Attack-aware Synchronization-free Data Timestamping in LoRaWAN

Low-power wide-area network technologies such as long-range wide-area network (LoRaWAN) are promising for collecting low-rate monitoring data from geographically distributed sensors, in which timestamping the sensor data is a critical system function. This article considers a synchronization-free approach to timestamping LoRaWAN uplink data based on signal arrival time at the gateway, which well matches LoRaWAN’s one-hop star topology and releases bandwidth from transmitting timestamps and synchronizing end devices’ clocks at all times. However, we show that this approach is susceptible to a frame delay attack consisting of malicious frame collision and delayed replay. Real experiments show that the attack can affect the end devices in large areas up to about 50,000, m 2 . In a broader sense, the attack threatens any system functions requiring timely deliveries of LoRaWAN frames. To address this threat, we propose a LoRaTS gateway design that integrates a commodity LoRaWAN gateway and a low-power software-defined radio receiver to track the inherent frequency biases of the end devices. Based on an analytic model of LoRa’s chirp spread spectrum modulation, we develop signal processing algorithms to estimate the frequency biases with high accuracy beyond that achieved by LoRa’s default demodulation. The accurate frequency bias tracking capability enables the detection of the attack that introduces additional frequency biases. We also investigate and implement a more crafty attack that uses advanced radio apparatuses to eliminate the frequency biases. To address this crafty attack, we propose a pseudorandom interval hopping scheme to enhance our frequency bias tracking approach. Extensive experiments show the effectiveness of our approach in deployments with real affecting factors such as temperature variations.

Self Efficiency And Symptom Control of Cancer Patients

Objective: This cross-sectional study was planned to evaluate the self-efficacy and symptom control of cancer patients and to determine the factors affecting them. Methods: The sample of the study consisted of 329 cancer patients who were treated in the Medical Oncology Clinic of a university hospital between April and June 2019 and accepted to participate in the study. Data were collected using the Patient Characteristics Information Form, Cancer Behavioral Inventory-Short Version (CBI-SV), and Edmonton Symptom Assessment Scale (ESAS). Percentage, mean, Mann Whitney U test, Kruskal Wallis analysis of variance were used in the analysis of the data. Results: The mean CBI-SV score of the patients was 79.10±17.55. It was determined that the highest mean score of ESAS of the patients was in the symptom of fatigue (3.53±2.81). Some symptoms were statistically lower in patients with good income, working, and non-smokers. Also it was determined that the self-efficacy levels of the patients with good income and quitting smoking were higher (p<0.05). At the same time, as the patients' self-efficacy scores increased, the severity of the symptoms they experienced decreased statistically (p<0.05). Conclusion: It was found that the patients' self-efficacy score was above the moderate level, the most intense symptom experienced by the patients was fatigue, and the severity of the symptoms decreased as the patients' self-efficacy level increased. In line with these results; the symptoms, self-efficacy perceptions and affecting factors of cancer patients should be evaluated by nurses at regular intervals, and care and consultancy services should be provided.

Enhancing the effectiveness of flipped classroom in health science education: a state-of-the-art review

Background In a flipped classroom, students acquire knowledge before class and deepen and apply this knowledge during class. This way, lower-order learning goals are achieved before class and higher-order skills are reached during class. This study aims to provide an overview of the factors that contribute to the effectiveness of the flipped classroom and how these factors can be stimulated. The effectiveness of the flipped classroom is conceptualized in this study as test scores, the achievement of higher learning goals, and student perceptions. Methods A state-of-the-art review was conducted. The databases MEDLINE, PsycINFO, PubMed, Web of Science, and Scopus were consulted. The timeframe is 2016 till 2020. The studies were qualitatively analyzed according to the grounded theory method. Results After screening the studies based on the inclusion-and exclusion criteria, 88 studies were included in this review. The qualitative analysis of these studies revealed six main factors that affect the effectiveness of the flipped classroom: student characteristics, teacher characteristics, implementation, task characteristics, out-of-class activities, and in-class activities. Mediating factors are, amongst other factors, the learner’s level of self-regulated learning, teacher’s role and motivation, assessment approach, and guidance during self-study by means of prompts or feedback. These factors can be positively stimulated by structuring the learning process and focusing the teacher training on competencies and learning-and teaching approaches that are essential for the flipped classroom. Conclusion This paper provides insight into the factors that contribute to the effectiveness of the flipped classroom and how these factors could be stimulated. In order to stimulate the effectiveness of the flipped classroom, the positively and negatively affecting factors and mediating factors should be taken into account in the design of the flipped classroom. The interventions mentioned in this paper could also be used to enhance the effectiveness.

A comparative investigation of clients' attitudes toward breaking bad news to patients with cancer

Background: Truth disclosure is one of the major challenges for physicians with cancer patients. The attitude toward breaking news adopted by individuals depends on their cultural background. The present study was conducted at Ardabil University of Medical sciences, Ardabil, Iran, to investigate the attitudes of Turkish-speaking patients with cancer and their families to the disclosure of bad news. Materials and Methods: The present descriptive cross-sectional study used convenience sampling to select 62 patients, 76 family members of young and 58 children. The mean age of the patients was 37.29 years, and their majorities were 32-42 years old. The data were collected using the questionnaire proposed by Managheb et al., which included six dimensions, i.e., suitability of the person, suitability of the time, the place, factors affecting the delivery of bad news, amount of disclosed information, and acceptance. Results: Despite the insignificant differences in the total score of attitude between the groups (P=0.23), significant differences were found in terms of suitability of the time (P=0.017) and affecting factors (P=0.007) between children's families. Also, in parents of children, employment made truth acceptance better (p=0.04). The acuteness of the disease increased the total attitude score in all the participants (P=0.047). Significant relationships were also observed between age and accepting truth (P=0.045), male gender and place of disclosing the truth (P=0.004), male gender and amount of disclosed information (P=0.043), as well as owning a house and accepting truth (P=0.002). Moreover, education was negatively related to the person for truth disclosing (P=0.036) and factors affecting the truth disclosing (P=0.015). Conclusion: There are different circumstances and economic impacts in children's families on their tolerance. Given the difficulty of disclosing the truth to the employee and highly-educated individuals, it is recommended that health workers consider individual conditions in these circumstances.

Unmet Health Need Among Roma: Visual Acuity and the Use of Vision Correcting Aids in the Hungarian Roma Population

The Roma population is the largest transnational ethnic minority group in Europe often facing socioeconomic inequalities and various health problems. In the present study we investigated the visual acuity and its affecting factors along with spectacle use of the Roma in comparison with the general population in Hungary.A cross-sectional survey was carried out including 832 participants aged 20 to 64 years. We recorded the visual acuity, anthropometric, demographic, socioeconomic and health-related data of each individual. Although the average uncorrected visual acuity was somewhat higher, the use of a visual aid was significantly less frequent in the Roma population, especially in the group with a visual acuity below 0.5 in both eyes (14.3% vs 77.1%, p<0.001). Age, abdominal obesity and disturbances of the carbohydrate metabolism had a negative impact on visual acuity in both populations, however, the latter was a much stronger risk factor in the Roma population (OR: 5.789, 95% CI: 2.239-14.964, p<0.001) than in the general population (OR: 2.075, 95% CI: 1.097-3.926, p=0.025). Our results show serious unmet health needs within the Roma population, which calls for public health programs to improve poor primary care indicators on regular eye examination, and a much more rigorous diabetes control.

Towards the Analysis of Urban Livability in China: Spatial-Temporal Changes, Regional Types and Influencing Factors

The increasing drift of urbanization and its impact on urban human settlements are of major concern for China cities. Therefore, demystifying the spatial-temporal patterns, regional types and affecting factors of urban livability in China are beneficial to urban planning and policy making regarding the construction of livable cities. In accordance with its connotation and denotation, this study develops a systematic evaluation and analysis framework for urban livability. Drawing on the panel data of 40 major cities in China from 2005 to 2019, an empirical research was further conducted. The results show that urban livability in China has exhibited a rising trend during the period, but this differs across dimensions. The levels of urban security and environmental health are lower than those of the three other dimensions. Spatially, cities with higher livability are mainly distributed in the first quadrant divided by the Hu Line and Bole-Taipei Line. Cities in the third quadrant are equipped with the lowest livability. In addition, the 40 major cities can be divided into five categories, and obvious differences exist in terms of the geographical distribution, overall livability level and sub-dimensional characteristics of the different types. Furthermore, the results of the System GMM estimator indicate that the overall economic development exerts an inhibiting effect on the improvement of urban livability in present-day China, but this logical effect exhibits obvious heterogeneity in different time periods and diverse city scales. Finally, there are also differences in the influencing direction and degree of specific economic determinants.