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The AMA Manual of Style is the ultimate go to resource for writing articles as well as understanding ethical standards in medical and scientific publishing, and it is now available online.  In the article below, Phil Sefton, ELS is Senior Manuscript Editor at JAMA and a contributor to www.amamanualofstyle.com weighs in on “nauseating” vs. “nauseous”. This article first appeared on the AMA Manuel of Style site.

Writers and editors rushing to meet deadlines know the feeling. The effects of stress, a few too many cups of coffee, and perhaps a candy bar or bag of chips in place of a meal can conspire to make the most steely-nerved wordsmith feel a tad nauseated. Or is it nauseous? And what of that stress, that coffee, that ill-chosen meal replacement—are its effects nauseating or nauseous?

Grammarians with more prescriptive leanings (ie, those concerned with language as it “should” be used, which presumably would include most writers and editors) would say that a person feels nauseated and that which has made him or her feel that way is nauseous. Those with more descriptive leanings (those concerned with language as it is actually used, which includes professional linguists as well as armchair observers of language) are eager to point out that while nauseated is still more often used to mean feeling the effects of nausea, the use of nauseous in that subjective sense is rapidly gaining acceptance. Similarly, while nauseous is still more often used to mean causing nausea, the use of nauseating in that causative sense will soon be more prevalent, if it is not already. Debates on the merits of prescriptive vs descriptive use of these terms can be quite heated, and current dictionaries and usage guides often attempt to walk a line between the two camps—which, considering the potential for rancor, is probably not a bad idea, particularly taking into account the ever-evolving nature of language as well as the history of these terms.

So first, a little history. Despite the pronouncements of some prescriptive grammarians promoting the idea that nauseous, when used to mean “feeling the effects of nausea,” is yet another example of a weed newly sprung up in the garden of educated usage, it appears that the term was used in that sense as early as 1604. What is more, it was likely not used to mean “causing nausea” until 1612 or later. At some point, the rule was set forth dictating that nauseous should be used to indicate causing nausea and nauseated to indicate the subjective feeling of nausea—a rule that for the most part held sway until the mid-20th century, when nauseous once again began to be used by persons describing how they feel.

Nauseous, then, when used to describe the feeling of nausea, is something of a grammatical atavism, a throwback to an earlier usage that seems to have fallen into disfavor in the intervening centuries. The term has regained its original meaning in a few generations, a resurrection only accelerated by today’s fast-paced media mix. For example, when comedian Mike Myers’ Saturday Night Live character, Linda Richman, claimed that something “makes me nauseous” (always pronounced as two syllables, with the slightest of pauses when pronouncing the first: “naaw′ shus”), the use of the term in that sense gathered steam in short order, gaining an ever-widening circulation as viewers of the program used it in conversation and e-mails; it likely now lives a healthy and happy life in the various social networking media. Other related terms from the 17th century—nauseation, nauseative, nauseity, nausity—are now obsolete or used very rarely, but for now nauseous as used to describe the subjective state of nausea seems here to stay.

So how does all of this pan out for the person seeking guidance on the use of nauseous, nauseated, and nauseating? As is often the case, an answer—very seldom is there such a thing as the answer—lies in the ever-shifting borders between the spoken and the written word. Whereas the use of nauseous in the subjective sense when speaking now seems a given, nauseated is still holding its own in text. Conversely, the use of nauseous to indicate the cause of nausea is rapidly falling into disuse in spoken conversation (and when it is used, it is sometimes confused with noxious), whereas it maintains only a rapidly diminishing tenuous lead over nauseating in text.

Accordingly, JAMA and the Archives Journals very seldom use nauseous in the causative sense and not at all in the subjective sense (unless part of quoted material); nauseating is used for the former and nauseated for the latter, at least until the dust has settled on another generation or two of language evolution. In the meantime, writers and editors rushing to meet deadlines are encouraged to take steps to eliminate or reduce stress, consume coffee in moderation, and make prudent dietary choices if skipping meals.

Brenda Gregoline, ELS, manages the copyediting team for 5 of the Archives Journals, and is a member of the committee that writes and updates the AMA Manual of Style. She is a member of the Council of Science Editors and has worked in scientific publishing for nearly 15 years. In this 3-part series, she reports on the most frequent mistakes authors make when submitting manuscripts to JAMA and the Archives Journals, and lets us in on what drives copy editors crazy. Read part one here and part two here.

It’s impossible to expect authors to absorb all the information in the thousand-page AMA Manual of Style–they’re just trying to get published, and it’s our job to help them. Here, in classic top-10-list reverse order, are the top 10 editorial problems we see in our submitted and accepted manuscripts, compiled by committee and editorialized upon by me. In Part I we discussed filling out author forms, omitting “behind the scenes” stuff, and generally making life difficult for the copy editor. In Part II we discussed common punctuation and style mistakes, errors of grandiosity, and wacky references. Today we discuss the final 4 in our top-10 list of most frequent mistakes.

4. Duplicate submission. In scientific publication, it is not acceptable to submit a report of original research to multiple journals at the same time. Journal editors are likely to be more disturbed by this if it looks deliberate rather than like a simple mistake (not realizing that a foreign-language journal “counts,” for example) or if the case is debatable (a small section of results was published in another paper, but the new paper adds tons of new material). Remember those forms from the 10th most common mistake? One of them asks about previous submission or publication. We need authors to be up-front about any other articles in the pipeline, even if (especially if) they’re not sure if they might constitute duplicate publication.

3. Failing to protect patient identity. Yup, there’s a form for this too! Any time a patient is identifiable, in a photograph or even in text (as in a case report), authors must have the patient’s consent. (Contrary to popular belief, the gossip-mag-style “black bars” over the eyes are not sufficient to conceal identity.) Usually we hear complaints about this, because studies are written long after patients are treated and it can be hard to track people down, but them’s the breaks. If it’s really impossible to obtain after-the-fact patient consent, editors will work with authors to crop photos, take out case-report details, or whatever it takes to “de-identify” patients.

2. Not matching up all the data “bits.” In the abstract, 76 patients were randomized to receive the intervention, but it’s 77 in Table 1. There was a 44.5% reduction in symptoms in the medicated group in the text, but later it’s 44.7%. Sometimes this is because the abstract is written first from the overall results, while the data in a table are more precisely calculated by a statistician; or maybe the number of patients changed along the way and no one went back to revise the earlier data. Either way, it drives copy editors crazy.

1. Not reading a journal’s Instructions for Authors. These days almost all scientific journals have online submission, and almost always there is a link to something called “Information for Authors,” “Guidelines for Manuscript Submission,” or something similar. Judging by the kinds of questions editorial offices receive almost daily, authors rarely read these—but the publication process would often go so much more smoothly if they would.

We are proud of our style manual here at JAMA/Archives, although we realize it isn’t the last word in scientific style and format. There can never really be a “last word” because some editor will always want to have it! Anyway, without authors there wouldn’t be anything to edit, so we would never hold any “mistakes” against them. No matter how grievous a manuscript’s misstep, an editor will be there to correct it, because it’s our job. (But mostly because we can’t stop ourselves.)

Brenda Gregoline, ELS, manages the copyediting team for 5 of the Archives Journals, and is a member of the committee that writes and updates the AMA Manual of Style. She is a member of the Council of Science Editors and has worked in scientific publishing for nearly 15 years. In this 3-part series, she reports on the most frequent mistakes authors make when submitting manuscripts to JAMA and the Archives Journals, and lets us in on what drives copy editors crazy.

It’s impossible to expect authors to absorb all the information in the thousand-page AMA Manual of Style–they’re just trying to get published, and it’s our job to help them. Here, in classic top-10-list reverse order, are the top 10 editorial problems we see in our submitted and accepted manuscripts, compiled by committee and editorialized upon by me. In Part I we discussed filling out author forms, omitting “behind the scenes” stuff, and generally making life difficult for the copy editor. Today we discuss the next 3 in our top-10 list of most frequent mistakes.

7. Common punctuation and style mistakes (not an exhaustive list). Most frequently we see authors fail to expand abbreviations; use different abbreviations for the same term throughout a manuscript; use commas like seasoning instead of like punctuation marks with actual rules of deployment; and overuse the em dash. However, I’d like to tell any authors reading this not to fret, because that’s the kind of stuff we’re paid to fix. Plus I can’t really throw stones—being a fan of the em dash myself.

6. Errors of grandiosity. Sometimes a perfectly nice and valid study will go hog-wild in the conclusion, claiming to be changing the future of scientific inquiry or heralding a sea-change in the treatment of patients everywhere. Or authors will selectively interpret results, focusing on the positive and ignoring the negative or neutral. It’s natural to want to write an elegant conclusion—it’s one of the few places in a scientific manuscript where one can really let loose with the prose—but it’s always better to err on the side of caution.

5. Wacky references. All journals have a reference citation policy, and across scientific journals it is fairly standard to give reference numbers at the point of citation, cite references in numerical order in the text (as opposed to only in tables or figures), and retain a unique number for each reference no matter how many times it’s cited. However, we still get papers with references handled in all kinds of odd ways (alphabetical, chronological, or seemingly inspired by the full moon). References that include URLs can mean big problems. Often the URL doesn’t work or the site is password-protected, subscription-only, or otherwise useless to the reader. Also aggravating: references that are just the result of the search string for the article and not the URL for the article itself.

Authors and aspiring authors: stay tuned for the final 4!

Brenda Gregoline, ELS, manages the copyediting team for 5 of the Archives Journals, and is a member of the committee that writes and updates the AMA Manual of Style. She is a member of the Council of Science Editors and has worked in scientific publishing for nearly 15 years. The AMA Manual of Style is the ultimate go to resource for writing corrections and clarifications as well as ethical standards in medical and scientific publishing, and it is now available online. In this 3-part series, Gregoline reports on the most frequent mistakes authors make when submitting manuscripts to JAMA and the Archives Journals, and lets us in on what drives copyeditors crazy.  Be sure to check back on Monday for the next two weeks for part two and three of this post.

Publishing a new edition of a style manual, particularly a lengthy, detailed manual that covers a ridiculous amount of technical material (Hello, AMA Manual of Style!), is a grueling process. In our case, it involved 10 people meeting for at least an hour every week for more than a year, where we tried not to get into arguments about grammar, usage, and the presentation of scientific data. After the meetings there would usually be flurries of e-mails about grammar, usage, and the presentation of scientific data. Then we’d all go home and dream about grammar, usage, and the presentation of scientific data. You get the picture.

My point is that the writers of style manuals are often a little, shall we say, too close to the material. In the case of the AMA Manual of Style, we are all editors as well—and it can be hard for us not to roll our eyes when we run into the same problems on manuscript after manuscript. Come on, authors: there’s a whole book on this stuff!

Which, of course, is precisely the problem. There is a whole THOUSAND-PAGE book that tries to encompass all aspects of medical editing. It’s impossible to expect authors to absorb all the information–they’re just trying to get published, and it’s our job to help them. Here, in classic top-10-list reverse order, are the top 10 editorial problems we see in our submitted and accepted manuscripts, compiled by committee and editorialized upon by me. If any authors happen to read this, maybe it will help them avoid the most common errors; if any journal Web site–design people read it, maybe they can grab some ideas for more explicit user interface; and if any copy editors read it, maybe they can enjoy shaking their heads in wry commiseration.

10. Missing or incomplete author forms. Most journals require authors to fill out some forms, usually involving things like copyright transfer, an assertion of responsibility for authorship, and so on. These forms are often filled out incorrectly or incompletely. Following a form’s instructions as to signatures and boxes to check can save significant amounts of time in the publication process.

9. Not explaining “behind the scenes” stuff. Values in a table don’t add up—oh, it’s because of rounding. The curve in this figure doesn’t connect the values listed in the “Results” section—oh, we used data smoothing. This kind of thing can be easily explained in a footnote, but many authors forget to do so because it seems so obvious to them.

8. Making life difficult for the copy editor. Authors and editors have the same goal: a polished, published, accurate manuscript. Sure-fire ways authors can ruin what should be a pleasant working relationship are to suggest that the copy editor is making changes in the manuscript for no reason; calling the copy editor to discuss changes without having read the edited manuscript first (this wastes OODLES of time); and not reading the cover letter that comes with the edited manuscript. This last is particularly charming when the author then calls the copy editor to ask all the questions that are very nicely answered in said cover letter.

Authors and aspiring authors: stay tuned for 7 more!