I start this time with a word you might not expect to see
that it most likely will be mild and transient. Whatever the
here: some. I recently edited a set of 130 narratives from
case, the statement should be more precise, e.g.: You may
different authors in oncology patients, and some, as an
have mild blurred vision in the first few days after you start
adjective, was often used not incorrectly, but inappropriate-
ly for the written context of our work. This is followed bya few words about upon, much more about either, and
finally I explore the use of that innocent-looking word, nor. Either is a real all-rounder: it can be an adjective, a con-
All have one thing in common: not surprisingly, they are
junction, a pronoun, or an adverb. When using either as an
used more loosely in spoken than in written English, which
adjective, take care that it cannot be misunderstood as a
means that care is due when using them in written texts. The antiproliferative effect of the combination was com-pared to that of either monotherapy on two breast carcino-ma cell lines (EMT-6, 4T1) in a concentration range of 1 nMHe had reported some headache in the 4 weeks before theto10 µM for DRUG A and 10 nM to 100 µM for DRUG B.
This sentence is complicated by the fact that the effects of
According to the patient, she had had some pain in the leg
each drug as monotherapy were compared with those of the
before she was admitted to the emergency room.
combination, but the effects of the individual drugs werenot compared with each other. Maybe you were lucky and
She had had some diarrhoea after starting drug X and took
read either as an adjective and therefore didn’t feel lost at
OTC loperamide without consulting her doctor.
the end of the sentence. If you read it as a conjunction,
“What is wrong with these?” you ask. Nothing is ‘wrong’
expecting an alternative introduced by or after the clause
with them; but you can literally hear the patient speaking
following either, then you will have been lost at the end of
here, and this illustrates very well that some used as an
the sentence and had to backtrack. It is our business to
adjective in this way is a constant feature of spoken
know when we might make readers backtrack, and avoid it
English, but that when you write it, the meaning is impre-
where we can. With the same word order, this could have
cise. The general feeling when speaking is that some used
been avoided here by saying each or the individual drugs
in this way means that the symptom was not severe,
occurred infrequently or was transient. But what does some
You might also consider changing the word order: The
really mean in these examples? A few episodes of
antiproliferative effect of the combination on two breast
headache, or just slight continuous headache? Intermittent
carcinoma cell lines (EMT-6, 4T1) in a concentration
pain, or just a dull ache, or a few episodes of shooting
range of 1 nM to10 µM for DRUG A and 10 nM to 100 µM
pain? Continuous diarrhoea for 2 days or isolated episodes
for DRUG B was compared to that of either monotherapy.
over an extended period? Often when writing narratives,you don’t know. Had the word some plus the symptom
With this word order, it is much less likely that either
been enclosed in inverted commas in these examples, it
would be read as a conjunction, but, for me, the ‘basic’ sub-
would have been clear that the patient (or investigator, i.e.
ject (The antiproliferative effect) is too far away from the
CIOMS form) was being quoted and signals to the reader
verb (was compared). The actual ‘compound’ subject in
that ‘We have only this information and cannot supply any-
this sentence is enormous. It stretches from The antiprolif-erative effect to DRUG B because the information on thecell lines and the concentration range are positioned before
Quote from a patient leaflet: You may have some blurred
the verb. So the problem with either may have been solved,
vision for a short period after you start taking drug X.
but the sentence itself has not been improved. I am still not
What is this supposed to tell the patient? The culprit here is
keen on either because what is really meant is both, so
not only some: what is a short period? Several hours, several
would probably prefer both individual treatments. I am not
days? The intention is obvious: not to alarm the patient by
yet at the stage where I feel comfortable with monotherapy
suggesting with some that blurred vision may occur, and
The Journal of the European Medical Writers Association
> > > Four letter words and others
In the following example, either is used as a conjunction
together with its frequent conjunction partner or, indicating
I have yet to find an instance where the preposition upon,
a choice between alternatives: The Territory Managers will
frequently used when speaking, cannot satisfactorily be
return the specified items to CPG, or to Head Office, with
replaced with on when writing in our context. Upon does
the appropriate forms, clearly marked either for reworking
not sound ‘better’ than on. It is acceptable if it forms part
of a collocation, e.g. ‘to put upon’ (I don’t want to put uponyou, but …[=I don’t want to cause you unnecessary effort,
Purists would say here that you should say for either
but…]), ‘Once upon a time …’, ‘The holiday season is
reworking or destruction, or, if you want to have either
almost upon us’, but in almost all cases such collocations
before for, then for has to be repeated before destruction.
are used only when speaking or in non-scientific writing.
This is because they consider that the entire phrase forreworking or destruction is governed by the either as a sin-
gle element and claim that a further possibility is required,
Nor is a conjunction and is therefore a linking word. I was
otherwise the sentence is incomplete: … clearly marked
recently asked whether nor is dropping out of common use
either for reworking or destruction, or for filing in the central
in English. My questioner had noticed that when ‘native
archive. For me, the original sentence would only be misun-
speakers’ used neither they ‘usually’ followed it ‘these
derstood or held to be incomplete by a bad-willed reader, and
days’ with or. I have noticed this too, but would not say
I don’t waste time correcting this sort of very marginally
that it is ‘usual’, and it happens mainly when people are
incorrect positioning of either as a conjunction, unless I think
speaking. Either…or…, neither… nor… was what we
it will lead to confusion, which not often the case.
learned at school, and this still holds true for writing. Here
A further example of this is: After treatment of the animalseither with DRUG A or DRUG B as described above, theyNeither Method 1 or Method 2 was chosen; we selectedreceived 5–bromo-2-deoxyuridine (BrdU) after the lasttreatment to label mitotic endothelial cells.
This should clearly be: Neither Method 1 nor Method 2
Again, some might insist on … of the animals with eitherwas chosen; we selected Method 3 because …. And I make
DRUG A or DRUG B. At the risk of sounding to lax, I no
Nor without neither is a useful linking word, as in the
An interesting conjunctional use of either in the sense of
examples for either above and the following:
‘not any more than the other’ is positioning it at the end of
… and there was no evidence of accumulation in plasma,
a sentence as a linking word: Clearance of DRUG X wasnor was there evidence for accumulation of the vehicle.rapid and there was no evidence of accumulation in plas-ma; although clearance of the vehicle was much slower,The physician admitted that he had failed to measure thethere was no evidence for accumulation in plasma either. blood pressure according to protocol, nor had he docu-mented the ejection fraction correctly.
This is the sort of sentence you will hear every day. I stressthe word ‘hear’, because this is a good example of a cor-
Note: When nor is used in the above way, the subject and
rect formulation that you would not normally write in sci-
verb are always inverted (a rarity: a 100% rule in English).
entific texts because it sounds too ‘spoken’. In conversa-
Caution with nor: it can sound poetic or formal because of
tion, you might say We didn’t find any impurities in the
the subject-verb inversion and because it can help in pre-
sample, and your conversation partner might answer No,
senting an idea in a compact phrase, a device often used in
we didn’t find any either (or Neither or nor did we, of
literature. Its perhaps most illustrious use in English is in
course). What is the solution if you want to express the
the Rime of the Ancient Mariner by Samuel Taylor
same idea in writing so it doesn’t sound spoken? Here are
two possibilities, but there are certainly more. … although clearance of the vehicle was much slower,there was also no evidence for accumulation in plasma, or
Clearance of DRUG X was rapid and there was no evi-dence of accumulation in plasma, nor was there evidence
(often misquoted as: But or And not a drop to drink)
for accumulation of the vehicle, although it was clearedmuch more slowly.
The necessary inversion of the verb and subject after norwithout neither is not a common device in English (the
Example of either used as a pronoun: Clean the slides
most frequent use is in conditional phrases such as ‘Had wethoroughly with fresh water or alcohol; either is suitable. selected the nonparametric model, we would have …, Were
When used as an adverb, there is clear overlap with its we to opt for a twice-daily regimen, we might…). This can
conjunctional use: Either reuse the slides after thorough
lead to text sounding a little too ‘literary’: A markedcleaning with alcohol or discard them.increase in AUC was not seen, nor was expected. The Journal of the European Medical Writers Association
This compact formulation is acceptable and grammatically
C) Neither the study nurse nor the study physician was present
correct, but some authors prefer to avoid this type of for-
D) Neither the study nurses nor the study physicians were present.
mulation in scientific texts. e.g.: A marked increase in AUC
I must add, however, that when speaking, many people
was not seen, and (this) was not expected, or A markedincrease in AUC was not expected and was not seen, or the
(including me, as I am unfortunately not consistent
very compact A marked increase in AUC was neither
here) spontaneously use ‘were’ for examples B and C,
because the feeling is that the subject of the verb is a
The number of the verb after nor coupled with neither
depends on the number of the subject nearer to the verb:
A) Neither the study physician nor the study nurses were presentAlistair Reeves B) Neither the study nurses nor the study physician was present.Ascribe Medical Writing and Translation
If both nouns are singular, the verb is in the singular; if
both nouns are plural, the verb is in the plural:
How to shorten text—we oweit to our readers
A little thought can relieve the reader of a great deal of
Then you start to think: but what are these two para- graphs actually telling me? They are telling me: ‘We did this and saw nothing’. Obviously the text cannot be Observation of neurobehavioural variables, automated
reduced to this, but it can be reduced by two-thirds and
motor activity (CNS) and assessment of the respiratoryfunction were performed in male rats at <NameX> dosesof 0.5 mg, 1.0 mg and 2.0 mg/kg b.w. lipid-complexedNeurobehavioural variables, automated motor activity<drug>. The CNS variables were measured 5 min, 6 hrsand respiratory function were assessed in male rats atand 24 hrs post-dosing, whereas the respiratory measure-<NameX> doses of 0.5, 1.0 and 2.0 mg/kg b.w. lipid-com-ments were done 5 min, 15 min, 30 min, 60 min and 150plexed <drug>. CNS variables were measured 5 min, and6 and 24 h after dosing, and respiratory function 5, 15,No effects were observed in any of the neurobehavioural30, 60 and 150 min after dosing. No effects werevariables measured after the treatment with <NameX> atany of the dose levels and time points tested. Likewise noeffects of <NameX> treatment, neither as a main treat-ment effect nor as an interaction with the time were
Removing the active linking voice by putting the
observed demonstrating that the breathing activity, the
action in the sentence into a verb, in this case: ‘were
tidal volume and the ventilatory flow were not affected at
assessed’ instead of ‘Observation of … and assess-
any of the dose levels and time points tested.
ment of … were performed’, and choosing a new sub-ject, in this case, the variables that were determined.
The first reaction is to make the following changes
Taking out the confusing conjunction ‘whereas’: this
Delete the unnecessary abbreviation ‘CNS’ in the
is too strong a linking word for this situation.
first sentence (It had been used before in the text to
‘Whereas’ implies a degree of unexpectedness or
denote ‘neurobehavioural variables’ and ‘automated
‘unusualness’, or that something special has to be
taken into consideration. This is not the case here:
Use ‘h’ instead of ‘hrs’ as the abbreviation for
all the author wanted was to list the measuring times
‘hours’ (‘hrs’ is not the scientific abbreviation, and
for different sets of variables, and the times for each
units are never used in the plural).
happen to be different, which is not surprising. This
Remove inappropriate definite articles, e.g. before
‘respiratory function’ in the first paragraph and
And, as you see, the second paragraph can be reduced
‘time’ in the second paragraph (controversial).
from 72 words to 4, because the message you want to
Substitute ‘after dosing’ for ‘post-dosing’ (jargon).
leave with the reader is: No effects were observed.
Change ‘neither’ and ‘nor’ to ‘either’ and ‘or’ in thesecond paragraph (double negative because it says
Alistair Reeves
‘no effects’ earlier in the sentence). The Journal of the European Medical Writers Association
Sensibilité d' Escherichia coli aux quinolones et aux céphalosporines de troisième génération dans les infections urinaires communautaires : étude AFORCOPI-BIO RICAI 2012 De Mouy D, Janvier F, Mérens A, Arzouni J-P, Bouilloux J-P, Dinnat-Courtiols N, Dubouix-Bourandy A, Fabre R, Gontier P, Grillet N, Noël C, Payro G, Pfeffer J ,Thierry J. Introduction
The US Food and Drug Administration (FDA) has approved labeling changes to the entire statin class . These clarifications include but are not limited to: • Use may be associated with hyperglycemia and elevated A1c; • Use may be associated with the potential for cognitive adverse effects; • Periodic monitoring of liver function tests is no longer required. Lovastatin labeling was revised to