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The purpose of this study was to identify clinical and traffic factors that influence pediatric pedestrian versus automobile collisions (P-ACs) with an emphasis on health care disparities.A retrospective review was performed of pediatric (18 years or younger) P-ACs treated at a Level I pediatric trauma center from 2008 to 2018. Demographic, clinical, and traffic scene data were analyzed. Area deprivation index (ADI) was used to measure neighborhood socioeconomic disadvantage (NSD) based on home addresses. Traffic scene data from the California Statewide Integrated Traffic Records System were matched to clinical records. Traffic safety was assessed by the streetlight coverage, the proximity of the collision to home addresses, and sidewalk coverage. Descriptive statistics and univariate analysis for key variables and outcomes were calculated using Kruskal-Wallis, Wilcoxon, χ 2 , or Fisher's exact tests. Statistical significance was attributed to p values of0.05.Among 770 patients, the majority were male (65%) and Hispanic (54%), with a median age of 8 years (interquartile range, 4-12 years). Hispanic patients were more likely to live in more disadvantaged neighborhoods than non-Hispanic patients (67% vs. 45%, p0.01). There were no differences in clinical characteristics or outcomes across ADI quintiles. Using the Statewide Integrated Traffic Records System (n = 272), patients with more NSD were more likely injured during dark streetlight conditions (15% vs. 4% least disadvantaged; p = 0.04) and within 0.5 miles from home ( p0.01). Pedestrian violations were common (65%). During after-school hours, 25% were pedestrian violations, compared with 12% driver violations ( p = 0.02).A larger proportion of Hispanic children injured in P-ACs lived in neighborhoods with more socioeconomic disadvantage. Hispanic ethnicity and NSD are each independently associated with P-ACs. Poor streetlight conditions and close proximity to home were associated with the most socioeconomically disadvantaged neighborhoods. This research may support targeted prevention programs to improve pedestrian safety in children.Prognostic/Epidemiological; Level IV.

Cyber attacks have become more sophisticated and frequent over the years. Detecting the components operated during a cyber attack and relating them to a specific threat actor is one of the main challenges facing cyber security systems. Reliable detection of malicious components and identification of the threat actor is imperative to mitigate security issues by Security Operations Center (SOC) analysts. The Domain Name System (DNS) plays a significant role in most cyber attacks observed nowadays in that domains act as a Command and Control (C&C) in coordinated bot network attacks or impersonate legitimate websites in phishing attacks. Thus, DNS analysis has become a popular tool for malicious domain identification. In this collaborative research associating Ben-Gurion University and IBM, we develop a novel algorithm to detect malicious domains and relate them to a specific malware campaign in a large-scale real-data DNS traffic environment, dubbed Identification of Malicious Domain Campaigns (IMDoC) algorithm. Its novelty resides in developing a framework that combines the existence of communicating files for the observed domains and their DNS request patterns in a real production environment. The analysis was conducted on real data from Quad9 (9.9.9.9) DNS recursive resolvers combined with malicious communicating files extracted from VirusTotal, and confirms the strong performance of the algorithm on a real large-scale data production environment.

Diabetic retinopathy (DR) is the leading cause of blindness for adults in developed countries. Both microvasculopathy and neurodegeneration are implicated in mechanisms of DR development, with neuronal impairment preceding microvascular abnormalities, which is often underappreciated in the clinic. Most current therapeutic strategies, including anti-vascular endothelial growth factor (anti-VEGF)-antibodies, aim at treating the advanced stages (diabetic macular edema and proliferative diabetic retinopathy) and fail to target the neuronal deterioration. Hence, new therapeutic approach(es) intended to address both vascular and neuronal impairment are urgently needed. The hypoxia-inducible factor 1α (HIF1α)–6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase 3 (PFKFB3) pathway is critically implicated in the islet pathology of diabetes. Recent evidence highlighted the pathway relevance for pathologic angiogenesis and neurodegeneration, two key aspects in DR. PFKFB3 is key to the sprouting angiogenesis, along with VEGF, by determining the endothelial tip-cell competition. Also, PFKFB3-driven glycolysis compromises the antioxidative capacity of neurons leading to neuronal loss and reactive gliosis. Therefore, the HIF1α-PFKFB3 signaling pathway is unique as being a pervasive pathological component across multiple cell types in the retina in the early as well as late stages of DR. A metabolic point-of-intervention based on HIF1α-PFKFB3 targeting thus deserves further consideration in DR.

A 15-year-old boy with no past medical or ophthalmic history presented at the Ochsner Hospital and Medical Center, New Orleans, 3 days after having been accidentally shot in his left temple with an air gun from distance of approximately 1 foot. The pellet lodged in his posterior left orbit. On examination in the emergency department, his visual acuity was 20/20 in the right eye and 20/25 in the left eye.