone's mood, for example, “This drug results in patients displaying a happy affect.” “Effect” may become a verb when it is used to mean that something has been accomplished, for example, “The new handwashing regulations should effect a positive change in infection rates.”
“Solely,” “Only,” and “Merely”
“Solely” (an adverb) means “only,” that is, completely, entirely, by itself, and without another or others. “Exclusively” (also an adverb) means the same and may be used in the place of “solely” or “only.” “Merely” (an adverb) can also mean “only,” but it is mostly used to mean “nothing more than,” for example, “His posturing is merely attention-seeking.” Take the “ly” ending out and you have the adjective “mere” meaning “pure or absolute” or “nothing more than what is being specified” as in “I only got paid a mere $50.00 to read that complicated MR imaging study.”
“Neither,” “Either,” “Or,” and “Nor”
“Neither” is a conjunction generally used with “nor” but never with “or,” for example, “Neither Paul nor Ringo would have guessed that John really liked them.” “Neither” generally is used when referring to 2 things but nowadays is also used when referring to more than 2 items as in “At the end nothing helped, neither courage, strength, morals, nor religion.” “Or” is also a conjunction meaning an alternative, “This shirt comes in red or white”; the equivalent of the substitutive character of 2 words; or an approximation, “I will see you again in 3 or 4 days.” “Nor” is another conjunction used to negate a clause, a phrase, or words, generally after using “neither.” It is a contraction of the Old English word “nother,” which when used with “neither” sounds awkward.
“Either” is a positive adjective that is only paired with “or” (never with “nor”). It means being one or the other of 2. It can be used to express a noun or pronoun doing a different thing than the second noun/pronoun, for example, “He wants to buy either a 1.5T or a 3T MR unit.”
Remember your verb concordance when using “neither and nor” and “either and or,” that is, for singular or plural elements (subjects) in your sentence, the verb must correspondingly be singular or plural.
“Bases” versus “Basis”
“Bases” is the plural of “base” (a noun). It is defined as the foundation, the main ingredient, the starting point, and, in some cases, may be used to imply the groundwork done. In chemistry, it is generally used to denote a liquid solution with a pH greater than 7. In genetics, it signifies any of the 5 purine or pyrimidine bases that form DNA and RNA. It is very commonly used in baseball. When something is “off base,” we mean that it is mistaken or wrong. “Basis” means the exact same thing! Why 2 different forms? “Bases” is the inflected form of “basis.” In the case of nouns, inflected forms are accomplished by adding “s” or “es” to their endings. Although inflected forms originated with the purpose of giving different grammatic functions to a word or words in a sentence, “bases” and “basis” can generally be interchanged.
“Entirely” versus “Mostly”
“Entirely” is an adverb that has 2 connotations. The first is “completely” or to the full extent of something, as in “I agree entirely with the decision to reject that article.” The second is “solely” or to the full exclusion of something: “I am entirely responsible for the rejection of your article.” “Mostly” is also an adverb and means mainly or for the greatest part of something, for example, “Mostly all case reports are now rejected by AJNR.”
Punctuation Marks, Part 1: Colons, Semicolons, and Commas
I have grouped these because they are the condiments of written language. Because they are strong condiments, they should be used sparingly. In scientific communications, it is better to use short sentences rather than long rambling ones where ideas are separated by these marks. The “colon” is a gate that opens into a list or explanation after a statement that can stand alone. Unlike the semicolon, you nearly always know what is coming after a colon even if you have not read it. If the statement that follows a colon comprises several sentences, the first word must be capitalized. Remember: If the initial part of the statement is very brief, what follows the colon also must be capitalized.
A semicolon (;) is more difficult to use. It may be used to organize a long list as in “During my vacation I visited several cities: Rome, London, Madrid, Barcelona, Berlin, Lucerne, Vienna; and Paris, the city of lights.” It may also be used to separate closely related clauses that may otherwise stand on their own. Avoid using it if you do not understand it well enough.
Commas have to be (together with periods) the most commonly used punctuation marks. They can be used to separate items in a list (generally 3 or more), to connect independent statements, to set off introductory remarks, and also in place of parentheses (think of them as “weak parentheses”). In science one does not commonly use lists of adjectives, but if you do, separate them with commas. The fact that when you are reading something you pause does not imply you must have a comma in that place. The reasons for using (and not using) commas are vast, so it is better to use them as little as possible.
Punctuation Marks, Part 2: Parentheses, Brackets, and Dashes
If something important that you wish to emphasize does not fit neatly into your text but you feel the need to point it out, use parentheses. If the parentheses lie within a sentence, do not use a capital letter for the first word or a period after the last one (an exclamation mark may be used to further emphasize). If the statement framed by parentheses is outside of accompanying sentences, you may treat it as a freestanding sentence (start with a capital letter and finish with a period).
Using brackets is tricky. They should only be used to explain something when you are quoting some other text or person. If you are quoting and need to change the form of a word in the quotation to fit your sentence, that word should be bracketed. If you italicized or underlined a word or words, you will need to point this out in brackets [italics mine]. Something that is commonly bracketed in a quotation is “sic.” [Sic] generally means that the original source contains a word that is misspelled, and it follows that word. Be sure to use this sparingly; it is poor manners to call attention to the mistakes of another writer unless absolutely necessary. Last, you can use brackets inside parentheses as in “The bleed seen in the image is heterogeneous (but mostly T1 bright [Fig 1]).”
Dashes are the “super commas” of language. They may also be used instead of parentheses (think of them as “super parentheses”). Use dashes when what you want to emphasize contains other punctuation marks, such as in “Certain precious metals—gold, platinum, and silver—were found to be the most common contaminants.” Note that no space is to be left between the dashes and their accompanying words. If commas can do the job, avoid dashes. Dashes that frame a statement are called “em dashes” because their length is the same as the letter “M” (long dashes). Single dashes such as the ones seen between dates (February 1–3), numbers (2233–2245), and letters (items A–E) are shorter (called “en dashes” because their length is equivalent to the letter “N”). A sequence of dashes may be used when you want to omit someone's names, for example, “Professor — — did not offer a convincing argument.” As a general rule, dashes are falling from grace and it is better to avoid them.
Punctuation Marks, Part 3: Apostrophes and Quotation Marks
Apostrophes (') are generally used to create possessive forms and contractions (avoid contractions in scientific writing and speech). Apostrophes once were commonly used to create plurals, for example, “This used to happen in the 1930's.” Such usage is no longer deemed necessary, for example, “This used to happen in the 1930s.”
Quotation marks frame the spoken language or material that is being quoted from another source. Between them, commas, periods, and other punctuation marks may be used (this is a peculiarity of the English language not commonly seen in other languages). To complicate things even more, single quotation marks are used to frame quoted material inside other quoted material. Unless you are directly quoting from a different source, it is better to avoid them.
Some of you may think this is editorial nitpicking. Remember that how an article is written may influence the reviewers. I have tried to give you an idea of the most commonly used (mostly erroneously) terms and punctuation marks. I have not addressed exclamation points and question marks because they are used very little in medical writing and their meaning is probably clear to most authors. When I was Senior Editor for the American Journal of Neuroradiology under Dr Michael Huckman, I remember using a red pencil to mark grammatic mistakes in manuscripts. Nowadays (and fortunately for us) this work is done by our editing service. Nonetheless, I hope these remarks will help some of our authors when they are writing their articles.
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