Three decades of Clinical Autonomic Research and beyond.

Clinical Autonomic Research was first published in March 1991. With this issue, we, therefore, mark the 30th anniversary of the journal. Christopher Mathias was the founding editor in chief, alongside an impressive array of eminent researchers as members of its inaugural editorial board, headed by Sir Roger Bannister as chairman (Fig. 1). The field of autonomic medicine was relatively small in 1991 but it has burgeoned over the following decades. Thirty years is a long time for an academic journal, worth celebrating. To capture some of the progress made over the past three decades and commemorate the journal’s anniversary, this issue features invited editorial comments from leading autonomic researchers, some of which were members of the founding editorial board of Clinical Autonomic Research back in 1991.

Fig. 1

First issue of Clinical Autonomic Research. Left panel. Cover of the first issue, published in March 1991. Right panel. Initial editorial board, with Christopher J. Mathias as first editor in chief and Sir Roger Bannister as editorial board chairman. Some of the initial board members including Phillip Low, Wouter Wieling, and Murray Esler, are still actively involved with the journal and have contributed commentaries to this special issue

While all the comments include recollections, thoughts, and opinions on the past, present, and future of autonomic medicine, the emphases vary. Some of the pieces highlight the progress in the practice of and key ideas and methods that have been increasingly incorporated into the practice of autonomic medicine, while others recall personal experiences and the impact that autonomic research had in their lives. Overall, a thought-provoking collection of invited manuscripts which, we hope, will make the readers’ delight.

This special issue also includes a commissioned article on the visibility of women in autonomic societies and journals. We hope this commentary will contribute to bringing positive developments in terms of diversity and inclusivity in autonomic medicine. On our end, we strive to increase the diversity in our journal among our editorial board members, the authors of invited manuscripts, and our reviewers. In this regard, we are thrilled that Qi Fu, Professor of Medicine at the University of Texas Southwestern and a world expert on human cardiovascular autonomic regulation, has joined our team as associate editor of Clinical Autonomic Research. Qi is the first female associate editor of our journal, a historic feat. We look forward to working with her.

Conversely, Vaughan Macefield has decided to step down as associate editor of Clinical Autonomic Research after almost 14 years of service. We wholeheartedly acknowledge Vaughan for his time, dedication, and insight during all these years. It was a delight and a privilege to work with him. We are lucky that he will still be helping as a member of the editorial board, author, and reviewer for the journal. Also, we would like to underline the colossal value and devotion of all of our associate editors who provide a superb assessment of every submission they manage.

Despite the many difficulties associated with the global COVID-19 pandemic, the year 2020 was a good one for Clinical Autonomic Research, and the prospects for 2021 are even better. During 2020, the journal published special issues and articles on the autonomic aspects related to COVID-19 [2, 5, 7, 10, 12, 13]. All COVID-19-related manuscripts are Open Access immediately upon publication. We also published a special issue on sex differences in cardiovascular autonomic control [1, 3, 4, 8, 9, 11]. The reception of these series was exceptionally good. We plan to continue highlighting other relevant topics in 2021, prioritizing rigorous research on potential autonomic aspects related to COVID-19 and the recently approved vaccines, as well as other topics of increasing interest such as digital wearables tracking autonomic function and dysfunction, and emerging therapeutics options such as neuromodulation and gene therapy.

In terms of journal metrics, our turnaround times remain very fast. The average time from submission to an initial decision in 2020 was of only 12 days, and to a final decision was just 26 days. The average time from acceptance to online publication was 17 days. The number of article downloads has sharply increased to an impressive average of more than 12,000 a month. Our most downloaded manuscript ever is a letter on “happy hypoxia” in COVID-19 published in 2020 by Alejandra Gonzalez-Duarte and Lucy Norcliffe-Kaufmann, with close to 30,000 visualizations at the time of writing [6]. Importantly, our 2019 impact factor (released in June 2020) was 2.968, the highest in the history of the journal, and the highest ever for any autonomic nervous system journal. Our impact factor places Clinical Autonomic Research in the vicinity of many physiology journals, and in the same group as -or better than- many neuroendocrinology, movement disorders, and neurophysiology publications. We now rank within the second quartile (Q2) of the “Clinical Neurology” category. This is important because many academic institutions, particularly in Europe, only consider manuscripts published in Q1 and Q2 journals for academic promotions and appointments. Thus, we should expect an increased number of high-quality submissions during 2021 owing to our improved rating. Our “no fee” policy with no submission, publication, or color figures fees, accelerated turnaround times, strong social media presence, and competitive impact factor should make Clinical Autonomic Research one of your initial choices -if not the first- for ultra-fast publication of your high-impact autonomic research.

Finally, as usual, this issue includes the list of those who reviewed for Clinical Autonomic Research during the previous year. We are indebted for their remarkable contributions. We are also very grateful to all those who have, in any capacity, contributed to the success of Clinical Autonomic Research since it launched in 1991, in particular to you, our readers, for your continued support. We hope you will find this special issue thought-provoking and insightful, and that we can celebrate together forthcoming anniversaries of the journal.