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The growing need for communication services and the rise in consumer demand for high quality services have contributed to a fundamental shift over how we handle networks in terms of abstracting, separating, management, control and mapping aspects of service forwarding. Business as well as the market with academics welcomes 6G as the potential network capable of serving vertical applications of the next generation with diverse service specifications. In order to implement an efficient existing network, the physical infrastructure must be split into several segregated logical networks of varying sizes and configurations allocated to different services focused on their preferences with different qualities and requirements. To meet the requirements of global coverage, enhanced energy/cost/spectral efficiency and intelligent and secure heuristics in 6G rely on new technologies with novel network architecture. A detailed survey of latest developments and future trends in these various areas is described in the article. Definitely, 6G would facilitate intelligent and effective communication with specific technological requirements beyond that of 5G, to the point that the distinction between the cyber and physical worlds disappears. This paper outlines innovative technologies like artificial intelligence, 3D dimension networking, intelligent reflecting surface, quantum communication, proactive caching, unmanned aircraft, wireless and power transmission integration, integrated sensors and communication, integrated access backhaul. This article explains emerging technologies like big data analytics that can assist the 6G architecture development in guaranteeing the QoS.

New operating requirements, new architectures and denser topologies are forcing change and driving more complexities. Self-Optimization, Self-configuration and Self-healing are the important objectives of the mobile-SON which is a software platform operating under network management layer. Cost effective with scalability and high bandwidth technology is required for IoT processes of all kind – from connected vehicles to critical industrial processes with automatic configuration. Scale, speed and cost combined parameters arises the new mobile capabilities of automatic operating processes in RAN and across the wider network. Objective of 5G is to reach any end point over any kind of access network with any kind of service i.e. evolved LTE, legacy RATs, fixed access and IoT applications over numerous access technologies. In converged network, common services such as entertaining video, bulk internet access and any managed contents using any access technology or legacy internet access and IP multimedia sub system (IMS) automatically configured in 5G core. In this article self-optimizing framework for ultra IoT is proposed, which represents the M2M communication, network cloud. Impact of network slicing by SDN controller and SON which plays important role in 5G cellular network architecture is discussed. Reviews of different authors are included regarding current use cases conducted in different countries. Next generation data lakes, data analytics on cloud and data warehouse performance depend on the new technology architecture.

In this paper, Quality of service based numerous mobility models with network performance parameters for optimization of HANETSs are reviewed, observed and analyzed. In smart cities, emergency services, traffic congestion and safety issues can be resolute by intelligent communication heuristic and transforming information between vehicles and transportation infrastructure. Self-organization and optimization in ICN, congestion, dynamic topology, high mobility, scalability and self-organization makes it difficult and costly to implement in real time deployment. Under multiple scenarios and conditions performance of different routing heuristics and network performance parameters are observed in literature by different authors using different simulation tools. Variable speed of vehicles, Road conditions, unpredictable driver behavior and obstacles influence the performance of different routing protocols. Data size and high mobility put a great influence on network lifetime. In this paper we analyzed the speed impact on VANET performance parameters like throughput and packet delivery ratio at different BSMs in different scenarios. Mobility and link awareness can enhance the network lifetime and other parameters like throughput, goodput and packet delivery ratio of vehicular ad hoc network observed under simulation

Oculoplastic surgeries encompass both emergency surgeries for traumatic conditions and infectious disorders as well as elective aesthetic procedures. The COVID-19 pandemic has brought about a drastic change in this practice. Given the highly infectious nature of the disease as well as the global scarcity of medical resources; it is only prudent to treat only emergent conditions during the pandemic as we incorporate evidence-based screening and protective measures into our practices. This manuscript is a compilation of evidence-based guidelines for surgical procedures that oculoplastic surgeons can employ during the COVID-19 pandemic. These guidelines also serve as the basic framework upon which further recommendations may be based on in the future, as elective surgeries start being performed on a regular basis.

Scalability, performance, optimization and security requirements of 5G are easily managed by the software-defined platforms and virtualization. Anytime, anywhere user access with QoS and business process automation demands agile and flexible 5G architecture. In time and space domain, the traffic demands are variable in nature. Heterogeneous traffic generated by massive IoT devices and machine-to-machine communication can easily handle with flexible and reconfigurable network in a cost-effective manner. Dynamic resource scheduling and on-the-fly MAC reconfiguration heuristic can improve the performance of heterogeneous network access and minimize latency. Content and context-aware reconfigurable radio platforms with sensors can easily predict interference source and modify protocol according to requirements. Knowledge of traffic and content can reduce the congestion in the network and enhance the performance and efficient utilization of the resources. In this paper, we analyze SDN controller with NFV, and CRAN is the key enabler for 5G architecture.

Link availability, mobility, scalability, transmitting and receiving power, path loss model, signal quality and intelligent resource utilization heuristics are numerous factors for enhancing the network performance of HANETs. Quality of service and quality of experience can be improved with cross-layer, cross-domain and cross-network design which extracts the critical information from different platforms as required by dynamic behavior and heterogeneity of the network. Distance between the nodes, packet size, link availability, mobility model, and transmission range are simulation parameters which can degrade the heuristic performance of the network. In this paper, we worked on optimized link heuristic under heterogeneous network where handover plays an important role. We observed that in ad hoc network, the performance of optimized link heuristic is stable as compared to reactive protocols. 6LoWPAN with congestion control policy performs efficiently for IoT scalable architecture, and protocol stack handling is suitable for energy-efficient device.

Zero Touch network requires no human involvement other than high level implementation and declarative independent intents. Machine and human interaction learning help machines to achieve the human objective efficiently and enhances the security domain. At the different places of the network, computation and intelligence decisions with cloud environment will enhance the performance of the network. Scalability and heterogeneity in IoT framework are important parameters for performance of 6LoWPAN network. Protocol stack of NGN is a key part of protocol for supporting limited processing capabilities, low memory and limited power constrained power supply devices to Internet. Heavy network traffic causes congestion in the network which degrades the network performance and influences the QoS aspects goodput, throughput, E2E delay, jitter, Energy consumption, reliability and latency. Numerous congestion control heuristics are discussed based on traffic modeling, queue management and hybrid algorithms. This paper represents the queue management in the heterogeneous ad hoc network. Impact of minimum and maximum value of queue size on goodput and with respect of packet size is discussed in this paper. Throughput, delay and Jitter for different objective functions are compared and burst rate in case of 6LoWPAN is represented. For IoT application requirements, a novel traffic modeling based on congestion for future work is summarized.

The malfunctioning of critical infrastructure causes high-quality deterioration, financial effect and loss of life in a town in the present scenario. It is essential to check the cost-effectiveness and reliability of the quality of critical infrastructures in the pandemic situation. Sensitive monitoring of an infrastructure is costly but necessary, in which fault identification and corrective action are needed at service levels to avoid cascading failures with minimal communication latency. With enhanced expense, resource, and process performance, the growing population in smart cities demanded a high living standard, rigorously straining energy, city services, and infrastructure. Intelligent houses, intelligent transport and smart buildings linked with intelligent networks are three pillars of the smart city initiative. In this paper, an improved framework for enhanced Quality of Service with higher performance in a 5G network is presented. A detailed description of reconfigurable intelligent Smart networks and reconfiguration analysis at various layers are also discussed. SDN and NFV, with the help of an intelligent SDN controller, provide the context for managing a multi-objective heterogeneous network. For self-optimization and self-healing, multiple clustering heuristics are useful for managing these networks at the various locations of smart projects.

Clinical reasoning (CR) is a key learning domain for physical therapy educators and a core skill for entry-level practitioners. Integrated clinical experience (ICE) and problem-based learning (PBL) have each been reported to improve interpersonal and social domains, while promoting knowledge acquisition and CR. Unfortunately, studies monitoring CR during ICE with concurrent PBL in physical therapy education are sparse. We hypothesized that ICE with concurrent PBL would be associated with improved self-reported CR in third-year student physical therapists (PTs) in the United States. The Self-Assessment of Clinical Reflection and Reasoning (SACRR) survey was administered to 42 student PTs at the beginning and end of their third and final year of didactic training. Between the pretest and posttest analyses, the participants completed faculty-led ICE and PBL coursework for 16 weeks. The overall SACRR score and 26 individual item scores were examined. The Wilcoxon rank-sum test and paired t-test were used, with statistical significance accepted at P< 0.05. Significant improvements were observed in the overall SACRR score (P< 0.001), including 6 of the 26 survey items centered around decision-making based on experience and evidence, as well as self-reflection and reasoning. ICE with PBL was associated with improved self-assessed CR and reflection in third-year student PTs in the United States. Monitoring the impact of curricular design on CR may improve educators’ ability to enhance cognitive and psychomotor skills, which underscores the importance of increasing the explicit use of theoretical frameworks and teaching techniques for coping with uncertainty as a way of enhancing entry-level training.

Key pairing and enciphering heuristics must be free from complexity whereas amount of confidentiality directs the adaptability of encryption and decryption scheme because an extensive ciphertext requires extra space complexity and more communication time. Fast and secure authenticators are present in the literature. As compared to RSA, an elliptic curve in secure paring using smallest size of key is more efficient without sub-exponential attack on the Discrete Logarithmic problem. This paper focuses on analytical representation of different elliptic curves used in pairing of devices in ad-hoc network. BN, BLS and KSS curves are mostly used in the Elliptic cryptography systems. Assortment of an appropriate Hash function in elliptic curve and constraints for pairing has great impact on security level and complexity. Analytically proved the performance of BLS curve with different embedding degree in terms of computation time is fair enough.

In the 1960s at Stanford University's Bing Preschool, children were given the option of taking an immediate, smaller reward or receiving a delayed, larger reward by waiting until the experimenter returned. Since then, the "Marshmallow Test" has been used in numerous studies to assess delay of gratification. Yet, no prior study has compared the performance of children across the decades. Common wisdom suggests children today would wait less long, preferring immediate gratification. Study 1 confirmed this intuition in a survey of adults in the United States (N = 354; Mdn age = 34 years). To test the validity of this prediction, Study 2 analyzed the original data for average delay-of-gratification times (out of 10 min) of 840 typically developing U.S. children in three birth cohorts from similar middle-high socioeconomic backgrounds in the late 1960s, 1980s, and 2000s, matched on age (3 to 5 years) at the time of testing. In contrast to popular belief, results revealed a linear increase in delay over time (p < .0001, ηp2 = .047), such that children in the 2000s waited on average 2 min longer than children in the 1960s, and 1 min longer than children in the 1980s. This pattern was robust with respect to age, sex, geography and sampling effects. We posit that increases in symbolic thought, technology, preschool education, and public attention to executive function skills have contributed to this finding, but caution that more research in diverse populations is needed to examine the generality of the findings and to identify causal factors. (PsycINFO Database Record

The nature of wireless ad hoc network is such that communication between the nodes is extremely volatile, resultantly the quality of the wireless links is heavily unstable. Implementation of algorithms with enormous processing power and memory capacity for small and restricted resource-constrained wireless nodes is an inspiring task. Performance and behaviour estimation and comparison of wireless ad hoc network protocols, simulations are upright solution between cost and complexity, on the one side, and accuracy of the results, on the other side. Such simulation tools should allow researchers to verify new ideas and compare the proposed solutions in a virtual environment helping to avoid unnecessary, time-consuming or expensive hardware implementations. Difficulty arises in selection of wireless ad hoc network simulator for specific objective, features and usability due to the prensence of lots of simulators. Reusability, availability, performance, scalability, support for rich-semantics, scripting languages and graphical support are the main requirments for best framework of the wireless ad hoc network simulator. Within the study, we have described desirable and valuable missing features of the simulators, demarcation of their strength and weaknesses. Lot of effort is required for installation, habituation, implementation and visualization of wireless ad hoc network simulator. A lot of researchers and Scholars can seek help from this paper to identify the suitability of simulator for their study.

Overview: A recent evaluation of children who had participated in the Parent-Child Home Program (PCHP) as toddlers found that at kindergarten age, these children were performing at levels expected for their age, despite the fact that they had multiple factors putting them at risk for school failure. The Study: In the winter and spring of 2002, 135 kindergartners in five Long Island school districts received a battery of tests focusing on 2 interrelated areas of school readiness: social-emotional skills such as the ability to follow teachers' directions and early literacy skills such as knowledge about books and about the alphabet. In addition, keeping in mind the recommendation of the National Education Goals Panel with regard to school readiness, parents were interviewed about their participation in and support of children's learning at home and at school. Children who had participated in PCHP at ages 2 and 3 were compared, at kindergarten age, with classmates who had not been in the program. Preliminary...

A prospective study examined the effects of maternal unresponsivity and of toddlers’ own negative affect on the child’s subsequent ability to use effective attentional control strategies in preschool. Maternal and child behaviors were measured in situations that varied in the level of stress to test the hypothesis that behaviors in high stress situations would be more diagnostic of children’s subsequent self-regulatory behavior. As predicted, both maternal unresponsivity and toddlers’ negative affect, particularly in a high stress as opposed to a low stress situation, predicted children’s later use of ineffective attentional control strategies. Similarly, maternal disengagement that occurred contingent to toddlers’ distress predicted ineffective attentional control strategies whereas maternal disengagement in response to toddlers’ non-distress behaviors did not. The findings supported the utility of a contextual approach to understanding the impact of maternal and child characteristics on the development of self-regulatory skills.

This study determined the pathogenic potential of Staphylococcus epidermidis. Ninety-one isolates from patients with infectious keratitis and 38 from controls were studied for slime production. Thirty-six ulcer isolates (39.5%) and 6 controls (15.7%) were slime positive. Significantly more slime-positive strains were isolated from patients with moderate to severe degrees of ulcerative keratitis than from controls. Keratitis induced in rabbits also showed that slime-positive organisms produced the severe from of ulcerative lesions.

The aim of this study was to determine the evolving trends of retinopathy of prematurity (ROP) at a tertiary neonatal intensive care unit. In an ongoing screening programme for ROP, we estimated the incidence of ROP among at-risk neonates in a tertiary care unit. We compared our data over the last 12 months (1999-2000; period II) to the previously published data (1993-94; period I) to study changes in the spectrum of the disease. The overall incidence of ROP in period II was not significantly different from the incidence in period I (32 vs. 20 per cent, p > 0.05). However, a decreasing trend in the proportion of severe ROP (stage III) from 46 to 21 per cent in the later period was noted. The need for cryotherapy also dropped significantly compared with the earlier period (8 vs. 46 per cent respectively, p < 0.05). On multivariate analysis, apnea (p < 0.001; RR = 12.5; 95 per cent CI, 3.03-50.9; clinical sepsis (p < 0.001; RR = 5.7; 95 per cent CI, 1.6-20.7); and male sex (p < 0.001; RR = 6.3; 95 per cent CI 1.6-25.5) emerged as significant risk factors. Although the incidence of ROP is static, the more severe form of the disease (stage III) is showing a decline. Our data suggests that efficient management of apnea and sepsis may be crucial in further minimizing the risk of ROP.

Toddlers' use of effective attention deployment strategies to cope with separation from the mother and with maternal behavior predicted the use of effective delay-of-gratification strategies at age 5, even though the contexts, measures, and manifest behaviors were different. Toddlers who used distraction strategies during a brief separation from the mother were able, at age 5, to delay immediate gratification longer for more valued rewards. Toddlers who explored at a distance from a controlling mother when she tried to engage the child also delayed longer and used more effective delay strategies at age 5, compared with toddlers who did not distance themselves. Toddlers whose mothers were not controlling showed the opposite pattern: Those who did not distance themselves from the mother's bids had longer preschool delay times and more effective strategies. Strategic attention deployment was shown to be an enduring self-regulatory skill visible in early development across domains, measures, and over time.

We report a rare presentation of a massive, locally aggressive, fibrous histiocytoma of the orbit. The importance of histopathological grading and appropriate management are highlighted.

One of the important aspects of MANET is the restraint of quantity of available energy in the network nodes that is the most critical factor in the operation of these networks. The tremendous amount of energy using the mobile nodes in wireless communication medium makes Energy Efficiency a fundamental requirement for mobile ad hoc networks. The cluster-based routing protocols are investigated in several research studies which encourage more well-organized usage of resources in controlling large dynamic networks. Clustering can be done for different purposes, such as, routing efficiency, transmission management, backbone management etc. Less flooding, distributed operation, locally repairing of broken routes and shorter sub-optimal routes are the main features of the Clustering protocol. In this paper, we present quantifiable analysis of energy efficient cluster-based routing protocol for uninterrupted stream queries.

In this study, the ocular surface anaesthetic and analgesic efficacies of 0.5% and 1% centbucridine both in saline were compared with 4% lignocaine drops in distilled water in normal healthy volunteers divided into three equal groups. In 99 healthy eyes, keeping one eye as an unanaesthetized control, one drop of any of the above three coded drugs was instilled in the contralateral eye, followed by one more drop of the same drug in the same eye after 3 minutes. The oneset of anaesthesia, achievement and duration of peak activity, total duration of action, the depth of analgesia, and period of burning sensation were all noted in this double-masked randomized controlled trial with the various drug solutions. Total peak duration of anaesthetic as well as analgesic effects in the 99 healthy normal eyes were found to be the highest with centbucridine 1%, followed by 4% lignocaine and 0.5% centbucridine respectively.

We describe a bimanual chopstick technique for nucleus removal after a posterior capsule tear and an impending dropped nucleus during phacoemulsification. The technique stabilizes the nucleus and nuclear fragments by providing posterior support with a Sinskey hook introduced from the pars plana. Once supported, the nucleus is gripped between 2 instruments, brought out of the capsular bag into the anterior chamber, and then taken out of the enlarged wound. This bimanual removal technique causes minimal disturbance to the vitreous, iris, and cornea.

Purpose: To evaluate the success of and timing for intervention in retinopathy of prematurity (ROP). Patients and Methods: Eighty-two eyes of 50 children with stage 3 ROP were divided into two groups based on severity. Cryotherapy or laser therapy was performed soon after the detection of threshold stage in the first group of 40 eyes and at a prethreshold stage in the second group of 42 eyes. The patients were observed from 4 months to 2 years and regression or progression was noted. Unfavorable outcomes including macular and disc drag ano the progression of ROP to stages 4 and 5 were correlated with birth weight, gestational age, age at threshold, and age at intervention. Results: Regression of ROP occurred in 75 (91.46%) of the eyes. An overall unfavorable outcome occurred in 14 (17.07%) of the eyes, 11 of which reached threshold during the critical period of 37 to 39 postconceptional weeks of age. Of the cases (n = 14) with an unfavorable outcome, 9 eyes (22.5%) were in the group treated in the threshold stage (n = 40) and 5 eyes (11.9%) were in the group treated at a prethreshold stage (n = 42). The mean birth weight, gestational age, age at threshold, and age at intervention in the favorable and unfavorable outcome groups were 953.2 ± 2.19 g and 1,059.57 ± 2.62 g, 28.63 ± 2.03 weeks and 28.36 ± 1.98 weeks, 38.04 ± 2.13 weeks and 37.71 ± 1.13 weeks, and 38.32 ± 2.34 weeks and 38.25 ± 1.05 weeks, respectively. Conclusion: Early intervention at a prethreshold stage of ROP or at a younger postconceptional age (ie, younger than 37 weeks) may decrease the incidence of an unfavorable outcome. J Pediatr Ophthalmol Strabismus 2003;40:330-334.

Fine-needle aspiration cytology (FNAC) was performed on an intraocular mass in a 32-yr-old Indian woman and a cytologic diagnosis of malignant melanoma was made, supported by immunocytochemistry. The cytologic features included spindle-shaped tumour cells with minimal pleomorphism and the presence of nuclear grooves. No intracellular pigment was identified; however, positivity for HMB-45 allowed a rapid and reliable diagnosis. The utility of FNAC in an atypical presentation of choroidal melanoma is discussed.

Luxation of the globe is a rare event that results from severe trauma to the orbit, often causing orbital rim and wall fractures. Though associated globe rupture often necessitates enucleation, repositioning of the globe can be attempted in these cases if the globe is intact. We report a case of globe luxation and optic nerve transection with its surgical management. A 17-year-old male presented with anterior luxation of the right globe and optic nerve transection following blunt trauma to the orbit. Computerized tomography revealed an anteriorly subluxated globe with complete transection of the optic nerve and multiple fractures of the orbital walls. The orbit was explored and the globe repositioned in the orbit with reattachment of the muscles. Postoperatively, the globe was in normal position with moderate motility and excellent overall cosmesis. Though the visual prognosis in these cases is usually extremely poor and depends on the extent and duration of injury, preservation of the globe not only helps the patient recover psychologically from the trauma but also allows better cosmesis.

Objective To evaluate the efficacy of 1-mm oversized corneal grafts in patients with acquired corneal opacities and extensive peripheral iridocorneal adhesions. Design Prospective noncomparative case series. Participants Twenty patients (20 eyes) aged 15 years or older with unilateral or bilateral corneal opacification and a shallow anterior chamber. Intervention Penetrating keratoplasty was performed with donor corneal buttons oversized by 1 mm. Main outcome measures The various parameters evaluated were visual acuity, graft clarity, keratometry, anterior chamber depth, intraocular pressure, and spherical equivalent refraction 12 months after surgery. Results The keratoplasties were performed in 15 eyes with a corneo-iridic scar after infectious keratitis (75%) and 5 eyes with failed graft (25%). At the final follow-up, a clear graft was achieved in 17 eyes (85%), and 14 eyes (70%) achieved a best-corrected visual acuity of 6/12 or better. Three of the grafts failed because of rejection. The average keratometry was 44.1 ± 1.0 diopters (D), and the mean spherical equivalent was −3.23 ± 2.86 D. The oversized grafts provided a mean anterior chamber depth of 2.36 ± 0.42 mm, and the mean intraocular pressure at the 12 month follow-up was 16.38 ± 2.09 mmHg. Conclusions Corneal grafts oversized by 1 mm provide adequate anterior chamber depth and reduce the risk of peripheral anterior synechiae and secondary glaucoma in patients with corneal opacities and extensive peripheral iridocorneal adhesions.

Remote flaps may be used for lid reconstruction when tissue loss is extensive and there is insufficient tissue in the adjoining areas. Median forehead flaps are usually used for upper lid, medial canthal or nasal repairs. We describe a complicated reconstruction of the lid and correction of a deformity which resulted from the injudicious use of a glabellar flap for lower lid repair. Improper use of a median forehead flap may interfere with the functioning of the lid, leading to corneal exposure and poor cosmesis. Lower lid defects are better repaired by advancement flaps or techniques like Tenzel's semicircular flap, reverse Cutler Beard, Hughes procedure or Mustarde's repair.

Human immunodeficiency virus (HIV) often causes latent infection. Transactivation by some DNA viruses has been implicated in inducing HIV-1 replication and pathogenesis. The transactivator (IE-2) gene of the human cytomegalovirus (CMV) can enhance HIV-2 as well as HIV-1 gene expression in vitro. This inducer can act in concert with the HIV-2 tat gene and T-cell activation in enhancing gene expression in human CD4+ lymphocytes. While the HIV-2 and HIV-1 tat genes and T-cell activators apparently employ independent modes of action, the CMV transactivator in combination with the HIV-2 tat or T-cell activators may employ a gene activation pathway with some common and some distinct components. Both HIV-2 and CMV transactivators enhance HIV-2 gene expression by transcriptional activation involving transcript initiation as well as elongation, with CMV transactivator affecting elongation more than the initiation. A significant proportion of transcripts appear to terminate prematurely in the absence of transactivators. Deletion mutation analysis of the HIV-2 long terminal repeat (LTR) suggests that the element that responds to CMV transactivation in human CD4+ lymphocytes is either a diffuse one or located downstream of the HIV-2 enhancer element.

Causal attributions for repeated success and failure by individuals differing in their achievement needs were examined. Undergraduate students (N=48) of Allahabad University, Allahabad, India were selected as high and low need achievers by administering the Indian adaptation of the Edward Personality Preference Schedule. The students were given anagram tasks on which they either succeeded or failed in all three trials. High need achievers showed an increased tendency, in comparison to low need achievers, to attribute success to their own efforts and to attribute failure to both lack of effort and task difficulty. As predicted by Weiner's theory, affective responses correlated with internal causes and expectations with stable causes. These linkages were, however, stronger in the case of high need achievers under the failure condition.