Editor-in-Chief, Midterm Report

This interview took place mid-March 2011 in Dr Castillo's office. His office is located on the third floor of one of the oldest buildings on the medical campus of the University of North Carolina. The office is nice and airy, exposed tubing runs in its ceiling as it does in many old buildings, and his window overlooks the roof and ventilation systems of the cardiac catheterization suites, which is why he keeps the blinds closed. Order prevails and all surfaces are clean (part of what his family calls his obsessive compulsive disorder). Amid certificates and pictures of his family are other pictures of those who have inspired him: Drs Quencer, Huckman, Taveras, and Shapiro, all of them neuroradiologists. Here, I present the most pertinent parts of our conversation.

Q: You are nearing the midpoint of your tenure as Editor-in-Chief of the American Journal of Neuroradiology (AJNR). How do you feel about the job now? What has changed from the beginning?

A: A few years ago, I decided that I was not cut out for a high-level administrative position and so decided to pursue my main interest: editorial and medical writing–related issues. As I get older, interpreting cases and teaching has become routine and less exciting. AJNR is the opposite—something exciting is always happening. It is the best job I have had because I see the results of my work (and errors) every month. I consider it to be the most important position in neuroradiology, and it is a true honor to do it. Compared with the beginning, I no longer feel overwhelmed by the amount of work AJNR generates, but it took me about 6 months to calm down. It still takes me about 4 hours per day, including weekends, to do the job, but I feel less anxious about it compared with how I felt at the beginning.

Q: I know that it is hard to point out the single most important change that has happened to AJNR in the last 4 years, but can you attempt to tell us?

A: I would have to say embracing Web 2.0, that is, bringing more of our functions and activities to the Web and at the same time making these somewhat interactive. The first major change was the remodeling of our Web site. Visits for 2010 were nearly 10 million! That is an incredible amount of activity when you think about the size of the American Society of Neuroradiology (ASNR) and our subscriber base. In 2010, all Web-based activities went up anywhere from 11% to over 50% compared with 2009. Our new Web site allowed us to do creative things such as the Case of the Week, blog, weekly Image Quiz, Brain Snacks, Special and Custom Collections, etc, which are accessed by individuals all over the world. In a few words: the globalization of AJNR.

Q: Out of these new activities, which one are you especially proud of?

A: The Special and Custom Collections, I'd have to say. These take care of all major aspects of the Journal: collate our best articles under the guidance of expert guest editors, present them free on-line, make use of print-on-demand for a beautiful (and relatively inexpensive) print product, and make AJNR a bit of money. We recently started our Custom Collections, which allows anyone to choose articles of his or her liking and create a collection. The Case of the Week is one of most popular activities with close to 13,000 hits every month. Although I initially had doubts about podcasts, I am glad that my Senior Editors pushed me to get them going. They are downloaded nearly 800 times per week. The weekly Image Quiz and the semiweekly Brain Snacks are new activities but together are already receiving about 500 hits per week, so we will see how they do in the future.

Q: But the Journal still continues to be your major activity, no?

A: Definitively. The mixture of submitted manuscripts is changing—much to our liking—toward fewer case reports and technical notes and more major research articles. Last year we received a record number of submissions, nearly 1400 articles with a 22% increase in major articles and a 27% decrease in case reports. I am grateful that the Executive Committee of ASNR approved increasing our number of issues to 11 per year (from previously 10), and I hope that soon we will be published monthly throughout the year (I will have to ask the committee again!). Before me, Dr Robert Grossman (the previous Editor-in-Chief) started the “Publication Preview” section. There you find articles published less than 6 months after submission and at least 3 months before print. This allows us to build a nice base of articles, which because they are already officially published, contribute positively to our Impact Factor.

Q: You mention the Impact Factor, what about it?

A: Every editor will tell you that it is an imperfect measure, but it continues to be the most popular indicator of the influence of a journal, so there is no escaping it. Since I took over, our Impact Factor has increased 1 whole point and now stands at nearly 3.3 (2010). This is due to 3 changes: fewer case reports (they are quoted about one-tenth as often as major articles are) and more review and original articles. The quality of our major articles continues to improve as they become more scientific and less clinical. To me, a measure of the science in our articles is simply the number of MR and CT images: the fewer images there are, the more “science” one finds in the articles. This may not be what our clinical colleagues want to hear, but it is essential to remember that AJNR is the scientific venue of our specialty. Drs Char Branstetter and Adam Flanders have assumed the task of revitalizing NeuroGraphics and making it into a true clinical journal. It will be the enduring educational venue for our society.

Q: What are the newest features of AJNR?

A: Our electronic Table of Contents has been revamped to make it easier to read and navigate. The summaries for the “Editor's Choices” and “Fellows' Journal Club” selections are now found within it. Our new app for the iPhone is very nice, and we are working on an iPad app. Most radiologists use iPhones rather than Android devices and that is why we decided to deploy it. Our mobile telephone app for the blog site works equally well with both platforms. Dr Fatterpekar is planning exciting changes in the Case of the Week section with additional cases that will try to stump the experts. I mentioned earlier the Brain Snacks feature, in which are pearls culled from our articles. We will soon be configuring a mini Web site to experiment with HTML5, which is a new way to view publications on-line.

Q: Since you mention the blog site, how is that going?

A: With the blog site, I have learned that most neuroradiologists are shy about expressing their opinions in public! The blog site is doing well, over 200 views per day (up 20% from last year), but it could still be better if everyone participated. It now contains all book reviews previously published in AJNR and houses tremendous educational materials. In February, we gave it a face lift, which resulted in a cleaner and easier-to-navigate version. I think about it as the Senate of Neuroradiology; all individuals will be heard if they want to speak and it is a great tool to pursue discussions with your colleagues. Maybe it is a generational situation, and as our society becomes “younger,” more individuals will use it.

Q: You obviously cannot work alone, how is the work divided?

A: I try to do with the Journal what I do at the hospital, that is, do more work than anyone else and lead by example. Needless to say it would impossible to do the work without a great team of Senior Editors. I am simply blessed to have these individuals helping out. I think that I have not thanked them personally as much as I should, so I will take this opportunity to do so. Harry Cloft and Charlie Strother handle the interventional articles. Despite other great interventional journals out there (including our collaboration with Interventional Neuroradiology), we continue to receive a very large number of submissions in this class of articles. Pam Schaefer, our upcoming Society President, handles all of the stroke and tumor articles. Lucien Levy does the advanced techniques, including functional imaging. Jeff Ross does everything related to trauma, spine, nerves, and CSF. Bill Dillon has done the head and neck articles, but earlier this year he decided to step down after 13 years of service to AJNR. Dr Nancy Fischbein from Stanford will take Bill's place and join our Senior Editors during the second half of 2011. I have to say that in the past, the head and neck and spine sections were mostly case reports, but recently we have had terrific full-length articles submitted from these subspecialties. I try to do the pediatric articles myself. Every month, we have a telephone conference in which we deal with problems and discuss ways to improve our publication, and we now invite the presidents of the subspecialty societies to join us once per year to let us know how AJNR can better serve them.

Q: You mention problems; what are the most serious ones?

A: I think that the most serious problem scientific journals face today is plagiarism. This comes in 2 flavors: self-plagiarism and stealing from others. Not a month goes by without being confronted by this type of behavior. Of course, spotting duplications is something that our reviewers are mostly responsible for. You can understand that we want to have some quality assurance program in this regard. We run 2 entire (randomly chosen) issues per year through iThenticate (http://www.ithenticate.com), a program that spots duplicated text. Because we pay for this service, we do not use it for every article.

Q: Since you mention the word “pay,” how are the financial aspects of AJNR?

A: The financial side of AJNR is overseen by the Publications Committee. My role is that of scientific officer and not Chief Financial Officer. Regardless of that, I think that I can say that AJNR is profitable for our society. The number of paid advertisements continues to increase (only Radiology has more), and activities such as the Special and Custom Collections and the paid open access option generate income that we partly use to improve programs. One of the pleasures of this job has been working with a very supportive Publications Committee under Gordon Sze, who has granted all my requests and in an expeditious fashion. Our central office is very efficient; just imagine that all of the work is done by only 3 individuals there! Karen Halm is my managing editor and has been a great person to work with. She is as obsessive compulsive with AJNR as I am, so we get along fine. Jason Gantenberg is essentially our IT person, and Mary Harder handles all communications with authors.

Q: You write an editorial—called Perspectives—every month; is it difficult to do this?

A: Yes, very difficult. I probably spend about 4 months preparing each one. That is not say that they are perfect when they appear in print. On the contrary, I think that work on them is never finished. I try to choose a general topic, something that has a philosophic, ethical, technical, etc, twist to it, and try to relate it to neuroimaging. Most have been very satisfying in the sense of receiving praise from many readers and colleagues. The editorials have given me the opportunity to hone my writing skills and to learn lots about their topics. For each one, I probably read 1–3 books, several journals, magazines, and newspaper articles and do extensive research on the Web. I like seeing how entertaining I can make them. Finding a good topic is becoming more difficult after the first 40!

Q: What will change with AJNR in the next 4 years?

A: I make it a habit of mine not to attempt to predict the future. This year I was invited to Taiwan and had to deliver a lecture on the Future of Neuroradiology. You have no idea how difficult that was! From a practical standpoint, I would like to redesign our print version. The current look was Bob Grossman's design. I like how Radiology approaches this issue: It gives the outgoing editor the chance to change the cover so that the incoming one does not have to worry about this, and a sense of continuity prevails during the transition of editors. We probably will have to shorten the length of our articles so that they will fit both in electronic hand-held devices and in print (some have suggested having 2 different types of articles, but I think that this is not a fiscally sound approach). We still have not exploited all of the possibilities of Web 2.0 on our Web site, but much of that depends on our provider and not us. We are due for a significant upgrade later this year, and maybe all of the Journal will be in HTML5 in the near future. We will need apps for different tablet devices, which will be expensive. I am sure that our Impact Factor will continue to increase, and I foresee a time in the near future when case reports will no longer be found in AJNR but will be published by NeuroGraphics. Podcasts will probably be complemented by vodcasts, that is, with productions that contain videos and images.

Q: I fear that this interview may be getting too long; should we quit?

A: I thought you would never ask that! Many thanks!

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