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FedDAA:a robust federated learning framework to protect privacy and defend against adversarial attack

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Frontiers of Computer Science 2024年第2期18卷 107-122页

作者： Shiwei LU Ruihu LI Wenbin LIU fundamentals department Air Force Engineering UniversityXi’an 710051China Institute of Advanced Computational Science and Technology Guangzhou UniversityGuangzhou 510006China

Federated learning(FL)has emerged to break data-silo and protect clients’privacy in the field of artificial intelligence.However,deep leakage from gradient(DLG)attack can fully reconstruct clients’data from the submitted gradient,which threatens the fundamental privacy of FL.Although cryptology and differential privacy prevent privacy leakage from gradient,they bring negative effect on communication overhead or model performance.Moreover,the original distribution of local gradient has been changed in these schemes,which makes it difficult to defend against adversarial attack.In this paper,we propose a novel federated learning framework with model decomposition,aggregation and assembling(FedDAA),along with a training algorithm,to train federated model,where local gradient is decomposed into multiple blocks and sent to different proxy servers to complete aggregation.To bring better privacy protection performance to FedDAA,an indicator is designed based on image structural similarity to measure privacy leakage under DLG attack and an optimization method is given to protect privacy with the least proxy servers.In addition,we give defense schemes against adversarial attack in FedDAA and design an algorithm to verify the correctness of aggregated results.Experimental results demonstrate that FedDAA can reduce the structural similarity between the reconstructed image and the original image to 0.014 and remain model convergence accuracy as 0.952,thus having the best privacy protection performance and model training effect.More importantly,defense schemes against adversarial attack are compatible with privacy protection in FedDAA and the defense effects are not weaker than those in the traditional FL.Moreover,verification algorithm of aggregation results brings about negligible overhead to FedDAA.

关键词： federated learning privacy protection adversarial attacks aggregated rule correctness verification

Association of spiritual well-being with quality of life among undergraduate nursing students

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Journal of Integrative nursing 2024年第1期6卷 49-54页

作者： Ahmad SHAHID Hina HUSSAIN Nazia SHUAIB Ahmad RASOOL Fatima YOUNIS Zoya NASAB department of nursing Professional College of Nursing and Health SciencesIslamabadPakistan department of nursing Rawal Institute of Health SciencesIslamabadPakistan department of nursing Rawal College of NursingIslamabadPakistan School of nursing and Health Zhengzhou UniversityZhengzhouChina

Objective:The study was conducted with the aim of determining the spiritual well-being(SWB)of nursing students and its association with quality of life(QOL).Materials and Methods:A cross-sectional analytical study was conducted with a sample size of 504 nursing students collected from January 2023 to March 2023 in the nursing institutes of Khyber Pakhtunkhwa,Pakistan,using convenient sampling techniques.A Spiritual Health and Life-Orientation Measure(SHALOM)questionnaire for SWB and K-27 QOL(K-27 QOL)instrument were used for data collection that contains three parts.Results:The number of female participants was in the majority(50.4%)compared to male nurses(49.6%).The overall mean score of SWB of the students was 3.79±0.48,while the mean K-27 QOL score was 3.73±0.57.There were significant differences between the groups of gender(P=0.001),while no significant difference within the groups of semester(P=0.061)and college status(0.285).In QOL,there were significant differences within the groups of semester(P=0.000)and college status(P=0.036)while no significant difference in gender category(P=0.480).SHALOM score is positively and moderately correlated with QOL score(r=0.597,P<0.05).Conclusion:Spiritual practices are one of the important factors that are associated positively with QOL,therefore to enhance the QOL,it will require spiritual practices.

关键词： nursing education nursing student quality of life spiritual nursing care spirituality well‑being

Evaluating the influence of a structured nursing protocol on targeted outcomes in rheumatoid arthritis patients

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Journal of Integrative nursing 2024年第1期6卷 22-28页

作者： Mohammed Elsayed ZAKY Shimaa Magdi FARGHALY Osama Mohamed Elsayed RAMADAN Rehab M.ABDELKADER Mostafa SHABAN department of Medical Surgical nursing Faculty of Nursing Cairo UniversityCairoEgypt department of Medical Surgical nursing College of NursingJouf UniversitySakakaAljawfSaudi Arabia Faculty of nursing Cairo University CairoEgypt department of Geriatric nursing Faculty of Nursing Cairo UniversityCairoEgypt

Objective:Rheumatoid arthritis(RA)requires comprehensive management.Structured nursing protocols may enhance outcomes,but evidence is limited.This study evaluated the effect of a structured nursing protocol on RA outcomes.Materials and Methods:In this one-group pre-post study,30 Egyptian RA patients completed assessments before and after a 12-week nursing protocol comprising education,psychosocial support,and self-management promotion.Assessments included clinical evaluation of joint counts,erythrocyte sedimentation rate(ESR),and C-reactive protein(CRP)and patient-reported Arthritis Self-Efficacy Scale(ASES),Health Assessment Questionnaire(HAQ),Visual Analog Scale(VAS)for pain,and Hospital Anxiety and Depression Scale(HADS).Results:The study demonstrated significant improvements in both clinical-and patient-reported outcomes.Joint count decreased from 18.4±4.2 to 14.2±3.8(Pnursing protocol significantly improved clinical disease activity,physical functioning,pain,self-efficacy,and emotional well-being in RA patients.A multifaceted nursing intervention appears beneficial for optimizing RA outcomes.

关键词： nursing care patient education quality of life rheumatoid arthritis self‑management

Optimizing pain management in elderly patients post-knee surgery:A novel collaborative strategy

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World Journal of Clinical Cases 2024年第15期12卷 2475-2478页

作者： Abdulqadir J Nashwan department of nursing Hamad Medical CorporationDoha 3050Qatar

Total knee replacement,a common surgery among the elderly primarily necessitated by osteoarthritis,replaces the damaged knee joint with an artificial one.Given the aging population and the increasing prevalence of such surgeries,the article highlights the critical need for effective postoperative care strategies.This editorial provides an overview of rehabilitation care for pain in elderly knee replacement patients,emphasizing the importance of a multimodal approach to postoperative recovery.Furthermore,the article advocates for a patient-centered,comprehensive rehabilitation regimen that enhances recovery and quality of life in elderly patients undergoing knee replacement surgery.

关键词： Elderly Postoperative pain management Rehabilitation care Multimodal pain strategy Total knee arthroplasty Enhanced recovery after surgery

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Frontiers of nursing 2024年第1期11卷 111-117页

作者： Dian Hudiyawati Kartinah Afidatul Mujannidah department of Medical Surgical nursing School of NursingUniversitas Muhammadiyah SurakartaJawa Tengah 57169Indonesia department of Geriatic nursing School of NursingUniversitas Muhammadiyah SurakartaJawa Tengah 57169Indonesia department of nursing School of NursingUniversitas Muhammadiyah SurakartaJawa Tengah 57169Indonesia

Objective:To determine factors that affect the health-related quality of life(HRQOL)of congestive heart failure(CHF)patients with preserved and reduced ejection fraction.Methods:A cross-sectional study design was used for this study.The stratified random sampling was applied for each subgroup.HRQOL was measured with the Minnesota Living with Hear t Failure Questionnaire.The data were analyzed using chi-square,Spearman's correlation analysis,and independent t-test.Results:A number of 67 respondents participated in the recent study.The total mean scores of HRQOL were significantly different(P=0.001)between heart failure(HF)patients with reduced and preserved ejection fractions,41.07±7.54 and 54.97±4.36,respectively.It related with the physical(mean±standard deviation[SD]=10.4±2.14;t=-10.08,95%CI=-12.46 to-8.34;P-value=0.001)and psychological(mean±SD=3.5±0.5;t=-6.68,95%CI=-4.55 to-2.45;P-value=0.001)domain.Strong correlation was found between age(r=-0.898,P<0.05),NYHA functional classes(r=-0.858,P<0.01),duration of HF(r=-0.807,P<0.01),family support(r=0.927,P<0.01),and quality of life(Qo L).Conclusions:HRQOL in HF patients with reduced ejection fraction was higher than in those with preserved ejection fraction.Family suppor t is a fur ther determinant factor that has a positive correlation to the Qo L.

关键词： ejection fraction family support heart failure quality of life social support

Pulmonary rehabilitation protocols in urgent lung transplantation patients

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World Journal of Emergency Medicine 2024年第1期15卷 47-51页

作者： Fei Zeng Lingyun Cai Luyao Guo Meijuan Lan Jiangshuyuan Liang Peipei Gu nursing department the Second Affi liated Hospital of Zhejiang University School of MedicineHangzhou 310009China

BACKGROUND:Prolonged invasive respiratory support and extracorporeal membrane oxygenation(ECMO)in patients requiring urgent lung transplantation(ULTx)present signifi cant challenges to clinical practice due to severe underlying diseases and complex conditions.The aim of the study was to report the clinical outcomes of patients who received ULTx and followed the perioperative rehabilitation protocol implemented in a lung transplant center.METHODS:A retrospective analysis was conducted in ULTx patients who required preoperative invasive mechanical ventilation(IMV)and ECMO between January 2018 and January 2023.Data were retrieved from electronic medical records at our lung transplant center.RESULTS:Fourteen patients(mean age 57.43±10.97 years;12 males,2 females)underwent ULTx with bridging ECMO and IMV.The mean body mass index was 23.94±3.33 kg/m²,and the mean Acute Physiology and Chronic Health Evaluation(APACHE)II score was 21.50±3.96.The Nutritional Risk Screening 2002(NRS 2002)scores were≥3.ULTx was performed after an 8.5-day waiting period(interquartile interval[IQR]5.0-26.5 d).Following the surgeries,the average lengths of ECMO and IMV were 1.0(IQR 1.0-2.0)d and 5.0(IQR 3.0-7.3)d,respectively.The total length of hospital stay was 60.1±30.8 d,with an average intensive care unit stay of 38.3±22.9 d and post-operative hospitalization stay of 45.8±26.1 d.Two patients died within 30 d after ULTx,with a 30-day survival rate of 85.71%.CONCLUSION:Patients receiving ULTx showed an acceptable short-term survival rate,validating the practicality and safety of the treatment protocols implemented in our center.

关键词： Urgent lung transplantation End-stage lung disease Extracorporeal membrane oxygenation Invasive respiratory support Pulmonary rehabilitation.

Factors associated with the incidence of patient falls in hospitals:A scoping review

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Journal of Integrative nursing 2024年第2期6卷 117-126页

作者： Nurul AINANI Andi Masyitha IRWAN Posgraduate nursing Program Faculty of NursingHasanuddin UniversityMakassarIndonesia department of Gerontological nursing Faculty of NursingHasanuddin UniversityMakassarIndonesia

When a patient falls within a hospital setting,there is a significant increase in the risk of severe injury or health complications.Recognizing factors associated with such falls is crucial to mitigate their impact on patient safety.This review seeks to analyze the factors contributing to patient falls in hospitals.The main goal is to enhance our understanding of the reasons behind these falls,enabling hospitals to devise more effective prevention strategies.This study reviewed literature published from 2013 to 2022,using the Arksey and O’Malley methodology for a scoping review.The research literature was searched from seven databases,namely,PubMed,ScienceDirect,Wiley Library,Garuda,Global Index Medicus,Emerald Insight,and Google Scholar.The inclusion criteria comprised both qualitative and quantitative primary and secondary data studies centered on hospitalized patients.Out of the 893 studies analyzed,23 met the criteria and were included in this review.Although there is not an abundance of relevant literature,this review identified several factors associated with falls in hospitals.These encompass environmental,patient,staff,and medical factors.This study offers valuable insights for hospitals and medical personnel aiming to enhance fall prevention practices.Effective prevention efforts should prioritize early identification of patient risk factors,enhancement of the care environment,thorough training for care staff,and vigilant supervision of high-risk patients.By comprehending the factors that contribute to patient falls,hospitals can bolster patient safety and mitigate the adverse effects of falls within the health-care setting.

关键词： Associated factors patient falls patient safety

Nurses'attitude toward patients'safety climate during COVID-19 pandemic:a cross-sectional study

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Frontiers of nursing 2024年第1期11卷 39-46页

作者： Asra Nassehi Kobra Ghorbanzadeh Somaye Moayedi Javad Jafari Parvin Mahmoodi Mojtaba Jafari department of nursing Bam University of Medical SciencesBamIran department of nursing Khalkhal University of Medical SciencesKhalkhalIran Community nursing Research Center Department of NursingZahedan University of Medical SciencesZahedanIran Clinical Care Research Center Department of NursingNursing and Midwifery SchoolKurdistan University of Medical SciencesSanandajIran

Objective:Patient safety is a fundamental factor in improving the quality of care provided in hospitals.Therefore,it is considered a significant parameter by all healthcare organizations around the world.The present study was conducted to investigate the attitude of nurses toward the patient safety climate during the Coronavirus Disease 2019(COVID-19)pandemic in the southeast of Iran.Methods:This is a cross-sectional descriptive study.Among all the nurses working in one of the hospitals in the southeast of Iran,171 nurses participated in the study through convenience sampling methods.The survey was conducted between June 1 and July 30,2020.A 2-part questionnaire including demographic information and an assessment of nurses'attitudes toward patients'safety climate was used for data collection in 2021.The content validity of the scale is(0.77)and reliability was re-calculated and confirmed by the present study with Cronbach's alpha(α=0.9).Data were analyzed by SPSS 20(IBM Corporation,Armonk,New York,United States)using descriptive and analytical statistical tests.Results:The mean score of safety climates was 3.2±5.20(out of 5 scores).The results showed that among all dimensions of the safety climate,only the education dimension was statistically significant between males and females(P<0.001).Also,there was a significant relationship between the overall average of the safety climate and its dimensions according to the people's position only in the dimension of supervisors'attitude(P<0.01)and burnout(P<0.01).Additionally,a significant correlation between the education level and the overall score of safety climate(P<0.01),as well as the supervisor's attitude dimension(P<0.01),was observed.Conclusions:The results showed that the safety climate was at a relatively favorable level.Considering the impact of nurses'attitudes on the safety climate of patients,its improvement seems necessary.It is recommended to design training courses and educate nurses in order to promote a patients safety climate in hospitals.

关键词： COVID-19 Iran nurses patient safety climate

Entrepreneurship training:its influences on innovation potentials among nursing students

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Frontiers of nursing 2024年第1期11卷 85-98页

作者： Asmaa Abdel Rahman Abdel Rahman Dalia Abdallah Abdelatief Medical Surgical nursing department Faculty of NursingAin Shams UniversityCairoEgypt

Objective:To evaluate the influences of entrepreneurship training on the innovation potential among nursing students.Methods:A quasi-experimental design was utilized to conduct this study.The study was conducted in the classroom at the faculty of nursing,and the“i Hub”center at Ain Shams University(ASU)in Cairo,Egypt.A purposive sample of 42 nursing students who participated in the“Ain Shams University-innovate”competition from the Faculty of nursing of ASU were included in this study.Data collection tools included(1)nursing students'innovation skills assessment questionnaire and(2)Innovative projects evaluation tool.Results:There was a statistically significant difference between the mean scores of nursing students'total innovation skills pre-and post-implementation of entrepreneurship training,where P-valuenursing students'innovation potential.Developing entrepreneurship education in nursing and integrating it into nursing programs will stimulate creativity,innovation,and entrepreneurship among nursing students and health care services.

关键词： entrepreneurship training innovation potentials nursing students creative skills energy/motivation