Massive spinal epidural infantile hemangioma, image findings, and treatment: a case report and review of literature.

Spinal involvement of infantile hemangiomas is rare with the predilection to involve the epidural space. A proper diagnosis might be challenging due to the atypical location and variable/inconsistent use of the International Society for the Study of Vascular Anomalies (ISSVA) classification by radiologists, pathologists, and clinicians. A proper diagnosis of epidural infantile hemangioma is key due to the different aggressiveness of the treatment options with inconstant literature regarding the best available treatment. Herein, we present a case of a massive epidural infantile hemangioma successfully treated with only beta-blocker. We discuss the clinical, MRI, CT, ultrasound, and histological features of this lesion as we review the literature with the objective of addressing some of the confusion surrounding the subject.

Imaging findings of the injured in the massive Beirut blast.

PURPOSE: (1) Describe imaging utilization and findings within two weeks of the 2020 Beirut blast according to the mechanism of injury, (2) determine the appropriate imaging modality per organ/system, and (3) describe changes in the workflow of a radiology department to deal with massive crises. MATERIALS AND METHODS: Two hundred sixty patients presented to the largest emergency department in Beirut and underwent imaging within 2 weeks of the blast. In this retrospective study, patients were divided into early (1) and late (2) imaging groups. Patients' demographic, outcome, type and time of imaging studies, body parts imaged, and mechanism and types of injuries were documented. RESULTS: Two hundred five patients in group 1 underwent 502 and 55 patients in group 2 underwent 145 imaging studies. Tertiary blast injuries from direct impact and falling objects were the most common type of injuries followed by secondary (shrapnel) injuries. Both types of injuries affected mostly the head and neck and upper extremities. Plain radiographs were adequate for the extremities and CT for the head and neck. A regularly updated and practiced emergency plan is essential to mobilize staff and equipment and efficiently deliver radiology services during crises. CONCLUSION: Because the powerful Beirut blast occurred at the port located in the periphery of the city, most injuries seen on imaging were of the upper extremities and head and neck caused by the severe blast wind or penetrating shrapnel and resulted from people using their arms to protect their heads and bodies from direct impact and falling objects.

Urban birds' tolerance towards humans was largely unaffected by COVID-19 shutdown-induced variation in human presence.

The coronavirus disease 2019 (COVID-19) pandemic and respective shutdowns dramatically altered human activities, potentially changing human pressures on urban-dwelling animals. Here, we use such COVID-19-induced variation in human presence to evaluate, across multiple temporal scales, how urban birds from five countries changed their tolerance towards humans, measured as escape distance. We collected 6369 escape responses for 147 species and found that human numbers in parks at a given hour, day, week or year (before and during shutdowns) had a little effect on birds' escape distances. All effects centered around zero, except for the actual human numbers during escape trial (hourly scale) that correlated negatively, albeit weakly, with escape distance. The results were similar across countries and most species. Our results highlight the resilience of birds to changes in human numbers on multiple temporal scales, the complexities of linking animal fear responses to human behavior, and the challenge of quantifying both simultaneously in situ.

Flight initiation distance and refuge in urban birds.

Risk-taking in birds is often measured as the flight initiation distance (FID), the distance at which individuals take flight when approached by a potential predator (typically a human). The ecological factors that affect avian FID have received great attention over the past decades and meta-analyses and comparative analyses have shown that FID is correlated with body mass, flock size, starting distance of the approaching human, density of potential predators, as well as varying along rural to urban gradients. However, surprisingly, only few studies (mainly on reptiles and mammals) have explored effects of different types of refugia and their availability on animal escape decisions. We used Bayesian regression models (controlling for the phylogenetic relatedness of bird species) to explore changes in escape behaviour recorded in European cities in relationship to the birds' distance to the nearest refuge and distance fled to the refuge. In our analyses, we also included information on the type of refuge, built-up and vegetation cover, starting distance, flock size, urbanization level, and type of urban habitat. We found that birds preferred tree refuges over artificial and bush refuges. Birds escaped earlier if the distance to the nearest refuge of any type was longer and if birds fled longer distances to the refuge. FID was shorter when birds used bushes as refugia or landed on the ground after flushing compared to using artificial refugia. Similarly, the distance fled to a refuge was shortest when using bushes, and increased when escaping to artificial substrates and trees. Birds were more timid in suburban than core areas of cities, cemeteries than parks, and in areas with higher bush cover but lower cover of built-up areas and trees. Our findings provide novel information regarding the importance of refuge proximity and type as factors affecting the escape behaviour of urban birds.