We asked and you answered

In November 2021, we wrote an editorial announcing our decision that as of January 1, 2023, the American Journal of Physiology-Heart and Circulatory Physiology (AJP-Heart and Circ) would require authors to consider the use of more than one sex or gender in experimental design, analysis, and reporting (1). Studies using only one sex or gender will be reviewed and published only if strong scientific justification is provided. That editorial announcement received some attention. It has been downloaded >3,700 times, with >30 citations to date. The purpose of this editorial is to report back on the success we have had incorporating sex as a biological variable in cardiovascular research manuscripts submitted to AJP-Heart and Circ and to let you know that we have created a new submission category to accommodate all of your submissions on an ongoing basis. We asked and you answered, and we have heard your response.

At the time of the announcement, we also launched a Call for Papers on Considering Sex as a Biological Variable in Cardiovascular Research. For the call, our curators were Consulting Editors Dr. Kristine DeLeon-Pennell and Dr. Charlotte Usselman along with Associate Editors Dr. Crystal Ripplinger and Dr. Jason Carter. When this call closed in August 2022, we had 127 submissions, of which 64 were accepted (50% acceptance rate). The collection can be found at https://journals.physiology.org/topic/ajpheart-collections/sex-as-biological-variable?seriesKey=&tagCode=. This call has been one of the most successful calls for papers our journal has had to date in terms of total submissions. In addition to the number of articles submitted and published, the interest from our readers for this collection has also been tremendous and unprecedented. In addition to the editorial launching this initiative, the four most downloaded articles have already received 10,017, 2,435, 1,827, and 1,569 downloads, whereas the two most cited articles have already received 12 and 8 citations (2–6). From your response, it is safe to say that sex as a biological variable as an area of research is here to stay.

A few months ago, we were discussing in a monthly editors’ meeting the upcoming start date of the new policy. We wondered if our authors were paying attention, if they were behind us with this decision, and if they were comfortable to implement the policy within their own laboratories. As with any change, we cannot predict how it will go. We wrote a follow-up editorial reminding our authors, reviewers, and readers that the time was coming due for the new policy and we provided a list of resources to facilitate implementation (7). This editorial has been downloaded >650 times to date. This tells us that there is overwhelming support from the cardiovascular research community for us to set and maintain high standards for rigor and reproducibility.

In January 2023, we started prechecking manuscripts before sending them out for peer review to ensure authors were meeting the new requirements. We were happy to discover that very few articles were rejected for noncompliance. Only two such decisions have been issued out of 186 decisions made from January 1–March 17, 2023, for a total of 2.2% of decisions. We also noticed that even when the call for papers ended, we kept receiving submissions focused on sex or gender as a biological variable. Based on the noticeable popularity for this topic, we have implemented a new Table of Contents category titled, “Sex as a Biological Variable.” This joins our other categories shown in Table 1. Of note, this is the first new Table of Contents category added since the original list was created in 2011 under the editorship of the late Dr. William Stanley.

Table 1.

Table of content categories for AJP-Heart and Circ

Calls for Papers
-. Cardiac Excitation and Contraction
-. Cardiovascular Neurohormonal Regulation
-. Energetics and Metabolism
-. Historical Article
-. Integrative Cardiovascular Physiology and Pathophysiology
-. Muscle Mechanics and Ventricular Function
-. Sex as a Biological Variable
-. Signaling and Stress Response
-. Translational Physiology
-. Vascular Biology and Microcirculation

Boldface indicates new category, effective immediately. AJP-Heart and Circ, American Journal of Physiology—Heart and Circulatory Physiology.

Effective immediately, you can select this category when submitting under any of our article types (e.g., research article, short report, review article, etc.). All manuscripts accepted in this category are housed in one collection, making it easy to find similar articles. We are pleased to make this announcement, as it reflects a true commitment from us all. The entire cardiovascular research community has come together and embraced an obligation to improve the rigor and reproducibility of cardiovascular research by considering sex as a biological variable. We are proud of our research community and applaud you for not only accepting the need for change but for fostering and fully embracing our call and for challenging us in return to update our expectations. As a result, we heard you and instilled this new permanent Table of Contents category as a home for your submissions.

As we look back over the progress of the last 2 yr, we are reminded of this quote: “Some people want it to happen. Some people wish it would happen. Others make it happen” (∼Michael Jordan). We thank the cardiovascular research community for making change happen.

GRANTS

We acknowledge funding from National Institutes of Health Grants AA024892 (to J.R.C.), AG053585 (to A.J.L.), HL111600 (to C.M.R.), and HL136737 and HL147570 (to J.A.K.); Biomedical Laboratory Research and Development Service of the Veterans Affairs Office of Research and Development Grant 5I01BX000505 (to M.L.L.); and U.S. Department of Defense Grants W81XWH-19-RTRP-IDA and W81XWH-13-2-0057 (to A.J.L.) and support from the Gheen’s Foundation (to A.J.L.), the Natural Sciences Engineering Research Council (to K.R.B.), Canadian Institutes of Health Research (to Z.K. and K.R.B.), Canadian Foundation for Innovation (to K.R.B.), Heart and Stroke Foundation of Canada (to Z.K. and K.R.B.), Heart and Stroke Foundation of New Brunswick (to K.R.B.), and New Brunswick Health Research and Innovation Foundations (to K.R.B.).

DISCLAIMERS

The content is solely the responsibility of the authors and does not necessarily represent the official views of any of the funding agencies or the American Physiological Society. All authors have reviewed and approved the article.

DISCLOSURES

Z. Kassiri holds a Canada Research Chair (Tier 1) in Cardiovascular Matrix Remodeling and is a member of the Royal Society of Canada: Collage of New Scholars. K. R. Brunt is a Translational Scientist at the New Brunswick Heart Centre. None of the other authors has any conflicts of interest, financial or otherwise, to disclose.

Merry Lindsey, Petra Kleinbongard, Zamaneh Kassiri, Jason Carter, Crystal Ripplinger, Amanda LeBlanc, Keith Brunt, and Jonathan Kirk are editors of American Journal of Physiology-Heart and Circulatory Physiology and were not involved and did not have access to information regarding the peer-review process or final disposition of this article. An alternate editor oversaw the peer-review and decision-making process for this article.

AUTHOR CONTRIBUTIONS

M.L.L. drafted manuscript; M.L.L., P.K., Z.K., J.R.C., K.H.K., C.M.R., A.J.L., K.R.B., and J.A.K. edited, revised, and approved final version of manuscript.