STPA-Sec Applied to Path Planning: Quantum-Safe Autonomous Vehicles

Autonomous vehicles and quantum computers are two emerging technologies that will transform our world in the not-too-distant future. This thesis examines the safety and security of autonomous vehicles in a world where adversaries have access to large-scale quantum computers. Large-scale quantum computers are relevant to automotive security because they can defeat the cryptographic foundation underlying critical safety systems such as path planning, perceptual unit, braking, steering, and engine electronic control units (ECUs). Peter Shor discovered a quantum computer algorithm in 1994 that can defeat modern-day public-key cryptography, including digital signatures (e.g., RSA, EdDSA), due to the algorithm’s ability to factor large numbers and find discrete logarithms efficiently [23]. According to existing mathematical theory, classical computers cannot factor large numbers or find discrete logarithms efficiently. The critical insight derived from this thesis is that an adversary can defeat an autonomous vehicle’s security of safety-critical systems with a large-scale quantum computer. In particular, the digital signatures used for authentication of over-the-air (OTA) software updates can be forged by an adversary with a large-scale quantum computer which, in the worst-case scenario, could enable a fleet-wide hack of an autonomous vehicle system potentially compromising a million vehicles simultaneously. The thesis explicitly identifies Tesla as a significant risk through their use of Ed25519, a discrete logarithm-based digital signature for OTA software updates [77], [78], [79]. Likely, most automotive manufacturers are at risk, but Tesla was the only company whose digital signature protocols were found to be publicly available on the internet. The analysis was completed using STPA-Sec (System-Theoretic Process Analysis for Security), an engineering risk management framework for identifying safety issues caused by security breaches. Overviews of quantum computing and quantum-safe cryptography are given. In addition, a Monte Carlo simulation framework is proposed to estimate the probability and severity of a large-scale quantum computer attack on autonomous vehicles. In addition to outlining the attack, countermeasures are provided to mitigate the risk, such as automotive companies upgrading to quantum-safe cryptography that NIST is currently standardizing. The NIST standardization is scheduled for completion in 2024. If automotive companies upgrade to quantum-safe cryptography, the risk against known attacks is eliminated, but there is a residual risk regarding currently unknown attacks. There is a reasonable amount of time to mitigate this risk as large-scale quantum computers are not expected to exist until the end of the decade. However, the section on quantum cyber risk analytics focuses on estimating the risk in the worst 1 in 1,000 chance scenario. Based on a model that estimates quantum risk, whose details including assumptions are outlined in Chapter 11, the central insight from the analytics is that there is an approximate 99 in 100 chance the RSA-2048 will be broken in 24 hours within the next 15 years in the worst 1 in 1,000 chance scenario. A vision of a quantum-safe and quantum-enhanced autonomous vehicle future is painted where quantum computers and quantum sensors may significantly enhance many aspects of autonomous vehicles. Recommendations to improve STPA-Sec are provided. The main contributions of this work are identifying a worst-case scenario where a million cars could be compromised by an adversary with access to a large-scale quantum computer, conducting a formal STPA-Sec analysis on the path planning control loop of an autonomous vehicle in the presence of an adversary with a large-scale quantum computer, providing suggestions on how to improve STPA-Sec, and the section on quantum risk management. In particular, conducting the first known quantum stress test by estimating the risk of the worst 1 in 1,000 chance scenario for RSA-2048 to be broken in 24 hours within 15, 20, and 30 years completes the contributions of this thesis

An invesigation into the rehabilitation of patients following primary total hip replacement due to osteoarthritis

This thesis investigates the effectiveness of occupational therapy interventions for patients undergoing primary total hip replacement for osteoarthritis using two research methodologies. A systematic review and meta-analysis assessed the effectiveness of occupational therapy interventions delivered either pre-admission, during hospital stay, or post-discharge. Findings indicated the interventions reduced anxiety, improved pre-surgery and long-term function, and reduced length of stay. Small sample sizes, high levels of clinical and statistical heterogeneity and lack of specific occupational therapy studies reduced the strength of findings. The PROOF-THR feasibility study (ISRCTN38381590) recruited 44 participants to investigate recruitment and randomisation processes, acceptance of group allocation, fidelity of the intervention, and appropriateness of outcome measures and data collection methods. The intervention group received a bespoke pre-surgery home visit by an occupational therapist; the control group received treatment as usual. The intervention was delivered successfully with no withdrawals or crossovers, and reasonable retention rates indicating a definitive trial could be conducted following the feasibility methodology, although methods to improve follow-up data collection should be implemented. This thesis concluded that higher quality occupational therapy specific research is needed to establish the efficacy and effectiveness of occupational therapy practices. A complex rehabilitation intervention can be successfully investigated by following established procedures

Designing in food technology – a curriculum intervention strategy in a one year design & technology postgraduate teacher training course

This study builds on previous work (Barlex and Rutland, 2004) exploring the effectiveness of a deliberate curriculum intervention strategy aimed at enhancing the design ability and design teaching skills of trainee teachers on a one year PGCE Design & Technology course. In this new study the focus is on the design ability and design teaching skills of food technology trainees. A parallel study was carried out at another institution and this will be reported in a future publication. The trainee's initial design ability in food technology was gauged in two ways; using an audit tool and evidence provided by the design portfolio produced during the first food technology design activity for all trainees on the course. The development of food technology design ability was then gauged using evidence from the design portfolios produced during two additional food design activities. The study includes two sets of interviews with a sample of food technology trainees following the food design activities and a final interview at the end of the research project. The ability to teach designing with food and its development across the one year course was gauged using data collected through classroom observation; trainee’s teaching practice file and analysis of interviews with the sample of food technology trainees at the end of each teaching experience. The study will report preliminary findings from data collected September 2004 – December 2004 concerning the development of design ability within food technology and the development of the ability to teach designing with food technology for trainees at a single institution

Hormone replacement therapy in postmenopausal women: endometrial hyperplasia and irregular bleeding

Background: The decline in circulating oestrogen around the time of the menopause often induces unacceptable symptoms that affect the health and well being of women. Hormone replacement therapy (both unopposed oestrogen and oestrogen and progestogen combinations) is an effective treatment for these symptoms. In women with an intact uterus, unopposed oestrogen may induce endometrial stimulation and increase the risk of endometrial hyperplasia and carcinoma. The addition of progestogen reduces this risk but may cause unacceptable symptoms, bleeding and spotting which can affect adherence to therapy. Objectives: The objective of this review is to assess which hormone replacement therapy regimens provide effective protection against the development of endometrial hyperplasia and/or carcinoma with a low rate of abnormal vaginal bleeding. Search strategy: Electronic searches for relevant randomised controlled trials of the Cochrane Menstrual Disorders and Subfertility Group Register of Trials, MEDLINE, EMBASE, PsycLIT, Current Contents, Biological Abstracts, Social Sciences Index and CINAHL were performed. Attempts were also made to identify trials from citation lists of review articles and drug companies were contacted for unpublished data. In most cases, the corresponding author of each included trial was contacted for additional information. Selection criteria: The inclusion criteria were randomised comparisons of unopposed oestrogen therapy, combined continuous oestrogen-progestogen therapy and sequential oestrogen-progestogen therapy with each other and placebo administered over a minimum treatment period of six months. Trials had to assess which regimen was the most protective against the development of endometrial hyperplasia/carcinoma and/or caused the lowest rate of irregular bleeding. Data collection and analysis: Twenty three RCTs were identified and five were excluded. The reviewers assessed the eighteen included studies for quality, extracted the data independently and odds ratios for dichotomous outcomes were estimated. Outcomes analysed included frequency of endometrial hyperplasia or carcinoma, frequency of irregular bleeding and unscheduled biopsies or dilation and curettage, and adherence to therapy. Main results: Unopposed moderate or high dose oestrogen therapy was associated with a significant increase in rates of endometrial hyperplasia with increasing rates at longer duration of treatment and follow up. Odds ratios ranged from 5.4 (1.4-20.9) for 6 months of treatment to 16.0 (9.3-27.5) for 36 months of treatment with moderate dose oestrogen (in the PEPI trial, 62% of those who took moderate dose oestrogen had some form of hyperplasia at 36 months compared to 2% of those who took placebo). Irregular bleeding and non adherence to treatment were also significantly more likely under these unopposed oestrogen regimens with greater effects with higher dose therapy. There was no evidence of increased hyperplasia rates, however, with low dose oestrogen. The addition of progestogens, either in continuous combined or sequential regimens, helped to prevent the development of endometrial hyperplasia and improved adherence to therapy (odds ratios of 3.7 for sequential therapy and 6.0 for continuous therapy). Irregular bleeding, however, was more likely under a continuous than a sequential oestrogen-progestogen regimen (OR = 2.3, 95% CI 2.1-2.5) but at longer duration of treatment, continuous therapy was more protective than sequential therapy in preventing endometrial hyperplasia (OR = 0.3, 95% CI 0.1-0.97). There was evidence of a higher incidence of hyperplasia under long cycle sequential therapy (progestogen given every three months) compared to monthly sequential therapy (progestogen given every month). No increase in endometrial cancer was seen in any of the treatment groups during the limited duration (maximum of three years) of these trials. Reviewers' conclusions: There is strong and consistent evidence in this review that unopposed oestrogen therapy, at moderate and high doses, is associated with increased rates of endometrial hyperplasia, irregular bleeding and consequent non adherence to therapy. The addition of oral progestogens administered either cyclically or continuously is associated with reduced rates of hyperplasia and improved adherence to therapy. Irregular bleeding is less likely under sequential than continuous therapy but there is a suggestion that continuous therapy over long duration is more protective than sequential therapy in the prevention of endometrial hyperplasia. Hyperplasia is more likely when progestogen is given every three months in a sequential regimen compared to a monthly progestogen sequential regimen.Output Type: Revie

What works to reduce sedentary behavior in the office, and could these intervention components transfer to the home working environment?:A rapid review and transferability appraisal

BackgroundWorking patterns have changed dramatically due to COVID-19, with many workers now spending at least a portion of their working week at home. The office environment was already associated with high levels of sedentary behavior, and there is emerging evidence that working at home further elevates these levels. The aim of this rapid review (PROSPERO CRD42021278539) was to build on existing evidence to identify what works to reduce sedentary behavior in an office environment, and consider whether these could be transferable to support those working at home.MethodsThe results of a systematic search of databases CENTRAL, MEDLINE, Embase, PsycInfo, CINHAL, and SportDiscus from 10 August 2017 to 6 September 2021 were added to the references included in a 2018 Cochrane review of office based sedentary interventions. These references were screened and controlled peer-reviewed English language studies demonstrating a beneficial direction of effect for office-based interventions on sedentary behavior outcomes in healthy adults were included. For each study, two of five authors screened the title and abstract, the full-texts, undertook data extraction, and assessed risk of bias on the included studies. Informed by the Behavior Change Wheel, the most commonly used intervention functions and behavior change techniques were identified from the extracted data. Finally, a sample of common intervention strategies were evaluated by the researchers and stakeholders for potential transferability to the working at home environment.ResultsTwenty-two studies including 29 interventions showing a beneficial direction of effect on sedentary outcomes were included. The most commonly used intervention functions were training (n = 21), environmental restructuring (n = 21), education (n = 15), and enablement (n = 15). Within these the commonly used behavior change techniques were instructions on how to perform the behavior (n = 21), adding objects to the environment (n = 20), and restructuring the physical environment (n = 19). Those strategies with the most promise for transferring to the home environment included education materials, use of role models, incentives, and prompts.ConclusionsThis review has characterized interventions that show a beneficial direction of effect to reduce office sedentary behavior, and identified promising strategies to support workers in the home environment as the world adapts to a new working landscape.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021278539, identifier CRD42021278539

Public Response to Cost-Quality Tradeoffs in Clinical Decisions.

PURPOSE: To explore public attitudes toward the incorporation of cost-effectiveness analysis into clinical decisions. METHODS: The authors presented 781 jurors with a survey describing 1 of 6 clinical encounters in which a physician has to choose between cancer screening tests. They provided cost-effectiveness data for all tests, and in each scenario, the most effective test was more expensive. They instructed respondents to imagine that he or she was the physician in the scenario and asked them to choose which test to recommend and then explain their choice in an open-ended manner. The authors then qualitatively analyzed the responses by identifying themes and developed a coding scheme. Two authors separately coded the statements with high overall agreement (kappa = 0.76). Categories were not mutually exclusive. RESULTS: Overall, 410 respondents (55%) chose the most expensive option, and 332 respondents (45%) choose a less expensive option. Explanatory comments were given by 82% respondents. Respondents who chose the most expensive test focused on the increased benefit (without directly acknowledging the additional cost) (39%), a general belief that life is more important than money (22%), the significance of cancer risk for the patient in the scenario (20%), the belief that the benefit of the test was worth the additional cost (8%), and personal anecdotes/preferences (6%). Of the respondents who chose the less expensive test, 40% indicated that they did not believe that the patient in the scenario was at significant risk for cancer, 13% indicated that they thought the less expensive test was adequate or not meaningfully different from the more expensive test, 12% thought the cost of the test was not worth the additional benefit, 9% indicated that the test was too expensive (without mention of additional benefit), and 7% responded that resources were limited. CONCLUSIONS: Public response to cost-quality tradeoffs is mixed. Although some respondents justified their decision based on the cost-effectiveness information provided, many focused instead on specific features of the scenario or on general beliefs about whether cost should be incorporated into clinical decisions

Effect of Assessment Method on the Discrepancy between Judgments of Health Disorders People Have and Do Not Have: A Web Study

Three experiments on the World Wide Web asked subjects to rate the severity of common health disorders such as acne or arthritis. People who had a disorder (“Haves”) tended to rate it as less severe than people who did not have it (“Not-haves”). Two explanations of this Have versus Not-have discrepancy were rejected. By one account, people change their reference point when they rate a disorder that they have. More precise reference points would, on this account, reduce the discrepancy, but, if anything, the discrepancy was larger. By another account, people who do not have the disorder focus on attributes that are most affected by it, and the discrepancy should decrease when people make ratings on several attributes. Again, if anything, the discrepancy increased when ratings were on separate attributes (combined by a weighted average). The discrepancy varied in size and direction across disorders. Subjects also thought that they would be less affected than others

Reviews

The following publications have been reviewed by the mentioned authors;Technology Education - A World Wide Concern - reviewed by Dr Thomas GinnerLiving Materials - Practical Activities in Science and Technology - reviewed by David FosterSTEP Design and Technology: Resistant Materials - reviewed by Les PorterSTEP Design and Technology: Food - reviewed by Jenny JupeTERU Diagnostic Tests in Design and Technology - reviewed by Bill GoddardUnderstanding Practice in Design and Technology - reviewed by Melanie FasciatoTeaching Design and Technology - reviewed by John HillD&T Alive at Alton Towers Key Stage 3 - reviewed by John DurrellSucceeding with Autocad - reviewed by P WhittakerTIckle the Senses! - reviewed by Ali FarrellThe Fast Food Diner - reviewed by Margaret Jepso

Interventions with potential to reduce sedentary time in adults:Systematic review and meta-analysis

Context: Time spent in sedentary behaviours (SB) is associated with poor health, irrespective of the level of physical activity. The aim of this study was to evaluate the effect of interventions which included SB as an outcome measure in adults. Methods: Thirteen databases, including The Cochrane Library, MEDLINE and SPORTDiscus, trial registers and reference lists, were searched for randomised controlled trials until January 2014. Study selection, data extraction and quality assessment were performed independently. Primary outcomes included SB, proxy measures of SB and patterns of accumulation of SB. Secondary outcomes were cardiometabolic health, mental health and body composition. Intervention types were categorised as SB only, physical activity (PA) only, PA and SB or lifestyle interventions (PA/SB and diet). Results: Of 8087 records, 51 studies met the inclusion criteria. Meta-analysis of 34/51 studies showed a reduction of 22 min/day in sedentary time in favour of the intervention group (95% CI −35 to −9 min/day, n=5868). Lifestyle interventions reduced SB by 24 min/day (95% CI −41 to −8 min/day, n=3981, moderate quality) and interventions focusing on SB only by 42 min/day (95% CI −79 to −5 min/day, n=62, low quality). There was no evidence of an effect of PA and combined PA/SB interventions on reducing sedentary time. Conclusions: There was evidence that it is possible to intervene to reduce SB in adults. Lifestyle and SB only interventions may be promising approaches. More high quality research is needed to determine if SB interventions are sufficient to produce clinically meaningful and sustainable reductions in sedentary time