JOURNAL

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RESEARCH

26, 591-604 (1979)

Art and Logic in Scientific Communication: Presentations, and Manuscript+

Abstracts,

AVRAM R. KRAFT, M.D. ,* JOHN A. COLLINS, M.D.,t LARRY C. CAREY, M.D. ,I: AND DAVID B. SKINNER, M.D.§ *Division of General Surgery, Cook County Hospital, and Abraham Lincoln School of Medicine, University of Illinois, Chicago, Illinois 60612, tDepartment of Surgery, Stanford University School of Medicine, Stanford, California 94305; $Department of Surgery, Ohio State University, Columbus, Ohio 43210; and BDepartment of Surgery, University of Chicago Pritzker School of Medicine, Chicago, Illinois 80637 Submitted for publication

Scientific communication (in abstract, presentation, or manuscript form) is generally not taught in medical school, may not be emphasized during postgraduate training, and usually is only learned by a process of painful experience. Individuals in the Association for Academic Surgery questioned the ability of the membership to transmit scientific data effectively and sought to test this hypothesis by assessing papers at an annual meeting of the Association. The study that ensued demonstrated that the majority of surveyed papers “failed” to transmit information effectively [ 11. Based on this disquieting finding and with the object of delineating art and logic in scientific communication, the Association programmed a panel presentation on the subject of scientific communication for its decade meeting. The panelists discussed the subjects of abstract development, slide and paper presentation, and manuscript writing. This article expands on the information presented at that meeting.

August 31, 1978

abstracts are almost exclusively collected and reviewed by a committee. This has implications for the author’s best chance of getting his (or her) abstract on a program. A. The Review Process

The first and most compelling problem faced by a committee reviewing abstracts deals with judging abstracts from differing fields. This is a serious and significant problem because the committee is usually composed of members with a spectrum of interests. How does the committee solve this dilemma? Does each member have a single vote meaning that every member judges each abstract and each vote is equal despite the reviewer’s knowledge and background? Do the committee members have their votes weighted based on their area of expertise? Most committees compromise by giving each reviewer an equal vote in judging each abstract, but with the reviewers relying heavily on the recommendation of the reviewing expert. A second problem faced by a selection I. THE ABSTRACT committee is the review process. There is a large and increasing number of abstracts John. A. Collins, M.D. submitted for each national meeting producThis section will discuss what happens to ing a rejection to acceptance ratio of 4-6 an abstract as it is reviewed and considered to 1. The committee has to judge 100 or for inclusion on a national program. Today, more abstracts over the short period between submission of the abstract,and selection of ’ Presented at the Decade Meeting of the Associathe program. This, incidentally, imposes tion for Academic Surgery, November 4, 1976, Key constraints on the committee’s flexibility in Biscayne, Fla. 591

0022-4804/79/060591-14$01.00/O Copyright 0 1979 by Academic Press, Inc. All rights of reproduction UI any form reserved.

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obtaining outside review and even in bringing the committee together to discuss the abstracts. The efficiency and quality of review does decrease as the number of submitted abstracts increases and as the time available for selection process decreases. This puts a premium on the initial impact that an abstract must make on the selection committee members. In dealing with large numbers of abstracts, most committees use a multiple step selection process. They first eliminate weak abstracts and select the outstanding ones and then consider the remaining “gray zone” abstracts in detail. If your abstract falls into the gray zone group, small differences in how you write an abstract make a big difference in your chance of the abstract being selected. The aims of a selection committee for a national meeting may be internally contradictory. The committee tries to select the best available material from that submitted. If one of the committee’s requirements is to achieve subject balance, however, quality in different areas must somehow be compared, and occasionally uneven weighting must be applied to different subject areas. Subject balance has to be an important consideration on the part of most committees. Geographic balance does come into question, but it is much less important than is often assumed. There also is the question of dealing with the author as a known individual. Should the author remain anonymous through the selection process or at some point does the committee break its “code” and take into account who the author is and use author and institution as considerations in the final selection process? Selection committees in “young” organizations prefer author anonymity during the selection process. “Older” committees almost always insist on knowing who wrote the abstract. There is something to be said for both approaches. For discussion purposes we can review the selection process used by the Society of University Surgeons over the last few

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years. The committee dealt with all abstracts anonymously. Both the institution and the name of the author were removed. This point was made very explicit in the instructions that were issued to authors, but was ignored by 10% of those submitting abstracts. The identification was in the wrong place or the senior author insisted on naming the institution three times in the first three sentences of the abstract, or even named himself as the individual who set the standard for this field of investigation. If a reviewer is looking for reasons to reduce the volume of abstracts, this fact immediately captures his attention. Of 209 abstracts, the committee was to select 33. The committee as a whole agreed that 8 abstracts were clearly outstanding and that 100 abstracts should be rejected. The committee then reviewed the gray zone group of 101 abstracts in greater detail. These abstracts were evaluated in detail and discussed individually, and 25 were finally selected. Of the remaining abstracts, 10 were put into an alternate group. After the selection process, the code was broken. Duplications from the same laboratory and material presented at other national meetings by the same authors were replaced from the list of alternates. The results of this selection process paralleled those of the preceding 4 years. The fields of interest into which papers were categorized were similar and included gastroenterology, oncology, vascular, immunology, shock, and cardiopulmonary. Comparing the ratio of papers in a particular area to the total number of abstracts submitted yielded a ratio which presumably reflected the investigative interests of the membership (Table 1). The breakdown of abstracts submitted by geographical area is shown in Table 2. The acceptance to submission ratios for subject matter and for geographic areas suggests that the committee’s choices were unbiased and were a function of the quality of the abstract itself. An important reason for rejection was the problem of duplication, submission of the

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ANALYSIS OF ABSTRACTS SUBMITTED FOR PRESENTATION AT THE ANNUAL MEETING OF THE SOCIETY OF UNIVERSITY SURGEONS BY SUBJECT MATTER” Submission ratio Acceptance 1973

Gl CP, Vascular Transplant Oncology Metabolism Wound, Infections Other

ratio

1976

(160)

1974 (178)

1975 (1W

(203)

1973

1974

1975

1976

0.18 0.19 0.18 0.08 0.33

0.20 0.27 0.15 0.10 0.25

0.17 0.15 0.23 0.35 0.11

0.04

0.19 0.24 0.13 0.14 0.19 0.09 0.02

0.21 0.19 0.24 0.25 0.13

0.02

0.19 0.19 0.15 0.10 0.21 0.04 0.11

0.33

0.29

0.24 0.16 0.10 0.16 0.21 0.25 0.05

0.24 0.18 0.23 0.11 0.13 0 0

(1Submission ratio equals number of abstracts in that category/total number of abstracts submitted (in parentheses below the year). Acceptance ratio equals number of abstracts accepted in that category/number of abstracts submitted in that category.

same material presented at another national meeting. To deal with this problem requires breaking the code before the final selection process. This particular problem is faced by every committee which selects abstracts for national meetings. Most national organizations specify in the call for abstracts that authors should carefully avoid duplication, but somehow the problem persists. Theoretically, it would be very helpful to immediately reject those abstracts before the review process, but this would have to be done by a secretary and an advisor and TABLE

would mean breaking the code at the outset. Consequently, many committees only look for duplicated work after the selection process. When this occurs, it annoys the committee members and creates a bad reputation for the authors, at least among the committee. If there is a problem of overlapping deadlines for the submission of abstracts and you submit your work to two groups which will review your work at the same time, this is acceptable. If your abstract is accepted by one group, however, you should immediately inform the other 2

ANALYSIS OF ABSTRACTS SUBMITTED FOR PRESENTATION AT THE ANNUAL MEETING OF THE SOCIETY OF UNIVERSITY SURGEONS BY GEOGRAPHICAL AREA OF ORIGINS Submission ratio Acceptance 1973

(160) Northeast Mid-Atlantic Midwest Southeast, Southwest West, Mountain Canada

0.28 0.11 0.30 0.19 0.13

ratio

1976

1974 (178)

1975 (1W

(203)

1973

1974

1975

1976

0.12 0.25 0.29 0.13 0.19 0.02

0.13 0.28 0.31 0.08 0.16 0.02

0.14 0.26 0.33 0.11 0.13 0.02

0.18 0.33 0.21 0.20 0.14

0.19 0.23 0.09 0.26 0.18 0.25

0.24 0.15 0.10 0.25 0.23 0.20

0.14 0.15 0.19 0.13 0.08 0.20

a Submission ratio equals number of abstracts submitted from that area/total number of abstracts submitted (in parentheses below the year). Acceptance ratio equals number of abstracts accepted from that area/ number of abstracts submitted from that area.

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group, explain what happened and request withdrawal of your abstract. Do not get a reputation for trying to get on every program by presenting the same material packaged slightly differently.

you were a member of a selection committee who had to reject four out of five such abstracts. It is often the final critical rewriting that separates the very good from the good.

B. Constructing the Abstract

C. A “DO and DON’T DO” List

In constructing an abstract, the first step is to review the experimental results. This is the heart of the abstract. Present the results simply. If the data lend themselves to a tabular format, then construct a relatively simple table, keeping in mind that the space for the table is valuable. If the results can be expressed in less space in sentence form, then use appropriate statements, but it is often obvious that the material would have been better stated in tabular form. Use only one table and make it fairly simple. The next step is to draw a succinct and logical conclusion. The final step is to write a brief introduction followed by a succinct materials and methods section in the space remaining. Remember that the abstract you are writing is probably not going to be read by people in your field. Except for very narrowly focused meetings, you will be lucky if there is one person on the program committee who is working in your specific area. Write a setting, an introduction, for people who are not working in your specific field so they can comprehend the significance of the problem, the question that you are asking, and why you are asking it. Care is required to avoid utilizing too much space for the introduction. It is wasteful of space and weakens the abstract to focus on certain known or accepted facts; for example, why infections are bad for surgical patients. Do not overstate the obvious and do not underestimate the people on the committee. Pay attention to what you write and try to balance your material. If you still have space left, review the abstract and consider where you can and should expand for completeness or clarity, and where you can rewrite to state things more simply. If at all possible, put it aside for days or weeks, then reread it as if

1. Do not exceed the space limits provided for the abstract. If an abstract is limited to 250 words on one side of a page, do not get a typewriter with the smallest print you can find and type from one margin to the other and then try to squeeze the lines together so that 400 words look like 250. Most program committees will not even read past the first sentence. 2. Do not be sloppy. If your abstract is full of erasures, irregularities, bad grammar, or obvious errors in constructing a table, it will not receive serious consideration. If you did not give it enough attention and enough care to submit it properly, neatly, and correctly, the committee will not waste its time trying to figure out what you were trying to say. In the content of your abstract, do not be vague, do not promise great things to come in the future, and do not draw conclusions that are not based on the data in the abstract. These are reasons for instant rejection by the reviewer. Avoid duplicating work that has already either been published or has been presented somewhere else. If you think it is different and is the next logical step in the sequence of work that you are exploring, you must make this clear to the reviewer. Do not try to “snow” the committee by claiming importance, relevance, or originality that may not quite be there. It is better to let such qualities speak for themselves. 3. State a hypothesis or question. Many abstracts would benefit by a brief but effective introduction which either states the hypothesis or gives the historical setting in which this work should be judged. This is necessary for the members of the committee who are not experts in that particular field. This is something that is hard to do

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correctly and you have to exert a certain amount of judgment. 4. Do submit data. Put in a table, if it is appropriate, with statistical evaluation of the data. A table captures the attention of any program committee. It emphasizes to them the fact that you are submitting data and that is what a program committee is looking for, sometimes in vain. 5. Draw appropriate conclusions. This was one of the most frequent errors that appeared in evaluating abstracts. The conclusion was either absent or there was very little relationship between it and the data. 6. Write in simple English. Do not try to write English as if it were German or Latin. Imitate Hemingway, not Cicero. Write simple, declarative sentences. Emphasize the points you want to emphasize. Use a clear and logical sequence leading from the work that you have done to the conclusions that you are drawing. II. THE PRESENTATION: AND TALK

SLIDES

Larry C. Carey, M.D.

When asked why he had paid so much attention to the style of constructing slides, Dr. Zollinger replied by saying, “When you have very little to say, it is important that you say it well.” When you are preparing a presentation for a scientific meeting, these are the four matters with which you should concern yourself: A. the preparation of the slides for the talk; B. the method and technique of the presentation; C. the method of slide construction; D. utilization of the slides once made. A. The Preparation Talk

of the Slides for the

Prepare yourself by deciding what your major points are and make slides that will emphasize those points. Prepare an introduction slide. Describe in slide form the materials

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and methods of the experiment or study. This feature is especially important if the talk is to be one of scientific impact. Describe your results and how you arrived at them and prepare a summary slide. Lastly, be prepared for discussion. The best way to prepare yourself for the discussion is to select and invite at least one person to discuss the paper and send him a copy of the manuscript in advance so that he has had a chance to review it. It is always distressing to me to have one of my friends stop me on an elevator or as I check into the hotel, saying, “By the way, would you mind discussing my paper? Here is the manuscript.” During the actual discussion period as you are listening to the discussants, write down their names so that you can acknowledge your responses to them in your closing remarks. Write down their questions and answer them in order. Finally, if you can, by your previous critique at home, anticipate what questions might arise and prepare slides that will allow you to answer those questions. There is a very dramatic moment when someone asks you a very pertinent question that you have not answered in your presentation and for you then to be able to put a final slide on the screen and answer that question. Incidentally, if you are a discussant and if you have been asked to discuss a paper and have been sent the manuscript, prepare in advance. Do not talk extemporaneously. We have all been exposed to that endless extemporaneous discussion given by an unprepared discussant which often says nothing. Ask a maximum of three questions but please do not give a “rejected” paper. B. The Method and Technique of the Presentation

After the slides are made, be sure the slides are clean. Spend a few minutes speaking with the projectionist prior to loading the cassette so that the slides are properly placed in the carousel. If you invest this time, you will find that it will reward you

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SLIDE CONSTRUCTION Eight

Lines

per

Seven

Words

Short

Title

Slide per

Simplify

Material

Readable

by

Color

for

Line

l-land Emphasis

FIG. 1. Slide construction using the embossograph technique.

handsomely. Check the lectern beforehand to make sure you know how it works. If you are not going to use notes, and I would advise you not to since your slides ought to be effective notes, turn off the light at the lectern. Position yourself so that you can see the screen. It is important to rehearse. You may use a mirror if you find that helpful; a tape recorder is also often helpful in preparing yourself. Finally, if possible, present the talk to a friend or to a group in your institution so that it is critiqued prior to the formal presentation either at the national or local meeting. There is a good deal of confidence gained in being familiar with your material and the mechanism that you are going to employ for its presentation. It is my own prejudice that talks that are

SLIDE UTILIZATION

read, in general, never have the same “punch” and effectiveness as talks that are given spontaneously. Time the presentation so you know that you can be comfortable and confident, so that before you begin you know you are going to stay well within the limitation imposed by the meeting at which you are making your talk. Remember when someone finally comes up with a cure for cancer they will only get to talk about it for ten minutes. Acknowledge the moderator, speak slowly, and be prepared for the equipment failure that occasionally happens. There have been some very distinguished surgeons in this country who have absolutely dissolved in front of a national audience when the projector broke, when the film broke, or when a slide burned. This will occasionally happen to you and you ought to be prepared for it. Then finally, when you are finished, let your audience know that you are through. There is nothing more pregnant than the pause that occurs at the end of a talk when the fellow is finished and nobody knows it but he, and it takes a minute or so for everyone to recognize that he really is finished. C. The Method of Slide Construction

There are a variety of techniques available. The embossograph is one of the most effective. It is a large typewriter that effectively makes an indented imprint on a heavy cardboard and gives the slide the suggestion of three dimensions (Fig. 1). LeRoy lettering, using a commercially available set, may not

Slide Utilization

USE CONTINUOUSLY USE AS AN OUTLINE

GIVE THOUGHT TO SEQUENCE

Use continuouslv Use as an outik

FIG. 2. LeRoy lettering may be effective and requires only a minimum amount of practice.

FIG. 3. Press type is relatively expensive but produces a very nice result.

USE ALL

PRESENTED

USE l- 1.5 SLIDES

MATERIAL

PER MINUTE

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Slide Utilization Usecontinuously Use’asan outline Useall presentedmaterial FIG. 4. Hand lettering which can be used very effectively.

require an illustrator and you may use this yourself with a little practice (Fig. 2). Press type is sort of a rapid LeRoy lettering type. It is relatively expensive but it can be done quickly and presents a very nice effect (Fig. 3). Legible hand lettering can be very effective and finally, the typewriter can be very helpful in slide construction (Figs. 4 and 5). Placing a piece of unused reversed carbon paper on the sheet to be typed allows better type contrast. When using a typewriter, you may color-mat. When developed, the negative can be left in the ammonia atmosphere for varying periods of time, thereby changing the developing process and allowing you to obtain varying contrasts. This process will allow for a pastel rather than a black or blue background. Remember that when you are making slides, you may end up making them your-

SLIDE CONSTRUCTION Embossograf LEROY

1. K?&&

AC/D

2. CO/W/hED

AC/D

9. D&@G’E%S Of- AC/D % 12 #Oh?

okF-kw/g~~

FIG. 6. It is important to keep the slide to a maximum of eight lines and to use short titles for maximum impact.

self. That is not an impossible chore and sometimes it can be a very effective way of preparing slides. You may set a bad example for both yourself and your institution if you do not pay adequate attention to the construction of your slides. Present your material in a legible form. If you are using an artist, discuss the material in the order of its presentation with him so he may help you in the preparation. Then give him ample time. These are just simple rules of form that I think you will find helpful: 1. Try to confine the material to a maximum of eight lines per slide and seven words per line (not to exceed 35 characters including stops, e.g., Fig. 6). 2. Use short titles (e.g., Fig. 6). 3. Simplify the materials as much as you possibly can; it is often better to use two slides rather than one. RECURRENTRECTAL ADENOCARCINOMA

Press Type

17 CEA

LegibleHandLettering Typewritten FIG. 5. Typewriter slide preparation is the least ex-

pensive with respect to both cost and time. It can be seen in comparison with the other techniques.

ng /ml

I2

7 4 8 12 16 20

24

28

UONTHS

FIG. 7. A graph which is simple in concept. Note that all lettering is oriented in the same plane.

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4. If you hold the slide up to the light and you can read it clearly, it will be legible and readable to the back room of a large auditorium. If on the other hand, you cannot read it, it will not be readable from the back of the auditorium. 5. Use color for emphasis. You can overdo it by using too much color and then the impact is lost. 6. When you are making charts and graphs, try to orient the lettering in the same plane. Keep the charts and graphs as simple as possible (e.g., Fig. 7). 7. Color code or label the charts or graphs clearly and remember that the image should fill the slide in order to obtain maximum clarity. 8. If you are taking photographs at an operation, make sure that you have a clean, dry field. You should clean instruments and wipe them off (including your hands) before you take the photograph. But keep your hands and head out of the field. Avoid white sponges, tapes, and drapes (blue or green is better). This is especially important in making movies because white is very distracting because of its reflection of light. Use close-up techniques so that you show the audience exactly what you want them to see. 9. X rays are very effective provided they are used properly. Use only good films (Fig. 8). Line drawings, arrows for emphasis, and sometimes two slides are better than one combining some of these points. An example is a slide of a pulmonary angiogram with arrows and a line drawing to show the area on which you want your audience to focus (Fig. 9). The imposition of a pathology specimen is often an effective way of making the X ray a more useful technique (Fig. IO). D. Slide

Utilization

If you are going to use slides, I think it is preferable to use them continuously. Do

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not have the lights on and off during the presentation with the audience’s pupils enlarging and diminishing rapidly so that they really cannot follow what you are trying to tell them. Use the slides as an outline. To use slides effectively, you do not need notes because your slides will serve as your notes. Use all of the material on the slides and look at them while you are talking about them. It is very distracting to have someone read a manuscript while slides are projected. He does not know what is on the screen. You may not be able to follow what he is saying because it may not be related to the projected slides. Use approximately 1 or 1.5 slides per minute ordinarily, considering how you are going to sequence the slides in order to tell the story you are trying to tell. When necessary, duplicate a slide rather than turn the lights on and off. Explain any scale to the audience so they will know what you are trying to show them, and then explain the information that you are trying to present so that the slide and the graph make sense. A case presentation is frequently that part of a presentation done least well. Be concise; give only the pertinent information. Nobody is interested in all the negative and unimportant laboratory data. Confine a case presentation to a maximum of three minutes. With anything more than that, the audience will go to sleep. Do not have any “revelations” (i.e., the X rays revealed). Use as many slides as you need. Do not crowd six slides into a three minute talk and also’do not use one slide with all the material on it, which then cannot be read from the back of the room. The pointer is important. When the pointer is up and down and around the ceiling, the first thing you know, the audience is watching the pointer as if it were a firefly, and “pointing” loses its effect. Turn it on before you get ready to talk and know how it works, steady your hand if it is shaking and then turn it off when it is not in use. Finally, when you are getting ready to give a presentation or if you are teaching a class, an old adage states, “Tell him what you are going to tell him, tell him, and then tell him what you told him. ”

KRAFT ET AL.: ART AND LOGIC IN SCIENTIFIC COMMUNICATION

FIG.

8. The use of an X ray spot film utilizing arrows to pinpoint the lesions.

of subject matter, the components of a manuscript including introduction, materials David 6. Skinner, M.D. and methods, results, discussion, summary Experience editing the Journal of Sur- or abstract, references, tables, and illustragical Research (JSR) permits certain recom- tions, and some general comments about mendations for writing a scientific manu- writing style. I shall describe the review script and hopefully points out errors to be process which a journal such as the JSR avoided. This section will cover the selection employs once a manuscript is received and III. THE MANUSCRIPT

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FIG. 9. Use of a line drawing in parallel with the X ray to focus attention on the pathology.

present some editorial policies of this journal. Of primary importance in the preparation of a scientific manuscript is the subject matter. The first question to be addressed is whether your messageis something which yt~u honestly believe will benefit other readers. Is your material sufficiently vali-

dated to become a written record of your work by which you will be judged as a scientist and journal contributor later in your career? Published manuscripts are a permanent example of the quality of your work to all interested parties now and in the future. Many of us have submitted one or more publications prematurely, before a

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FIG. 10. The technique of on1laying the operati ve specimen on an X ray for visual effect.

technique was validated or before having obtained sufficient results to make a supportable interpretation and conclusion of the data. What to do with negative results is often a dilemma. You invest much effort in the exploration of an attractive hypothesis but find that the data indicate that the initial ,hypothesis is incorrect or that the techniques which you used are not going to be able to answer the question. These occasions are less likely if the initial planning for the research is done with great care following a careful and thoughtful review of the previous publications in the field. Most often, studies leading to negative results should not be published. Occasionally, it is justifiable to publish negative results if they are unexpected or do not agree with commonly held perceptions or with previously published reports. When this is the case, it should be so stated in the introduction to your article. Another consideration is the selection of the journal for your publication. Most jour-

nals state in the “Introduction to Authors” the purposes and the range of interest of the journals. If your manuscript does not fail within that range, it is much less likely to be accepted for publication. If your subject has previously been covered in the journal, it is likely that the editors will continue their interest in the same topic. Surgical research for example, is best defined as research which focuses upon problems encountered by surgeons rather than as research done by surgeons. Editorial boards may place a high priority on clinical investigation which is a planned experiment conducted with the informed consent of patients and designed to answer a specific clinical problem. The archival reporting of surgical experiences, clinical results, and case histories is usually considered to be of greater interest to select surgical journals. Once you have decided to prepare a manuscript, it is essential to recognize that the manuscript reflects your carefulness and thoughtfulness just as much as does the conduct of the original research. A sloppily

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prepared manuscript with many errors causes the reviewer to question and doubt the care with which your original research was done. If you are a meticulous investigator, this is reflected in the attention which you pay to the transmission of your results to others. While many styles of manuscripts are employed successfully, the following standard format for the preparation of manuscripts is widely accepted. Presentation in this form is useful to a reader as it allows him to become oriented quickly to your material and to move readily to the portions of the manuscript of major interest to him. The Introduction should be brief, certainly less than one typewritten page. It simply states in one or two sentences the issue w,hich the paper addresses. The approach which you take to clarify the issue is presented succinctly. Detailed discussion of the rationale of your experiment and its relation to previous publications is reserved for a discussion. The Materials and Methods section is critical for the reader who wishes to ascertain the experimental design and technology employed. Your methods must be stated with sufficient detail to enable the reader to determine whether the results are likely to be reliable and valid. Critical techniques upon which the results depend must be spelled out so that the reader can reproduce the experiment if he wishes. On the other hand, standard preparations and techniques do not require detailed explanation. A common error is to relate how the measurements were made. In describing a study on coronary artery flow, the phrase, “the heart was exposed through a lateral thoracotomy incision,” is sufficient. A description of the muscle layers divided, instruments employed, and the ligatures used is inappropriate. However, failure to mention the electromagnetic flow meter system used, how zero-flow baselines are determined, and how the flow meter is calibrated is a significant omission sufficient to cause rejection of your manuscript. The techniques employed for a statistical analysis of your data should be stated.

In the Results section, the findings should be limited to the positive observations and essential negative data. The reader is quickly confused and loses interest if irrelevant results are presented. Whenever possible, data should be presented in the text. Tables and illustrations should be reserved for information which does not readily lend itself to a simple explanation in words. For experiments with several parts, the order in which the Results are presented should be identical to that used in the Methods section. The same terminology should be used in both parts of the paper. The Discussion section enables you to give the reader your interpretation of the principle findings, relates the findings to those of others, and cautions the reader about overinterpretation of your results. The Discussion is best started by a brief restatement of the principle findings and your interpretation of their meaning. Next, you may wish to describe the findings in similar papers and note your concurrence or disagreement with them. It is often wise to criticize your own experimental design and point out why additional or erroneous interpretations should be avoided. Do not discuss planned experiments which you did not do. Do not extrapolate your results to situations in which your experimental design may not apply. A common mistake is the application of laboratory data to the clinical setting with no evidence to justify that translation. The Conclusion should be brief and consist only of statements which can be substantiated by the results. Numbering of the conclusion is often helpful. This section should not include speculation about the application of your results nor discuss your future planned experiments. If a Summary or Abstract is requested, this is different from the Conclusion. A brief statement of the purpose, experimental design, results, and a conclusion are presented. A summary should be similar to an abstract prepared for a critical program committee. References should be prepared in the style

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requested by the Journal in its Introduction to Authors. Failure to comply with this is a common reason for the return of a manuscript. Some journals request that the references be numbered in the sequence as they appear in the text or that they be listed alphabetically according to the last name of the principal author. This enables the reader to scan the references quickly to see whether important previous work on the subject is cited. Judgment is required in the selection of the references. Statements generally accepted to be common knowledge or fact need not cite the original reference. When you refer to a particular statement, however, or a result published previously, a reference is essential. When in doubt, it is better to cite the reference than to omit it. When numerous previous publications all make the same point, it is unnecessary to list all of them but appropriate to list the first and one or two additional publications which are particularly clear and effective. Avoid the temptation to list your entire personal publications. This alone is grounds for rejection by some reviewers. The Citation Indices, now used by some to judge the value of a publication, routinely exclude the author’s reference to his own works. Of the entire manuscript, the Reference section is the most likely part to contain typographical and other errors which go unnoticed in your proofreading. Good reviewers often check selected references to determine the care with which the manuscript was prepared. Tables should only be used when they are essential to present the data. The same guidelines which are used in preparing a slide should be used for preparing a table. Complicated slides which cannot be quickly comprehended by the reader or the viewer are worthless in an oral presentation. Similarly, detailed tables which the reader cannot quickly understand are usually ignored. A common error is to present all of the raw data from the experiment in a table. The purpose of statistics is to condense your raw data and your multiple data points into a few numbers which describe the raw data mathematically. Statistically,

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descriptions of means and differences are essential. Illustrations should not duplicate data which is presented in the text or tables. This is a common redundancy in manuscripts which are presented at meetings. Many slides used in an oral presentation are unnecessary in the published manuscript. Illustrations should be prepared by professionals and should not be handmade unless you are an expert. Units on both axes of graphs must be stated. Photographs often publish poorly and fail to show details which you may hope to present. Diagrams are often more effective. Writing style is personal but important and creates an overall impression of your work. Attention must be paid to the technical use of the English language. Verb tenses should not be changed within a sentence or a paragraph. Split infinitives are still frowned upon. Double negatives are confusing. The use of positive and negative adjectives in the same sentence is guaranteed to confuse the reader. A sentence such as, “The highest of the lowest range of values is still less than the lowest of the upper levels,” may make perfect sense to you but it is doubtful if anyone else will take the time to understand what you mean. Avoid the temptation to use numerous transition words such as thus, therefore, however, also, and hence. Sentences containing several phrases should be divided into several sentences. Nearly every manuscript has some redundancy in which two sentences in the paragraph state the same thing. It is good discipline to reword the nearly finished manuscript and eliminate unnecessary words and phrases just as you would prepare an abstract with a strict word limit. When you submit a manuscript to the Journal ofSurgical Research, for example, it receives a preliminary screening to determine suitability of subject matter and is then assigned to at least two expert reviewers. The reviewers are asked to make detailed comments with their recommendation and to return the manuscript within a week. These primary reviewers have the

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greatest influence on the eventual decision by the editors about the manuscript. If the reviewers disagree, other assessments are obtained. The Editorial Board members generally frown upon manuscripts which present negative results unless there is a strong reason for this. They reject papers which describe a method or technique without providing results which demonstrate its value. Similarly, they reject manuscripts which present results without an adequate description of the technique. They mark down manuscripts which make extravagant interpretations from limited data or manuscripts which fail to relate current experiments with previous work in the field. They may vote for rejection of a manuscript based upon unsuitability of the subject material. Ethical considerations may be of concern, especially if clinical studies are reported without describing the methods employed for obtaining informed patient consent or if the experiments are harmful to patients. For the Journal of Surgical Research, the minimum time for the submission of a manuscript until it appears in print is 4 months, 1 for the review and editing process and 3 for publishing. The manuscripts from the November meeting of the Association for Academic Surgery are usually published

between February and May. The JSR maintains a policy of returning the reviewers’ comments anonymously to the author. This policy reduces the number of poorly prepared or unsuitable manuscripts as no one enjoys receiving the caustic comments which some members of our Editorial Board are known to make from time to time. This policy also enables many authors to use the comments accompanying a rejection to write a more effective paper which may later be resubmitted and accepted for publication. Journals which follow this policy are generally considered to be “peer review” journals and maintain a higher rating in the scientific community than do journals which simply inform an author as to the acceptance or rejection of his manuscript without comment. We believe that an acceptance rate of approximately 50% for submitted manuscripts is desirable, and periodically expand the pages of the JSR to adjust to the increasing flow of manuscripts. REFERENCE 1. Kraft, A. R., Saletta, J. D., Moss, G. S., Herman, C. M., and Tompkins, R. K. A critical appraisal of the effectiveness of scientific presentations. J. Surg. Res. 20: 377, 1976.