Learning needs of the 21st century: Using intentional emergence with Generation Z college students.

The student body within a university is a dynamic entity, with each cohort being shaped by current societal events and technological advancements. Thus, higher education institutions and other providers of leadership education and development must consider the nature of today's college students and employees, who are primarily from Generation Z, when engaging in teaching and learning practices. One such pedagogy that aligns with this student cohort is intentional emergence (IE). This article will discuss ideas and considerations for using IE with Generation Z students.

Emergent teaching movements in leadership development: Group relations, case-in-point, and intentional emergence.

In a post-pandemic context, the need for leadership students to navigate ambiguous conditions and examine their automatic responses to authority has increased. Yet, common approaches to teaching leadership, such as group discussions and simulations, overlook the potential for using development spaces as living laboratories. This article explores three emergent-based pedagogies (group relations, case-in-point, and intentional emergence) that de-center the instructor, prioritize co-creation and emergence, and provide living laboratories for students to examine their assumptions and default behaviors related to leadership.

Cautions and limitations of emergent pedagogies in leadership development.

While emergent pedagogies offer potentially high impact, the risks in using such pedagogies can be significant when not handled carefully. This article explores the cautions and limitations of emergent-based pedagogies such as case-in-point, intentional emergence, and group relations. Leadership educators who use emergent-based approaches need to be well-versed in how to hold the heat in the classroom, even when the heat may be directed at them. The learning and impact from the pedagogy may sometimes take months or even years to be felt. As such, considerations like administration buy-in are necessary in addition to the adequate development of the facilitator. This article explores resources to develop educators in their use of emergent pedagogies, including hallmark readings and trainings that are available to those interested in learning more.

Surgical Management of Polymethylmethacrylate-Collagen Gel Complications in the Lower Eyelid: A Case Series.

BACKGROUND: As nonsurgical rejuvenation with fillers continues to grow in popularity, patients are increasingly interested in more durable results. Polymethylmethacrylate (PMMA)-collagen gel is unique among fillers in that the PMMA microspheres are not completely absorbed and phagocytosed by the body. This durability coupled with the biophysical properties of PMMA makes it a poor choice for periorbital rejuvenation, an unforgiving and highly complex anatomic area. METHODS: Between 2011 and 2018, 14 patients with PMMA granulomas in various facial areas self-referred to the senior author's practice. Of these patients, 11 were managed nonsurgically; however, all 3 patients who presented with granulomas in the infraorbital area required surgery to remove the filler and restore a natural aesthetic. RESULTS: The 3 patients with significant swelling and PMMA filler nodules in the infraorbital area with unacceptable cosmetic appearance were females between the ages of 50 and 55 years. Nonsurgical protocols were unsuccessful, and surgical removal was required. All subjects have been followed for a minimum of 2 years with no immediate- or long-term postoperative complications secondary to PMMA removal. Patients remain satisfied with the outcome of the surgery. CONCLUSIONS: Despite the evidence that the periorbital area is prone to adverse events when injected with particulate fillers, misguided enthusiasm for PMMA-collagen gel as a durable treatment continues to lead to unnecessary and severe complications in patients. The case studies presented here highlight that this product should not be introduced into the periorbital area. We also describe a surgical treatment approach for its removal if complications arise.

The impact of embolization on radiosurgery obliteration rates for brain arteriovenous malformations: a systematic review and meta-analysis.

There exists no consensus in the literature regarding the impact of pre-stereotactic radiosurgery (SRS) embolization on obliteration rates and clinical outcome after radiosurgery treatment of intracranial arteriovenous malformations (AVM). We performed a systematic review of four databases and included studies with at least 10 patients evaluating obliteration rates of intracranial AVMs treated with SRS alone (SRS cohort) and combined pre-SRS embolization followed by SRS (E + SRS cohort). Meta-analytic results were pooled together via random-effects models. A total of 43 studies, with 7103 patients, were included in our analysis. Among our included patients, complete obliteration was achieved in 51.5% (964/1871) of patients in the E + SRS cohort as compared to 61.5% (3217/5231) of patients in the SRS cohort. Meta-analysis of the pooled data revealed that obliteration was significantly lower in the E + SRS cohort (pooled OR = 0.64, 95% CI = 0.54-0.75, p < 0.0001). The use of pre-SRS embolization was significantly associated with lower AVM obliteration rates when compared to treatment with SRS alone. Our analysis seeks to provide a macroscopic insight into the complex interaction between pre-SRS embolization and brain AVM obliteration rates and prognosis. Pre-SRS embolization may still be beneficial in select patients, and further studies are needed to identify patients who benefit from neoadjuvant AVM embolization.

Assessing leadership development in groups and organizations.

This article discusses considerations and methodologies for leadership educators to assess leadership development in groups and organizations using groups as the unit of analysis rather than aggregating individual scores.

A snapshot of contemporary leadership at pediatric neurosurgery fellowships.

OBJECTIVE: Many pathways to positions of leadership exist within pediatric neurological surgery. The authors sought to investigate common trends in leadership among pediatric neurosurgery fellowship directors (FDs) and describe how formalized pediatric neurosurgical training arrived at its current state. METHODS: Fellowship programs were identified using the Accreditation Council for Pediatric Neurosurgery Fellowships website. Demographic, training, membership, and research information was collected via email, telephone, curricula vitae, and online searches. RESULTS: The authors' survey was sent to all 35 identified FDs, and 21 responses were received. Response data were supplemented with curricula vitae and online data prior to analysis. FDs were predominantly male, self-identified predominantly as Caucasian, and had a mean age of 53 years. The mean duration from residency graduation until FD appointment was 13.4 years. The top training programs to produce future FDs were New York University and Washington University in St. Louis (residency) and Washington University in St. Louis (fellowship). CONCLUSIONS: This study characterizes the current state of pediatric neurosurgery fellowship program leadership. The data serve as an important point of reference to compare with future leadership as well as contrast with neurosurgery and other surgical disciplines in general.

Surgical management of quadrigeminal cistern arachnoid cysts: case series and literature review.

OBJECTIVE: Quadrigeminal cistern arachnoid cysts (QACs) are congenital lesions that can cause pineal region compression and obstructive hydrocephalus when sufficiently large. Management of these cysts is controversial and rates of reintervention are high. Given the limited data on the management of QACs, the authors retrospectively reviewed 20 years of cases managed at their institution and performed a literature review on this topic. METHODS: The authors performed a retrospective analysis of patients treated for QAC at their institution between 2001 and 2021. They also performed a literature review of studies published between 1980 and 2021 that reported at least 5 patients treated for QACs. Patient characteristics, radiographic findings, management course, and postoperative follow-up data were collected and analyzed. RESULTS: A total of 12 patients treated for a QAC at the authors' institution met the inclusion criteria for analysis. Median age was 9 months, mean cyst size was 5.1 cm, and 83% of patients had hydrocephalus. Initial treatment was endoscopic fenestration in 92% of these patients, 27% of whom had an endoscopic third ventriculostomy (ETV) performed concurrently. Reintervention was required in 42% of patients. Cases that required reintervention had a statistically significant lower median age at the initial intervention (5 months) than the cases that did not require reintervention (24.33 months; p = 0.018). There were no major complications. At a mean follow-up of 5.42 years, 83% of patients had improvement or resolution of their symptoms. A literature review revealed 7 studies that met the inclusion criteria, totaling 108 patients with a mean age of 8.8 years. Eighty-seven percent of patients had hydrocephalus at presentation. Ninety-two percent of patients were initially treated with endoscopic fenestration, 44% of whom underwent concurrent ETV. Complications occurred in 17.6% of cases, and reintervention was required in 30.6% of cases. The most frequent reason for reintervention was untreated or unresolved hydrocephalus after the initial procedure. CONCLUSIONS: Endoscopic fenestration is the most common treatment for QACs. While generally safe and effective, there is a high rate of reintervention after initial treatment of QACs, which may be associated with a younger age at the first intervention. Additionally, identifying patients who require initial treatment of hydrocephalus is critically important, as the literature suggests that untreated hydrocephalus is a common cause of reintervention.

Large sphenoid mucocele presenting with cranial neuropathies in a 10-year-old boy: case report and literature review.

INTRODUCTION: Mucoceles in the sphenoid sinus are rare, making up 1-3% of all paranasal sinus mucoceles. Sphenoid sinus mucoceles among pediatric patients are uncommon and have a range of presentations due to their proximity to other structures, in rare cases causing oculomotor and visual disturbances through expansion and mass effect. CASE REPORT: We present a case of a large expansile sphenoid sinus mucocele causing cranial nerve III and VI palsies in a 10-year-old boy. Endoscopic resection of the mucocele was performed for diagnosis and decompression, leading to immediate relief of the patient's symptoms and improvement in cranial nerve function. Post-operative imaging showed complete resolution of the mucocele. CONCLUSION: Our case report and review of the current literature emphasizes that prompt diagnosis and intervention can lead to a good clinical outcome and prevention of permanent cranial neuropathy.

Learning from our students: Being student-centered in an unstable world.

From the deaths of George Floyd and Breonna Taylor to the attack on Asian Americans in Georgia to the police shooting of Daunte Wright, the instances of traumatic events recently are too long to list, but the almost daily trauma is impacting our classrooms through the lived experiences of those who are a part of this living, dynamic system. Within this article we explore how we, as educators, have more responsibility than ever to acknowledge this trauma and work to support students bringing their whole selves to our classrooms.

Leadership educators: Acknowledging our whole selves in the work.

This article dives into the complexity of managing our "self" and our "roles," and how we can acknowledge the vast multitudes contained in each of our identities in our work as leadership educators. We wanted to incorporate a more conversational format to this article by highlighting the different ways ideas can be expressed and the gifts of the co-inquiry discussion model for gleaning deeper insights into a topic.

Co-inquiry during unprecedented times.

The confluence of crises facing our global and local communities have challenged leadership educators to think and practice differently. This has meant shifts in how we teach, how we connect with students, and how we understand our role in making change in our institutions and communities. How can we navigate change personally and as a community? The purpose of this article is to introduce co-inquiry as an emerging method for professional community building, leadership learning, and action-oriented research.

Interrogating leadership education: Why? For what? For whom?

This article is an exploration into the purpose of leadership education and leadership learning in higher education. It will simultaneously explore who leadership education is for and investigate privilege, identities, class, and the intersecting impact on access to these programs and content.

Leadership learning reconsidered: Adopting new considerations for practice.

This article examines how dialogue and a liberatory pedagogical approach can work in concert with one another to expand the opportunity for transformative leadership practice. Personal accounts are shared of how the events of the pandemic and beyond continue to shape our perspectives as leadership educators.