Geometric parameters of HEXA parallel robot.
\r\n\tThe formation and development of seagrass meadows take many years. Among all the plant habitats in the world, the most carbon storage feature belongs to seagrass with 2000 tons/ha. Posidonia oceanica is the most important seagrass species for primary production and is endemic to the Mediterranean. This species is a perennial herb that spreads to a depth of 45 meters on the Mediterranean coast and can live up to 30 years. Their presence is indicative of clean seas.
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This problem is almost impossible to be solved analytically. Numerical methods are the most common approaches to solve this problem. Nevertheless, the possible lack of convergence of these methods is the main drawback. In this chapter, two types of neural networks – multilayer perceptron (MLP) and wavelet based neural network (wave-net) - are used to solve the forward kinematics problem of the HEXA parallel manipulator. This problem is solved in a typical workspace of this robot. Simulation results show the advantages of employing neural networks, and in particular wavelet based neural networks, to solve this problem.
The idea of designing parallel robots started in 1947 when D. Stewart constructed a flight simulator based on his parallel design (Stewart, 1965). Then, other types of parallel robots were introduced (Merlet, 1996). Parallel manipulators have received increasing attention because of their high stiffness, high speed, high accuracy and high carrying capability (Merlet, 2002). However, parallel manipulators are structurally more complex, and also require a more complicated control scheme; in addition, they have a limited workspace in compare to serial robots. Therefore, parallel manipulators are the best alternative of serial robots for tasks that require high load capacity in a limited workspace.
A parallel robot is made up of an end-effector that is placed on a mobile platform, with
Similar to serial robots, kinematic analysis of parallel manipulators contains two problems: forward kinematics problem (FKP) and inverse kinematics problem (IKP). In parallel robots unlike serial robots, solution to IKP is usually straightforward but their FKP is complicated. FKP involves a system of nonlinear equations that usually has no closed form solution (Merlet, 2001).
Traditional methods to solve FKP of parallel robots have focused on using algebraic formulations to generate a high degree polynomial or a set of nonlinear equations. Then, methods such as interval analysis Merlet, 2004), algebraic elimination (Lee, 2002), Groebner basis approach Merlet, 2004) and continuation (Raghavan, 1991) are used to find the roots of the polynomials or to solve nonlinear equations. The FKP is not fully solved just by finding all the possible solutions. Further schemes are needed to find a unique actual position of the platform among all the possible solutions. Use of iterative numerical procedures (Merlet, 2007), (Wang, 2007) and auxiliary sensors (Baronet et al., 2000) are the two commonly adopted schemes to further lead to a unique solution. Numerical iteration is usually sensitive to the choice of initial values and nature of the resulting constraint equations. The auxiliary sensors approach has practical limitations, such as cost and measurement errors. No matter how the forward kinematics problem may be solved, direct determination of a unique solution is still a challenging problem.
Artificial neural networks (ANNs) are computational models comprising numerous nonlinear processing elements arranged in patterns similar to biological neural networks. These computational models have now become exciting alternatives to conventional approaches in solving a variety of engineering and scientific problems. Traditional neural networks are back propagation networks that are trained with supervision, using gradient-descent training technique which minimizes the squared error between the actual outputs of the network and the desired outputs. Two common types of them are multilayer perceptron (MLP) and radial basis function (RBF) are used in modeling of different problems. Recently wavelet neural networks have been presented by Zhang et al. in 1992 based on wavelet decomposition (Zhang et al., 1992). The proposed wavelet neural network (WNN) inspired by feed forward neural networks and wavelet decompositions is an efficient alternative to multilayer perceptron (MLP) and redial basis function (RBF) neural networks for process modeling and classifying problems. The structure of proposed WNN is similar to that of the radial basis function (RBF) networks, except that their main activation function is replaced by orthogonal basis functions with simple network topology (Zhang, 1995). The WNN can further result in a convex cost index to which simple iterative solutions such as gradient descent rules are justifiable and are not in danger of being trapped in local minima when choosing the orthogonal wavelets as the activation functions in the nodes (Zhang et al., 1992). Wave-nets are a class of wavelet-based neural networks with hierarchical multiresolution learning. Wave-nets were introduced by Bakshi and Stephanopoulos (Bakshi & Sephanopolus, 1993). Then, their nature and applications were thoroughly investigated by Safavi (Safavi & Romagnoli, 1997). There have also been other attempts at using wavelets for NNs, with the learning algorithms that are different from wave-nets (Szu et al., 1992).
Some researchers have tried using neural networks for solving the FKP of parallel robots (Geng et al., 1992), (Yee, 1997). Almost all of prior researches have focused on using ANNs approach to solve FKP of Stewart platform. Few of them have also applied this method to solve FKP of other parallel robot (Ghobakhlo et al., 2005), (Sadjadian et al., 2005). In this chapter, we focus on HEXA parallel robot, first presented by Pierrot (Pierrrot et al.,1990), whose platform is coupled to the base by 6 RUS-limbs, where R stands for revolute joint, U stands for universal joint and S stands for spherical joint (see Fig. 2). Complete description of HEXA robot is presented in Section 2.
The solution of IKP of HEXA was first presented in (Pierrrot et al., 1990) by F. Pierrrot who solved the system of nonlinear equations and obtained a unique solution for the problem. A numerical solution for FKP of HEXA parallel robot was presented by J.P. Merlet in (Merlet, 2001). FKP of this robot has no closed form solution and at most 40 assembly modes (assembly modes are different configurations of the end-effecter with given values of joint variables) exist for this problem. He suggested iterative methods for solving HEXA FKP. But, these methods have some drawbacks, such as being lengthy procedures and giving incorrect answers (Merlet, 2001). Utilization of the passive joint sensors; however, enables one to find closed form solutions. In (Last et al., 2005) it has been shown that a minimum number of three passive joint sensors are needed for solving the FKP analytically.
In this chapter, two neural network approaches are used to solve FKP of HEXA robot. To carry out this task, we first estimate the IKP in some positions and orientations -posses- of the workspace of the robot. Then a multilayer perceptron (MLP) network and a wave-net are trained with data obtained by solving IKP. We test the networks in the other positions and orientations of the workspace. Finally the simulation results will be presented and these two networks will be compared.
A typical RUS parallel robot (
The rest of the chapter is organized as follows: Section 2 contains HEXA mechanism description. Kinematic modeling of the manipulator is discussed in Section 3 where inverse and forward kinematics are studied and the need for appropriate method to solve forward kinematics is justified. MLP network and wave-net method to solve FKP are discussed in section 4. In section 5 the results of solving FKP for HEXA parallel manipulator robot by these networks are presented. Comparison of these networks and conclusion are discussed in section 6.
There are different classes of parallel robots. Undoubtedly, the most popular member of the 6-RUS class is the HEXA robot (Pierrrot et al., 1990), of which an improved version is already available. The first to propose this architecture, however, was Hunt in 1983 (Hunt, 1983). Some other prototypes have been constructed by Sarkissian in 1990 (Sarkissian et al., 1990), by Zamanov (Zamanov et al. 1992) and by Mimura in 1995 (Mimura, 1995). The latter has even performed a detailed set of analyses on this type of manipulator. Two other designs are also commercially available by Servos & Simulation Inc. as motion simulation systems (Merlet, 2001). Finally, a more recent and more peculiar design has been introduced by Hexel Corp., dubbed as the “Rotary Hexapod” (Merlet, 2001). Among these different versions, Pierrrot’s HEXA robot is considered in this chapter (see Fig. 2).
Pierrrot’s HEXA robot (Pierrrot
All types of HEXA robots are 6-DOF parallel manipulators that have the following characteristics:
a) With multiple closed chains, it can realize a greater structural stiffness.
b) To prevent the angular error of each motor from accumulating, it can realize a higher accuracy of the end-effecter position.
c) As all the actuators can be placed collectively on the base, it can realize a very light mechanism.
Consequently, HEXA enjoys the advantages of faster motions, better accuracy, higher stiffness and greater loading capacities over the serial manipulators (Uchiyama et al., 1992).
As in the case of conventional serial robots, kinematics analysis of parallel manipulators is also performed in two phases. In forward or direct kinematics the position and orientation of the mobile platform is determined given the leg lengths. This is done with respect to a base reference frame. In inverse kinematics we use position and orientation of the mobile platform to determine actuator lengths. For all types of parallel robots, IKP is easily solved. For HEXA parallel robot this problem was solved by Pierrrot (Pierrrot et al., 1990). Brief solution of IKP is presented by Bruyninckx in (Bruyninckx, 1997). Fig. 3 shows one mechanical chain in HEXA design. In each chain, M specifies the length of the crank which is the mechanical link between the revolute and universal joints, and L gives the length of the rod which connects universal and spherical joints. Other parameters, H, h and a, are introduced as shown in Fig. 4 The relationship between the joint angles θ
In this equation, the joint angle θ
In each chain, a loop closure formulation can be adopted as follows (see Fig. 3):
It is possible to solve (3), (4), (5), for θ
where
The inspiration for neural networks comes from researches in biological neural networks of the human brains. Artificial neural network (ANN) is one of those approaches that permit imitating of the mechanisms of learning and problem solving functions of the human brain which are flexible, highly parallel, robust, and fault tolerant. In artificial neural networks implementation, knowledge is represented as numeric weights, which are used to gather the relationships between data that are difficult to realise analytically, and this iteratively adjusts the network parameters to minimize the sum of the squared approximation errors using a gradient descent method. Neural networks can be used to model complex relationship without using simplifying assumptions, which are commonly used in linear approaches. One category of the neural networks is the back propagation network which is trained with supervision, using gradient-descent training technique and minimizes the squared error between the actual outputs of the network and the desired outputs.
A typical chain of the HEXA design. The joint angle θ
The MLP is one of the typical back propagation ANNs and consists of an input layer, some hidden layers and an output layer, as shown in Fig. 5.
MLP is trained by back propagation of errors between desired values and outputs of the network using gradient descent or conjugate gradient algorithms. The network starts training after the weight factors are initialized randomly. Valid data consisting of the input vector and the corresponding desired output vector is fed to the network and the difference between the output layer result and the corresponding desired output result is used to adjust the weights by back propagation of the errors. This procedure continues until errors are small enough or no more weight changes occur. A first challenge in training the back propagation neural network is the choice of the appropriate network architecture, i.e. number of hidden layers and number of nodes of each layer. There is no available theoretical result which such choice may rely on. This can only be determined by user’s experience (Medsker et al., 1994).
Top views of the base and mobile platforms.
Schematic of the MLP network (
The hierarchical multiresolution wavelet based network, namely wave-net, was first introduced by Bakhshi (Bakshi and Sephanopolus, 1993) and was further investigated by Safavi (Safavi and Romagnoli, 1997). There has been another approach to develop wavelet based neural network with almost an MLP structure presented by Zhang (Zhang et al., 1992). However, the latter type of neural network lacks an efficient use of the capabilities of wavelets and multiresolution analysis and therefore is not considered in this chapter.
Wavelets are a new family of localized basis functions and have found many applications in quite a large area of science and engineering (Daubechies, 1992). These basis functions can be used to express and approximate other functions. They are functions with a combination of powerful features, such as orthonormality, locality in time and frequency domains, different degrees of smoothness, fast implementations, and in some cases compact support. Wavelets are usually introduced in a multiresolution framework developed by Mallat (Mallat, 1989). These are shortly explained in the following. Consider a function F(X) in L2(R), where L2(R) denotes the vector space of all measurable, square integrable one-dimensional functions. The function can be expressed as
where
Here, the function φm,k (not to be confused with the orientation angle φ)is called a scaling function of the multiresolution analysis (MRA) and a family of scaling functions of the MRA is expressed as;
To gain a thorough understanding of the role of scaling functions and wavelets within the multiresolution approximation framework see (Daubechies, 1992).
Equation (11) describes the basic framework of a wave-net in that it explains how each wavelet co-operates in the whole approximation scheme. It also shows that the scaling functions are only used at the earliest stage of approximation to produce F0, after which the approximation scheme uses only wavelets. Fig. 6 depicts a typical wave-net structure. The hierarchical nature of the scheme is also obvious. Once the first approximation to a function F is obtained, that is F0, one can get a better approximation, namely F-1, by including wavelets of the same dilation factor as the scaling function, here m=0. Adding wavelets of the next highest resolution, here m= -1, leads to an approximation F-2, finer than the previous one F-1. This process is continued until the original function is reconstructed or an arbitrary degree of accuracy for the approximation is obtained.
In the above hierarchical approach, wavelets with different dilations and translations are incorporated.
The approaches to find the network coefficients, am,k and dm,k are presented by Safavi (Safavi and Romagnoli, 1997).
The wave-net structure.
In order to model HEXA FKP with neural networks, first, a typical workspace for the robot is determined. Then, IKP is solved in some points of the workspace and finally the MLP and wave-net are trained with the data of IK solution in the typical robot workspace.
It is well known that parallel manipulators have a rather limited and complex workspace. Six parameters consisting of three coordinates of position of center of mass for mobile platform in the base frame (X, Y, Z) and three RPY orientation angles of mobile platform with respect to the base frame (three angles of mobile platform orientation in space consist of φ, ψ and θ angles, see Fig. 3) vary in the HEXA workspace.
Complete analysis of HEXA workspace is presented in (Bonev et al., 2000) by A. Bonev. We use a typical workspace shown in Fig. 7. In this workspace, end-effector can move 300 millimeters in both directions of X and Y axes; also it can move 600 millimeters in positive Z direction. In all positions of the workspace, mobile platform can rotate in the range of [-π/3, π/3] for φ, ψ and θ angles. Fig. 7 shows the typical workspace which is used in this chapter. The geometric parameters of the robot are given in Table 1.
H | h | M | L | a |
360mm | 51mm | 220mm | 280mm | 51mm |
Geometric parameters of HEXA parallel robot.
A typical workspace for the HEXA parallel robot.
Now a MLP network can be trained with the data generated by the solution of IKP. In order to model the FKP in terms of 6 variables of positions and orientations of the mobile platform, a MLP network with a configuration of 6×13×13×13×13×13×6 has been developed with the smallest error and has been used to model FKP. In other words, the ANN model has 6 inputs consisting of 6 joint angles, 5 hidden layers with 13 neurons in each layer, and 6 neurons in the output layer. The activation functions used in the hidden layers and the output layer are logarithmic and pure linear, respectively. The number of patterns used for training and test are 17500 and 35000, respectively. The network is trained over 1200 epochs with error back propagation training. Each network is evaluated by comparing the predictions and the true outputs, resulting in a prediction error for each orientation angle. The autocorrelation coefficients are also computed for the predicted error of each orientation angle.
In order to model the FKP with wave-net, MRA framework is used to approximate this process in different resolutions. Inputs, outputs and the number of patterns used for training and test are similar to the MLP network. The network is trained in resolutions m=0,-1 and -2 and the best results of modeling are reached at resolution -2. Figure 10 shows the training results for the successive resolutions zero, -1 and -2 for the X, Y, Z positions. For φ, ψ and θ angles the results are not represented due to the similarity and also to save space.
In this section the result of modeling FKP are presented. Error parameters in the tables are:
Figures 8-11 show the modelling error and the correlations between the outputs of networks and the target outputs.
Table 2 and Figs. 8 and 9 show the results of FKP solution by MLP; Table 2 shows the resulted errors of FKP modeling.
It is apparent from Table 2 that
Figures 10 and 11 show the results of FKP solution by wave-net. Table 3 shows the resulted errors of FKP modeling. In Table 3
In section 6 two approaches were used to model the FKP of HEXA robot – MLP network and wavelet based neural network. Though both neural network approaches showed great potential for this study, some comparison between these two approached are presented here. It is apparent from the results that errors of modelling by wave-net is less than MLP network, also the required time for modeling by wave-net is smaller than MLP; therefore, the wave-net modeling shows superior results in comparison to the MLP. Table 4 shows the results of modeling with these networks.
Figure 11 shows the linear regression between target X and Y positions and wave-net outputs. The same regressions can be obtained for φ, θ and ψ angles and Z position which are omitted here because of the similarity.
Variable | mse | mae | nrmse | R |
X | 1.3232e-005 | 0.0089 | 0.01 | 0.999 |
Y | 5.76992e-006 | 0.0076 | 0.0094 | 0.999 |
Z | 1.79034e-005 | 0.0091 | 0.0045 | 0.999 |
φ | 5.77768e-006 | 0.01 | 0.0073 | 0.988 |
θ | 1.20364e-006 | 0.009 | 0.0034 | 0.988 |
ψ | 2.1676e-006 | 0.0087 | 0.0045 | 0.999 |
The resulted errors of FKP modeling by test data with MLP network.
The results of HEXA parallel robot modeling with ANN for X,Y,Z axes and φ, ψ, θ angles, from 8-a to 8-f, respectively.
The error of HEXA parallel robot modeling with ANN for X,Y,Z axes and φ, ψ, θ angles, from 9-a to 9-f, respectively.
Modeling results of X, Y, Z positions in resolution 0,-1 and -2 by the trained data, respectively.
Modeling results of X and Y positions with the wave-net, a is X model and b is Y model.
Variable | mse | mae | R |
Ψ | 8.2568e-010 | 2.5947e-004 | 1 |
Y | 2.6346e-013 | 4.6090e-006 | 1 |
Z | 1.2103e-006 | 4.7103e-002 | 0.9999 |
Φ | 1.1402e-09 | 2.9911e-004 | 0.9999 |
Ө | 8.2568e-09 | 2.5947e-003 | 1 |
X | 1.8501e-015 | 3.1252e-008 | 1 |
The resulted errors of FKP modeling by test data with wave-net.
Wave-net | MLP | |||||
Training time 33 min | Training time 123 min | |||||
Variable | mse | mae | R | mse | mae | R |
Ψ | 8.26e-010 | 2.60e-004 | 1 | 1.33e-005 | 0.0089 | 1 |
Y | 2.64e-013 | 4.61e-006 | 1 | 5.77e-006 | 0.0076 | 1 |
Z | 1.21e-006 | 4.71e-002 | 0.999 | 1.79e-005 | 0.0091 | 0.999 |
Φ | 1.15e-09 | 2.99e-004 | 0.999 | 5.78e-006 | 0.01 | 0.999 |
Ө | 8.26e-09 | 2.60e-003 | 1 | 1. 1.20e-006 | 0.009 | 1 |
X | 1.85e-015 | 3.13e-008 | 1 | 1.85e-015 | 3.13e-008 | 1 |
The comparison between results of modeling by wave-net and MLP.
In this chapter, we proposed to use neural networks for FK solution of HEXA robot, which can be elaborated to generate the best estimation of forward kinematics of the robot. The research results in this chapter are quite important as they solve a problem for which there is no known closed form solution. Besides, the presented solution in this research has the better prediction and obtains smaller error in compare to the other works which have studied FKP of HEXA robot to the best of our knowledge.
Corticosteroids play an important role in the pharmacological treatment in different otorhinolaryngological disorders such as Sudden Sensorineural Hearing Loss (SSNHL), Meniere’s Disease (MD), Tinnitus and as a supportive treatment in the different ENT (ear-nose-throat) surgery procedures, including cochlear implantation (CI). The effectiveness of therapy of corticosteroids in otorhinolaryngology depends on many different factors. The main are: the duration of the therapy, occurrence or not of adverse reactions, especially in those patients with additional risk factors as comorbidities. A widely discussed challenge among ENT scientists is the optimal way of administration of corticosteroids – local or systemic – due to the different pharmacokinetic and pharmacodynamic properties of corticosteroids. One of these is the effective delivery way of a drug to its place of action, because of the presence of blood-labyrinth barrier (BLB) and the inaccessibility due to the inner ear.
From a pharmacokinetic point of view, the inner ear can be considered to be made up of multiple fluid compartments in hydrostatic balance (maintained by the blood-labyrinth barrier). The pharmacokinetic process is helpfully described by the acronym LADME (L – liberation; A – absorption; D – distribution; M – metabolism; E – elimination). The first step – liberation – means that the drug (or its carrier) must be water-soluble, so it can easily be carried in the blood [1].
The next pharmacokinetic step is absorption and depends on lipophilicity and the solubility of the drug [1]. Only a few drugs can be used effectively in otorhinolaryngological practice due to the difficulty of achieving sufficient concentrations in the inner ear [2]. Two groups of drugs are commonly used in clinical practice: aminoglycosides (mainly gentamicin) in the pharmacotherapy of Meniere’s disease, and corticosteroids (dexamethasone, triamcinolone) in pharmacotherapy for idiopathic sudden sensorineural hearing loss and other cases of acute hearing loss [3].
The distribution process depends on many different factors as a route of administration, mode of administration, single or repeated administration, dose, ionic composition, pH, and osmolarity. The elimination of a drug from the body (its clearance rate) depends on the same set of chemical and physical properties. A key factor here is the protein binding of the drug: the greater the protein binding of the drug, the longer its therapeutic activity. The finite binding between the protein and the drug molecule allows the drug to gradually liberate.
As far as, the inner ear drug delivery strategies are concerned, three routes of administration are possible: systemic (intravenous, oral), intratympanic, and intracochlear [4]. Systemic administration of glucocorticoids is reasonable due to pharmacological properties such as the lipophilic nature of glucocorticoids and vascularity of the middle ear mucosa [5]. Blood labyrinth barrier (BLB) and round window membrane (RWM) are two main challenges in delivering drugs to the inner ear. Blood labyrinth barrier is the most important barrier that separates the inner ear from systemic blood circulation and, as a result, maintains the microhomeostasis in the inner ear. This barrier protects also the integrity of the inner ear due to the presence of efflux pumps system such as MRP-1 (multidrug resistance-related protein-1) and P-glycoprotein. The tight junctions permit to penetrate only small lipid-soluble molecules. The concentration of corticoids in the perilymph increase when the osmotic agent (e.g. glycerol) is added. RWM is a soft tissue barrier which role is to separate the inner ear from the middle ear and it is permeable to low molecular weight molecules such as corticoids. Generally and despite the adverse effects, systemic delivery (oral, intravenous, intramuscular routes) is still considered as the most convenient method of drug administration and the first-line approach in the treatment of inner ear disorders [4]. Additionally, both oral and intravenous route of administration is complied with the characteristic of medical products used in this study.
The intratympanic route of administration may be performed via injection or perfusion to the middle ear. The drawbacks of intratympanic delivery of drug include such barriers as: anatomic barriers (RWM), loss of drug in the middle ear cavity through the Eustachian tube and the pharmacokinetic profile of administrated drugs is unknown or variable [6, 7]. As a result, the number and percentage of drugs that may enter the inner ear are relatively low.
The intracochlear route of drug delivery can bypass the middle ear and allows drug to get the direct place of action. Although this strategy seems to be more risky in terms of deafness, according to the observations of surgical procedures which include perforation and significant manipulations [8]. Currently, there is no available safe and effective technique for intracochlear drug administration not only in terms of medical device but also in terms of appropriate drug formulation [4].
In the summary, the inner ear is a very subtle and complicated organ from anatomical and physiological point of view. Hearing loss may be one of the most dangerous and severe adverse effects in the inner ear caused by novel drug delivery systems. All routes of drug administration should be carefully examined and considered.
In a study published in 2018, Plontke, Götze, Rahne & Liebau compared the effects of dexamethasone with saline (in a guinea pig model). Both substances were administrated intravenously 60 minutes before implantation. The conclusion was that dexamethasone could reduce scarring in the hook region or near the electrode tip, but they did not see any relation between dexamethasone and reduction of fibrosis relating to cochleostomy. At the same time, in vitro studies have shown a correlation between reduction (loss) of auditory cells after exposure to tumor necrosis factor-alpha and dexamethasone-releasing polymer (used to coat the CI electrode carrier) [9, 10, 11, 12].
Cochlear implantation is a golden standard for patients who suffer from severe to profound hearing loss. The preservation of hearing in patients who underwent cochlear implantation depends, in the first place, on surgical technique, and in the second place, on the selecting of the appropriate electrode. The pharmacological treatment, such as administration of corticosteroids in different periods of cochlear implantation, is the third important factor [6, 7]. Insertion of the frequency-specific electrode array into the cochlea is a delicate operation and requires a very careful surgical technique. Even with the utmost care, however, it is difficult not to cause some tissue damage, especially in cases of partial deafness where there are still some partially functioning hair cells. In this situation, the use of corticosteroids (local or systemic) is important: these drugs can reduce oxidative stress, inflammatory reaction, and the apoptosis of hair cells due to insertion damage. A major challenge in effectively delivering pharmacological agents to the cochlea is its physical inaccessibility and the presence of a blood-labyrinth barrier. These factors are especially apt for patients suffering partial deafness, where the hair cells at the apex of the cochlea (responsible for receiving low frequencies) are anatomically remote.
Symptoms of Meniere\'s disease are defined as recurring episodes of spontaneous, usually rotational vertigo, sensorineural hearing loss, tinnitus, and a feeling of fullness or pressure in the affected ear for up to decades. The disease can be unilateral or bilateral. The diagnosis of the disease is made based on the symptoms present, however, it is sometimes difficult to make, because the diagnosis should exclude other diseases that exhibit symptoms similar to Meniere\'s disease, such as dizziness of other origins, occurring independently with hearing loss and tinnitus, and may react differently to treatment (e.g. mild positional vertigo, acute labyrinthitis, migraine) and to hearing neuronal. The disease most often affects adults between the ages of 30 and 60. It is estimated to affect 50-200/100,000 cases annually in Europe [13].
Meniere’s disease is associated with anatomical changes in the inner ear: the so-called endolymphatic swellings. The volume of the endolymph, which fills the endolymphatic labyrinth, increases while the volume of the perilymph, which surrounds the endolymphatic labyrinth and fills the bony labyrinth, decreases. However, swelling occurs in many other conditions associated with hearing loss and there is no known cause of this condition. Specific disorders associated with swelling (such as temporal bone fracture, syphilis, end-stage otosclerosis, and auditory nerve neuroma) may produce symptoms similar to those of Meniere\'s disease. Meniere\'s disease initially progresses but changes unpredictably. It is difficult to distinguish natural resolution from treatment effects, as dizziness resolves in 57% of patients after 2 years and 71% after 8 years with the disease [13, 14].
The primary goal of pharmacotherapy is to reduce the frequency, duration, and severity of vertigo attacks. The secondary goals are to stop the progression of hearing loss and to reduce the occurrence of tinnitus. Unfortunately, no medication can currently slow or stop the progression of hearing loss or stop tinnitus.
The use of corticosteroids (CS) in the treatment of MD has been implicated because of the presence of autoimmune disorders in the course of the disease, and the role of the innate immune system and inflammation in the pathophysiology of MD. Studies have revealed the presence of glucocorticoid receptors in the inner ear. The action of corticosteroids in the course of MD is based on their anti-inflammatory and immunosuppressive effects, as well as regulation of inner ear homeostasis [15, 16, 17]. The treatment of MD includes the use of oral dexamethasone or methylprednisolone to reduce vomiting and vestibular symptoms, particularly in cases of marked hearing loss, but there are no RCTs showing any long-term benefit of steroids in MD [16]. When administered by intratympanic injection, CS achieve higher concentrations in the inner ear compared to systemic administration, with fewer systemic side effects [16, 18]. Substances administered intratympanically include dexamethasone and methylprednisolone, one that triamcinolone is also a therapeutic option. Studies have shown that methylprednisolone gives higher concentrations in the endolymph and perilymph than dexamethasone, but the latter drug may be more effective because it is more rapidly absorbed by endocytosis into the vascular striatum and surrounding tissues, where it acts intracellularly [19, 20]. Several retrospective/prospective control placebo or non-control studies have assessed intratympanic administration of CS, with varying remission results [14, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31]. An RCT study by Garduño-Anaya et al. showed that inner ear perfusion with dexamethasone (4 mg/ml) in a group of patients with unilateral Meniere\'s disease, demonstrated 82% complete control of vertigo compared to placebo (57%) [25]. In a subsequent study using an extended-release form of intrathecally administered dexamethasone, the form was shown to reduce the number of definitive days with dizziness, the severity of dizziness, and the mean daily number of dizziness compared with placebo at month 3 after drug administration [32, 33]. The systematic review combined these two RCTs with the Garduño-Anaya study with a total of 220 patients. The authors of this new review conclude that there is still no solid confirmation that ITC has a positive effect in MD [16, 34]. Although the results of some studies support the conclusion that high-dose steroid is effective in treating MD, the optimal treatment protocol has not yet been properly established. In addition, the development of an appropriate protocol to confirm the unequivocal efficacy of CS in MD is difficult because there is considerable variability in patients\' symptoms and over time, as well as a group of patients in the population who do not respond to CS treatment [14, 35, 36].
Sudden sensorineural hearing loss (SSNHL) is a syndrome that develops rapidly, with hearing loss progressing over 72 hours, hearing loss observed by at least 30 dB at 3 consecutive frequencies on tonal audiometry. It is considered an otologic emergency requiring immediate diagnosis and treatment. The disease can occur at any age; however, it most commonly affects patients 65 years of age or older. The annual incidence of SSNHL is 5-27 per 100,000. According to clinical guidelines for the treatment of SSNHL, systemic CS is recommended as initial therapy and intratympanic CS is recommended as salvage therapy, but the latter is increasingly used as first-line therapy. In addition, pharmacotherapeutic models combining both routes of administration are appropriate [37]. Because of the risk of catastrophic consequences of permanent severe hearing loss, administration of CS should be done as soon as possible, allowing the greatest improvement to be seen within the first two weeks, but continuing therapy for an additional 6 weeks. The mechanism of action of CS is still uncertain, but its effect is possible due to its ability to reduce inflammation and swelling [38]. Treatment uses a 7-14 day series of oral high doses of prednisone — (1 mg/kg/d max. 60 mg/d), methylprednisolone — 48 mg/d or dexamethasone at 10 mg/d, despite possible side effects [39]. Treatment by intratympanic injection has efficacy equivalent to systemic administration with the benefit of reducing the proportion of adverse reactions occurring after systemic administration as well as when oral administration is not possible or contraindicated [40, 41, 42, 43, 44, 45, 46]. In addition, Crane et al. also looked at the efficacy of intratympanically administered steroids against intratympanically administered steroids as initial therapy and showed no overall superiority of intratympanically administered steroids over systemic steroids, with the single exception of the Battaglia et al. study, which showed an advantage of using intratympanically administered CS without or in combination with systemic versus using systemic CS alone [39, 47, 48]. The frequency of IT steroid administration also varies widely in different studies, and may be self-administered by the patient through a pressure equalization tube several times a day to physician administration from once a day to once a week or less frequently. Intratympanic treatments include: Dexamethasone (DEX) at a dose of 1.5-2 mg, Methylprednisolone at a dose of 25-40 mg or Triamcinolone Acetonide at a dose of 40 mg [39, 49]. Alexander et al. in their retrospective study comparing the response to two different doses of DEX demonstrated that in patients receiving DEX the preferred unit dose of 24 mg/mL dexamethasone in a series of three doses over a 1-3 week period in a variable dose from 0.5-1 mL dependent on anatomical [50]. Given the available literature, corticosteroids may not be used to treat SSNHL in every case. However, for a patient with severe to profound SSNHL, corticosteroid treatment is one of the few treatment options for which there are any data indicating efficacy, although even these data are somewhat inconclusive.
Tinnitus is the perception of sound without an external stimulus. This symptom can occur alone or with other disorders such as hearing loss. Subjective tinnitus is the most common form of tinnitus, and globally, it can be detected in almost 10% of the general population, and approximately 20% of adults with tinnitus require clinical intervention. The most common site of subjective tinnitus is the cochlea, but other auditory pathways may also be responsible. Tinnitus can occur on one or both sides of the head and can be perceived as coming from inside the head or from outside the head, and is most common with coexisting sensorineural hearing loss. The presence of tinnitus has been shown to affect a patient\'s quality of life (QOL) in a variety of ways, ranging from a mild deterioration in QOL to severe anxiety, depression, and extreme life-altering events, including the presence of active suicidal thoughts. Many different treatments for tinnitus have been described, including: tinnitus correction, tinnitus masking, biofeedback therapy, and various pharmacological treatments; however, these treatments have limited effectiveness. The most common pharmacological treatments include intratympanic administration of aminoglycoside antibiotics and steroids. CS are used in the treatment of tinnitus due to their anti-inflammatory and electrolyte-modifying effects. According to the available literature, the therapeutic effect of drugs administered intratympanically occurs by diffusion through the round window, the annular ligament of the oval window, the capillaries, or through the lymphatic system of the inner ear. However, the effectiveness of intratympanic therapy in the treatment of tinnitus remains limited [51, 52]. The American Academy of Otolaryngology guidelines provide detailed patient management criteria and outline pharmacologic treatment options for patients with varying levels of confidence and recommendations. These recommendations address the treatment of tinnitus with intratympanic steroid injection and present models of pharmacotherapy using dexamethasone or methylprednisolone with or without concomitant therapy. Based on the RCTs cited in the guideline, steroids are not recommended for the treatment of vertigo because no treatment has shown a better response compared to placebo [51, 53, 54, 55, 56]. However, the scientific literature reports positive effects of steroid treatment of tinnitus, indicating that there is still a need for a broad investigation of the contribution of steroids to the treatment of tinnitus. In a study by Yaner et al. a statistically significant parameter score was obtained indicating positive treatment effects with intratympanic dexamethasone versus placebo [52]. Subsequently, a study by Shim et al. indicates the positivity of intratympanic injection of dexamethasone as an adjunctive treatment for tinnitus in patients treated with alprazolam [57]. The positive aspects of adding a steroid to therapy were confirmed by Albu and Chirtes, in their RCT. The addition of dexamethasone to melatonin therapy had a statistically significant effect on reducing tinnitus compared to melatonin alone [58]. Most articles on the subject conclude that intratympanic steroid injections are effective mostly in patients with acute tinnitus and mostly show no effect in those with chronic tinnitus [52, 59]. The studies presented here primarily utilize dexamethasone as the drug administered to the patient; however, it is not the only substance used. The literature reports that intratympanic administration of methylprednisolone has also been studied; however, data detailing the effectiveness of each substance in the treatment of tinnitus remains scarce. Only She et al. in their study compared the efficacy of two types of steroids together with oral carbamazepine, where they found no statistically significant differences indicating the benefit of using individual substances [55]. In opposition to these results indicating an effect of methylprednisolone, is a study by Topak et al. who in their placebo-controlled RCT showed that the steroid had no benefit in the treatment of subjective tinnitus of cochlear origin refractory to treatment [56]. For the treatment of tinnitus, the effect of subcutaneously administered triamcinolone acetonide was analyzed in an RCT by Diao et al. However, it has no obvious benefit over placebo for subjective tinnitus [60]. The use of steroids in the treatment of tinnitus is widespread, as illustrated by the multitude of studies that have been conducted, but there is still a need for strong evidence to support or exclude their use in the treatment of subjective tinnitus.
The main aim of the present study was to compare the hearing preservation levels of partial deafness patients following cochlear implant surgery when two different procedures for administrating dexamethasone (or dexamethasone and prednisone) were used with different cochlear implants. Patients enrolled in the study suffered severe to profound hearing loss and were classified according to the Skarżyński Partial Deafness Treatment (PDT) classification scheme [61] into two groups: PDT-EC (Partial Deafness Treatment – Electrical Stimulation)or PDT-EAS (Partial Deafness Treatment – Electro-Acoustic Stimulation) (Figure 1).
Partial deafness treatment groups for cochlear implantation. ENS – Electro-natural stimulation; EC – Electrical complement; EAS – Electrical-acoustic stimulation; ES – Electrical stimulation.
The inclusion and exclusion criteria were in accordance with the consensus of the international HEARRING group on hearing preservation in cochlear implantation. Study eligibility criteria were participants ≥18 years of age with a cochlear duct ≥27.1 mm (measured by computerized tomography), with:
hearing levels in the range of 10-120 dB HL at frequencies of 125–250 Hz;
hearing levels of 35–120 dB HL at frequencies of 500–1,000 Hz;
hearing levels of 75–120 dB HL at frequencies of 2,000–8,000 Hz.
Exclusion criteria included suffering from a severe disease for which steroid treatment could worsen the patient’s condition or where might be possible interactions between the patient’s medications and steroids. Non-parametric tests were used due to differences in the number of participants between subgroups, the small number of participants in the study, and the violation of normal distribution of pure tone audiometry results [62].
Patients who were enrolled in this prospective study were divided into 3 subgroups. Patients from the first subgroup underwent intravenous (IV) steroid therapy (Figure 2). For patients in the first subgroup, dexamethasone was administrated intravenously (0.1 mg per kg of body mass) 30 minutes before the cochlear implant surgery. The same dose was administered every 12 hours for 3 consecutive days (6 doses). The dexamethasone used in this study was supplied in ampoules of a 2 mL solution (4 mg/mL). Before injection, the sterile contents of the ampoule were diluted with isotonic sodium chloride solution. To standardize corticosteroid delivery, the IV route of administration was chosen.
Scheme of steroid administration in the first subgroup of patients.
Patients from the second subgroup underwent combined oral and IV corticosteroid therapy (prolonged steroid therapy) following cochlear implantation (Figure 3). Prednisone was administrated orally at a dose of 1 mg per kg of body mass 3 days before surgery. Then 30 minutes before the implantation surgery, dexamethasone at a dose of 0.1 mg per kg of body mass was administered IV (as with the first group). During the next 3 days, prednisone was administrated orally (1 mg of prednisone per kg body mass). After this time, the dose was reduced by about 10 mg per day until it reached zero. To investigate the effects of prolonged steroid administration, we chose to compare the IV and oral administration routes.
Scheme of administration of steroids in the second subgroup of patients.
The third subgroup was a control group. Patients enrolled in this group underwent a standard cochlear implantation procedure without steroid treatment.
The primary outcome variables were mean hearing thresholds averaged across all 11 measured frequencies (0.125–8 kHz). A secondary outcome variable was hearing preservation (HP). HP was calculated by comparing hearing thresholds in the 1-year postoperative period with preoperative hearing thresholds according to the HP formula in section 3.3 and classified into one of three levels: minimal, partial, or complete hearing preservation.
The clinical effect of administered substances was evaluated by pure tone audiometry over six different periods: before cochlear implant surgery (first point), at the activation of the audio processor (second point), and 1 (third point), 6 (fourth point), 9 (fifth point), and 12 months (sixth point) after activation of the audio processor. There were three different periods in Medel and Oticon implants: the preoperatively period (the first point), at the activation of the audio processor (the second point), and 12 months after activation of the audio processor (the third point). Non-parametric tests were used due to the differences in size between each of the groups. Statistical analysis was performed using IBM SPSS software v.24.0.
The mean hearing preservation rate (HP) was 52.1% (SD = 36.7) in patients with standard steroid therapy, 71.4% (SD = 22.7) in patients with prolonged steroid therapy, and 22.1% (SD = 33.9) in the control group. The smallest variation in hearing preservation rate was observed in patients with prolonged steroid therapy.
Data concerning hearing preservation converted to three categories (minimal, partial, complete). HP is defined as follows (Figure 4).
Hearing preservation formula.
In this equation, PTApre is the pure tone average measured preoperatively, PTApostis the pure tone average measured postoperatively, and PTAmax is the maximum sound intensity generated by a standard audiometer (usually 120 dB HL) and HP is the degree of hearing preservation as a percentage [63].
Preoperatively, there were no statistically significant differences in hearing thresholds between patients in each of the three subgroups, including the control group, which means that all study participants had similar hearing levels in the preoperative period.
Deterioration of mean hearing thresholds in pure-tone audiometry (PTA) was observed from the first follow-up interval, which is at the time of sound processor activation. Statistically significant differences were observed between the second sub-group (combined steroid treatment: prednisone + dexamethasone) and the control group: patients in the second study subgroup have obtained better PTA results in low frequencies than the control group. A similar observation was made in the measurements performed at 1, 6, 9, and 12 months after activation of the sound processor – patients who underwent the combined (prolonged) glucocorticoid treatment had more stable hearing thresholds in all follow-up periods (Figures 5–8).
Average hearing thresholds in patients from the first subgroup with standard steroid treatment in the preoperative period, upon activation, at 1, 6, 9, and 12 months after CI.
Average hearing thresholds in patients from the second subgroup with combined steroid treatment in the preoperative period, upon activation, at 1, 6, 9, and 12 months after CI.
Average hearing thresholds in patients from the third subgroup (control) with standard steroid treatment in the preoperative period, upon activation, at 1, 6, 9, and 12 months after CI.
Average hearing thresholds in patients with standard steroid treatment (group 1), patients with prolonged steroid treatment (group 2), and control (group 3) in the preoperative period, upon activation, at 1, 6, 9, and 12 months after CI.
The rate of hearing preservation was calculated following the formula based on the PTA measurements performed 12 months after implant activation and preoperatively. The results were then divided into three groups according to the HP classification: minimal HP, partial HP, and complete HP. The smallest variability of results and the highest overall hearing preservation rate (38%) was observed in the second subgroup. All patients from the second subgroup (prolonged steroid treatment) and almost 69% of patients from the first subgroup had partially or fully preserved hearing. The majority of patients from the control group had minimal HP at 70.6% (see Table 1 and Figure 9).
Minimal HP (0–25%) | Partial HP (26%–75%) | Complete HP (75%-100%) | |
---|---|---|---|
Subgroup 1 | 5 (31.2%) | 7 (43.8%) | 4 (25.0%) |
Subgroup 2 | 0 (0.0%) | 8 (61.5%) | 5 (38.5%) |
Control Group | 12 (70.6%) | 3 (17.6%) | 2 (11.8%) |
HP measured 12 months after implantation, in relation to the therapy applied – the number and percent of patients.
Hearing preservation rate (HP) in three subgroups.
The role of glicocorticosteroids in the treatment of ENT diseases is very important. According to the results of this study have clearly shown the effect of steroids (dexamethasone and dexamethasone/prednisone) in stabilizing mean hearing thresholds in both experimental subgroups in comparison with the control subgroup during CI. In the preoperative period, the hearing thresholds of participants in all three subgroups were statistically indistinguishable. During the cochlear implantation, the appropriate scheme of pharmacology (corticosteroids) next to the surgical technique and the technology of cochlear implants are key in the cochlear implantation. The corticosteroids play an important role in the pharmacological treatment in different otorhinolaryngological disorders such as Sudden Sensorineural Hearing Loss (SSNHL), Meniere’s Disease (MD), Tinnitus and as a supportive treatment in the different ENT (ear-nose-throat) surgery procedures, including cochlear implantation (CI). The effectiveness of therapy of corticosteroids in otorhinolaryngology depends on many different factors. The main are: the duration of the therapy, occurrence or not of adverse reactions, especially in those patients with additional risk factors as comorbidities.
The authors declare no conflict of interest.
MD | Meniere’s Disease |
SSNHL | Sudden Sensorineural Hearing Loss |
ENT | Ear-Nose-Throat |
BLB | Blood-Labyrinth-Barrier |
CI | Cochlear Implantation |
CS | Corticosteroids |
LADME | L – liberation; A – absorption; D – distribution; M – metabolism; E – elimination |
RWM | Round Window Membrane |
DEX | Dexamethasone |
QOL | Quality of Life |
RCT | Randomized Clinical Trial(s) |
PDT | Partial Deafness Treatment |
PDT–EC | Partial Deafness Treatment – Electrical Stimulation |
PDT–EAS | Partial Deafness Treatment – Electro-Acoustic Stimulation |
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This chapter discusses the different types of UAVs, their application in pest control, crop irrigation, health monitoring, animal mustering, geo-fencing, and other agriculture-related activities. Beyond applications, the advantages and potential benefits of UAVs in agriculture are also presented alongside discussions on business-related challenges and other open challenges that hinder the wide-spread adaptation of UAVs in agriculture.",book:{id:"6864",slug:"autonomous-vehicles",title:"Autonomous Vehicles",fullTitle:"Autonomous Vehicles"},signatures:"Chika Yinka-Banjo and Olasupo Ajayi",authors:null},{id:"66432",doi:"10.5772/intechopen.85566",title:"Model of the Optimal Maneuver Route",slug:"model-of-the-optimal-maneuver-route",totalDownloads:901,totalCrossrefCites:7,totalDimensionsCites:9,abstract:"The chapter deals with the mathematical model for planning the optimal movement route, which has been implemented in the Tactical Decision Support System (TDSS). The model processes and evaluates the data contained in the five raster layers, which are tactically relevant for planning the movement route of troops or autonomous vehicles on the battlefield. The basis for calculating the optimal movement route is a ground surface layer, which is then modified by algorithmic and criterion relationships with the layers of hypsometry, weather attack, and the activities of enemy and friendly units. The result of mathematical model calculations is a time-optimized and safe movement route displayed on the topographic basis. The experiments realized have verified the function of the optimal movement route model when neither the reconnaissance group nor the autonomous vehicle was observed by the enemy. The total time of the UGV with the use of the TDSS to cover the route of maneuver was 67 minutes shorter than the real time of the BRAVO group movement with the use of the TDSS and 105 minutes shorter than the real time of the ALFA group without the use of the TDSS. The comparison of responses to the attack shows that the BRAVO group using the Maneuver Control System (MCS CZ) as part of the TDSS has destroyed the attackers faster by 71 seconds than the ALFA group without the use of the TDSS.",book:{id:"7779",slug:"path-planning-for-autonomous-vehicles-ensuring-reliable-driverless-navigation-and-control-maneuver",title:"Path Planning for Autonomous Vehicle",fullTitle:"Path Planning for Autonomous Vehicles - Ensuring Reliable Driverless Navigation and Control Maneuver"},signatures:"Jan Nohel, Petr Stodola and Zdeněk Flasar",authors:[{id:"162332",title:"Prof.",name:"Petr",middleName:null,surname:"Stodola",slug:"petr-stodola",fullName:"Petr Stodola"},{id:"286639",title:"Dr.",name:"Jan",middleName:null,surname:"Nohel",slug:"jan-nohel",fullName:"Jan Nohel"},{id:"287297",title:"Prof.",name:"Zdenek",middleName:null,surname:"Flasar",slug:"zdenek-flasar",fullName:"Zdenek Flasar"}]},{id:"51781",doi:"10.5772/64730",title:"Application of Sampling-Based Motion Planning Algorithms in Autonomous Vehicle Navigation",slug:"application-of-sampling-based-motion-planning-algorithms-in-autonomous-vehicle-navigation",totalDownloads:2368,totalCrossrefCites:7,totalDimensionsCites:7,abstract:"With the development of the autonomous driving technology, the autonomous vehicle has become one of the key issues for supporting our daily life and economical activities. One of the challenging research areas in autonomous vehicle is the development of an intelligent motion planner, which is able to guide the vehicle in dynamic changing environments. In this chapter, a novel sampling-based navigation architecture is introduced, which employs the optimal properties of RRT* planner and the low running time property of low-dispersion sampling-based algorithms. Furthermore, a novel segmentation method is proposed, which divides the sampling domain into valid and tabu segments. The resulted navigation architecture is able to guide the autonomous vehicle in complex situations such as takeover or crowded environments. The performance of the proposed method is tested through simulation in different scenarios and also by comparing the performances of RRT and RRT* algorithms. The proposed method provides near-optimal solutions with smaller trees and in lower running time.",book:{id:"5285",slug:"autonomous-vehicle",title:"Autonomous Vehicle",fullTitle:"Autonomous Vehicle"},signatures:"Weria Khaksar, Khairul Salleh Mohamed Sahari and Tang Sai Hong",authors:[{id:"182534",title:"Dr.",name:"Weria",middleName:null,surname:"Khaksar",slug:"weria-khaksar",fullName:"Weria Khaksar"}]}],mostDownloadedChaptersLast30Days:[{id:"63775",title:"Fundamental Research on Unmanned Aerial Vehicles to Support Precision Agriculture in Oil Palm Plantations",slug:"fundamental-research-on-unmanned-aerial-vehicles-to-support-precision-agriculture-in-oil-palm-planta",totalDownloads:2922,totalCrossrefCites:6,totalDimensionsCites:27,abstract:"Unmanned aerial vehicles carrying multimodal sensors for precision agriculture (PA) applications face adaptation challenges to satisfy reliability, accuracy, and timeliness. 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In particular, new types of these methods presented for the first time by the chapter’s authors have enormously influenced the progress of separation and LSB, resulting in postponing of the stall and enhancing the aerodynamic performance of wind turbine applications.",book:{id:"6864",slug:"autonomous-vehicles",title:"Autonomous Vehicles",fullTitle:"Autonomous Vehicles"},signatures:"Mustafa Serdar Genç, Kemal Koca, Hacımurat Demir and Halil Hakan Açıkel",authors:null},{id:"70496",title:"Sky-Farmers: Applications of Unmanned Aerial Vehicles (UAV) in Agriculture",slug:"sky-farmers-applications-of-unmanned-aerial-vehicles-uav-in-agriculture",totalDownloads:1826,totalCrossrefCites:10,totalDimensionsCites:18,abstract:"Unmanned aerial vehicles (UAVs) are unpiloted flying robots. The term UAVs broadly encompasses drones, micro-, and nanoair/aerial vehicles. 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Beyond applications, the advantages and potential benefits of UAVs in agriculture are also presented alongside discussions on business-related challenges and other open challenges that hinder the wide-spread adaptation of UAVs in agriculture.",book:{id:"6864",slug:"autonomous-vehicles",title:"Autonomous Vehicles",fullTitle:"Autonomous Vehicles"},signatures:"Chika Yinka-Banjo and Olasupo Ajayi",authors:null},{id:"63245",title:"Autonomous Underwater Vehicle Guidance, Navigation, and Control",slug:"autonomous-underwater-vehicle-guidance-navigation-and-control",totalDownloads:1249,totalCrossrefCites:3,totalDimensionsCites:3,abstract:"A considerable volume of research has recently blossomed in the literature on autonomous underwater vehicles accepting recent developments in mathematical modeling and system identification; pitch control; information filtering and active sensing, including inductive sensors of ELF emissions and also optical sensor arrays for position, velocity, and orientation detection; grid navigation algorithms; and dynamic obstacle avoidance among others. In light of these modern developments, this article develops and compares integrative guidance, navigation, and control methodologies for the Naval Postgraduate School’s Phoenix, a submerged autonomous vehicle. The measure of merit reveals how well each of several methodologies cope with known and unknown disturbance currents that can be constant or harmonic while maintaining safe passage distance from underwater obstacles, in this case submerged mines.",book:{id:"6864",slug:"autonomous-vehicles",title:"Autonomous Vehicles",fullTitle:"Autonomous Vehicles"},signatures:"Timothy Sands and Kevin Bollino",authors:[{id:"258189",title:"Prof.",name:"Timothy",middleName:null,surname:"Sands",slug:"timothy-sands",fullName:"Timothy Sands"}]},{id:"70382",title:"Lunar Science: Internet for Space Tourism",slug:"lunar-science-internet-for-space-tourism",totalDownloads:668,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"The increased interest in space exploration drives the development of novel technologies that are useful in other areas, such as aviation. The use of these technologies gives rise to new challenges and applications. Space tourism is an emerging application due to advances in space exploration technologies. This paper addresses two challenges aimed at ensuring continued internet access in space tourism. The first is designing network architecture to ensure continued internet access for space tourists aboard a space vehicle. The second is using aerial vehicle technology to enhance access to cloud content in areas with poor telecommunication infrastructure. The paper proposes the distributed handover algorithm ensuring that the space vehicle can execute handover from terrestrial wireless networks to aerial platforms and satellites as a last mile connection. It also proposes the concept of aerial diversity ensuring low cost access to cloud content. Performance simulation shows that the use of the distributed handover algorithm enhances channel capacity by 18.4% on average and reduces latency by 11.6% on average. 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He also obtained an MSc in Molecular and Genetic Medicine, and a Ph.D. in Clinical Immunology and Human Genetics from the University of Sheffield, UK. He also completed a short-term fellowship in Pediatric Clinical Immunology and Bone Marrow Transplantation at Newcastle General Hospital, England. Dr. Rezaei is a Full Professor of Immunology and Vice Dean of International Affairs and Research, at the School of Medicine, Tehran University of Medical Sciences, and the co-founder and head of the Research Center for Immunodeficiencies. He is also the founding president of the Universal Scientific Education and Research Network (USERN). Dr. Rezaei has directed more than 100 research projects and has designed and participated in several international collaborative projects. He is an editor, editorial assistant, or editorial board member of more than forty international journals. He has edited more than 50 international books, presented more than 500 lectures/posters in congresses/meetings, and published more than 1,100 scientific papers in international journals.",institutionString:"Tehran University of Medical Sciences",institution:{name:"Tehran University of Medical Sciences",country:{name:"Iran"}}},{id:"180733",title:"Dr.",name:"Jean",middleName:null,surname:"Engohang-Ndong",slug:"jean-engohang-ndong",fullName:"Jean Engohang-Ndong",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180733/images/system/180733.png",biography:"Dr. Jean Engohang-Ndong was born and raised in Gabon. After obtaining his Associate Degree of Science at the University of Science and Technology of Masuku, Gabon, he continued his education in France where he obtained his BS, MS, and Ph.D. in Medical Microbiology. He worked as a post-doctoral fellow at the Public Health Research Institute (PHRI), Newark, NJ for four years before accepting a three-year faculty position at Brigham Young University-Hawaii. Dr. Engohang-Ndong is a tenured faculty member with the academic rank of Full Professor at Kent State University, Ohio, where he teaches a wide range of biological science courses and pursues his research in medical and environmental microbiology. Recently, he expanded his research interest to epidemiology and biostatistics of chronic diseases in Gabon.",institutionString:"Kent State University",institution:{name:"Kent State University",country:{name:"United States of America"}}},{id:"188773",title:"Prof.",name:"Emmanuel",middleName:null,surname:"Drouet",slug:"emmanuel-drouet",fullName:"Emmanuel Drouet",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/188773/images/system/188773.png",biography:"Emmanuel Drouet, PharmD, is a Professor of Virology at the Faculty of Pharmacy, the University Grenoble-Alpes, France. As a head scientist at the Institute of Structural Biology in Grenoble, Dr. Drouet’s research investigates persisting viruses in humans (RNA and DNA viruses) and the balance with our host immune system. He focuses on these viruses’ effects on humans (both their impact on pathology and their symbiotic relationships in humans). He has an excellent track record in the herpesvirus field, and his group is engaged in clinical research in the field of Epstein-Barr virus diseases. He is the editor of the online Encyclopedia of Environment and he coordinates the Universal Health Coverage education program for the BioHealth Computing Schools of the European Institute of Science.",institutionString:null,institution:{name:"Grenoble Alpes University",country:{name:"France"}}},{id:"131400",title:"Prof.",name:"Alfonso J.",middleName:null,surname:"Rodriguez-Morales",slug:"alfonso-j.-rodriguez-morales",fullName:"Alfonso J. Rodriguez-Morales",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/131400/images/system/131400.png",biography:"Dr. Rodriguez-Morales is an expert in tropical and emerging diseases, particularly zoonotic and vector-borne diseases (especially arboviral diseases). He is the president of the Travel Medicine Committee of the Pan-American Infectious Diseases Association (API), as well as the president of the Colombian Association of Infectious Diseases (ACIN). He is a member of the Committee on Tropical Medicine, Zoonoses, and Travel Medicine of ACIN. He is a vice-president of the Latin American Society for Travel Medicine (SLAMVI) and a Member of the Council of the International Society for Infectious Diseases (ISID). Since 2014, he has been recognized as a Senior Researcher, at the Ministry of Science of Colombia. He is a professor at the Faculty of Medicine of the Fundacion Universitaria Autonoma de las Americas, in Pereira, Risaralda, Colombia. He is an External Professor, Master in Research on Tropical Medicine and International Health, Universitat de Barcelona, Spain. He is also a professor at the Master in Clinical Epidemiology and Biostatistics, Universidad Científica del Sur, Lima, Peru. In 2021 he has been awarded the “Raul Isturiz Award” Medal of the API. Also, in 2021, he was awarded with the “Jose Felix Patiño” Asclepius Staff Medal of the Colombian Medical College, due to his scientific contributions to COVID-19 during the pandemic. He is currently the Editor in Chief of the journal Travel Medicine and Infectious Diseases. His Scopus H index is 47 (Google Scholar H index, 68).",institutionString:"Institución Universitaria Visión de las Américas, Colombia",institution:null},{id:"332819",title:"Dr.",name:"Chukwudi Michael",middleName:"Michael",surname:"Egbuche",slug:"chukwudi-michael-egbuche",fullName:"Chukwudi Michael Egbuche",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/332819/images/14624_n.jpg",biography:"I an Dr. Chukwudi Michael Egbuche. I am a Senior Lecturer in the Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka.",institutionString:null,institution:{name:"Nnamdi Azikiwe University",country:{name:"Nigeria"}}},{id:"284232",title:"Mr.",name:"Nikunj",middleName:"U",surname:"Tandel",slug:"nikunj-tandel",fullName:"Nikunj Tandel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/284232/images/8275_n.jpg",biography:'Mr. Nikunj Tandel has completed his Master\'s degree in Biotechnology from VIT University, India in the year of 2012. He is having 8 years of research experience especially in the field of malaria epidemiology, immunology, and nanoparticle-based drug delivery system against the infectious diseases, autoimmune disorders and cancer. He has worked for the NIH funded-International Center of Excellence in Malaria Research project "Center for the study of complex malaria in India (CSCMi)" in collaboration with New York University. The preliminary objectives of the study are to understand and develop the evidence-based tools and interventions for the control and prevention of malaria in different sites of the INDIA. Alongside, with the help of next-generation genomics study, the team has studied the antimalarial drug resistance in India. Further, he has extended his research in the development of Humanized mice for the study of liver-stage malaria and identification of molecular marker(s) for the Artemisinin resistance. At present, his research focuses on understanding the role of B cells in the activation of CD8+ T cells in malaria. Received the CSIR-SRF (Senior Research Fellow) award-2018, FIMSA (Federation of Immunological Societies of Asia-Oceania) Travel Bursary award to attend the IUIS-IIS-FIMSA Immunology course-2019',institutionString:"Nirma University",institution:{name:"Nirma University",country:{name:"India"}}},{id:"334383",title:"Ph.D.",name:"Simone",middleName:"Ulrich",surname:"Ulrich Picoli",slug:"simone-ulrich-picoli",fullName:"Simone Ulrich Picoli",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334383/images/15919_n.jpg",biography:"Graduated in Pharmacy from Universidade Luterana do Brasil (1999), Master in Agricultural and Environmental Microbiology from Federal University of Rio Grande do Sul (2002), Specialization in Clinical Microbiology from Universidade de São Paulo, USP (2007) and PhD in Sciences in Gastroenterology and Hepatology (2012). She is currently an Adjunct Professor at Feevale University in Medicine and Biomedicine courses and a permanent professor of the Academic Master\\'s Degree in Virology. She has experience in the field of Microbiology, with an emphasis on Bacteriology, working mainly on the following topics: bacteriophages, bacterial resistance, clinical microbiology and food microbiology.",institutionString:null,institution:{name:"Universidade Feevale",country:{name:"Brazil"}}},{id:"229220",title:"Dr.",name:"Amjad",middleName:"Islam",surname:"Aqib",slug:"amjad-aqib",fullName:"Amjad Aqib",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229220/images/system/229220.png",biography:"Dr. Amjad Islam Aqib obtained a DVM and MSc (Hons) from University of Agriculture Faisalabad (UAF), Pakistan, and a PhD from the University of Veterinary and Animal Sciences Lahore, Pakistan. Dr. Aqib joined the Department of Clinical Medicine and Surgery at UAF for one year as an assistant professor where he developed a research laboratory designated for pathogenic bacteria. Since 2018, he has been Assistant Professor/Officer in-charge, Department of Medicine, Manager Research Operations and Development-ORIC, and President One Health Club at Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan. He has nearly 100 publications to his credit. His research interests include epidemiological patterns and molecular analysis of antimicrobial resistance and modulation and vaccine development against animal pathogens of public health concern.",institutionString:"Cholistan University of Veterinary and Animal Sciences",institution:null},{id:"62900",title:"Prof.",name:"Fethi",middleName:null,surname:"Derbel",slug:"fethi-derbel",fullName:"Fethi Derbel",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/62900/images/system/62900.jpeg",biography:"Professor Fethi Derbel was born in 1960 in Tunisia. He received his medical degree from the Sousse Faculty of Medicine at Sousse, University of Sousse, Tunisia. He completed his surgical residency in General Surgery at the University Hospital Farhat Hached of Sousse and was a member of the Unit of Liver Transplantation in the University of Rennes, France. He then worked in the Department of Surgery at the Sahloul University Hospital in Sousse. Professor Derbel is presently working at the Clinique les Oliviers, Sousse, Tunisia. His hospital activities are mostly concerned with laparoscopic, colorectal, pancreatic, hepatobiliary, and gastric surgery. He is also very interested in hernia surgery and performs ventral hernia repairs and inguinal hernia repairs. He has been a member of the GREPA and Tunisian Hernia Society (THS). During his residency, he managed patients suffering from diabetic foot, and he was very interested in this pathology. For this reason, he decided to coordinate a book project dealing with the diabetic foot. Professor Derbel has published many articles in journals and collaborates intensively with IntechOpen Access Publisher as an editor.",institutionString:"Clinique les Oliviers",institution:null},{id:"300144",title:"Dr.",name:"Meriem",middleName:null,surname:"Braiki",slug:"meriem-braiki",fullName:"Meriem Braiki",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/300144/images/system/300144.jpg",biography:"Dr. Meriem Braiki is a specialist in pediatric surgeon from Tunisia. She was born in 1985. She received her medical degree from the University of Medicine at Sousse, Tunisia. She achieved her surgical residency training periods in Pediatric Surgery departments at University Hospitals in Monastir, Tunis and France.\r\nShe is currently working at the Pediatric surgery department, Sidi Bouzid Hospital, Tunisia. Her hospital activities are mostly concerned with laparoscopic, parietal, urological and digestive surgery. She has published several articles in diffrent journals.",institutionString:"Sidi Bouzid Regional Hospital",institution:null},{id:"229481",title:"Dr.",name:"Erika M.",middleName:"Martins",surname:"de Carvalho",slug:"erika-m.-de-carvalho",fullName:"Erika M. de Carvalho",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/229481/images/6397_n.jpg",biography:null,institutionString:null,institution:{name:"Oswaldo Cruz Foundation",country:{name:"Brazil"}}},{id:"186537",title:"Prof.",name:"Tonay",middleName:null,surname:"Inceboz",slug:"tonay-inceboz",fullName:"Tonay Inceboz",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/186537/images/system/186537.jfif",biography:"I was graduated from Ege University of Medical Faculty (Turkey) in 1988 and completed his Med. PhD degree in Medical Parasitology at the same university. I became an Associate Professor in 2008 and Professor in 2014. I am currently working as a Professor at the Department of Medical Parasitology at Dokuz Eylul University, Izmir, Turkey.\n\nI have given many lectures, presentations in different academic meetings. I have more than 60 articles in peer-reviewed journals, 18 book chapters, 1 book editorship.\n\nMy research interests are Echinococcus granulosus, Echinococcus multilocularis (diagnosis, life cycle, in vitro and in vivo cultivation), and Trichomonas vaginalis (diagnosis, PCR, and in vitro cultivation).",institutionString:"Dokuz Eylül University",institution:{name:"Dokuz Eylül University",country:{name:"Turkey"}}},{id:"71812",title:"Prof.",name:"Hanem Fathy",middleName:"Fathy",surname:"Khater",slug:"hanem-fathy-khater",fullName:"Hanem Fathy Khater",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/71812/images/1167_n.jpg",biography:"Prof. Khater is a Professor of Parasitology at Benha University, Egypt. She studied for her doctoral degree, at the Department of Entomology, College of Agriculture, Food and Natural Resources, University of Missouri, Columbia, USA. She has completed her Ph.D. degrees in Parasitology in Egypt, from where she got the award for “the best scientific Ph.D. dissertation”. She worked at the School of Biological Sciences, Bristol, England, the UK in controlling insects of medical and veterinary importance as a grant from Newton Mosharafa, the British Council. Her research is focused on searching of pesticides against mosquitoes, house flies, lice, green bottle fly, camel nasal botfly, soft and hard ticks, mites, and the diamondback moth as well as control of several parasites using safe and natural materials to avoid drug resistances and environmental contamination.",institutionString:null,institution:{name:"Banha University",country:{name:"Egypt"}}},{id:"99780",title:"Prof.",name:"Omolade",middleName:"Olayinka",surname:"Okwa",slug:"omolade-okwa",fullName:"Omolade Okwa",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/99780/images/system/99780.jpg",biography:"Omolade Olayinka Okwa is presently a Professor of Parasitology at Lagos State University, Nigeria. She has a PhD in Parasitology (1997), an MSc in Cellular Parasitology (1992), and a BSc (Hons) Zoology (1990) all from the University of Ibadan, Nigeria. She teaches parasitology at the undergraduate and postgraduate levels. She was a recipient of a Commonwealth fellowship supported by British Council tenable at the Centre for Entomology and Parasitology (CAEP), Keele University, United Kingdom between 2004 and 2005. She was awarded an Honorary Visiting Research Fellow at the same university from 2005 to 2007. \nShe has been an external examiner to the Department of Veterinary Microbiology and Parasitology, University of Ibadan, MSc programme between 2010 and 2012. She is a member of the Nigerian Society of Experimental Biology (NISEB), Parasitology and Public Health Society of Nigeria (PPSN), Science Association of Nigeria (SAN), Zoological Society of Nigeria (ZSN), and is Vice Chairperson of the Organisation of Women in Science (OWSG), LASU chapter. She served as Head of Department of Zoology and Environmental Biology, Lagos State University from 2007 to 2010 and 2014 to 2016. She is a reviewer for several local and international journals such as Unilag Journal of Science, Libyan Journal of Medicine, Journal of Medicine and Medical Sciences, and Annual Research and Review in Science. \nShe has authored 45 scientific research publications in local and international journals, 8 scientific reviews, 4 books, and 3 book chapters, which includes the books “Malaria Parasites” and “Malaria” which are IntechOpen access publications.",institutionString:"Lagos State University",institution:{name:"Lagos State University",country:{name:"Nigeria"}}},{id:"273100",title:"Dr.",name:"Vijay",middleName:null,surname:"Gayam",slug:"vijay-gayam",fullName:"Vijay Gayam",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/273100/images/system/273100.jpeg",biography:"Dr. Vijay Bhaskar Reddy Gayam is currently practicing as an internist at Interfaith Medical Center in Brooklyn, New York, USA. 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