Writing Effective Scientific Abstracts: Tips and Guidelines

1. Getting YOUR Message Out…. • Tips for • Writing a Scientific Abstract • Drafting Your Manuscript • Taking Your Show on the Road M. Evinger, Ph.D. Sept. 27, 2017

2. Why it’s essential to spend timeTHINKING, PLANNING, EDITING your abstract Writing a Scientific Abstract They’re SHORT but they’re very IMPORTANT – for Meetings AND for Publications YOUR ABSTRACT is The only part of your study that is actually published for conference proceedings (before you write The Manuscript) What Referees/ Reviewers see in deciding whether your study gets presented at the conference What other attendees (including potential program directors & employers) see when they search the Proceedings & list of Key Words

3. The fact is…… Leafing through a Program or a Journal, What do YOU look at? TITLES ABSTRACT (If interested, then Intro, maybe Discussion_ For most folks – including Conference Organizers and Journal Executive Editors- A PAPER DOESN’T EXIST BEYOND ITS ABSTRACT • Your ABSTRACT sets the tone • Must be sufficiently representative to read as a Stand-alone • Should contain Information Content – detailed but within limits • Precision writingis essential – what’s needed and what’s not • Should ‘sell the point’ of the study – but not be biased

4. Where are you submitting? Is this a General Interest meeting? vs. Highly Specialized Sub-Specialty Who are your audience? Physicians Scientists Other Medical Professionals Lay Audience (Including Patients, Advocates, Charitable Organizations) Administrative, Policy Makers You must adjust your level of detail and your approach to be appropriate for your audience.

5. What type of study are you presenting? General format may vary Clinical Study Basic Research QA/ QI Case Report Literature Review Educational Conferences may provide format guidelines for specific types of studies. Follow the most effective format for YOUR type of study

6. The Preliminaries What General Format is required for your Society’s Abstract? “Free Flowing” Up to the authors – No style Can be a sizeable word count Word Count Paragraph Frequently 200- 250 words for large proceedings Structured Defined Sections – Some with word counts Standard Specialized Figures (Not) Allowed Pointers to keep in mind Know the Society/ Journal Know the submission and formatting guidelines

7. Addressing the Major Elements in Your Abstract • 1-2 introduction sentences that explain topic, purpose, and research question(s). • 1-2 sentences outlining your research methods (this may also include the type of data analysis you used). • 1-2 sentences describing the results / findings. • 1-2 sentences containing your conclusions and recommendations.

8. INTRODUCTIONto your concept Keeping in mind that the Abstract Is a SYNOPSIS of your study…. Most well-constructed abstracts contain a single simple sentence beginning with “Here we show…” or a phrase with similar meaning. This is a landmark for the reader, indicating that this particular sentence has special significance. Placement of this sentence can vary; it can come at the beginning, middle (generally where you find it in most manuscripts) or end of the abstract.

9. Let’s work through a brief example “Taken together, these results represent the first demonstration of silencing of a metabolic gene central to pathogenesis by aberrant DNA methylation, offering a possible explanation for the less malignant phenotype of XX cells relative to YY-dependent cells.”  Problems: Too long  Reader fatigue / confusion Not direct Version 2…. “Our results demonstrate silencing of a metabolic gene central to pathogenesis by aberrant DNA methylation, offering a possible explanation for the less malignant growth phenotype of XX cells relative to YY-dependent cells.”  Better - More direct – Sets stage for reader to understand main point of the article.  However…. Still cluttered with too much information -> Need to make info available in smaller bites

10. Version 3“Our results demonstrate the silencing of a metabolic gene by aberrant DNA methylation during pathogenesis. This finding offers a possible molecular explanationfor the less malignant phenotype of XX cells relative to YY-dependent cells.”  Clearer content – However, we still need to show connection between sentences. One more time… Version 4 “Here we provide the first direct link between metabolic gene silencing by aberrant DNA methylation and pathogenesis. Importantly, these findings offer a possible molecular explanation for the less malignant phenotype of XX cells relative to YY-dependent cells.” Has Significance Content Connection -> ANCHORS the reader to start understanding the study.

11. NOW ….. Let’s Expand and Include Manuscripts As Well…… EACH JOURNAL HAS ITS OWN SCOPE AND FORMATTING GUIDELINES • Instructions to Authors for the three main Pediatric Journals can be found at: • Journal of Pediatrics: • http://www.jpeds.com/content/authorinfo • Pediatrics: • http://mchelp.manuscriptcentral.com/gethelpnow/tutorials/author.pdf • Pediatric Research: • http://www.nature.com/pr/for_authors.html

12. From Dr. Lewis First (Editor in Chief, Pediatrics) What Makes a Good (to Great) Article? Subject matter should • Deal with important topic (or author should convince us of such) • Appeal to general pediatric audience or at least more than one subspecialty • Add something new and not be redundant • Beof interest to both clinicians and scientists (although this is more easily said than done) • Not be better suited for a subspecialty journal • Article should be well-written • Statistics should be appropriately used and sample size is adequate and representative • “Hierarchy of Evidence” reigns with RCTs and systematic reviews of RCTs at the top and descriptive survey data (observational studies) near the bottom (but not always)

13. Title‘Catches the eye’ - Needs to be accurate description of the study BUT – Also needs to come across as interesting If possible, avoid The Effect of…. Characteristics of … Evaluation of … Review of…. Avoid too much description in the title: Intra-nasal Lipopolysaccharide (LPS) Alters Lung Cellular Differentiation (CD)14 and Toll-Like Receptor (TLR) 2 Levels in Three- Week Old Rats Exposed to Birth Hyperoxia without Affecting CD4 and CD8 Positive T Cells or TLR 4 Levels

14. A few examples…. Effective Titles for Clinical Study Abstracts “Predicting Endotracheal Tube Insertion Depths in Neonates” “Can Tracheal Colonization Predict Severity of Bronchopulmonary Dysplasia in Very Low Birthweight Neonates?” “Is There A Correlation Between Self-Reported Third Hand Smoke Exposure and Asthma Exacerbation Severity?”

15. Effective Titles for Basic Research Abstracts • A Eukaryotic-Specific Transmembrane Segment Carries Out Distinct Roles in AMPA and NMDA Receptor Function • Okay…. • The Effect of Food Additives and Bacterial Antigens on Intestinal Epithelial Cells • But Better….. • Bacterial Antigens and Food Additives Alter Membrane Integrity and Induce Intestinal Inflammation in vitro • Still Improving… • The Food Additive Potassium Bromate inhibits Cell Cycle Progression and Induces Cell Death in Intestinal Epithelial Cells • Okay… • Acute Effects of Hyperoxia on Gene Expression in Lipopolysaccharide-Treated Newborn Rat Lung • Better • Brief Exposure to Hyperoxia Suppresses Surfactant Proteins in Lungs of Lipopolysaccharide Exposed Newborn Rats

16. Effective Titles for Case Studies Case Reports Keeping it light- Netti Pot, Netti Not: Thromboembolitic Phenomenon in a Patient Linked to Chronic Netti Pot Use Magnets Attract Trouble in Teen • Combined Supravalvar and Valvar Aortic Stenosis in a Neonate with Familial Noonan Syndrome • Opioid-Induced Hyponatremia in a Patient with Central Diabetes Insipidus: Independence from ADH

17. Authors Applies to Abstracts and Manuscripts Should reflect Relative Contribution – First Author has contributed most to the study Senior Author is Last Position May depend upon ‘contract’ with Mentor What about Authors who do not actively participate in study – but do make a contribution ? What to do about ‘Gratuitous Authorships’ GUIDELINES ONLY ----- Have an agreement with your MENTOR

18. Author Criteria for Pediatrics—Individual Authors Must Meet All 4 • Substantial contribution to conception & design. Also acquisition of, analysis or interpretation of data • Drafting the article or critical revision of draft • Approving final version for publication • Agree to be accountable for all aspects of the work. Insuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Adapted from L. First (Editor, Pediatrics) Presentation on 9/21/16.

19. Background Abstracts and Manuscripts • What is known about the subject • What is NOT known about the subject – How you will fill that gap: ‘This study seeks to present….’ • Factoids that ‘build your case’ • Usually 2-3 sentences (but occasionally more for complex subject)

20. For Pediatrics Journals and Meetings- Advice: Open with a statement about implications for (children’s) health/ development From Pediatrics (September, 2016): • Postpartum infections remain a leading cause of neonatal morbidity and mortality worldwide. • A high percentage of these infections may stem from bacterial colonization of the umbilicus, because cord care practices vary in reflection of cultural traditions within communities and health care practices globally. • After birth, the devitalized umbilical cord often proves to be an ideal substrate for bacterial growth and also provides direct access to the bloodstream of the neonate.

21. Methods(Materials and Methods) • Enough info for reader to understand • What was done • How it was done • For a clinical study- • Research design(prospective study, retrospective chart review) • Clinical diagnosis of patients recruited for study? • If relevant, what was Setting of study (in patient vs. ambulatory out patient) • Samplingof patients (random, assigned to groups by criteria) • Sample size of whole group vs. subgroups (if variable sizes) • Treatment of patients (dosages and durations) • Research instruments used to evaluate patients (lab results , standardized surveys) • What was the Primary Outcome measure??? • Any secondary measures discussed?

22. RESULTS • Most important portion • Accuracy of info is critical • Should contain as much detail as the word count permits Results – Clinical Study Abstract • Number of patients completing study • Drop out rates in different study groups, esp. related to Adverse Events in treatment groups • Resultsof analyses of the primary objectives – in words plus P values in parentheses • Analyses of more important secondary objective – word description + P value • Numerical infoabout these analyses, e.g. means +SD, response/remission rates • If possible, effect sizes, relative risks, numbers needed to treat + stats with Confidence Intervals for each • (Data on important Adverse Events)

23. Here’s an example of well-documented Results

24. Results – Basic Science Abstract • Strive for greatest information content AND precis writing • Present data with hard numberswhenever possible • Include statistical analyses, sample sizes (n), statistical significance • Build a case with your data – all should proceed in a logical progression from your hypothesis • Keep description in active voice • Provide interpretations but avoid drawing conclusions

25. Conclusions • This is the take-home message of your study • Primary Outcomeis usually the finding highlighted in this section • Additional findings of importance also mentioned • The Perspective • Customary to express opinion about theoretical/ practical implications or • IMPORTANCE TO THE FIELD • Keep in mind This section has greatest impact on readers. Therefore important to be scrupulously honest in interpretation. Do not draw implications not justified by the data.

26. Wrap-Up for AbstractSubmission AFTER you have a draft of your manuscript, Take time to • Read your abstract all the way through: • Add transition words to tie ideas together, • Eliminate unnecessary content • Add in anything that might be missing, • Correct errors in mechanics and • Proofread

27. ForManuscripts-Dr. Lewis First Recommends: • Follow the journal instructions! Tailor Ms to journal’s mission and scope • Cover letter –strongly recommended! Straightforward 1–2 sentence overview of your study and its key findings. • Do not copy from Abstract – Write like an Author’s Summary statement – shorter and less formal. • Explain how your manuscript fits the mission and scope of the journal. • Abstract – single most important page, know the format • Speak with editor(s) first • Practice Quality Control - (to ‘inspire good will’ with editors and reviewers) • Proofread • Use Active Voice • Avoid ‘wordiness’ • Format figures and captions correctly • Insure Citations and References are accurate Adapted from L. First Presentation 9/21/16 and N. Blow (Ed., Biotechniques“Manuscript Tips—Top 10 Submission Tips 8/22/14)

28. Let’s take a look at a practical example …. One of your colleagues has just completed a draft of a manuscript Here’s her take on how her research experience evolved AND What’s REALLY INVOLVED in putting ‘pen to paper’ Actually writing a manuscript- Getting your feet wet

29. From start

30. To Finish

31. If You’ve Been Thinking about Taking Your Show on the Road…. In addition to professional clinical and academic meetings, you may find yourself applying for: Foundation or Organizational Grants to fund your study American Academy of Pediatrics American Pediatrics Association Thrasher Research Foundation – Early Career Awards Rheumatology Research Foundation Radiological Society of North America Competitions to Showcase Your Research Nassau Pediatric Society Harvey Aiges Residents Research Night NY Academy of Medicine Pediatric Trainee Night Workshops to Advance Your Career Mead Johnson “Striving for Excellence in Research and Critical Thinking: A Symposium for Pediatric Residents Letters of Intent Abstracts Platform Presentations Program Applications

32. Letter of Intent Work in Progress…. PROBLEM, BACKGROUND AND SIGNIFICANCE: Approximately 30% of children in the United States are overweight/obese leading to a public health epidemic.[1] Pediatric obesity is linked to numerous acute and chronic health conditions including cardiovascular disease, diabetes, cancers, hypertension, and significant increase in all-cause mortality.[2, 3] Diet and exercise decrease the risk of obesity.[4] However, only 27% of children perform the recommended 60 minutes of daily exercise. [5] The American Academy of Pediatrics endorses that pediatricians assist children and their families with lifestyle modification such as diet and exercise to improve the physical, cognitive and mental state of children.[4] Fit Kids for Life (FKFL) is a 10 week lifestyle modification program developed and offered by Stony Brook Children’s since 1998 which incorporates nutritional guidance, wellness and a supervised exercise regimen for obese children in our community. Efficacy of pediatric obesity interventions is equivocal with many studies noting high attrition rates and poor long term adherence.[6-8] Factors that contribute to high attrition include: difficulty of exercise, repetitiveness/boredom from exercise routine or that weight loss was not visible. [6] Therefore, it is important to develop a novel, time efficient modality that will motivate, captivate and promote exercise and healthy nutrition for children to help reduce rates of pediatric obesity. Ideal intensity and duration of exercise programs for effective weight loss and improved health in pediatric populations is unclear.[6] Most pediatric obesity programs, including FKFL, have utilized moderate intensity training (MIT) which consists of exercise in 60 minute circuits.[6, 7] High intensity interval training programs (HIIT) have emerged and are effective at reducing weight and cardiovascular risk markers in adults.[9] Less is known about the role of HIIT in the overweight/obese pediatric population. Early studies suggest that HIIT may have improved health benefits for children and adolescents. [10] Compared to MIT, HIIT programs employ short bursts of near maximal exercise intensity (HR ≥75% HR max) followed by brief rest periods and have a shorter duration (generally 30-45 minutes). [10] HIIT programs have been found to be attractive to children and adolescents for several reasons including: 1) HIIT more closely mimics typical movements of children - short bouts (< 15 seconds) and high intensity, 2) HIIT can be delivered in a shorter timeframe, and 3) HIIT paradigms are more like playing a game which may decrease boredom, increase enjoyment and promote higher adherence.[11-13] Currently used outcome measures in pediatric obesity studies (such as height, weight, waist to hip ratio, Body mass Index [BMI], heart rate [HR] and blood pressure [BP]) may not be ideal. For example, BMI is influenced by linear growth and ineffective at quantifying body composition; waist circumference, while promoted by the WHO as a valid predictor of cardiovascular disease, is fraught with measurement reliability issues; and vascular health may not be reflected by BP and HR changes alone. Three dimensional (3D) body imaging is a new technique which may offer greater reliability in measuring body circumferences and inferring body composition. In addition, bio-electrical impedance has shown to evaluate fat content and muscle mass fairly accurately. In terms of cardiovascular health, brachial artery flow-mediated dilatation (FMD) is a safe, non-invasive technique which correlates strongly with coronary endothelial function and predicts cardiovascular disease.[14, 15] In the adult literature, FMD has revealed improved vascular health following exercise and diet, even in the absence of weight loss. Therefore, FMD may be a strong indicator of cardiovascular improvement following the FKFL program, and this outcome may reflect program success despite lack of change in anthropometric measures. Studies show improved vascular health (FMD) in adults even when body composition and weight have not changed, thus FMD may potentially be a more sensitive measure of exercise (and overall program) effect.[15] SPECIFIC AIMS: Specific Aim 1: To determine if high intensity interval training (HIIT) is a better alternative to moderate intensity training (MIT) for improvements in a) BMI and weight loss, b) body composition by a novel 3D body scanning method and bioelectric impedance and and, c) cardiovascular health measured by FMD and heart rate variability in children and adolescents who are overweight and obese. Specific Aim 2a: To determine if children/adolescents who complete HIIT program have better attendance and long term adherence to lifestyle changes compared to the MIT group. Specific Aim 2b: To determine if children in the HIIT program report higher enjoyment and satisfaction compared to the MIT group. HYPOTHESES: Hypothesis 1: Children who complete the FKFL HIIT protocol will have greater improvements in CV health (as measured by BMI, body composition, vital signs, and FMD) as compared Commented [1]: I would remove this line. BIA is not that accurate , and the sentence is confusing. If you want to leave it, then you need to ref it... and the ref on BIA show that it is not great for children The effect of high intensity interval training versus moderate intensity training on anthropometric and cardiovascular health in children who are overweight or obese: A pilot study. PI Name: Ashwin Agrawal, DO, MA Stony Brook Children’s Hospital HSC T-11, Room 040 Stony Brook, NY 11794-8111 631-358-6106 ashwin.agrawal@stonybrookmedicine.edu Funding Path Academic Pediatric Association Resident Investigator (RIA) Primary Mentor Name Peter Morelli, MD, FACC peter.morelli@stonybrookmedice.edu Residency Program Director Name Robyn Blair, MD robyn.blair@stonybrookmedicine.edu Department Chair Name Margaret McGovern, MD margaret.mcgovern@stonybrookmedicine.edu Participation Statement If funded, I agree to participate in any conference calls and/or in-person grantee meetings

33. Polished and Ready to Go STUDY TIMELINE: Anticipated Outcomes and Relevance: It is expected that this study will help identify an exercise format that is more enjoyable and effective for overweight/obese children. This is very important for our community as well as communities across the nation. Pediatricians and health professions require further guidance on how to create effective weight management programs so that the epidemic of pediatric obesity can be decreased and our study hopes to identify an exercise program that will be more effective and fun.. This study will also help ascertain reliable measures of body composition and cardiovascular healthy which may validated programs like FKFL and may also: 1)demonstrate to physicians and families that lifestyle changes improve overall vascular health even if body composition improvements are negligible, and 2) prove that HIIT is a better exercise modality to offer and show that. This pilot data will inform the methodology for a planned larger, multi-site study and a grant application to the American Heart Association. References 1. Ogden, C.C., M. Fryar, C. and Flegal, K. , Prevalence of obesity among adults and youth: United States, 2011-2014. NCHS data brief, no 219. National Center for Health Statistics 2015. 2. Daniels, S.R., The consequences of childhood overweight and obesity. Future Child, 2006. 16(1): p. 47-67. 3. Daniels, S.R., Complications of obesity in children and adolescents. Int J Obes (Lond), 2009. 33 Suppl 1: p. S60-5. 4. Daniels, S.R., S.G. Hassink, and N. Committee On, The Role of the Pediatrician in Primary Prevention of Obesity. Pediatrics, 2015. 136(1): p. e275-92. 5. Prevention, C.f.D.C.a., State indicator report on physical activity, 2014. 2014, U.S. Depeartment of Health and Human Services: Atlanta, GA. 6. Lenders, C.M., et al., Addressing Pediatric Obesity in Ambulatory Care: Where Are We and Where Are We Going? CurrObes Rep, 2016. 5(2): p. 214-40. 7. Dias, K.A., et al., Exercise and Vascular Function in Child Obesity: A Meta-Analysis. Pediatrics, 2015. 136(3): p. e648-59. 8. Martin, A., et al., Lifestyle intervention for improving school achievement in overweight or SPECIFIC AIMS: Specific Aim 1: To determine if high intensity interval training (HIIT) is a better alternative to moderate intensity training (MIT) for improvements in a) weight loss, b) body composition by a novel 3D body scanning method and bioelectric impedance and c) cardiovascular health measured by FMD and heart rate variability in children and adolescents who are overweight and obese. Specific Aim 2a: To determine if children/adolescents who complete HIIT program have better attendance and long term adherence to lifestyle changes compared to the MIT group. Specific Aim 2b: To determine if children in the HIIT program report high enjoyment compared to the MIT group. HYPOTHESES: Hypothesis 1: Children who complete the FKFL HIIT protocol will have greater improvements in CV health (as measured by BMI, body composition, vital signs, and FMD) as compared to children who complete the MIT protocol. Hypothesis 2a: Children who complete the HIIT protocol will have greater attendance (as measured during the 10 week program) and better adherence (as measured following 10 weeks post program) as compared to children who complete the FKFL MIT protocol. Hypothesis 2b: Children who complete the FKFL HIIT protocol will report greater enjoyment and satisfaction with the program (as measured during the 10 week program) and better enjoyment towards a healthy lifestyle (as measured following 10 weeks post program) as compared to children who complete the MIT protocol. METHODS: This pilot study will examine 2 groups (Group 1 = HIIT [n=30], Group 2=MIT [n=30]) of children aged 8-17 who are overweight/obese who will complete the 10 weeks of GKGL program. Children will then enter a 10 week “home program” where they will be asked to continue with exercise at home followed by a final measurement to assess retention. Sampling will occur from an established pool of patients who have been screened for the FKFL program. Measurements of cardiovascular health and anthropometric measurements will be performed prior to the start of FKFL (Week 0) and at completion of FKFL (Week 10). To determine effect of HIIT vs MIT on adherence, all measurements will be repeated at Week 20. A survey to gauge enjoyment/satisfaction will be completed at 10 and 20 weeks.

34. All these applications will involve “Getting to Know YOU” Applications will ask for…. Demographics Abstract (Personal Statement / Essay “Why I want to go to summer camp….) Consider adding a little something extra…

35. Consider addressing these topics • in a brief cover letterto accompany your application: • Describe your role (identify yourself) – past, current, and future you • What are your professional skills? • 3. What will this symposium add to your professional skills? • 4. How will you apply lessons of this symposium to your research as a resident/ as a fellow? • 5. How long do you expect to be doing research? • Specifically - What impact do you think this Symposium will have on your academic research career?

36. Top 10 Tips for Manuscript Submission • Know the journal. Tailor to journal’s mission and scope • Usually found on journal’s website as part of Instructions to Authors • Know the submission and formatting guidelines. • Write in active voice. • Avoid “wordiness”. • “Here we show through a variety of experiments that adding three additional amplification cycles to the existing protocol often increases the final product yield” • Becomes • “Here we show that adding three amplification cycles increases final product yield” • 5. Practice quality control. • Proofread – Enlist an outside person to read. Grammatical and formatting errors are “unlikely to inspire good will from editors and reviewers • 6. Create a true cover letter. • Important to provide a straightforward 1–2 sentence overview of your study and its key findings. • Do not copy from Abstract – • Write like an Author’s Summary statement – shorter and less formal. Explain how your manuscript fits the mission and scope of the journal.  • 7. Know your references. • Format figures and captions correctly. • Ask the editor • 10. Rebut decisions effectively. Adapted from N. Blow Biotechniques “Manuscript Tips—Top 10 Submission Tips 8/22/14

37. THANKS! DENISSE and ASHWIN (and Mentors) For your participation today