Manuscript best practices: Takeaways from a community conversation
Authors: Carmen Chak-Lui Wong, Elliot B. Tapper, Harmeet Malhi, Gregory J. Gores
Journal: Hepatology (2024)

At The Liver Meeting® 2023, the editors of Hepatology and Hepatology Communications held a community conversation with the goal of demystifying the journals for trainees and imparting key best practices. While this is not a treatise on scientific writing, the key take-home points are summarized here. OPTIMIZING THE MANUSCRIPT: READABILITY AND SEARCH ENGINES Language and structure are key to optimizing a manuscript for readability. Keywords and metadata help optimize discoverability in scientific search engines. Language and structure The bedrock of scientific writing in English is language and structure. A few best practices can elevate a manuscript from average and confusing to excellent and easy-to-read. Let's start with the title. The title should be declarative and clearly state the main idea of the manuscript. It is good practice to avoid acronyms in titles and to avoid catchy titles, both of which may decrease the search engine discoverability of the manuscript. For example, the title: Report of an Artificial Intelligence Novel Tool to Predict Hepatocellular Carcinoma in at-risk MASH patients with Stage 3 Fibrosis, while sufficiently declarative, should not be abbreviated as RAIN. A PubMed search for "RAIN" at the time of writing this manuscript yielded 22,744 results. The manuscript and the abstract should follow the general structure outlined by the journal in its instructions to authors. A common mistake is approaching the abstract as an afterthought. The abstract should be carefully crafted to hook readers and thus clearly identify the key gap, key methods, and key findings of the study. The manuscript should be crafted with simple words, short sentences, precision, consistent tense, and correct syntax, grammar, and punctuation. Pay attention to details such as using the International System of Units, symbols, and nomenclature. Frontload a sentence with meaning to avoid keeping the reader guessing. Authors may use human or artificial intelligence resources to help prepare the manuscript; however, the ultimate responsibility for the content rests with the authors and it is best practice to disclose the use of such services in the methods or acknowledgments section of the paper. The use of resources for plagiarism prevention and inadvertent image duplication is encouraged, and these are offered by many academic institutions. Metadata and keywords Search engines rely on manuscript data, metadata, and keywords to discover relevant content. Medical subject headings (MeSH) are standardized words from a repository of MeSH terms that describe the subject of a manuscript and make it discoverable regardless of the words chosen by the authors. Indexers at the National Library of Medicine manually assign MeSH terms for indexing articles in Pubmed and Medline. When submitting manuscripts, it is recommended that MeSH terms be used as keywords. The MeSH vocabulary is updated annually and can be found at www.ncbi.nlm.nih.gov/mesh. Keywords may also be selected using a word cloud to select the most frequently occurring words in a manuscript. Other search engines use manuscript metadata in their search algorithms. Therefore, include all the details you can about rank, academic affiliation, business address, and contact information that is requested at the time of manuscript submission. Lastly, the use of a persistent digital identifier improves the specificity of search results. A commonly used option is ORCiD which can be obtained through www.orcid.org and included in the metadata at the time of manuscript submission. STANDING OUT Three key components that make your manuscript stand out are topic, organization, and methodology. Choosing a great topic, organizing your work effectively with a clear presentation of information, and the appropriate use of methodology will enhance the impact of your manuscript. Topic When choosing a topic, consider the scientific novelty and clinical relevance of the work. It is important to study areas that have the potential to make meaningful contributions to the field and have direct implications for scientific advancement and clinical practice. In addition, a great research topic is most likely time-bound. Tissue-based studies relying on omics technologies serve as an excellent example. The impact of publishing transcriptomic data on human liver cancer tissues was likely higher a decade ago, when RNA sequencing began to gain popularity, compared to now due to the increased sharing and utilization of public databases. To ensure that your work captivates researchers, it is important to understand the current knowledge and identify any gaps in the literature so that you can be prepared to push the knowledge frontiers when the relevant reagents, samples, and tools are ready. Organization Organizing your thoughts and putting the data and interpretation together is crucial. A well-organized work should have a clear, concise, and logical flow of information. The abstract of your manuscript is particularly important, as it determines whether a reader will invest the time to read your article. In the new era of rapid information growth, authors are encouraged to utilize visual abstracts as tools to capture readers' attention and enhance their memory retention. This could increase the likelihood of the work being widely read and cited. In the introduction, provide sufficient information to help readers understand the significance of your work and the experimental design. The results should have tidy, well-arranged, and attractive figures, supported by proper statistical analysis. To maintain a coherent logical flow, it is imperative to establish strong connections between each piece of data and avoid jumping logic. For example, if you are studying gene A in liver diseases and want to establish a connection with another gene or pathway, make sure you have strong literature or experimental evidence to support the transition. In the discussion section, do not simply duplicate the introduction. Instead, emphasize original interpretation and highlight how the new knowledge can be integrated into the existing knowledge. Methodology Incorporating appropriate as well as new technologies is advantageous. As omics technologies are burgeoning, it is best to validate the omics data with independent experiments to ensure accuracy and reproducibility. Having a reasonable sample size and an adequate number of data points helps increase the statistical power of the analysis and improves the reliability of the findings. Notably, relying solely on high-technology tools does not guarantee success in publication. An illustration of this is single-cell RNA sequencing, which remains a groundbreaking technology that offers profound insights into the cellular heterogeneity and cell-cell dynamics within diseased tissues. However, single-cell RNA sequencing data without biological interpretations and validations are often considered overly descriptive. For example, when a novel cluster of cells is identified, supporting the observation with functional studies is highly compelling. Complementary approaches such as protein-based studies like flow cytometry or immunofluorescent staining to confirm the presence of the newly identified clusters would also be convincing. Cross-validation with other omics data will also increase the credibility of single-cell RNA sequencing. In addition, depositing omics data at public repositories is highly beneficial to the scientific community, allowing other researchers to access and build upon your work, thereby increasing the impact and influence of the study. POST-PUBLICATION IMPACT The impact of one's work is proportional to the awareness of one's manuscript among key stakeholders in the subject matter. There are 3 key factors that can increase impact: discoverability, socialization, and sociability. Discoverability Authors must carefully optimize elements of the paper to maximize the opportunity for their work to appear in searches by readers. The title and keywords should be selected for discoverability. Titles should use common verbiage and offer a clear, declarative statement encompassing the population studied, methods employed, and central findings. Keywords should be broad categories and must be distinct from those in the title to maximize the number of searches in which the paper would appear. For example, "viral hepatitis" instead of "hepatitis B." Socialization An author is the paper's greatest advocate. There are a number of ways that an author can broaden exposure to the work by "socializing" it in multiple venues. Delivering lectures—for example, grand rounds, CME, presentations at The Liver Meeting®, and AASLD Special Interest Group (SIG) webinars—and writing review articles to highlight the implications of the work are conventional platforms for increasing impact. The AASLD-endorsed Liver Fellow Network has successfully promoted new research through trainee-led summaries that are warehoused on an open-access website and disseminated through social media channels. Sharing one's work on social media is now a standard approach. The specific venue where the impact is highest may change over time and depend on the intended audience. To reach patients or the lay public, the best venues are likely Facebook and Instagram; to reach academics and professionals, for now, the most effective platforms are Twitter (X) and LinkedIn. Finally, and particularly for work with policy or public health implications, op-eds or summaries in online or paper outlets (ie, STATNews, Healio, GI, and Hepatology News) should be considered. Sociability The impact of outreach mechanisms depends on their framing and design. People are more likely to read about a study if the notice includes an attractive figure. On social media platforms, any attached figure will increase attention but there is some evidence that a structured description of the study in a graphical abstract can improve engagement. An additional strategy to increase engagement on Twitter (X) is to author a "thread" or multiple-connected posts thereby occupying a larger space on the viewer's timeline and providing more information to interested readers. Beyond the format, the content affects impact. In contrast to scientific prose, writing for post-publication impact should connect readers to the humans behind the manuscript, their motivations, and hopes for the work. In a randomized trial, social media posts featuring the authors behind the work and their reasons for undertaking the study were associated with significantly higher and deeper levels of engagement (paper downloads) than standard graphical abstracts.1 CONCLUSIONS All of these suggestions serve as a vehicle to package and disseminate the significance, novelty, robustness, and relevance of an author's work. This deliberate approach to writing and presentation can maximize the impact of one's quality work.