\\n\\n
IntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\\n\\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\\n\\nLaunching 2021
\\n\\nArtificial Intelligence, ISSN 2633-1403
\\n\\nVeterinary Medicine and Science, ISSN 2632-0517
\\n\\nBiochemistry, ISSN 2632-0983
\\n\\nBiomedical Engineering, ISSN 2631-5343
\\n\\nInfectious Diseases, ISSN 2631-6188
\\n\\nPhysiology (Coming Soon)
\\n\\nDentistry (Coming Soon)
\\n\\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\\n\\nNote: Edited in October 2021
\\n"}]',published:!0,mainMedia:{caption:"",originalUrl:"/media/original/132"}},components:[{type:"htmlEditorComponent",content:'With the desire to make book publishing more relevant for the digital age and offer innovative Open Access publishing options, we are thrilled to announce the launch of our new publishing format: IntechOpen Book Series.
\n\nDesigned to cover fast-moving research fields in rapidly expanding areas, our Book Series feature a Topic structure allowing us to present the most relevant sub-disciplines. Book Series are headed by Series Editors, and a team of Topic Editors supported by international Editorial Board members. Topics are always open for submissions, with an Annual Volume published each calendar year.
\n\nAfter a robust peer-review process, accepted works are published quickly, thanks to Online First, ensuring research is made available to the scientific community without delay.
\n\nOur innovative Book Series format brings you:
\n\nIntechOpen Book Series will also publish a program of research-driven Thematic Edited Volumes that focus on specific areas and allow for a more in-depth overview of a particular subject.
\n\nIntechOpen Book Series will be launching regularly to offer our authors and editors exciting opportunities to publish their research Open Access. We will begin by relaunching some of our existing Book Series in this innovative book format, and will expand in 2022 into rapidly growing research fields that are driving and advancing society.
\n\nLaunching 2021
\n\nArtificial Intelligence, ISSN 2633-1403
\n\nVeterinary Medicine and Science, ISSN 2632-0517
\n\nBiochemistry, ISSN 2632-0983
\n\nBiomedical Engineering, ISSN 2631-5343
\n\nInfectious Diseases, ISSN 2631-6188
\n\nPhysiology (Coming Soon)
\n\nDentistry (Coming Soon)
\n\nWe invite you to explore our IntechOpen Book Series, find the right publishing program for you and reach your desired audience in record time.
\n\nNote: Edited in October 2021
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Techniques for assessment of hearing and the appropriateness of the Mongolian gerbil as a model for age-dependent hearing loss in humans are presented. Parental attitudes to childhood deafness and role of early intervention for better treatment of hearing loss are also discussed. Comprehensive details are provided on the role of different environmental insults including injuries in causing deafness. Additionally, many genes involved in hearing loss are reviewed and the genetics of recessively inherited moderate to severe and progressive deafness is covered for the first time. 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The intended purpose of the book will be to extend the circle of users of the Kalman filter by considering it not as a means of theoretical analysis, but rather as a powerful tool for the design of a technical system. The editor accumulated experience of using suboptimal KF in various aerospace applications and would wish to share it with the pool of potential users and like-minded specialists. Instead of the formal programming of the recursive KF equations some simple and robust sub-optimal forms are proposed. For example, developed by the editor, suboptimal (KBF), with bounded grows of memory (FBGM) and its steady-state form- the time-invariant filter with constant coefficients is aimed to be considered. This allows the developer to use the KBF not only for system state estimation but for control as well. Proceeding in this way developer can be guaranteed the filter stability and robustness in many practically uncertain situations when the statistic characteristics of system disturbances and measured errors are not entirely known. A guaranteed approach with using an equivalent white noise is also aimed to be considered. Some representative examples from typical aerospace systems (the editor’s main professional field) are intended to be presented. Summarizing the above, it can be emphasized that when implementing the KF it is always useful to replace the art of programming with the experience of designing conventional robust systems having an idealistic estimate of maximum (best) of achievable performance. This would prevent the system's real-time computer from many possible situations with “empty “computations and even to the divergence of the computational process. It can also show that the filter is not a magic mill and cannot achieve the desired performance if it cannot be achieved in principle, better that it can be “promised” by the KF quadratic criterion minimum, or if some state vector components are not observable and controllable.
",isbn:"978-1-80356-576-7",printIsbn:"978-1-80356-575-0",pdfIsbn:"978-1-80356-577-4",doi:null,price:0,priceEur:0,priceUsd:0,slug:null,numberOfPages:0,isOpenForSubmission:!1,isSalesforceBook:!1,isNomenclature:!1,hash:"4c3e68adcaeaa44f9fbfe9bb19bdd55b",bookSignature:"Dr. Yuri Kim",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/11504.jpg",keywords:"Separation Theorem, Extended Kalman Filter, Covariance Matrix, Riccati Equation, FBGM, Analytical Implementation Forms, Physical Implementation Forms, Steady State Filter, Inertial Navigation System, Global Positioning System, Controllability, Multisensory Navigation",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:null,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"March 15th 2022",dateEndSecondStepPublish:"June 2nd 2022",dateEndThirdStepPublish:"August 1st 2022",dateEndFourthStepPublish:"October 20th 2022",dateEndFifthStepPublish:"December 19th 2022",dateConfirmationOfParticipation:null,remainingDaysToSecondStep:"2 months",secondStepPassed:!0,areRegistrationsClosed:!0,currentStepOfPublishingProcess:4,editedByType:null,kuFlag:!1,biosketch:"Prof. Y.V. Kim is a Doctor of Technical Science, having a broad and wealthy international scientific, engineering, and teaching experience, obtained in the former USSR, Israel, and Canada. He has many scientific publications and implemented inventions dedicated to Aerospace GN&C.",coeditorOneBiosketch:null,coeditorTwoBiosketch:null,coeditorThreeBiosketch:null,coeditorFourBiosketch:null,coeditorFiveBiosketch:null,editors:[{id:"316140",title:"Dr.",name:"Yuri",middleName:null,surname:"Kim",slug:"yuri-kim",fullName:"Yuri Kim",profilePictureURL:"https://mts.intechopen.com/storage/users/316140/images/system/316140.jpg",biography:"Yuri Kim\n24 Buttenut, Gatineau, QC, Canada\nTel : 1-(514)- 466-1033, e-mail: yurikim@hotmail.ca\n\nHIGHLIGHTS OF QUALIFICATIONS:\n\nExperienced scientist, engineer and manager with internationally recognized achievements in area of Aerospace Avionics, (GN&C); Analysis, design (HW&SW), integration, testing and operation for various aerospace platforms and missions. \n\nGained a broad experience in preparation of technical documents for Joint (Industry-Customer) State Commissions for the acceptance (commissioning) of Aerospace Avionics, Navigation and Special application experimental equipment for further serial production, and operational support. Last works have been dedicated to R&D projects developing new Satellite Navigation Control Technology and customer support of Canadian satellites Control system design.\n\n\nACADEMIC DEGREES:\n\n 1991 *Doctor of Technical Science Diploma in Aerospace Vehicles Guidance \n Navigation and Control \n Scientific Council of State Institute of Automatic Systems, Ministry of Aviation\n Industry of USSR, Moscow\n (Recognized by Canadian Professional Counsel of Engineers) \n1982 * Senior Scientific Fellow Diploma in Gyroscopes and Navigation systems \n Capital Certification Commission of Scientists, Ministry of High Education of\n USSR, Moscow.\n (Recognized by Canadian Professional Counsel of Engineers)\n1974 * Candidate of Technical Science Diploma in Aerospace Navigation\n and Control Systems (Accredited as Ph.D by York University, Toronto.)\n Scientific Council of Moscow Aviation Institute, Moscow.\n1970 * Engineer Electromechanic Diploma in Gyro and Navigation systems,\n Faculty of Flight Apparatuses Control Systems, Moscow Aviation Institute, \n Moscow (Accredited as between Masters Degree and Bachelor Degree by\n York University, Toronto).\n1965 * Radio and TV Systems Technician Certificate, Dnepropetrovsk Technical School \n of preparation of technical specialists for Soviet Army, Military Aviation and \n Navy.\n\nMILITARY EDUCATION:\n\n1970 * Engineer in ballistic rocket control system, Military Faculty of MAI, last rank senior engineer-lieutenant (in reserve)\n\n\n\nEMPLOYMENT HISTORY:\nA. GOVERNMENT\n\nAt present - Canadian Space Agency, Space Science and Technology Division, David Florida Laboratory\n\n Senior Aerospace System engineer \n\n° Performing, developing and supporting phases of design, testing, commissioning and \n operation for space vehicle orbit and attitude control systems, in particular: Tecsas, Scope, \n J2Sat, Small satellite, M3Msat, Cassiopea, Neossat, RCM, PCW\n\n° Reviewing and commenting on Attitude Control systems design documentations, related to \n all phases of system development commissioning and operation\n \n° Supporting Aerospace Industry R&D projects funding by CSA (STDP) as Scientific\n Authority, in particular: Microwheel (Dynacon), LOCOOS (NGC), PCW (Bristol)\n\n° Providing expertise on new initiatives for Space Exploration and Utilization regarding \n Attitude and Orbital Control and possible development of Canadian space launcher\n\n° Developing basic mathematical (Simulink/Matlab) simulator for developing the \n requirements and expected performance of AODCS for new space vehicles\n\n° Developing new basic technology (based on Kalman Filter) for satellite attitude\n determination and sensor calibration, developing of FF test-bed equipment and GPS \n navigation in environment of CSA laboratory, developing of methods of ACS sensors\n calibration, measuring and compensation of satellite residual magnetic moment, experimental determination of satellite inertia matrix during ACS integration tests\n\n° Interacting with Space Industry and Universities in the problems, related to development of \n new methods and systems for space vehicle attitude and orbit determination and control\n \n° Sharing with International Aerospace community CSA achievements and experience in\n development of new technologies and methods for space vehicle attitude and orbit \n determination and control through publications, presentations and participation in scientific\n conferences, meetings and symposiums as well as maintaining an awareness about new \n technological advancements\n \n° Providing professional training for students and post. Graduates in the area of Orbital and\n Attitude Dynamic and Control\n\nB. INDUSTRIAL\n\nSept. 1998 – Feb. 1999 – Olympia Engineering Ltd. (Toronto)\n\nResearch and Development Engineer\n\n•\tDevelopment of measuring instrument for measuring remote measuring of micro- deformations of machinery (milling machine) equipment\n•\tResearch and testing of differential GPS survey equipment and antennas in environment of industrial facility for developing a new remote method for the measuring of machinery micro-deformations\n\n\n\n\nFeb.1999 – Jun.2002 – Saskatoon Engineering Division of Calian Company, \n Radarsat-1 Operation Team (CSA, Montreal)\n\nAttitude Control System Analyst\n\n•\tWorking as RADARSAT-1 Attitude Control System Analyst performing day-to-day operation TLM data analysis; reporting, monitoring and solving ACS flight anomaly problems, maintaining ACS software and performance \n•\tAuthor of many reports (see attached list of publications), devoted to solving of Radarsat-1 non-benign Safe Hold Mode problem, Momentum Wheel failure problems and improvement of the performance of attitude determination method with Magnetometer and Sun Sensor (back up, ADM3 mode for the case of potential failure of Horizon Scanner).\n•\tPreparation and implementation of the solution for RADARSAT-1 operation without failed Momentum Wheels, that saved the satellite mission after the wheel failures\n(This work was prolonged after in CSA and awarded by the Canadian Government Award for the invention used by the Government)\n•\tDesign and implementation of new dynamic simulators (based on Simulink\ntoolbox) for Radarsat-1 ACS for operation support\n•\tPreparation for operation of new Canadian satellites Scisat and RADARSAT-2 \n\n\n\nJan. 1994 – Sep. 1997 – Israel Aviation Industry (IAI factories: TASHAN, LAHAV)\n\nAvionics system engineer\n\n•\tResearch and preliminary design of the Special Data Fusion System for a fighter-interceptor\n•\tIntegration of Inertial Navigation System with Global Position System into Upgraded Avionics Suit and installation in aircraft cockpit for A/C – trainer T-38\n\nNov. 1977 – Apr. 1993 – Moscow Research and Design Institute of Electromechanic and Automatic (formerly P/B: M5537, presently “Aviapribor” Corporation)\n\n \nHead of Division (R&D in Pilot-Navigation Systems)\n\n•\tLeadership of the Division, performing planning, financial and methodological duties, related to this position, reporting to the R&D deputy director of the Institute\n•\tResponsibility for Pilot-Navigation System integration, interaction, tests and transferring for serial production and operational support\n•\tInitiation and methodical leadership of innovative research and development projects\n•\tReviewing, commenting and implementation of Technical standards and Navigation norms\nas well as sharing progressive methods and results within Aerospace organizations within former USSR\n \n Head of Department (INS and Flight Management System SW Development)\n\n•\tLeadership and performing of duties of Head of Department \n•\tResponsibility for the prospective research and preliminary design of the Inertial Navigation Systems (INS) and Flight Management Systems (FMS)\n•\tDesign of the INS and FMS algorithms and simulation of expected performance\n•\tDevelopment of INS/FMS flight code\n•\tDevelopment of test procedures and simulators for FMS, and pilot nav.complexis for aircrafts \n•\tResponsibility for system performance analysis in the ground and flight tests\n\n Head of Sector (System Flight Test data analysis) \n\n•\tLeadership of the Sector\n•\tDevelopment of ground and flight test simulation procedures and requirements for test equipment and simulators, for flight test aircraft measuring equipment, installation and recorded data processing\n•\tDesign of Estimation and Identification algorithms for ground and flight data processing\n•\tTest data analysis, preparation of test results analysis reports and conclusions\n\n Senior Scientific Fellow\n\n•\tResearch, development and principal design of the special Suboptimal Kalman Filter for the fusion of data of various navigation sensors for aviation and space platforms\n•\tDevelopment of new Guidance and Navigation methods for aviation and space platforms\n•\tAnalysis of INS and FMS performance in ground and flight tests\n\nC. ACADEMIC \n\n1977–1993 – Moscow Aviation Institute, Moscow Institute of Instrument -\n Making, Aviation Industry Ministry Upgrade Qualification Institute\n(Part Time) Professor, Associate professor, Chairmen of State Diploma Commission,\n Member of Scientific Council\n•\tLecturer of the disciplines: Applied Oscillation, Theory (MIIM), Design of Instruments (MIIM), Integrated Navigation Systems (MUQI)\n•\tChairman of the State Diploma Commission -Gyro Instruments and Systems (MAI)\n•\tLeadership of postgraduates, participation in sessions of Scientific Council (MAI)\n•\tMethodical management of cathedra of Orientation and Navigation in MAI \n\n2009 McGill University, Montreal\n\nPart time lecturer for course (in English): Aircraft Performance, Stability and Control\n\n1970–1977 – Moscow Aviation Institute \n(Full Time) Associate Professor, Senior Researcher, Assistant Lecturer \n•\tLecturer of the courses: Spacecraft orbital mechanics and attitude determination and control, Inertial Navigation Systems, Gyro Instruments and Systems\n•\tResearch and development of suboptimal robust estimation methods for navigation data processing\n•\tResponsibility for the navigation systems laboratory\n•\tDeputy head of cathedra of Orientation and Navigation\n\nFIELDS OF THEORETICAL AND METHODOLOGIC EXPERTISE:\n \n•\tSpace vehicle Orbit and Attitude determination and control\n•\tGyro instruments and systems\n•\tRadio navigation systems\n•\tInertial Navigation systems\n•\tAirplane Navigation and Control\n•\tAnalytical mechanics \n•\tApplied oscillation theory\n•\tAutomatic control theory\n•\tStochastic estimation theory\n\nENGINEERING EXPERIENCE:\n\n•\tFlight and laboratory tests of Aerospace Avionics Equipment\n•\tDistribution of mission requirements between Aerospace vehicle subsystems, definition of functions and ICD \n•\tSpacecraft operation and performance maintenance\n•\tAvionics system (hardware and software) development and testing (autonomously and integration)\n•\tInertial navigation systems\n•\t Development of Avionics for Soviet Military aircrafts: Tu-142, Tu-95MC, An-124, An-70, A-40, Soviet Space shuttle “Buran” (responsibility for preliminary design of radio-navigation automatic landing system), \n•\tIsrael (IAI) upgrade of Avionics system for T-38 (USA Air force trainer) \n•\tOperation and modification in space Canadian Satellite RADARSAT-1 Attitude Control system\n•\tParticipation in commissioning of ACS of Canadian Satellite Scisat\n•\tDevelopment of a generic mathematical simulator for satellite AODCS analysis and simulation of expected performance for a family of Canadian new generation small satellites\n\nSCIENTIFIC EXPERIENCE:\n\n•\tTheoretical and experimental investigation in the fields of S/C Orbital and Attitude Control\n•\tKalman Filter suboptimization and robust guarantee estimation theory development: authorship of new Suboptimal Kalman Filter modification, methods of INS correction and calibration, Geomagnetic Inertial Navigation System\n•\tResearch in areas of ACS and INS sensors development, their performance improvement\n•\tVarious Avionics Systems Mathematical models development and mathematical and semi-natural simulation\n•\tCoordination of research and development projects related to Aerospace equipment performed by Universities and Industries\n•\tScientific reports and articles reviewing and editorship \n•\tMembership in Scientific Counsels and Commissions\n•\tTutorship of under-graduate, graduated and post -graduate students \n\n•\tScientific reports and inventions in the field of GN&C for aircraft and spacecraft methods development \n•\tSeveral articles dedicated to the development of new methods in estimation theory: new suboptimal Kalman Filter with limited growth of the memory, observability and factor of state vector components estimation, guaranteed ellipsoidal estimation and stochastic estimation comparison \n\nLANGUAGES:\n \n•\tEnglish, Russian, Ukrainian, Hebrew, French (beginning level)\n•\tProgramming languages: Matlab/Simulinc/С",institutionString:"Canadian Space Agency",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"0",institution:{name:"Canadian Space Agency",institutionURL:null,country:{name:"Canada"}}}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"15",title:"Mathematics",slug:"mathematics"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"453623",firstName:"Silvia",lastName:"Sabo",middleName:null,title:"Mrs.",imageUrl:"https://mts.intechopen.com/storage/users/453623/images/20396_n.jpg",email:"silvia@intechopen.com",biography:null}},relatedBooks:[{type:"book",id:"1591",title:"Infrared Spectroscopy",subtitle:"Materials Science, Engineering and 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Coelho",authors:[{id:"38427",title:"Prof.",name:"Denis",middleName:null,surname:"Coelho",fullName:"Denis Coelho",slug:"denis-coelho"},{id:"154341",title:"MSc.",name:"Inalda",middleName:null,surname:"Rodrigues",fullName:"Inalda Rodrigues",slug:"inalda-rodrigues"}]},{id:"43458",title:"Visual and Material Culture in the Context of Industrial Design: The Contemporary Nigerian Experience",slug:"visual-and-material-culture-in-the-context-of-industrial-design-the-contemporary-nigerian-experience",signatures:"I.B. Kashim",authors:[{id:"39941",title:"Dr.",name:"Isah Bolaji",middleName:null,surname:"Kashim",fullName:"Isah Bolaji Kashim",slug:"isah-bolaji-kashim"}]}]}],publishedBooks:[{type:"book",id:"323",title:"Industrial Design",subtitle:"New Frontiers",isOpenForSubmission:!1,hash:"6712ef0cc1fdf610d17e8aa70170f773",slug:"industrial-design-new-frontiers",bookSignature:"Denis A. 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Coelho",coverURL:"https://cdn.intechopen.com/books/images_new/3116.jpg",editedByType:"Edited by",editors:[{id:"38427",title:"Prof.",name:"Denis",surname:"Coelho",slug:"denis-coelho",fullName:"Denis Coelho"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9174",title:"Product Design",subtitle:null,isOpenForSubmission:!1,hash:"3510bacbbf4d365e97510bf962652de1",slug:"product-design",bookSignature:"Cătălin Alexandru, Codruta Jaliu and Mihai Comşit",coverURL:"https://cdn.intechopen.com/books/images_new/9174.jpg",editedByType:"Edited by",editors:[{id:"2767",title:"Prof.",name:"Catalin",surname:"Alexandru",slug:"catalin-alexandru",fullName:"Catalin Alexandru"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],publishedBooksByAuthor:[{type:"book",id:"1802",title:"Manufacturing System",subtitle:null,isOpenForSubmission:!1,hash:"4db5cd5587e7ab1fe6e34507c103ee13",slug:"manufacturing-system",bookSignature:"Faieza Abdul Aziz",coverURL:"https://cdn.intechopen.com/books/images_new/1802.jpg",editedByType:"Edited by",editors:[{id:"109136",title:"Associate Prof.",name:"Faieza",surname:"Abdul Aziz",slug:"faieza-abdul-aziz",fullName:"Faieza Abdul Aziz"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},onlineFirst:{chapter:{type:"chapter",id:"80589",title:"Perspective Chapter: Total Vaginal Hysterectomy for Unprolapsed Uterus",doi:"10.5772/intechopen.101383",slug:"perspective-chapter-total-vaginal-hysterectomy-for-unprolapsed-uterus",body:'The uterus is an organ with a particular anatomic situation localized with the uterine body intraperitoneally, the isthmus extra-peritoneally, and the cervix can be considered visible intravaginal organs. The uterine body is coated by the visceral peritoneum, which intimately adheres to its sides. In front, the visceral peritoneum reflects it on the bladder and in the back to the rectum. On the lateral side, the visceral uterine peritoneum detaches from the two sides of the uterus into two sheets that are joined to each other but are anatomically distinct and surgically separable, forming
The uterus is maintained in anatomical position inside the pelvis by two systems: a
The suspension and orientation system of the uterus consists of
The
The supporting system reunites all the elements that work together to maintain the uterus in its intrapelvic anatomical position and resist the descending tendency generated by the weight of the intestines at rest or under effort.
Biomechanical studies show that the support of the uterus and the upper part of the vagina are provided by the
The supporting system anchors the uterus and vagina to the pelvic brim: the
The cardinal ligament consists of three segments: Proximal and intermediate segments containing the mesenteric elements and the terminal ureter and a common segment with the homologous uterosacral ligament, which is the main support element of the pericervical ring.
Cardinal ligaments provide reliable support for the vascular and lymphatic axes that converge or emerge in the uterus. Their fibers dissipate in the pubocervicovesical fascia towards the cervix uteri and superior vagina at the level of the cervical ring, and the fascial and areolar structures towards the pelvic walls, structures that cover the pelvic diaphragm, the obturator pelvic fascia, and the tendinous arch of the pelvis (arcus taendineus fascia pelvis-ATFP). (Campbell).
Like the cardinal ligaments, the uterosacral ligaments defined three segments: a proximal segment that merges with the cardinal ligament, an intermediate segment that represents the structure that can be used as a suspension element, and a distal segment that merges with the presacral fascia. Sacrouterine ligaments contain nervous fibers from the superior hypogastric plexus. Those innervating the urinary bladder are of particular importance in nerve-sparing surgery for cervical cancer (Figure 3).
Definition of three segments of uterosacral ligaments. MRI reconstruction -spatial disposition of posteriorly oriented uterosacral ligaments (in green) and cardinal ligaments oriented vertically (in beige yellow), P = pubis arch, Isch = ischion, Il = ilion, S = sacrum.
Vaginal hysterectomy consists of disconnection from below of all elements that maintain the uterus in anatomical position.
From the vaginal point of view, the uterus suspension-supporting system consists of three main connective-vascular pedicles; lower, middle, and upper pedicles.
like abdominal hysterectomy, where the lower pedicle is most difficult to approach, vaginal hysterectomy solves this operative step as the first maneuver of the disconnection of the uterus.
Lower Pedicle
On the caudal side, the cervix and uterine isthmus provide insertion for two fibrous-connective structures: anteriorly,
The juxta vesical ureter, surrounded by fatty tissue, is located in the thickness of each pillar. The
The
The uterosacral ligaments on the lateral sides, towards their sacral insertion, are flanked by the hypogastric nerve, which, along with the pelvic nerves, will be part of the inferior hypogastric plexus. For this reason, sectioning the uterosacral ligaments in radical vaginal hysterectomy as close as possible to the sacral insertion bears the risk of urinary disorders occurring through bladder denervation. Laterally and caudally, the uterosacral ligaments continue with the superior paracolpium, and a division of them achieves the upper level of suspension of the vagina (Delancey).
Campbell identified three distinct histologic regions of the uterosacral ligament. At the cervical attachment, the ligament was made up of carefully packed bundles of smooth muscle, abundant medium-sized and small blood vessels, and small nerve bundles. The intermediate third of the ligament was composed of predominantly connective tissue and only a few scattered smooth muscle fibers, nerve elements, and blood vessels. The sacral third was almost entirely composed of loose strands of connective tissue and intermingled fat, few vessels, nerves, and lymphatics.
The mechanical strength of the uterosacral ligaments is remarkable. The cervical and intermediate portions of the uterosacral ligament supported more than 17 kg of weight before failure. (Nichols) (Figure 4).
Middle Pedicle
The middle connective-vascular pedicle consists of the cardinal ligaments and a variable contingent of fibers that are part of the uterosacral ligaments. Vaginally, each cardinal ligament has a fibrous-connective segment consisting of inferior fibers of the uterosacral ligament and a cranially located vascular segment, which consists of the superior bundle of the cardinal ligament and uterine vascular pedicle. The two segments can be surgically treated as a single pedicle or as separate depending on the thickness and insertion area of the uterine edge (Shiff).
On its cranial aspect, the cardinal ligament is crossed by the ureter under the crossing-point with the uterine artery. The distance between the lateral side of the cervix and isthmus and the wall of the pelvis is approximately 4–5 cm. The ureter crosses the cardinal ligament halfway, approximately 2–2.5 cm from the cervix. The ureteral risk is reduced in vaginal hysterectomy because, once the lower pedicle is cut, the cardinal ligament is elongated, removing the ureter from the operator’s field. (Kovak) (Figure 5).
Upper Pedicle
The upper pedicle consists of
The primary vascular element of the upper pedicle is the
A. Lower connective-vascular pedicle (cardinal uterosacral complex -CUSC the first pedicle in vaginal hysterectomy). 1 = cervicovesical ligament, 2 = uterosacral ligaments, 3 = cardinal ligament. Redline mark where the same pedicle might secure bladder pillar, uterosacral ligaments, and cardinal ligaments. B. Lower connective pedicle at vaginal hysterectomy with distinct uterosacral ligament (USL) and cardinal ligament (CL) in the same pedicle.
Middle pedicle. 1 = uterine artery, 2 = cardinal ligament, 3 = inferior pedicle cut, 4 = parametrial ureter. Once cut, the uterosacral ligament’s traction on the cervix makes the cardinal ligament elongated and removes the ureter from the surgical field.
The uterus is a highly vascular organ with two arterial and two venous systems intertwined.
The primary arterial system is composed of the
Between the
The venous system is composed of the
The arterial blood supply is provided by three different sources: the
The origin of the uterine artery can be encountered most often in a common trunk with the umbilical artery, which arises as to the terminal branch from the previous division of the hypogastric artery. However, there is also the anatomic variant of direct origin from the hypogastric artery. From its origin, the uterine artery follows a 3–5 cm intrapelvic trajectory, approaching the cervix at a constant distance of approximately 2–2.5 cm without coming into contact.
The level where the uterine artery enters the uterine body, regardless of the shape or size of the uterus, corresponds to the level of the internal cervical orifice (Figure 6).
The point where the uterine artery reaches the uterus is constant at the level of the internal cervical orifice. ICO = internal cervical orifice, UP = uterine point. 1 = main uterine artery, 2 = ascending branch of the uterine artery, three = descending branches of the uterine artery. 4 = Beliaeva triangle.
In its trajectory, the uterine artery has three distinct segments:
In the
The
The uterine artery reaches the uterus in a triangular zone near the isthmus (Beliaeva triangle) situated at the base of the broad ligaments at three o clock for the right side and nine o clock for the left side (from the vaginal point of view). The descending uterine artery supplies the isthmus, cervix, and upper vagina. The ascending uterine artery supplies the body of the uterus. The ascending uterine artery is tortuous and gives rise to 10–12 arcuate arteries that course between the outer and middle thirds of the myometrium.
The crossing point of the uterine artery with the ureter is located sideways, approximately 20 mm away from the cervix and 10–12 mm cranially from the lateral vaginal fornix. At this level, there are two venous currents, one in front and another in the back of the ureter, which is predisposed to bleed during maneuvers to unroof the parametrial ureter (Figure 7).
Arterial supply of uterus and vagina. 1 = arterial trunk of hypogastric artery, 2 = Main trunk of the uterine artery, 3 = the ascending branch of the uterine artery, 4 = the descending branch of uterine artery (superior vaginal artery), five = inferior vaginal artery, 6 = umbilical vesical artery, 7 = ureteral branches from the uterine artery, 8 = middle hemorrhoidal artery, nine = ovarian artery, ten = ovarian arch between ovarian and uterine branches, 11 = tubal arch between ovarian and uterine branches, 12 = fundal branch of the uterine artery, 13 = arcuate arteries from right side, 14 = anastomotic branch between the uterine artery and ovarian arch, 15 = funicular branch (round ligament) artery.
The
Between the right and left sides of the uterine body, the arcuate arteries are anastomosed by collateral and small, direct branches. At the uterine fundus, approximately 15 mm away from the insertion of the tube, the ascending uterine artery divides into two branches:
A branch from the uterine artery.
The vaginal artery.
The middle hemorrhoidal artery.
The source of the uterine artery is composed of vesicovaginal and cervicovaginal branches and ensures the blood flow for the upper part of the vagina. The correct vaginal artery (lower vaginal artery or large vaginal artery) originates from the hypogastric artery. The artery from both sides anastomose in the midline and forms the longitudinal artery from the cervix to the vulva named the
The
The
The bilateral ligature of the anterior trunk of hypogastric arteries cannot stop the blood flow into the pelvis. Two primary sources ensure arterial collateral circulation of the pelvis:
Iliolumbar arteries
Lateral sacral arteries
Middle hemorrhoidal arteries
Lumbar arteries
Middle sacral artery
Superior hemorrhoidal arteries
Venous blood from the uterine body comes from the veins located in the thickness of the myometrium, which is venous sinuses with reduced endothelial cover. Venous blood drains into two collecting veins on each side of the uterus, with anastomoses in between. The collateral venous blood supply is significant concerning the alternative route for blood flow in case of significant obstruction of main venous branches.
Collateral venous circulation of the uterus can be done in three main ways:
The
The
The
The venous blood supply of the vagina consists of veins that come from each side of the vagina and anastomose on the median line on the same path as the azygos arteries. The blood flow is oriented to uterine veins at the level of the cervix.
Veins are mainly located on the sides of the vagina and anastomose each other at the extremities of the vaginal canal. In the middle region of the vagina, anastomoses are carried out in the azygous arteries draining the blood to the uterine veins at the level of the cervix. The uterine veins are anastomosis with the average hemorrhoidal veins, which, in turn, communicate with the upper hemorrhoids, forming at this level a porta-cave anastomose. The
Vaginal hysterectomy has as its first step the disconnection of the upper vagina from the cervix and uterine body. As a result, the anastomotic flow between the uterus and vagina is interrupted.
After the middle pedicles are cut, due to caudal traction of the cervix in the vaginal canal, the transversal segment of the uterine artery elongates, and it can be secured by occluding both the ascending and descending branch. After that, all the maneuverers in the uterus, until the upper pedicles, are bloodless.
If the diameter of the uterus exceeds the lower pelvic brim, as the uterus is released, the bleeding is stopped by compressing the vessels on the hard plane of the pelvis.
After extracting a large uterus, important bleeding may occur, caused by either ligature sliding or from the tearing of veins in the broad ligament.
Many vaginal hysterectomies may result in insignificant bleeding as compared to those in abdominal hysterectomies.
Unlike abdominal hysterectomy, regardless of the method, open or laparoscopic, vaginal hysterectomy produces a particularly favorable effect by reducing bleeding, especially in the case of large uteri due to special hemodynamic conditions. During a vaginal hysterectomy, a series of hemodynamic events occur concerning the uterine circulation, especially for a large uterus:
Traction exerts on the cervix of a large uterus almost throughout the operation, so that blood flow is significantly diminished. After the bilateral ligature of the uterine arteries, which can affect both the ascending and the descending branches, the blood flow is completely stopped, allowing maneuvers for dimensional reduction of the uterus with no risk of significant bleeding.
During the vaginal hysterectomy, after the ligature of uterine arteries, visible bleeding does not come from vascular pedicles but from blood stored in the myometer.
In cases where labia minora are hypertrophic and hinder access to the vaginal introit, they are anchored laterally by suture or by using the Richter retractor. The surgical area is bounded by a set of fields isolating the anterior vulval-perineal region (Figure 8).
Pericervical infiltration with saline solution. The cervix is grasped with 2 Pozzi clamps, and a magenta dye marks the limit of the anterior and posterior incision. Infiltrating is strictly submucosal.
The course of the future colpotomy is infiltrated submucosally with a vasoconstrictive solution. (1/200,000 epinephrine, 4 ml of ropivacaine, and up to 20 ml of saline solution). When there are contraindications for administering the epinephrine, saline solution alone may be used. Through infiltration with saline solution, a hydric dissection of the tissues is achieved, which determines the opening of the cleavage spaces, and the local anesthesia blocks the nervous transmission from the receptor level.
Accidental intravascular injection should be avoided.
The incision of the vaginal wall can be done with a cold or electric scalpel.
The incision of the vagina around the cervix is circular, with the anterior limit in the first transversal fold of the vaginal mucosa from its insertion into the cervix (
The incision includes the entire thickness of the vaginal wall, anteriorly and posteriorly. Laterally only the epithelium is interested. In this way, with the ligature of the first pedicle, the vagina will remain anchored sideways to the uterosacral ligaments, ensuring the prevention of the vaginal vault prolapse (Figure 9).
The incision of the anterior wall of the vagina 1.5–2 cm away from the external cervical orifice includes the entire thickness of the vaginal wall. Posteriorly, the incision is placed at the level of the first posterior rugae of the vaginal wall.
Entry into the anterior cleavage space starts with opening the vesicouterine space by cutting the
To expose the cervico-vesical septum, the cervix is pulling down and the cutting edge of the vaginal wall in the opposite direction. The sectioning of the cervicovesical septum is done with scissors facing the mass of the cervix.
The anterior cleavage space is open. Bladder pillars delineate the spatial side of anterior cleavage space. The dissection of the vesicouterine space is done by the progression of the index on the median line.
The peritoneal vesicouterine fold remains up as long as the uterus keeps its connections with the superior connective vascular pedicle. For this reason, its opening is not an immediate objective once the bladder has been detached from the uterus.
In our basic technique, opening the vesicouterine pouch becomes extremely simple after the disconnection of the inferior pedicle if the uterus is not enlarged or deformed. After sectioning the inferior pedicle, the uterus descends 3–4 cm, where the white-pearly transversal fold of the peritoneal vesicouterine fold can be observed. It is grasped with a clamp and cut where it enters the pelvis. The surgeon digitally explores the anterior side of the uterus and inserts a Briesky-Navratil retractor in this space, discharging the bladder upward (Figure 12).
A. Identifying and opening the real vesicovaginal fold (white arrow). The black arrow marks the cervical insertion of the peritoneal fold (false fold). B. the vesicovaginal fold opens.
Unlike with anterior colpoceliotomy, entering the rectovaginal cleavage space and opening the pouch of Douglas can be done at the same time. The level of posterior vaginal incision described above is significant to ensure a good entry into the rectovaginal space. The edge of the posterior vaginal wall incision is grasped with Allis clamps, and the rectovaginal space is entered by sharp or blunt dissection. After entering the rectovaginal space and pressing the rectum down, the peritoneal cul-de-sac may be observed swelling when the cervix is moved in or out. After opening the pouch of Douglas, the posterior side of the uterus, uterosacral ligaments, and the posterior leaf of the broad ligaments can be explored digitally (Figures 13 and 14).
Developing rectovaginal cleavage space. Allis clamps grasp the vaginal cutting edge, and the space is open by sharp dissection. The posterior aspect of the cervix is pulled upward, and the dissection is carried out using a Sims retractor.
The rectovaginal fold is open, and the posterior side of the uterus is visible. (arrow).
In difficult cases, a particular variant can be used to avoid the creation of an excessively sizeable retroperitoneal space between the vagina and the rectum. (see Chapter 6).
The lower pedicle is represented by the uterosacral ligament posteriorly and the vesicouterine ligament anteriorly. For the disconnection of the inferior pedicle, it is not mandatory to open the rectouterine pouch, and the maneuver can be done extra-peritoneally.
The bladder is removed cranially with a Briesky-Navratil retractor, placing the two vesical pillars under tension, and the rectum is depressed with a posterior Sims retractor (Figures 15 and 16).
Right lower pedicle. A dotted line separates the bladder pillar (blue arrow) from the uterosacral ligament (blue light arrow). Clamping the inferior part of the bladder pillar and uterosacral ligament together form the right lower pedicle.
A. Right lower pedicle secured by Vicryl 2/0. B. the left lower pedicle is clamped prepared to cut.
Using a Wertheim clamp, one of the uterosacral ligaments and the homologous bladder pillar are loaded together, after which, the pedicle is cut and ligated. The maneuver is repeated on the opposite side. In many situations, after cutting the pedicle, the pouch of Douglas opens spontaneously near the uterine edge.
The middle pedicle is represented by the cardinal ligament that contains the main uterine vascular supply for the uterus and cervix. By caudal traction on the cervix, the vascular pedicle has a parallel direction on the uterine edge, removing the ureters from the surgical field (Figure 17).
Right middle pedicle formed by cardinal ligament and uterine artery and veins clamped and cut. Left middle pedicle clamped. Arrow mark the uterine artery. In our technique, the pediculisation of uterine vessels is not useful as long as the clamping of the pedicle is done strictly parallel to the uterine side. The risk to the ureter’s damage is reduced if the lower pedicle is previously sectioned. (see chapter 2).
For this reason, during the vaginal hysterectomy, the urethral risk is lower than with the abdominal approach. After clamping, the pedicle is cut and ligated with 2–0 Vicryl.
In some situations, the cardinal ligament can be well represented and cannot be clamped at a single time. In this case, a second clamping and cutting should be cautiously be done. There is the risk of clamping and cutting a part of the superior pedicle and, in the maneuver, tilting the uterus. If so, the latter might break, causing some unwanted bleeding.
For vaginally delivering the uterus, securing the superior connective vascular pedicle is the most important and sometimes the most difficult step of vaginal hysterectomy.
In most cases, the superior pedicle can be brought into the surgical field by tilting the uterus. The uterus can be tilted anteriorly (Doderlain-Kronig maneuver) or posteriorly (Heaney maneuver).
When the uterus is highly mobile and small, its release from the pelvis can also be done without tilting.
For the uterus weighing up to 200–280 g, access to the superior pedicle is done by tilting, a maneuver that brings the superior pedicle into the surgical field, which consists in anatomical order of the round ligament, fallopian tube, and homologous utero-ovarian ligament. This pedicle includes the anastomotic branch of the uterine artery and the tubo-ovarian vascular arch.
The main disadvantage of the tilting maneuvers is that it forces the vaginal opening through which the uterus is pulled, which can lead to the slipping of ligatures placed on the anteriorly cut and ligated connective vascular pedicles (Figures 18–20).
Disconnection of upper pedicle by posterior tilting (Heaney maneuver).
Disconnection of the superior pedicle. In this case, the uterus is hemisected previously. The pedicle is hooked by the index finger and then clamped.
Clamped left upper pedicle. We can see what it is made of 1 = round ligament, 2 = utero-ovarian ligament, 3 = tube.
Anterior tilting (Doderlain-Kronig maneuver). After anterior colpoceliotomy, the anterior side of the uterus is evident. Using Pozzi forceps, the uterine fundus is extracted, and the superior pedicle can be clamped and cut.
The cervix is forcefully pulled caudally to expose as much as possible the anterior side of the uterus. Using a Pozzi clamp, the mass of the uterine body is clamped on the median line as high up as possible. It is gradually pulled, without sudden moves that lead to the rupture of the myometrium. At the same time, the cervix is left free without traction or pushed cranially and posteriorly with the Pozzi clamp. Along with the uterus’s progress into the surgical field, using another Pozzi clamp, the mass of the uterine tissue is escalated as high up as possible until the uterine fundus and one or two superior pedicles appear in the surgical field. At this time, the cervix is pulled cranially to place the pedicle under tension. The index finger of the surgeon’s left hand cranially and caudally loads the superior uterine pedicle, while the right-hand loads the pedicle into the arms of the Wertheim clamp.
After clamping and cutting, the pedicle is ligated, and the ends of the threads are kept as benchmarks. For the contralateral side, the maneuver for clamping the pedicle simplifies because, by pulling onto the cervix, the pedicle will be well exposed. Cutting and ligating the pedicles gives rise to the extraction of the uterus. The pedicle can be completely clamped or the round ligament isolated when one aims to perform the adnexectomy.
Posterior tilting (Heaney maneuver) is the most frequently used maneuver to access the superior pedicle for non-prolapsed uteruses weighing more than 180 g. Posterior tilting has the main advantage of being able to rotate the uterus in a much larger space, represented by the sacral concavity.
The cervix is forcefully pulled cranially while the assistant depresses the rectum using a Sims retractor to reveal as much as possible of the posterior side of the uterus. The surgeon places a Pozzi clamp on the dorsal middle bottom of the uterus, as close as possible to the uterine pouch. Relaxing the tension exerted on the cervix, it is pulled progressively by the clamp while the assistant tries to extract the uterus using the posterior retractor. When uterus progression is observed, the position of the uterus pulling clamp is changed to become as cranial as possible, and the releasing maneuvers are continued until the uterine fundus appears in the surgical field (Figures 22 and 23).
Posterior tilting (Heaney maneuver). Clamping the left superior pedicle. The cervix is pulled cranially at the same time that the uterine fundus is pulled hard caudally.
The Heaney maneuver. The right pedicle is clamped ˝a la Vue easily. ˝.
Unlike anterior tilting, the superior pedicle does not become visible. To be able to identify it, the surgeon places a Briesky retractor in the area between the lateral wall of the vagina and the uterine horn, usually on the left side, where access is more accessible. As an aiding maneuver, the clamp anchoring the uterine fundus is repositioned as close as possible to the externalized uterine horn. Thus, by simultaneously pulling the cervix and uterine fundus and maneuvering the Briesky-Navratil retractor laterally, the superior pedicle is revealed at its insertion into the uterus. With the medius of the left hand, the surgeon loads the pedicle in a cranial position to clamp the pedicle in a caudal place with the right hand using a Wertheim clamp.
In certain situations (early endometrial cancer, interventions under local anesthesia), it is necessary to release the uterus with minimum trauma, without tilting or morcellation. Direct access to the superior pedicle is possible mainly in multiparous women with perineal relaxation and small uteruses with a weakly represented bearing system. In these cases, clamping and section of the pedicle are done without any difficulties. Clamping the superior pedicle can be done safely by successively escalating the elements included in the utero-adnexal pedicle.
After extracting the uterus, gauze is inserted through the vaginal opening and into the pelvic cavity, pushing the bowels and leaving the pelvic-subperitoneal space open to view. The posterior wall of the vagina is retracted with an auto-static retractor. The vesicouterine peritoneum is revealed using a Briesky-Navratil retractor. The basis of the parameter is shown on the appropriate side, pulling the thread locating the superior pedicle. Bleeding at the end of the intervention is usually profuse, and its primary source is the vaginal cutting edges. In the case of active arterial bleeding from parameters, the surgical field is flooded, and the primary sources, such as the uterine arteries or the utero-ovarian arches, are to be found immediately.
At the end of a vaginal hysterectomy, the surgical field is rarely “dry” until the vaginal cuff is closed.
In the technique we used for a vaginal hysterectomy for a non-prolapsed uterus, we adopted the Wertheim manner of closing the peritoneal cavity and the remaining vaginal edges. The main drawback of this maneuver is the closing of the surgical field without controlling the hemostasis until the end of the operation. We modified the technique, closing down the pelvic-peritoneal space and anchoring the superior vagina to the remaining cuffs of the inferior pedicle containing the most substantial elements of suspension – the uterosacral ligaments. With this procedure, the prevention of vaginal vault prolapse is done like the McCall procedure.
The manner we proposed is done in three distinct times:
Closure of the pelvic-subperitoneal posterior space
Closure of the pelvic-subperitoneal anterior space
Full closure of the vaginal cuff
Closure of the pelvic-subperitoneal posterior space
Closing down the pelvic-subperitoneal space is done by running a suture with Vicryl nr. 0 to close the edge of the vagina and the posterior visceral peritoneum, starting from the lower pedicle on one side to the similar pedicle on the other side (Figure 24).
Closure of the pelvic-subperitoneal anterior space
This step usually is not necessary, but when the dissection of the bladder wall is difficult or in the case of an inadvertent wound, closing the space between the bladder and vagina is the best alternative. By joining the wall of the vagina with the visceral vesical peritoneum using a running suture, space is closed down.
Full closure of the vaginal cuff
The vaginal cuff can be fully closed by sutures with separate suture points. The closure of the vaginal cuff is done with Vicryl 0 and with suture points in a figure of eight that starts at the center of the section and goes out towards each lateral vaginal commissure (Figure 25).
Prophylactic apical support
The technique described above refers to the unprolapsed uterus where post-hysterectomy vault prolapse occurs very rarely. For this reason, we do not include in the operative procedure an appropriate step addressed for it. The prevention of vaginal vault prolapse is necessary in case of an association of early forms of uterovaginal prolapse. By the technique described by us, the means of suspension of the upper vagina are preserved as long as the circular (Figure 26).
Closing the posterior pelvic-subperitoneal space by running suture. The edge of the vagina (green arrow) is sutured together with the visceral posterior peritoneum (yellow arrow).
The final closing of the vaginal vault by separate suture points, from middle to lateral.
Superficial incision of the lateral aspect of the vagina allows the section of the lower connective vascular pedicle to anchor the vaginal wall to uterosacral ligaments making prophylaxis of vaginal vault prolapse. (yellow arrows – Vaginal wall).
The incision in the cervix is of interest only to the vaginal mucosa. For cases where early apical prolapse is present, McCall culdoplasty is an excellent way to resuspend the upper vagina at the first level (DeLancey).
The presented technique of vaginal hysterectomy resulted from combining several variants tried by authors over the years of more than 4500 vaginal hysterectomies. From each variant of the technique, we chose the most efficient and safe method to achieve each operator time as a confirmation of the validity of the succession of operating times proposed by us, the International Society of Endoscopic Surgery (ISGE) published in 2020 a set of recommendations on the technique of vaginal hysterectomy on the unprolapsed uterus.
Six recommendations were established similar to the standard technique proposed by us:
Circular incision at the level of the cervical-vagina junction is recommended (grade IC).
Posterior peritoneum should be opened first (grade IC).
Clamping and cutting the uterosacral and cardinal ligaments before or after getting access to the anterior peritoneum are recommended (grade IC).
Routine closure of the peritoneum during vaginal hysterectomy is not recommended (grade IB).
Vertical or horizontal closure of the vaginal vault following vaginal hysterectomy is recommended (grade IC).
To insert the vaginal plug following vaginal hysterectomy is not recommended (grade IB).
..,
There is no standard technique for vaginal hysterectomies. Every case poses different strategical problems. It is not necessary to follow every step of the operation in order as described elsewhere in literature or even in this chapter. The surgeon can treat every operation as a distinct one with a specific strategy.
The disconnection of the leading vascular pedicles causes fewer problems than delivering the uterus from the upper connective vascular pedicle. For large uteri, this operative step is time-consuming and challenging to work for the surgeon.
If during the first steps of the operation, incidental bleeding begins that cannot be managed, the surgeon should not hesitate to convert the vaginal operation to an open abdominal or laparoscopic one. Every minute lost means 250 ml of blood lost from each uterine artery.
In many cases, there is significant blood loss until the uterus is released, and after that, the drama begins. In some cases, the abrupt withdrawal of the uterus from the pelvis causes the sliding of ligatures from a uterine artery. If the bleeding seems to be to one side, you have to look for it on the opposite side.
The most important thing is to finish this partially blind operation without any doubt regarding the safety of the patient.
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However, studies conducted in Tanzania indicate that access to agricultural knowledge among agricultural stakeholders is inadequate. This chapter investigates how to strengthen the exchange of agricultural knowledge can be strengthened. Specifically, the chapter assesses how agricultural knowledge flows, determines how communication channels are chosen and analyses critical factors for effective agricultural knowledge exchange. The study involved different agricultural stakeholders identified through stakeholders’ analysis. Random and non-random sampling techniques were used in drawing the sample for the study. The study involved 371 respondents. Key findings indicate that agricultural knowledge sharing, exchange, transfer and dissemination which facilitate the flow of agricultural knowledge. Findings indicate that availability and accessibility of the communication channels, ICT infrastructure, affordability of communication tariffs and ownership of communication tools influenced the choice of communication channels. Likewise, membership in professional groups, accessibility of knowledge sources, affordability of tariffs for, access to agricultural extension services, availability of knowledge and ICT infrastructure influence the flow of agricultural knowledge. It is concluded that effective agricultural knowledge flow increases knowledge accessibility, usage and creation. It is recommended that each agricultural stakeholder should be involved in conducting relevant agricultural knowledge roles so as to enhance the accessibility, sharing, exchange, dissemination and usage of agricultural knowledge.",book:{id:"5844",slug:"ontology-in-information-science",title:"Ontology in Information Science",fullTitle:"Ontology in Information Science"},signatures:"Wulystan P. 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Indeed, such conceptualization methods particularly ontologies for process management which is currently allied to semantic process mining trails to combine process models with ontologies, and are increasingly gaining attention in recent years. In view of that, this chapter introduces an ontology-based mining approach that makes use of concepts within the extracted event logs about domain processes to propose a method which allows for effective querying and improved analysis of the resulting models through semantic labelling (annotation), semantic representation (ontology) and semantic reasoning (reasoner). The proposed method is a semantic-based process mining approach that is able to induce new knowledge based on previously unobserved behaviours, and a more intuitive and easy way to represent and query the datasets and the discovered models compared to other standard logical procedures. To this end, the study claims that it is possible to apply effective reasoning methods to make inferences over a process knowledge-base (e.g. the learning process) that leads to automated discovery of learning patterns and/or behaviour.",book:{id:"5844",slug:"ontology-in-information-science",title:"Ontology in Information Science",fullTitle:"Ontology in Information Science"},signatures:"Kingsley Okoye, Syed Islam and Usman Naeem",authors:[{id:"219803",title:"Dr.",name:"Kingsley",middleName:null,surname:"Okoye",slug:"kingsley-okoye",fullName:"Kingsley Okoye"},{id:"219806",title:"Dr.",name:"Syed",middleName:null,surname:"Islam",slug:"syed-islam",fullName:"Syed Islam"},{id:"219807",title:"Dr.",name:"Usman",middleName:null,surname:"Naeem",slug:"usman-naeem",fullName:"Usman Naeem"}]},{id:"59449",title:"Examples of Ontology Model Usage in Engineering Fields",slug:"examples-of-ontology-model-usage-in-engineering-fields",totalDownloads:2137,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"The proposed research deals with the improvement of engineering knowledge classification and recognition by means of ontology usage. Ontology model allows structure information as well as to raises the effectiveness of search. Research describes the development of ontology models for engineering knowledge in Internet portal and modeling system for the classification and recognition of marine objects. The ontology model usage for the engineering knowledge portal development allows to systematize data and knowledge, to organize search and navigation, to describe informational and computational recourses according to the meta-notion standards. The description of modeling system subject domain is based on ontology that allows to realize the recognition of marine objects based on their parameters.",book:{id:"5844",slug:"ontology-in-information-science",title:"Ontology in Information Science",fullTitle:"Ontology in Information Science"},signatures:"Larysa Globa, Rina Novogrudska, Alexander Koval and Vyacheslav\nSenchenko",authors:[{id:"105085",title:"Prof.",name:"Larysa",middleName:null,surname:"Globa",slug:"larysa-globa",fullName:"Larysa Globa"},{id:"219895",title:"Dr.",name:"Rina",middleName:null,surname:"Novogrudska",slug:"rina-novogrudska",fullName:"Rina Novogrudska"},{id:"219896",title:"Prof.",name:"Alexander",middleName:null,surname:"Koval",slug:"alexander-koval",fullName:"Alexander Koval"},{id:"221967",title:"Dr.",name:"Vyacheslav",middleName:null,surname:"Senchenko",slug:"vyacheslav-senchenko",fullName:"Vyacheslav Senchenko"}]},{id:"58350",title:"Semantic Remote Sensing Scenes Interpretation and Change Interpretation",slug:"semantic-remote-sensing-scenes-interpretation-and-change-interpretation",totalDownloads:1403,totalCrossrefCites:3,totalDimensionsCites:8,abstract:"A fundamental objective of remote sensing imagery is to spread out the knowledge about our environment and to facilitate the interpretation of different phenomena affecting the Earth’s surface. 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Ms. Mehtab has published seven papers in international conferences and one of her papers has been accepted for publication in a reputable international journal. She has won the best paper awards in two prestigious international conferences – BAICONF 2019, and ICADCML 2021, organized in the Indian Institute of Management, Bangalore, India in December 2019, and SOA University, Bhubaneswar, India in January 2021. Besides, Ms. Mehtab has also published two book chapters in two books. Seven of her book chapters will be published in a volume shortly in 2021 by Cambridge Scholars’ Press, UK. Currently, she is working as the joint editor of two edited volumes on Time Series Analysis and Forecasting to be published in the first half of 2021 by an international house. Currently, she is working as a Data Scientist with an MNC in Delhi, India.",institutionString:"NSHM College of Management and Technology",institution:{name:"Association for Computing Machinery",country:{name:"United States of America"}}},{id:"226240",title:"Dr.",name:"Andri Irfan",middleName:null,surname:"Rifai",slug:"andri-irfan-rifai",fullName:"Andri Irfan Rifai",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/226240/images/7412_n.jpg",biography:"Andri IRFAN is a Senior Lecturer of Civil Engineering and Planning. He completed the PhD at the Universitas Indonesia & Universidade do Minho with Sandwich Program Scholarship from the Directorate General of Higher Education and LPDP scholarship. He has been teaching for more than 19 years and much active to applied his knowledge in the project construction in Indonesia. His research interest ranges from pavement management system to advanced data mining techniques for transportation engineering. He has published more than 50 papers in journals and 2 books.",institutionString:null,institution:{name:"Universitas Internasional Batam",country:{name:"Indonesia"}}},{id:"314576",title:"Dr.",name:"Ibai",middleName:null,surname:"Laña",slug:"ibai-lana",fullName:"Ibai Laña",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314576/images/system/314576.jpg",biography:"Dr. Ibai Laña works at TECNALIA as a data analyst. He received his Ph.D. in Artificial Intelligence from the University of the Basque Country (UPV/EHU), Spain, in 2018. He is currently a senior researcher at TECNALIA. His research interests fall within the intersection of intelligent transportation systems, machine learning, traffic data analysis, and data science. He has dealt with urban traffic forecasting problems, applying machine learning models and evolutionary algorithms. He has experience in origin-destination matrix estimation or point of interest and trajectory detection. Working with large volumes of data has given him a good command of big data processing tools and NoSQL databases. He has also been a visiting scholar at the Knowledge Engineering and Discovery Research Institute, Auckland University of Technology.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"314575",title:"Dr.",name:"Jesus",middleName:null,surname:"L. Lobo",slug:"jesus-l.-lobo",fullName:"Jesus L. Lobo",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/314575/images/system/314575.png",biography:"Dr. Jesús López is currently based in Bilbao (Spain) working at TECNALIA as Artificial Intelligence Research Scientist. In most cases, a project idea or a new research line needs to be investigated to see if it is good enough to take into production or to focus on it. That is exactly what he does, diving into Machine Learning algorithms and technologies to help TECNALIA to decide whether something is great in theory or will actually impact on the product or processes of its projects. So, he is expert at framing experiments, developing hypotheses, and proving whether they’re true or not, in order to investigate fundamental problems with a longer time horizon. He is also able to design and develop PoCs and system prototypes in simulation. He has participated in several national and internacional R&D projects.\n\nAs another relevant part of his everyday research work, he usually publishes his findings in reputed scientific refereed journals and international conferences, occasionally acting as reviewer and Programme Commitee member. Concretely, since 2018 he has published 9 JCR (8 Q1) journal papers, 9 conference papers (e.g. ECML PKDD 2021), and he has co-edited a book. He is also active in popular science writing data science stories for reputed blogs (KDNuggets, TowardsDataScience, Naukas). Besides, he has recently embarked on mentoring programmes as mentor, and has also worked as data science trainer.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"103779",title:"Prof.",name:"Yalcin",middleName:null,surname:"Isler",slug:"yalcin-isler",fullName:"Yalcin Isler",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRyQ8QAK/Profile_Picture_1628834958734",biography:"Yalcin Isler (1971 - Burdur / Turkey) received the B.Sc. degree in the Department of Electrical and Electronics Engineering from Anadolu University, Eskisehir, Turkey, in 1993, the M.Sc. degree from the Department of Electronics and Communication Engineering, Suleyman Demirel University, Isparta, Turkey, in 1996, the Ph.D. degree from the Department of Electrical and Electronics Engineering, Dokuz Eylul University, Izmir, Turkey, in 2009, and the Competence of Associate Professorship from the Turkish Interuniversity Council in 2019.\n\nHe was Lecturer at Burdur Vocational School in Suleyman Demirel University (1993-2000, Burdur / Turkey), Software Engineer (2000-2002, Izmir / Turkey), Research Assistant in Bulent Ecevit University (2002-2003, Zonguldak / Turkey), Research Assistant in Dokuz Eylul University (2003-2010, Izmir / Turkey), Assistant Professor at the Department of Electrical and Electronics Engineering in Bulent Ecevit University (2010-2012, Zonguldak / Turkey), Assistant Professor at the Department of Biomedical Engineering in Izmir Katip Celebi University (2012-2019, Izmir / Turkey). He is an Associate Professor at the Department of Biomedical Engineering at Izmir Katip Celebi University, Izmir / Turkey, since 2019. In addition to academics, he has also founded Islerya Medical and Information Technologies Company, Izmir / Turkey, since 2017.\n\nHis main research interests cover biomedical signal processing, pattern recognition, medical device design, programming, and embedded systems. He has many scientific papers and participated in several projects in these study fields. He was an IEEE Student Member (2009-2011) and IEEE Member (2011-2014) and has been IEEE Senior Member since 2014.",institutionString:null,institution:{name:"Izmir Kâtip Çelebi University",country:{name:"Turkey"}}},{id:"339677",title:"Dr.",name:"Mrinmoy",middleName:null,surname:"Roy",slug:"mrinmoy-roy",fullName:"Mrinmoy Roy",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/339677/images/16768_n.jpg",biography:"An accomplished Sales & Marketing professional with 12 years of cross-functional experience in well-known organisations such as CIPLA, LUPIN, GLENMARK, ASTRAZENECA across different segment of Sales & Marketing, International Business, Institutional Business, Product Management, Strategic Marketing of HIV, Oncology, Derma, Respiratory, Anti-Diabetic, Nutraceutical & Stomatological Product Portfolio and Generic as well as Chronic Critical Care Portfolio. A First Class MBA in International Business & Strategic Marketing, B.Pharm, D.Pharm, Google Certified Digital Marketing Professional. Qualified PhD Candidate in Operations and Management with special focus on Artificial Intelligence and Machine Learning adoption, analysis and use in Healthcare, Hospital & Pharma Domain. Seasoned with diverse therapy area of Pharmaceutical Sales & Marketing ranging from generating revenue through generating prescriptions, launching new products, and making them big brands with continuous strategy execution at the Physician and Patients level. Moved from Sales to Marketing and Business Development for 3.5 years in South East Asian Market operating from Manila, Philippines. Came back to India and handled and developed Brands such as Gluconorm, Lupisulin, Supracal, Absolut Woman, Hemozink, Fabiflu (For COVID 19), and many more. In my previous assignment I used to develop and execute strategies on Sales & Marketing, Commercialization & Business Development for Institution and Corporate Hospital Business portfolio of Oncology Therapy Area for AstraZeneca Pharma India Ltd. Being a Research Scholar and Student of ‘Operations Research & Management: Artificial Intelligence’ I published several pioneer research papers and book chapters on the same in Internationally reputed journals and Books indexed in Scopus, Springer and Ei Compendex, Google Scholar etc. Currently, I am launching PGDM Pharmaceutical Management Program in IIHMR Bangalore and spearheading the course curriculum and structure of the same. I am interested in Collaboration for Healthcare Innovation, Pharma AI Innovation, Future trend in Marketing and Management with incubation on Healthcare, Healthcare IT startups, AI-ML Modelling and Healthcare Algorithm based training module development. I am also an affiliated member of the Institute of Management Consultant of India, looking forward to Healthcare, Healthcare IT and Innovation, Pharma and Hospital Management Consulting works.",institutionString:null,institution:{name:"Lovely Professional University",country:{name:"India"}}},{id:"310576",title:"Prof.",name:"Erick Giovani",middleName:null,surname:"Sperandio Nascimento",slug:"erick-giovani-sperandio-nascimento",fullName:"Erick Giovani Sperandio Nascimento",position:null,profilePictureURL:"https://intech-files.s3.amazonaws.com/0033Y00002pDKxDQAW/ProfilePicture%202022-06-20%2019%3A57%3A24.788",biography:"Prof. Erick Sperandio is the Lead Researcher and professor of Artificial Intelligence (AI) at SENAI CIMATEC, Bahia, Brazil, also working with Computational Modeling (CM) and HPC. He holds a PhD in Environmental Engineering in the area of Atmospheric Computational Modeling, a Master in Informatics in the field of Computational Intelligence and Graduated in Computer Science from UFES. He currently coordinates, leads and participates in R&D projects in the areas of AI, computational modeling and supercomputing applied to different areas such as Oil and Gas, Health, Advanced Manufacturing, Renewable Energies and Atmospheric Sciences, advising undergraduate, master's and doctoral students. He is the Lead Researcher at SENAI CIMATEC's Reference Center on Artificial Intelligence. In addition, he is a Certified Instructor and University Ambassador of the NVIDIA Deep Learning Institute (DLI) in the areas of Deep Learning, Computer Vision, Natural Language Processing and Recommender Systems, and Principal Investigator of the NVIDIA/CIMATEC AI Joint Lab, the first in Latin America within the NVIDIA AI Technology Center (NVAITC) worldwide program. He also works as a researcher at the Supercomputing Center for Industrial Innovation (CS2i) and at the SENAI Institute of Innovation for Automation (ISI Automação), both from SENAI CIMATEC. He is a member and vice-coordinator of the Basic Board of Scientific-Technological Advice and Evaluation, in the area of Innovation, of the Foundation for Research Support of the State of Bahia (FAPESB). He serves as Technology Transfer Coordinator and one of the Principal Investigators at the National Applied Research Center in Artificial Intelligence (CPA-IA) of SENAI CIMATEC, focusing on Industry, being one of the six CPA-IA in Brazil approved by MCTI / FAPESP / CGI.br. He also participates as one of the representatives of Brazil in the BRICS Innovation Collaboration Working Group on HPC, ICT and AI. He is the coordinator of the Work Group of the Axis 5 - Workforce and Training - of the Brazilian Strategy for Artificial Intelligence (EBIA), and member of the MCTI/EMBRAPII AI Innovation Network Training Committee. He is the coordinator, by SENAI CIMATEC, of the Artificial Intelligence Reference Network of the State of Bahia (REDE BAH.IA). He leads the working group of experts representing Brazil in the Global Partnership on Artificial Intelligence (GPAI), on the theme \"AI and the Pandemic Response\".",institutionString:"Manufacturing and Technology Integrated Campus – SENAI CIMATEC",institution:null},{id:"1063",title:"Prof.",name:"Constantin",middleName:null,surname:"Volosencu",slug:"constantin-volosencu",fullName:"Constantin Volosencu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/1063/images/system/1063.png",biography:"Prof. Dr. Constantin Voloşencu graduated as an engineer from\nPolitehnica University of Timișoara, Romania, where he also\nobtained a doctorate degree. He is currently a full professor in\nthe Department of Automation and Applied Informatics at the\nsame university. Dr. Voloşencu is the author of ten books, seven\nbook chapters, and more than 160 papers published in journals\nand conference proceedings. He has also edited twelve books and\nhas twenty-seven patents to his name. He is a manager of research grants, editor in\nchief and member of international journal editorial boards, a former plenary speaker, a member of scientific committees, and chair at international conferences. His\nresearch is in the fields of control systems, control of electric drives, fuzzy control\nsystems, neural network applications, fault detection and diagnosis, sensor network\napplications, monitoring of distributed parameter systems, and power ultrasound\napplications. He has developed automation equipment for machine tools, spooling\nmachines, high-power ultrasound processes, and more.",institutionString:'"Politechnica" University Timişoara',institution:null},{id:"221364",title:"Dr.",name:"Eneko",middleName:null,surname:"Osaba",slug:"eneko-osaba",fullName:"Eneko Osaba",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/221364/images/system/221364.jpg",biography:"Dr. Eneko Osaba works at TECNALIA as a senior researcher. He obtained his Ph.D. in Artificial Intelligence in 2015. He has participated in more than twenty-five local and European research projects, and in the publication of more than 130 papers. He has performed several stays at universities in the United Kingdom, Italy, and Malta. Dr. Osaba has served as a program committee member in more than forty international conferences and participated in organizing activities in more than ten international conferences. He is a member of the editorial board of the International Journal of Artificial Intelligence, Data in Brief, and Journal of Advanced Transportation. He is also a guest editor for the Journal of Computational Science, Neurocomputing, Swarm, and Evolutionary Computation and IEEE ITS Magazine.",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"275829",title:"Dr.",name:"Esther",middleName:null,surname:"Villar-Rodriguez",slug:"esther-villar-rodriguez",fullName:"Esther Villar-Rodriguez",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/275829/images/system/275829.jpg",biography:"Dr. Esther Villar obtained a Ph.D. in Information and Communication Technologies from the University of Alcalá, Spain, in 2015. She obtained a degree in Computer Science from the University of Deusto, Spain, in 2010, and an MSc in Computer Languages and Systems from the National University of Distance Education, Spain, in 2012. Her areas of interest and knowledge include natural language processing (NLP), detection of impersonation in social networks, semantic web, and machine learning. Dr. Esther Villar made several contributions at conferences and publishing in various journals in those fields. Currently, she is working within the OPTIMA (Optimization Modeling & Analytics) business of TECNALIA’s ICT Division as a data scientist in projects related to the prediction and optimization of management and industrial processes (resource planning, energy efficiency, etc).",institutionString:"TECNALIA Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"49813",title:"Dr.",name:"Javier",middleName:null,surname:"Del Ser",slug:"javier-del-ser",fullName:"Javier Del Ser",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49813/images/system/49813.png",biography:"Prof. Dr. Javier Del Ser received his first PhD in Telecommunication Engineering (Cum Laude) from the University of Navarra, Spain, in 2006, and a second PhD in Computational Intelligence (Summa Cum Laude) from the University of Alcala, Spain, in 2013. He is currently a principal researcher in data analytics and optimisation at TECNALIA (Spain), a visiting fellow at the Basque Center for Applied Mathematics (BCAM) and a part-time lecturer at the University of the Basque Country (UPV/EHU). His research interests gravitate on the use of descriptive, prescriptive and predictive algorithms for data mining and optimization in a diverse range of application fields such as Energy, Transport, Telecommunications, Health and Industry, among others. In these fields he has published more than 240 articles, co-supervised 8 Ph.D. theses, edited 6 books, coauthored 7 patents and participated/led more than 40 research projects. He is a Senior Member of the IEEE, and a recipient of the Biscay Talent prize for his academic career.",institutionString:"Tecnalia Research & Innovation",institution:{name:"Tecnalia",country:{name:"Spain"}}},{id:"278948",title:"Dr.",name:"Carlos Pedro",middleName:null,surname:"Gonçalves",slug:"carlos-pedro-goncalves",fullName:"Carlos Pedro Gonçalves",position:null,profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRcmyQAC/Profile_Picture_1564224512145",biography:'Carlos Pedro Gonçalves (PhD) is an Associate Professor at Lusophone University of Humanities and Technologies and a researcher on Complexity Sciences, Quantum Technologies, Artificial Intelligence, Strategic Studies, Studies in Intelligence and Security, FinTech and Financial Risk Modeling. He is also a progammer with programming experience in:\n\nA) Quantum Computing using Qiskit Python module and IBM Quantum Experience Platform, with software developed on the simulation of Quantum Artificial Neural Networks and Quantum Cybersecurity;\n\nB) Artificial Intelligence and Machine learning programming in Python;\n\nC) Artificial Intelligence, Multiagent Systems Modeling and System Dynamics Modeling in Netlogo, with models developed in the areas of Chaos Theory, Econophysics, Artificial Intelligence, Classical and Quantum Complex Systems Science, with the Econophysics models having been cited worldwide and incorporated in PhD programs by different Universities.\n\nReceived an Arctic Code Vault Contributor status by GitHub, due to having developed open source software preserved in the \\"Arctic Code Vault\\" for future generations (https://archiveprogram.github.com/arctic-vault/), with the Strategy Analyzer A.I. module for decision making support (based on his PhD thesis, used in his Classes on Decision Making and in Strategic Intelligence Consulting Activities) and QNeural Python Quantum Neural Network simulator also preserved in the \\"Arctic Code Vault\\", for access to these software modules see: https://github.com/cpgoncalves. He is also a peer reviewer with outsanding review status from Elsevier journals, including Physica A, Neurocomputing and Engineering Applications of Artificial Intelligence. Science CV available at: https://www.cienciavitae.pt//pt/8E1C-A8B3-78C5 and ORCID: https://orcid.org/0000-0002-0298-3974',institutionString:"University of Lisbon",institution:{name:"Universidade Lusófona",country:{name:"Portugal"}}},{id:"241400",title:"Prof.",name:"Mohammed",middleName:null,surname:"Bsiss",slug:"mohammed-bsiss",fullName:"Mohammed Bsiss",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/241400/images/8062_n.jpg",biography:null,institutionString:null,institution:null},{id:"276128",title:"Dr.",name:"Hira",middleName:null,surname:"Fatima",slug:"hira-fatima",fullName:"Hira Fatima",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/276128/images/14420_n.jpg",biography:"Dr. Hira Fatima\nAssistant Professor\nDepartment of Mathematics\nInstitute of Applied Science\nMangalayatan University, Aligarh\nMobile: no : 8532041179\nhirafatima2014@gmal.com\n\nDr. Hira Fatima has received his Ph.D. degree in pure Mathematics from Aligarh Muslim University, Aligarh India. Currently working as an Assistant Professor in the Department of Mathematics, Institute of Applied Science, Mangalayatan University, Aligarh. She taught so many courses of Mathematics of UG and PG level. Her research Area of Expertise is Functional Analysis & Sequence Spaces. She has been working on Ideal Convergence of double sequence. She has published 17 research papers in National and International Journals including Cogent Mathematics, Filomat, Journal of Intelligent and Fuzzy Systems, Advances in Difference Equations, Journal of Mathematical Analysis, Journal of Mathematical & Computer Science etc. She has also reviewed few research papers for the and international journals. She is a member of Indian Mathematical Society.",institutionString:null,institution:null},{id:"414880",title:"Dr.",name:"Maryam",middleName:null,surname:"Vatankhah",slug:"maryam-vatankhah",fullName:"Maryam Vatankhah",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Borough of Manhattan Community College",country:{name:"United States of America"}}},{id:"414879",title:"Prof.",name:"Mohammad-Reza",middleName:null,surname:"Akbarzadeh-Totonchi",slug:"mohammad-reza-akbarzadeh-totonchi",fullName:"Mohammad-Reza Akbarzadeh-Totonchi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Ferdowsi University of Mashhad",country:{name:"Iran"}}},{id:"414878",title:"Prof.",name:"Reza",middleName:null,surname:"Fazel-Rezai",slug:"reza-fazel-rezai",fullName:"Reza Fazel-Rezai",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"American Public University System",country:{name:"United States of America"}}},{id:"426586",title:"Dr.",name:"Oladunni A.",middleName:null,surname:"Daramola",slug:"oladunni-a.-daramola",fullName:"Oladunni A. Daramola",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Federal University of Technology",country:{name:"Nigeria"}}},{id:"357014",title:"Prof.",name:"Leon",middleName:null,surname:"Bobrowski",slug:"leon-bobrowski",fullName:"Leon Bobrowski",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Bialystok University of Technology",country:{name:"Poland"}}},{id:"302698",title:"Dr.",name:"Yao",middleName:null,surname:"Shan",slug:"yao-shan",fullName:"Yao Shan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Dalian University of Technology",country:{name:"China"}}},{id:"354126",title:"Dr.",name:"Setiawan",middleName:null,surname:"Hadi",slug:"setiawan-hadi",fullName:"Setiawan Hadi",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Padjadjaran University",country:{name:"Indonesia"}}},{id:"125911",title:"Prof.",name:"Jia-Ching",middleName:null,surname:"Wang",slug:"jia-ching-wang",fullName:"Jia-Ching Wang",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"National Central University",country:{name:"Taiwan"}}},{id:"332603",title:"Prof.",name:"Kumar S.",middleName:null,surname:"Ray",slug:"kumar-s.-ray",fullName:"Kumar S. Ray",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Statistical Institute",country:{name:"India"}}},{id:"415409",title:"Prof.",name:"Maghsoud",middleName:null,surname:"Amiri",slug:"maghsoud-amiri",fullName:"Maghsoud Amiri",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Allameh Tabataba'i University",country:{name:"Iran"}}},{id:"357085",title:"Mr.",name:"P. Mohan",middleName:null,surname:"Anand",slug:"p.-mohan-anand",fullName:"P. Mohan Anand",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"356696",title:"Ph.D. Student",name:"P.V.",middleName:null,surname:"Sai Charan",slug:"p.v.-sai-charan",fullName:"P.V. Sai Charan",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}},{id:"357086",title:"Prof.",name:"Sandeep K.",middleName:null,surname:"Shukla",slug:"sandeep-k.-shukla",fullName:"Sandeep K. Shukla",position:null,profilePictureURL:"//cdnintech.com/web/frontend/www/assets/author.svg",biography:null,institutionString:null,institution:{name:"Indian Institute of Technology Kanpur",country:{name:"India"}}}]}},subseries:{item:{id:"27",type:"subseries",title:"Multi-Agent Systems",keywords:"Collaborative Intelligence, Learning, Distributed Control System, Swarm Robotics, Decision Science, Software Engineering",scope:"Multi-agent systems are recognised as a state of the art field in Artificial Intelligence studies, which is popular due to the usefulness in facilitation capabilities to handle real-world problem-solving in a distributed fashion. The area covers many techniques that offer solutions to emerging problems in robotics and enterprise-level software systems. Collaborative intelligence is highly and effectively achieved with multi-agent systems. Areas of application include swarms of robots, flocks of UAVs, collaborative software management. Given the level of technological enhancements, the popularity of machine learning in use has opened a new chapter in multi-agent studies alongside the practical challenges and long-lasting collaboration issues in the field. It has increased the urgency and the need for further studies in this field. We welcome chapters presenting research on the many applications of multi-agent studies including, but not limited to, the following key areas: machine learning for multi-agent systems; modeling swarms robots and flocks of UAVs with multi-agent systems; decision science and multi-agent systems; software engineering for and with multi-agent systems; tools and technologies of multi-agent systems.",coverUrl:"https://cdn.intechopen.com/series_topics/covers/27.jpg",hasOnlineFirst:!0,hasPublishedBooks:!1,annualVolume:11423,editor:{id:"148497",title:"Dr.",name:"Mehmet",middleName:"Emin",surname:"Aydin",slug:"mehmet-aydin",fullName:"Mehmet Aydin",profilePictureURL:"https://mts.intechopen.com/storage/users/148497/images/system/148497.jpg",biography:"Dr. Mehmet Emin Aydin is a Senior Lecturer with the Department of Computer Science and Creative Technology, the University of the West of England, Bristol, UK. His research interests include swarm intelligence, parallel and distributed metaheuristics, machine learning, intelligent agents and multi-agent systems, resource planning, scheduling and optimization, combinatorial optimization. Dr. Aydin is currently a Fellow of Higher Education Academy, UK, a member of EPSRC College, a senior member of IEEE and a senior member of ACM. In addition to being a member of advisory committees of many international conferences, he is an Editorial Board Member of various peer-reviewed international journals. 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We encourage the submission of manuscripts that provide novel and mechanistic insights that report significant advances in the fields. Topics can include but are not limited to: Biotechnology such as biotechnological products and process engineering; Biotechnologically relevant enzymes and proteins; Bioenergy and biofuels; Applied genetics and molecular biotechnology; Genomics, transcriptomics, proteomics; Applied microbial and cell physiology; Environmental biotechnology; Methods and protocols. Moreover, topics in biosensor technology, like sensors that incorporate enzymes, antibodies, nucleic acids, whole cells, tissues and organelles, and other biological or biologically inspired components will be considered, and topics exploring transducers, including those based on electrochemical and optical piezoelectric, thermal, magnetic, and micromechanical elements. Chapters exploring biomaterial approaches such as polymer synthesis and characterization, drug and gene vector design, biocompatibility, immunology and toxicology, and self-assembly at the nanoscale, are welcome. Finally, the tissue engineering subcategory will support topics such as the fundamentals of stem cells and progenitor cells and their proliferation, differentiation, bioreactors for three-dimensional culture and studies of phenotypic changes, stem and progenitor cells, both short and long term, ex vivo and in vivo implantation both in preclinical models and also in clinical trials.",annualVolume:11405,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/9.jpg",editor:{id:"126286",title:"Dr.",name:"Luis",middleName:"Jesús",surname:"Villarreal-Gómez",fullName:"Luis Villarreal-Gómez",profilePictureURL:"https://mts.intechopen.com/storage/users/126286/images/system/126286.jpg",institutionString:null,institution:{name:"Autonomous University of Baja California",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"35539",title:"Dr.",name:"Cecilia",middleName:null,surname:"Cristea",fullName:"Cecilia Cristea",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYQ65QAG/Profile_Picture_1621007741527",institutionString:null,institution:{name:"Iuliu Hațieganu University of Medicine and Pharmacy",institutionURL:null,country:{name:"Romania"}}},{id:"40735",title:"Dr.",name:"Gil",middleName:"Alberto Batista",surname:"Gonçalves",fullName:"Gil Gonçalves",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYRLGQA4/Profile_Picture_1628492612759",institutionString:null,institution:{name:"University of Aveiro",institutionURL:null,country:{name:"Portugal"}}},{id:"211725",title:"Associate Prof.",name:"Johann F.",middleName:null,surname:"Osma",fullName:"Johann F. 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