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Abstract Empirically supported treatments for posttraumatic stress disorder (PTSD) exist, but research suggests these therapies are less effective, acceptable, and feasible to deliver to active duty service members (SMs) compared to civilians. Stellate ganglion block (SGB) procedure, in which a local anesthetic is injected around the cervical sympathetic chain or stellate ganglion to temporarily inhibit sympathetic nervous activity, is gaining popularity as an alternative PTSD treatment in military settings. However, it is unknown whether certain PTSD symptoms are more responsive to SGB than others. The current study involved a secondary analysis of data collected from a previous randomized controlled trial of SGB compared to sham (normal saline) injection (N = 113 SMs). PTSD symptoms were assessed via clinical interview and self-report at baseline and 8 weeks post-SGB or sham. Logistic regression analyses showed that the marked alterations in arousal and reactivity PTSD symptom cluster demonstrated the greatest symptom severity reductions after SGB, relative to sham. The reexperiencing cluster also showed pronounced response to SGB in clinician-rated but not self-reported outcomes. Post-hoc item-level analyses suggested that arousal and reactivity cluster findings were driven by reductions in hypervigilance, concentration difficulties, and sleep disturbance, whereas clinician-rated reexperiencing cluster findings were driven by reductions in physiological reactions to trauma cues, emotional reactions to trauma cues, and intrusions. Our findings align with a burgeoning literature positioning SGB as a potential novel or adjunctive PTSD treatment. Results could guide future hypothesis-driven research on mediators of therapeutic change during SGB for PTSD symptoms in SMs.

Abstract Global gridded data sets of observed extremes indices underpin assessments of changes in climate extremes. However, similar efforts to enable the assessment of indices relevant to different sectors of society have been missing. Here we present a data set of sector‐specific indices, based on daily station data, that extends the HadEX3 data set of climate extremes indices. These additional indices, which can be used singly or in combinations, have been recommended by the World Meteorological Organization and are intended to empower decision makers in different sectors with accurate historical information about how sector‐relevant measures of the climate are changing, especially in regions where in situ daily temperature and rainfall data are hard to come by. The annual and/or monthly indices have been interpolated on to a 1.875° × 1.25° longitude‐latitude grid for 1901–2018. We show changes in globally‐averaged time series of these indices in comparison with reanalysis products. Changes in temperature‐based indices are consistent with global scale warming, with days with Tmax > 30°C (TXge30) increasing virtually everywhere with potential impacts on crop fertility. At the other end of the scale, the number of days with Tmin

Objective: To report the incidence of and evaluate demographic, ocular comorbidities, and intraoperative factors for rhegmatogenous retinal detachment (RRD) and retinal tear (RT) after cataract surgery in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight). Design: Retrospective cohort study. Participants: Patients aged ≥ 40 years who underwent cataract surgery between 2014 and 2017. Methods: Multivariable logistic regression was used to evaluate demographic, comorbidity, and intraoperative factors associated with RRD and RT after cataract surgery. Main Outcome Measures: Incidence and risk factors for RRD or RT within 1 year of cataract surgery. Results: Of the 3 177 195 eyes of 1 983 712 patients included, 6690 (0.21%) developed RRD and 5489 (0.17%) developed RT without RRD within 1 year after cataract surgery. Multivariable logistic regression odds ratios (ORs) showed increased risk of RRD and RT, respectively, among men (OR 3.15; 95% confidence interval [CI], 2.99–3.32; P < 0.001 and 1.79; 95% CI, 1.70–1.89; P < 0.001), and younger ages compared with patients aged > 70, peaking at age 40 to 50 for RRD (8.61; 95% CI, 7.74–9.58; P < 0.001) and age 50 to 60 for RT (2.74; 95% CI, 2.52–2.98; P < 0.001). Increased odds of RRD were observed for procedure eyes with lattice degeneration (LD) (10.53; 95% CI, 9.82–11.28; P < 0.001), hypermature cataract (1.61; 95% CI, 1.06–2.45; P = 0.03), complex cataract surgery (1.52; 95% CI, 1.4–1.66; P < 0.001), posterior vitreous detachment (PVD) (1.24; 95% CI, 1.15–1.34; P < 0.001), and high myopia (1.2; 95% CI, 1.14–1.27; P < 0.001). Lattice degeneration conferred the highest odds of RT (43.86; 95% CI, 41.39–46.49; P < 0.001). Conclusion: In the IRIS Registry, RRD occurs in approximately 1 in 500 cataract surgeries in patients aged > 40 years within 1 year of surgery. The presence of LD conferred the highest odds for RRD and RT after surgery. Additional risk factors for RRD included male gender, younger age, hypermature cataract, PVD, and high myopia. These data may be useful during the informed consent process for cataract surgery and help identify patients at a higher risk of retinal complications. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

ABSTRACT Microbiome analyses of low-biomass samples are challenging because of contamination and inefficiencies, leading many investigators to employ low-throughput methods with minimal controls. We developed a new automated protocol, KatharoSeq (from the Greek katharos [clean]), that outperforms single-tube extractions while processing at least five times as fast. KatharoSeq incorporates positive and negative controls to reveal the whole bacterial community from inputs of as few as 50 cells and correctly identifies 90.6% (standard error, 0.013%) of the reads from 500 cells. To demonstrate the broad utility of KatharoSeq, we performed 16S rRNA amplicon and shotgun metagenome analyses of the Jet Propulsion Laboratory spacecraft assembly facility (SAF; n = 192, 96), 52 rooms of a neonatal intensive care unit (NICU; n = 388, 337), and an endangered-abalone-rearing facility (n = 192, 123), obtaining spatially resolved, unique microbiomes reproducible across hundreds of samples. The SAF, our primary focus, contains 32 sOTUs (sub-OTUs, defined as exact sequence matches) and their inferred variants identified by the deblur algorithm, with four (Acinetobacter lwoffii, Paracoccus marcusii, Mycobacterium sp., and Novosphingobium) being present in >75% of the samples. According to microbial spatial topography, the most abundant cleanroom contaminant, A. lwoffii, is related to human foot traffic exposure. In the NICU, we have been able to discriminate environmental exposure related to patient infectious disease, and in the abalone facility, we show that microbial communities reflect the marine environment rather than human input. Consequently, we demonstrate the feasibility and utility of large-scale, low-biomass metagenomic analyses using the KatharoSeq protocol. IMPORTANCE Various indoor, outdoor, and host-associated environments contain small quantities of microbial biomass and represent a niche that is often understudied because of technical constraints. Many studies that attempt to evaluate these low-biomass microbiome samples are riddled with erroneous results that are typically false positive signals obtained during the sampling process. We have investigated various low-biomass kits and methods to determine the limit of detection of these pipelines. Here we present KatharoSeq, a high-throughput protocol combining laboratory and bioinformatic methods that can differentiate a true positive signal in samples with as few as 50 to 500 cells. We demonstrate the application of this method in three unique low-biomass environments, including a SAF, a hospital NICU, and an abalone-rearing facility.

David Loye is one of those people that the longer you get to know them the more you begin todiscover a bit of their depth and breadth of perspective and creativity in the world. Hispublications speak for themselves. His network with leading scientists and thinkers around theworld is equally impressive.Actually, my first contact was with David’s wife, Riane Eisler, author of the Chalice and theBlade (among other books written with and without David). Despite the fact that they live overthe hill from me, I did not meet her face to face right away. Rather, I interviewed her over thetelephone for the Integral Leadership Review, which I publish and edit. When I first approachedher about doing the interview she suggested that I should interview David, but I did not knowDavid Loye’s work at all. In that interview I discovered more about Riane’s work and the extentof their partnership. In fact, they are prime movers of a partnership approach to leadership thatthey promote through a nonprofit center and in a Master’s program at the California Institute ofIntegral Studies in San Francisco.My conversation with Riane piqued my curiosity about David’s work and I bought one of hisbooks, Darwin’s Lost Theory of Love. Here I found evidence of the extraordinary scope anddepth of David’s work that made him a natural candidate for an interview. The only questionwas would I use it in Integral Leadership Review or in Integral Review: such is the quality of hisinterests and intellect.Before doing the interview, I borrowed a copy of one of David’s earlier books. When I went totheir house to pick it up I met them both. They are quite a team and I recommend their work toall.

Over the past three years our journey as editors of Integral Review has been full of rich learning. The processes of providing authors with feedback, going over reviews of articles as well as writing ourselves have all contributed to our growth. The primary forum for this learning has been the many conversations amongst us to deal with the various issues that arise in publishing IR. Our intention in this brief piece is to share some of our reflections on this learning journey with you. These will take the form of contributions/reflections from individual editors, allowing us to share with you the particular issues we feel of value in this process. By writing these short pieces, we aim to provide additional resources for understanding how IR works. While we have guidelines and criteria for submissions on our website, it seems that narrative voices from individuals may add some flesh to them. Relating how we perceive issues around writing for an “integral” journal offers a supplement for engaging these criteria, and will hopefully bring them to life. As well, we hope that our writing provides insights into how and what we think about issues relevant to IR’s mission. These pieces reflect the unique voices we have as editors of Integral Review, and demonstrate some of the thinking and passions behind this journal.

Over the past three years our journey as editors of Integral Review has been full of rich learning. The processes of providing authors with feedback, going over reviews of articles as well as writing ourselves have all contributed to our growth. The primary forum for this learning has been the many conversations amongst us to deal with the various issues that arise in publishing IR. Our intention in this brief piece is to share some of our reflections on this learning journey with you. These will take the form of contributions/reflections from individual editors, allowing us to share with you the particular issues we feel of value in this process.By writing these short pieces, we aim to provide additional resources for understanding how IR works. While we have guidelines and criteria for submissions on our website, it seems that narrative voices from individuals may add some flesh to them. Relating how we perceive issues around writing for an “integral” journal offers a supplement for engaging these criteria, and will hopefully bring them to life. As well, we hope that our writing provides insights into how and what we think about issues relevant to IR’s mission. These pieces reflect the unique voices we have as editors of Integral Review, and demonstrate some of the thinking and passions behind this journal.

Abstracts for short works are not provided

For over forty years Courtney Nelson was engaged in projects in Africa, Asia and the Middle East that were focused on trying to make a positive difference in the lives, work, and organizations of people confronting rapid change, new demands on themselves and their families, and worldwide economic and political forces that few understood. Courtney’s integral perspective is evident here as he forges a clear presentation of the relationships among variables in development.

For over forty years Courtney Nelson was engaged in projects in Africa, Asia and the Middle East that were focused on trying to make a positive difference in the lives, work, and organizations of people confronting rapid change, new demands on themselves and their families, and worldwide economic and political forces that few understood. Courtney’s integral perspective is evident here as he forges a clear presentation of the relationships among variables in development.

Known more widely as the “Father of Crisis Management,” University of Southern California professor Ian Mitroff came to the work of Ken Wilber and integral theory over two decades ago. No one else has brought an integral perspective to the fields of management and organization theory for as long as Mitroff. In this interview he talks about the development of his theories, the people he has worked closely with, his spiritual development and the streams of his work, including his research on spirituality in organizations. While his involvement with Wilber’s Integral Institute is not what he would like it to be, he sees there the potential to develop an institution that addresses the politicization and failures of our institutions of higher education. In the face of the crisis in leadership, integral and transdisciplinary approaches have the potential for making a positive difference as we are faced with the dissolution of distinctions that underlie how we make meaning in the world.

Thomas Jordan discusses the intellectual and research foundations that have led to his creation of a consciousness development model. In interview research that he conducted among selected personnel in Swedish defense and security agencies, Jordan has focused on three key skill sets: consciousness skills, self-awareness and embeddedness or identification. From this he has identified seven characteristics that show up in various patterns among those he interviewed. The first three—good, clever, and wise—are key characteristics. The next four follow from them: curious, inventive, modest and handy. These show up in variable combinations among these integral change agents involved with promoting change within political institutions.

In this introduction to Integral Review’s inaugural issue, we explain the meaning we give to the title of this electronic journal which is open-access, both refereed and peer-reviewed, and why that meaning is important for us in today’s world. The draft of the basic article, which was intensely discussed among the members of the editorial committee, was written by Sara Ross and Reinhard Fuhr,* and following it, other members of the editorial committee added their personal emphases in reference to the integral paradigm as well as their (critical) evaluation of the premises made in the basic article. Thus Thomas Jordan offers a set of categories and criteria for integral qualities which turned out to be most important in practice and evaluation processes. Michel Bauwens makes distinctions about the multi-perspectival nature of the integral paradigm, points out ways to avoid four different kinds of reductionism, and highlights layers of awareness. Russ Volckman emphasizes the connection between the diversity of worldviews and methodologies, which allow us to also integrate recent developments in behavioral approaches in his professional field of organization and leadership development. Jonathan Reams emphasizes the new, transcendent quality of an integral approach that enables us to use different qualities of “reflection” flexibly and - as we have a meta-framework of human perceptions and values - to recognize everybody's truth and feel compassionate with it. We then close with a discussion of the relationship between Integral Review and the mission of its non-profit publisher, ARINA, Inc.

Thomas Jordan discusses the intellectual and research foundations that have led to his creation of a consciousness development model. In interview research that he conducted among selected personnel in Swedish defense and security agencies, Jordan has focused on three key skill sets: consciousness skills, self-awareness and embeddedness or identification. From this he has identified seven characteristics that show up in various patterns among those he interviewed. The first three—good, clever, and wise—are key characteristics. The next four follow from them: curious, inventive, modest and handy. These show up in variable combinations among these integral change agents involved with promoting change within political institutions.