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Najah Abu Ali Wesam Aleyadeh Mervat AbuElkhair
Faculty of Information Technology Faculty of Medicine Faculty of Computer and Information Sciences
United Arab Emirates University Hashemite University Mansoura University
Al Ain, UAE Zarqa, Jordan Mansoura, Egypt
najah@uaeu.ac.ae wesama@med.hu.edu.jo mfahmy78@mans.edu.eg
Abstract— The advent of the Internet of Things (IoT) has given network systems will expand the array of services that can be
the opportunity for the optimization and realization of different provided to patients as well as healthcare decision makers.
applications in various areas. The implementation of the Internet Various data dissemination requirements that stem from IoNT’s
of Nano-Things (IoNT) will revolutionize healthcare systems. It unique features need to be incorporated into its protocol stack
will streamline the diagnostic and prognostic processes and aid in model for this to come to light. Different challenges against
the treatment of patients through accurate and localized drug protocols design are still being investigated with no currently
delivery and tumor and disease detection. In this paper, we outline fully developed solutions. Traditional TCP/IP protocol stack
the different network models of IoNT and the architectural model is not feasible for implementation in nanonetworks since
requirements for implementation. We highlight the main
the TCP/IP model was originally designed for the high
applications of IoNT and the significant challenges we face in
processing of general purpose network nodes. Conversely,
implementing this technology in healthcare. We also discuss the
communication and networking aspects of IoNT examining two nanomachines nodes are limited in the power supply,
paradigms; layer-based and non-layer based models including the processing, and communication range. Currently, introducing an
comprised layers in the layered model. We finally provide a innovative protocol stack model that captures the specific
comparison between the two models and discuss the advantages, characteristics of nanonetworks is still in its early stages and an
disadvantages of both. active area of research. Several proposals in current literature
address the nanonetworks protocol stack as the proposals can be
Keywords— Internet of Nano-Things; healthcare applications; categorized into two main categories: Layer-based models, and
nanonetworks. no-layer models.
I. INTRODUCTION This paper is organized as follows. Section II will provide a
general overview of the ubiquitous healthcare ecosystem and the
Recent advancement in nanotechnology development and architectural requirements that will incorporate nanonetworks.
design of nanoscale components with sizes ranging from one to The IoNT projected healthcare applications and their
a few hundred nanometers (nanosensors, nanoprocessors, characteristics are highlighted in Section III. The current status
nanobatteries, nanoantennas, nanomemory, etc.) executing of performance analysis and evaluation is discussed in Section
simple tasks such as sensing, actuation and computing have IV. Section V outlines the IoNT networking requirements and
promoted a new class of application and service such as intra- challenges that need to be addressed in order to realize novel
human body monitoring. A standalone nanodevice is highly healthcare applications. Finally, Section VI concludes the paper.
constrained by limited energy, processing and communication
range. The nanonetwork holds significantly greater II. IONT NETWORK MODELS
communication and processing potential that overcomes the
limitations of standalone nanomachines through nanodevices A. Layer-Based Models
cooperation. This may allow for the provision of advanced Some proposals attempted to implement a minor form of TCP/IP
services and applications in several fields such as industry, model regardless of the constraints of the employment of
environment, military and health. One of the most attractive TCP/IP model in nanonetworks while other proposals suggested
applications of nanonetworks is in the healthcare and biomedical the use of layer-based models specifically designed for
fields. Nanomachines can monitor inaccessible parts of the nanonetworks. The work in [1] attempts to apply the model in
human body, such as the aortic heart valve and collect sensory its current form for practical use in nanonetworks. Similar to the
data of the valve. A nanonetwork, in turn, can carry the sensory
TCP/IP model, the protocol stack is composed of the following:
data to an external device such as a Smartphone or an Internet
Application, Transport, Network and Physical layers from the
gateway enabling nanodevices to wirelessly communicate with
powerful external processing devices. Nanonetworks connected sender and the receiver side. The Application layer functions
to internet gateways enables a new network paradigm called the mainly as an interface between the sender and the receiver. It
IoNT. initiates transmission by compiling a message at the sender side
as a response to sensing an event and then executes this message
IoNT holds an exciting potential for advanced health services at the receiver side. Transport layer functions are similar to the
and applications. Integrating IoNT with other healthcare traditional transport layer responsible for the error and flow
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temperature to reach a steady state. However, a major barrier to B. Transport Layer
this technique is the hyperthermic damage to surrounding tissue. Nanomachines suffer from unreliable transmission due to the
Application design for healthcare services needs to address high level of biological noise [10]. The projected dense
requirements for real-time, reliable, and context-aware deployment of nanomachines may allow the nanonetwork to
operation. The critical significance of health services makes become more reliable holistically. The Dense deployment will
real-time or near-real-time operation a fundamental also make up for the potential packet loss since more
requirement. However, due to the unpredictable transmission nanomachines with the same functionality can report the same
medium and the significantly short range of intra-body data.
communication, a random delay is to be expected. The The nanoscale of the IoNT makes it impractical to have
heterogeneous nature of nanomachines and their use for several individual network addresses for the individual nanomachines.
medical purposes inside the body will result in different data Addressing can thus be cluster-based instead of node-based.
representations and formats. Data fusion will, therefore, need to This makes it possible to address a group of nodes based on the
be optimal, dynamic, and delay-tolerant for applications that health functionality they perform or the biological organ or
rely on the integration of diverse data sources [10]. Applications phenomena they monitor [13].
that involve periodic monitoring can be designed to operate on One challenge that is not addressed in the literature is control of
sliding-window-based data aggregation in order to cater for congestion, especially in a dense nanomachines deployment
delay-tolerance. However, data aggregation and fusion are not scenario. Although some techniques from electromagnetic
always suitable for healthcare applications, because of the real- communication may be adapted for the Terahertz band, it is not
time requirements, and since many of those applications depend yet clear how congestion will be avoided in molecular
on fine-grained variations in the temporal domain that are lost in communication, since the molecules are the medium that carries
the aggregation/fusion process. the information.
Context awareness is another challenging aspect for
nanonetworks. Networks deployed outside of the body can be C. Network Layer
geographically tagged and can communicate with the external The communication range for the IoNT systems is expected to
environment in order to determine and update their context. be between 1 cm and 1 m for terahertz-based communication
Nanonetworks deployed inside the human body need a and 1 nm to 1 cm for molecular communication [13]. This means
noninvasive mechanism to recognize their context, especially that the transmission range is extremely limited, which makes
for deployments that depend on node mobility. Furthermore, multi-hop communication and routing a critical aspect for
applications need to coordinate multiple contexts for specific nanonetworks. Furthermore, the direction of a communication
services that can benefit from the integration of intra-body route is not deterministic and is dependent on the drift velocity
networks and on-body networks as well as external networks. of nanomachines inside the body, which may lead to
For example, an on-body network can detect the change of communication delay. The mobility of nanomachines can be
context for a patient and be alerted by an environmental network utilized for routing to reduce the delay incurred due to biological
about the presence of a certain allergen to which the patient is propagation limitations. This will require efficient schemes for
sensitive. The intra-body network is then notified and the proper multi-hop path creation and management.
drug is released in the body to control the allergic reaction. The limited processing and storage capabilities of nanomachines
Current research on challenges to implementing IoNT in dictate that routing design should not assume that nodes have
medical applications is lacking and unexplored. One of the areas knowledge of the network topology. Network topology inside
that must be examined is THz radiation and the thermal and non- the body can be random and dynamic due to the uncontrolled
thermal effect of terahertz waves on tissues and cellular properties of the biological communication medium. This also
processes. [11] exposed Jurkat human T-lymphocyte cells to affects cooperation between nanomachines, which has to be kept
THz radiation (2.52 THz, 227 mW/cm2 with durations reaching to a minimum. Node mobility inside the body and proximity-
40 minutes and found that most cells underwent necrosis after based opportunistic routing can be suitable solutions. Topology
being exposed for 20 minutes or longer. 60% of Jurkat cells information can be maintained by cluster heads and gateways
survived the 30-minute exposure, and only 20% survived 40 [10]. The work presented in [14] proposes a geographic routing
minutes. The effects are not only restricted to higher wattage and protocol; the nodes of the nanonetworks is assumed to comprise
frequencies. [12] exposed a monolayer-cultured human-hamster two types anchor nodes, which have higher communication and
hybrid cell line to a 0.106 THz radiation source for 30 minutes, processing capabilities than user nodes. User nodes are required
with power densities ranging from 0.043 mW/cm2 to 4.3 to localize their position reference to these anchor nodes. The
mW/cm2 and found that THz radiation affected chromatid authors assume that the network topology is square with four
separation during the mitotic anaphase and telophase. Further anchors located at the vertices of the square corners. The authors
research is thus required to understand the effects of THz claim that two anchors are sufficient for each node to measure
radiation on living tissue. At the forefront of research will be the its location. The forwarding scheme operates at two phases;
need to provide reliable mathematical and physical models, as setup phase and operation phase. Setup phase designed to assist
well as computer simulations that can be applied on the user nodes in measuring their distances from the anchors. In the
biological medium. operation phase, a source node selects the anchor nodes and
incorporates this information in a packet header proposed by the
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authors. A receiving node checks its location, the destination deterministic MAC protocol using TDMA instead of the
location and source location to decide on forwarding or dropping probabilistic proposed scheme of [19].
the packet. Similar to [5], the proposed scheme is topology Coding and collision avoidance schemes may reduce
dependent and assumed fixed topology, which may not be retransmissions and multiuser interference but will require
applicable for nanonetworks. Additionally, the scheme requires longer data packets and additional packets overhead. This may
addressing for all nodes, which was not discussed in the paper. result in higher energy consumption at both the transmitter and
The setup phase requires careful synchronization among anchor the receiver when compared with the transparent MAC layer.
nodes and user nodes. A sound routing scheme for energy Performance evaluation of transparent MAC protocols in
harvesting was proposed in [15]. The routing scheme assumes a comparison to error control-based MAC protocols is required.
hierarchical cluster-based architecture. Packet transmission The schemes can be evaluated using classic metrics such as
from the source to the cluster-head or nano-controller can be energy consumption per transmitted bit, throughput, and packet
direct or multihop based on the probability of saving energy loss. The evaluation results may then provide insight on the
through transmission, optimizing throughput and minimizing advantages and disadvantages of the two main aspects of MAC
nanosensors load. The aforementioned solutions addressed protocol designs and allow us to identify the protocol type that
partial challenges and constraints of nanonetworks. Some is a better fit to combat the limitations of nanodevices.
proposals assume multitier nanonetworks, explicit node
E. Physical Layer
addressing and cluster/tier wide time synchronization. Others
overlook the randomness nature of the nanonetworks and mostly Three main requirements are needed by health applications at
topology-based routing schemes. Generalized routing schemes the PHY layer: a channel capacity that guarantees reliable data
that consider the requirements and constraints of nanonetworks delivery, an accurate channel model that accounts for the unique
discussed above continue to be an open area of research. biological transmission medium and its associated noise, and
efficient coding schemes that are resilient to errors.
D. Medium Access Control Layer Channel capacity is dependent on the end-to-end
MAC protocols designed for traditional wireless media cannot communication path between the transmitter and the receiver.
capture the special characteristics of terahertz band Since the transmission range for nanonetworks is severely
communication and nanonodes specification. Traditional limited, dense deployment of nanomachines is required, coupled
Wireless MAC protocols, therefore, cannot be implemented in with multi-hop communication support in order to be support
IoNT. Terahertz band communication provides enormous reliable data delivery [20].
bandwidth and significantly short transmission time [16], which Channel models that incorporate path loss, thermal noise, and
leads to fewer collisions and interference than in traditional channel capacity for both molecular and electromagnetic nano-
networks. Comparatively, different researchers advocate the communication are needed [21]. The channel medium for
design of transparent MAC protocols. Transparent MAC is a molecular communication is the molecules, which have to
simplified protocol, where the packet received from the network propagate through biological tissue and are subject to Brownian
layer is transmitted to the physical interface without handling motion [20]. This makes it challenging to predict how the data
any flow control, error control or adding any headers to the will propagate through the biological channel. Since the body is
packet [3]. The high path-loss and low energy of nano-devices composed of 65% water, even EM radio frequency propagation
coupled with noisy transmission media increase the probability will be challenging to model. Ultrasonic communication was
of packet errors regardless of the huge link bandwidth. This proposed as a more reliable and currently operational paradigm
promotes the need for error-control MAC protocols that address to achieve internetworking of nanomachines for intra-body
the necessity of controlling access to the THz-band channel to communication [22]. Channel characteristics for intra-body
reduce packets retransmissions. Packets retransmissions may be nanonetworks may vary with health conditions and from person
costly because nanoscale devices are self-powered using energy to person, making it most difficult to identify how this variation
harvesting. Fully charged nanodevices are capable of just can be incorporated into channel modeling.
transmitting a few packets before getting fully depleted. Efficient coding is affected by the ability to accurately
Consequently, nanonodes are required to wait to recharge using characterize and model the sources of error both in molecular
energy harvesting before being able to transmit again, which and electromagnetic communication. Coding at the nanoscale
may introduce an unavoidable delay that renders packet needs to have significantly low complexity due to the limited
retransmission useless. Schemes presented in [17, 18] are processing capacity of nanomachines [16].
examples of proposals that attempt to alleviate the need for
retransmissions by proposing a lightweight coding energy IV. CONCLUSIONS
saving aware schemes for error correction and error detection at In this study, we presented a comprehensive survey of the
the MAC layer. network models of IoNT and highlighted the different layers
Shahram et al. proposed energy harvesting aware MAC protocol involved in the layered model. We presented the most
inspired by CSMA/CA-CD called RIH-MAC [19]. The scheme significant applications such as drug delivery and disease
is receiver-oriented, where a receiver sends an RTR signal to all detection for implementation in healthcare services and
interested sources once it has the sufficient harvested energy to demonstrated their importance. The effects of the use of
receive a packet. An interested source replies with a DATA terahertz waves on the human tissue will need to be examined
packet sent to the receiver. The work in [20] proposed a prior to utilizing IoNT in the healthcare system. Developing
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reliable mathematical and physical models, as well as computer expression signatures." BiOS. International Society for
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ACKNOWLEDGEMENT
Meyyappan, "Enabling communication and cooperation in
This work was made possible by NRF-UAEU grant bio-nanosensor networks: toward innovative healthcare
#31T005- from United Arab Emirates University, NRF. solutions," IEEE Wireless Communications, vol. 19, no. 5,
pp. 42-51, 2012.
[14]. Tsioliaridou, Ageliki, et al. "CORONA: A Coordinate and
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