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Production and distribution are critical components of the furniture supply chain, and achieving optimal performance through their integration has become a vital focus for both the academic and business communities. Moreover, as economic globalization progresses, distributed manufacturing has become a pioneering production technique. Via leveraging a distributed flexible manufacturing system, mass flexible production at lower costs can be achieved. To this end, this study presents an integrated distributed flexible job shop and distribution problem to minimize makespan and total tardiness. In our research, a set of custom furniture orders from different customers are processed among flexible job shops and then delivered by vehicles to customers as the due date. To distinctly show the presented problem, a mixed integer mathematical programming model is created, and a multi-objective brain storm optimization method is introduced considering the problem's features. In comparison to the other three advanced methods, the superiority of the algorithm created is showcased. The findings of the experiments demonstrate that the constructed model and the introduced algorithm have remarkable competitiveness in addressing the problem being examined.

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Objective: This study aimed to (1) examine coping strategies and their relationship with demographics, perceived stress, and hair cortisol; and (2) explore whether coping partially mediated the relationship between perceived stress and hair cortisol. Methods: Baseline data from 191 socioeconomically marginalized parents enrolled in two community-based clinical trials were used. The IBM SPSS Statistics Version 27 and Mplus Version 8 were used for data analyses. Results: Parents' engagement in various coping strategies differed by age, ethnicity, race, marital status, education level, and number of children living in the household. Parents' use of problem-focused (instrumental support, planning), emotion-focused (venting, self-blame), and avoidant coping (self-distraction, denial, behavioral disengagement) increased from having low to moderate stress. However, when perceived stress increased from moderate to high, their use of emotion-focused and avoidant coping increased significantly, but problem-focused coping did not. Emotion-focused coping lowered the influence of perceived stress on hair cortisol, while avoidant coping increased the relationship between perceived stress and hair cortisol. Conclusions: Although needing future investigation with longitudinal studies, the results suggest the need of promoting adaptive emotion-focused coping (emotional support, venting, and humor) to help socioeconomically marginalized parents manage their appraised overwhelming and uncontrollable stressors of food, house, and income insecurity.

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Background: Due to the lack of complexity and variety of stimuli, conventional housing conditions of laboratory mice do not allow these animals to fully express their behavioral repertoire, including manipulative and cognitive activities. Therefore, we designed mechanical puzzles, so-called lockboxes, for mice that can be provided in their home cages. We investigated the impact of the lockbox enrichment on their phenotype and affective state when compared to conventional housing (CH) and super-environmental enrichment (SEE). Methods: Young adult female C57BL/6JCrl mice were examined before and after 2-month exposure to the different types of enrichment in a phenotyping test battery, including tests for trait and state anxiety-related behavior, calorimetric measurements, body weight measurements, the analysis of stress hormone metabolite concentrations, and sequential problem-solving abilities with a novel lockbox. At the end of the study, adrenal gland weights were determined and pathohistological evaluation was performed. For all continuous variables, the relative variability was calculated. Results: While the different types of enrichment affected trait anxiety-related behavior, neither state anxiety-related behavior nor physiological variables (i.e., bodyweight, resting metabolic rate, stress hormone metabolite concentrations, adrenal gland weights) were influenced. LE improved sequential problem-solving (i.e., solving novel lockboxes) when compared to SEE. Regardless of the housing condition, the relative variability increased in most variables over time, although the coefficient of variation decreased for some variables, especially in animals with access to LE. There was no evidence of toxicopathological effects associated with the material from which the lockboxes were made. Conclusions: All lockboxes are available as open-source tool. LE revealed beneficial effects on the affective state of laboratory mice and their performance in solving novel lockboxes. Neither relevant phenotype of the mice nor reproducibility of the data were compromised by LE, similar to SEE. The lockboxes may also be used as novel approach for assessing cognition in mice.

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BACKGROUND: Negative role models can significantly impact nursing students' adherence to standard infection control precautions (SP) but there has been limited research on impacts and relevant strategies. PURPOSE: This review examined the impact of negative role models on nursing students' adherence to SP and explored strategies that nursing instructors could use to help students effectively manage the influence of negative role models. METHODS: An integrative review was conducted, guided by Whittemore and Knafl's methodology (2005). PubMed, CINAHL, and Scopus were searched for articles from 2008-2023. Research studies were critically appraised using appropriate tools. RESULTS: Fourteen articles met the inclusion criteria and were included in this review. The literature indicates that nursing students frequently encounter negative role models during their clinical placements and that such negative encounters detrimentally impact their adherence to SP. Five strategies to potentially mitigate the impact of negative role models were identified. CONCLUSION: To address the issue of negative role models, nursing instructors can help students learn specific strategies to manage encounters with negative role models, promote discussion of role modeling with students and clinical staff, and act as role models themselves. Further research is needed to inform specific strategies.

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Early intervention in problem sexual behavior (PSB) is critical; however, little is known about the engagement of children and families in therapeutic intervention for PSB. This research explored the characteristics, presenting issues, and engagement of 242 children aged 4-12 years attending a therapeutic service for PSB. Most frequently, PSB occurred within sibling relationships. Girls were more likely to engage in PSB alone (self-directed or non-targeted behaviors), while boys were more likely to involve other young people (interpersonal PSB). One-third (35%) of clients engaged in completion of therapy. Parental noninvolvement and self-directed or non-targeted PSB predicted early disengagement. Client demographics, sexual abuse, and interpersonal sexual behaviors were not associated with therapy completion. Implications for therapeutic intervention in children's PSB are discussed.

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Due to consistent cassava cultivation, small-scale processing centers rely heavily on the cassava grater. However, these machines face stagnation in innovation and design evolution, leading to inefficiencies, limited capacity, and inconsistent output. Adding to these challenges is the competitive global market, demanding a focus on design enhancements. This study employs a multi-faceted approach involving the Analytic Hierarchy Process (AHP), Quality Function Deployment (QFD) and Theory of Inventive Problem Solving (TRIZ) to prioritize customer requirements, propose technically aligned solutions, and offer innovative design options for cassava graters. A total of 10 customer requirements (CR), 21 technical solutions (TS), and 63 innovative design options (IDO) were established and prioritized, aiming for easy adoption by fabricators, engineers, manufacturers, and artisans. Implementing these insights boosts cassava grater efficiency and productivity and significantly advances knowledge. This work presents a thorough scientific framework for product design, empowering local manufacturers to remain viable and relevant in the rapidly changing field of product enhancement.

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AIM: Compare the effects of Simulation with problem-based learning (SPBL) and Problem-based learning (PBL) in nursing ethics education on nursing students' moral sensitivity, empathy, critical thinking, test scores and teaching satisfaction. BACKGROUND: Promoting nursing students' individual and ethical and abilities through education is an essential way to improve their ethical performance and build trustful relationship with patients. Despite significant efforts in this area, few have evaluated the effectiveness of Simulation with problem-based learning and Problem-based learning as applied to nursing ethics education. DESIGN: A quasi-experimental design based on a non-equivalent control group pre-test/post-test. METHODS: A quasi-experimental design was used. Participants were 161 undergraduate nursing students from two levels of a university, 88 subjects in the experimental group were taught using Simulation with problem-based learning and 73 subjects in the control group were taught using Problem-based learning. A pre-test, post-test and questionnaire were used to assess the effectiveness of student nursing ethics education. χ2 test was used to examine group differences in students' characteristics and satisfaction with teaching post-intervention. Student's t-test was used to assess group differences in scale scores and test scores. RESULTS: Compared to the pre-test, empathy as well as critical thinking were significantly higher in the PBL group (P<0.05), but there was no significant change in moral sensitivity (P>0.05); moral sensitivity, empathy and critical thinking were significantly higher in the SPBL group (P<0.05). Moreover, this study also showed that improvement in moral sensitivity, empathy, critical thinking and grades was more significant in the SPBL group of nursing students compared to the PBL group (P<0.05) and no statistically significant difference was found between the two groups in terms of teaching satisfaction (P>0.05). CONCLUSION: The use of Simulation with problem-based learning in nursing ethics education has a positive impact on nursing students' competency development and knowledge acquisition. Nurse educators should consider this teaching method and promote change to increase the effectiveness of nursing ethics education.

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Background: Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or experiencing poor-quality sleep. People with this problem often have trouble falling asleep at night, wake up frequently during the night, and may wake up too early in the morning and feel tired and not refreshed. This can lead to daytime fatigue, irritability, difficulty concentrating, and impaired functioning in their day-to-day activities. Study is scarce in resource-limited countries such as Ethiopia, particularly concerning the study setting. As a result, this study aimed to assess the prevalence of insomnia and its associated factors among undergraduate students at Hawassa University. Methods: An institution-based cross-sectional study design was used. A stratified simple random sampling method was used among 398 study participants. The data were collected using a structured self-administered questionnaire. The outcome variable was assessed by the insomnia severity index (ISI). The data were then gathered by using the Kobo toolbox online and then exported into the Statistical Package for Social Sciences version 27 to analyze the data. Data cleaning and screening were conducted exclusively by the investigators. Descriptive statistics like frequency, percentages, and mean were used. Bivariate and multivariate binary regression were performed. In multivariate binary logistic regression, a p-value of<0.05 was identified as a significantly associated factor with the dependent variable. Results: Among 398 students who participated in the study, 81 (20.4%) experienced insomnia. Being female [adjusted odds ratio (AOR) = 2.98; 95% confidence interval (CI) 1.56-5.69], age (AOR = 3.06; 95% CI 1.11-8.45), mild anxiety symptom (AOR = 4.89; 95% CI 1.56-15.37), and mobile device use ≥30 min just before going to sleep (AOR = 7.81; 95% CI 2.34-26.12) were significantly associated with insomnia. Conclusion: In this study, the prevalence of insomnia was one-fifth among university students, which is high when compared to another study at the national level. There were significant associations between being female, age, anxiety symptoms, and mobile device use before going to sleep with insomnia. This indicates that there is a need to treat and prevent insomnia in college students, emphasizing the necessity for mental healthcare and ethical technology use.

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Introduction: The FDA oversees regulatory aspects of all U.S. tobacco products. Understanding the impact of emerging health trends and incidents associated with various tobacco and nicotine products is vital for public health. This study utilizes the FDA's Tobacco Product Problem Reports (TPPRs) to characterize and track adverse health events (AHEs) associated with tobacco and nicotine products over time, considering the impact of EVALI and the COVID-19 pandemic. Methods: FDA TPPRs from 2017-2022 provided information on AHEs related to various tobacco products. After data cleaning, 839 reports were categorized by two independent coders based on affected health category, frequency of AHEs reports, and proportion of AHEs per each health category. Additionally, variations in AHEs over time were assessed, considering major health events like EVALI and the COVID-19 pandemic. Results: Among the 839 reports, electronic cigarettes (e-cigarettes) were the primary product of concern, comprising 90.6% (n = 760) of all reports, surpassing traditional cigarettes (5.1%; n = 43) and other products. Notably, 45.6% of reports (n = 383) identified the neurological system as the most frequently mentioned health category, each reporting at least one AHE. This was followed by the respiratory (39.1%; n = 328) and digestive (10.7%; n = 90) systems. Among all reported AHEs, respiratory system issues were most frequent (25.9%; n = 512), closely followed by neurological (25.2%; n = 499) and digestive (6.6%; n = 131) concerns. Most reports occurred in 2019 (65.7%; n = 551), coinciding with the EVALI outbreak, with a subsequent decline post-Q3 2019, highlighting the potential impact of specific health crises on reporting trends. Conclusion: E-cigarettes dominated adverse health reports, particularly affecting the neurological and respiratory systems, with a peak in 2019. Our findings provide insights to regulatory entities and future research, enhancing understanding of AHEs in lesser-explored bodily systems, such as the neurological and digestive systems. This study emphasizes the need for ongoing and improved surveillance of emerging tobacco products to protect public health.

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Chasing refers to the escalation of betting behaviour. It is conventionally seen when losing but can also be seen after wins. Diagnostic and screening items for gambling problems describe chasing as returning 'another day' to gamble. However, gamblers may also chase within sessions, and this is particularly relevant in online gambling. This study focused on two expressions of within-session chasing: (1) increasing the bet amount, or (2) a reduced probability of quitting the session, as a function of prior losses or wins. These expressions were examined across five online gambling products: slot machines, probability games, blackjack, video poker, and roulette. Our results showed that gamblers bet more and played longer sessions after immediate losses, but they bet less and played shorter sessions when losing cumulatively. The reversed pattern in the cumulative model may be due to financial constraints. For wins, gamblers bet more after both immediate and cumulative wins, but they also played shorter sessions. Chasing patterns were qualitatively similar by game type-with limited evidence for our hypothesis that chasing would be greatest for slot machines as an established high-risk category. Overall, chasing is multi-faceted, varying across the behavioural expressions, by the immediate or cumulative timeframe of prior outcomes, and by game type.

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OBJECTIVE: Aim: To assess the initial results of using 3 Tesla contrast-enhanced breast magnetic resonance imaging in Ukraine. PATIENTS AND METHODS: Materials and Methods: Our study included 498 diagnostic breast magnetic resonance imaging performed in Neuromed medical center in Kyiv, between March 2020 and December 2022. Patients were positioned prone, with breasts suspended in a dedicated 7-channel bilateral breast coil. MR-images were acquired with the PHILIPS Achieva 3.0Tesla x-series scanner. All studies were made by standard protocol: localizer, morphological and dynamic studies were performed. RESULTS: Results: Our study revealed a statistically significant increase in problem-solving contrast-enhanced breast magnetic resonance examinations compared to other indications. Additionally, we observed a higher incidence of women with a greater amount of fibroglandular tissue (p-value<0.05). CONCLUSION: Conclusions: The utilization of 3Tesla contrast-enhanced breast magnetic resonance imaging has become prevalent in Ukraine as a problem-solving tool for inconclusive findings in ultrasound (US) or/and mammography (MG). It is particularly useful in preoperative local breast cancer staging for women with a significant amount of fibroglandular breast tissue. However, the implementation of breast magnetic resonance imaging in Ukraine is in its nascent stages and requires further investigation, especially in middle-income country settings.

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Wildlife resources are strategic resources of a country, and the investigation of which is a key task for effective management in protection and utilization. Since the 1990s, two national surveys of terrestrial wildlife resources have been carried out in China, and the situation of wildlife resources has been known to a certain extent. Due to the complexity and difficulty of national wildlife survey, we are still not able to grasp the background and dynamics of wildlife resources as a whole promptly and effectively. The results and effectiveness of wildlife resources investigation will directly affect the decision-making related in wildlife protection. According to Law of the People's Republic of China on the Protection of Wildlife and Regulations of the People's Republic of China for the Implementation of the Protection of Terrestrial Wildlife, it is imperative to carry out the third national survey of terrestrial wildlife resources, and to be integrated with the national strategy of ecological civilization construction. The aims of this review were to summarize the earlier experiences in time, to further improve the investigation scheme and technical methods, to serve the third national survey of terrestrial wildlife resources, in addition to obtain more comprehensive and reliable data of wildlife resources, grasp the development trend of domestic wildlife resources, and provide more effective supports for the wildlife conservation in China.

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Older adults are receiving increased attention in gambling research, in part because gambling and related problems appear to be increasing in this population. To date, little or no research has examined the complexities of gambling and later-life circumstances, including life events, and individual and social factors. This study utilized longitudinal data (5 waves) from older adults (60 + ; N = 670) in the Quinte Longitudinal Study (Williams et al., in: The Quinte longitudinal study of gambling and problem gambling 2006-2011, Bay of Quinte region, Ontario, 2014). Longitudinal multilevel models examined between- and within-person effects of stressful life events on gambling frequency and Problem Gambling Severity Index (PGSI) scores, and the possible moderating role of individual (age, gender, mental health, physical health) and social variables (marital status, social support) on this relationship. Results of the final model showed significant effects (p < .01) for linear time (PGSI scores declined across waves; ß = - .06); gender (women's mean PGSI greater than men's; γ = .26); social support (less support associated with greater PGSI; γ = .05); and an interaction between age and stressful life events (effect of stressful events on PGSI is lesser with greater age; γ = - .02). Simple slopes (at mean age of 66 at wave 1, and ± 1SD) showed that at 61 (γ = .35) and 66 years (γ = .23), mean PGSI scores were greater with each additional stressful life event; there was no significant effect for stressful events at age 71. These findings suggest women, those with less social support, and greater stressful life events may be at greater risk of problem gambling, while greater age weakens the effect of stressful events and problem gambling.

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The purpose of the current study was to extend the research on the possible role of verbal mediation in the establishment of comparative relations. We conducted four experiments in which 14 participants received conditional discrimination training with nonarbitrary and arbitrary stimuli, followed by derived comparative and transformation of function tests. Participants learned to select the smallest or biggest comparison across multiple exemplars in the presence of abstract samples. Next, participants learned to select arbitrary comparisons in the presence of contextual cues to establish a size ranking among comparisons. To assess verbal mediation during mutual and combinatorial entailment tests, participants were instructed to talk out loud. When they failed to perform correctly during derived relations tests, participants were trained to tact and intraverbally relate stimuli. The results suggest that relational training alone was not sufficient to establish comparative relations and that adult participants engaged in problem solving consistent with intraverbal bidirectional naming during emergent relations tests.

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Home and community-based services are key to an aging society and the aging in place strategies that are preferred by older adults as well as policymakers. But the provision of these kinds of services is often inadequate in territorial terms, raising the question of how to increase their reach and efficiency. This article analyzes the spatial coverage of home support services in the Aveiro Region of Portugal, considering the distribution of their target population and identifying network configurations which would provide these services more efficiently, through a location analysis that minimizes the distance to potential users of these services. This approach showed that, in the Aveiro Region, the spatial coverage of these services is highly uneven and insufficient, considering that the population with difficulties in performing daily tasks exceeds the population benefiting from these services and that the level of coverage differs greatly between territories. It also showed that significant efficiency and equity gains are possible by optimizing the service providers' location at the supra-municipal scale, decreasing the distances to be covered and reducing territorial inequalities.

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BACKGROUND: Smartphone-delivered attentional bias modification training (ABMT) intervention has gained popularity as a remote solution for alleviating symptoms of mental health problems. However, the existing literature presents mixed results indicating both significant and insignificant effects of smartphone-delivered interventions. OBJECTIVE: This systematic review and meta-analysis aims to assess the impact of smartphone-delivered ABMT on attentional bias and symptoms of mental health problems. Specifically, we examined different design approaches and methods of administration, focusing on common mental health issues, such as anxiety and depression, and design elements, including gamification and stimulus types. METHODS: Our search spanned from 2014 to 2023 and encompassed 4 major databases: MEDLINE, PsycINFO, PubMed, and Scopus. Study selection, data extraction, and critical appraisal were performed independently by 3 authors using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. When necessary, we pooled the standardized mean difference with a 95% CI. In addition, we conducted sensitivity, subgroup, and meta-regression analyses to explore moderator variables of active and placebo ABMT interventions on reducing symptoms of mental health problems and attentional bias. RESULTS: Our review included 12 papers, involving a total of 24,503 participants, and we were able to conduct a meta-analysis on 20 different study samples from 11 papers. Active ABMT exhibited an effect size (Hedges g) of -0.18 (P=.03) in reducing symptoms of mental health problems, while the overall effect remained significant. Similarly, placebo ABMT showed an effect size of -0.38 (P=.008) in reducing symptoms of mental health problems. In addition, active ABMT (Hedges g -0.17; P=.004) had significant effects on reducing attentional bias, while placebo ABMT did not significantly alter attentional bias (Hedges g -0.04; P=.66). CONCLUSIONS: Our understanding of smartphone-delivered ABMT's potential highlights the value of both active and placebo interventions in mental health care. The insights from the moderator analysis also showed that tailoring smartphone-delivered ABMT interventions to specific threat stimuli and considering exposure duration are crucial for optimizing their efficacy. This research underscores the need for personalized approaches in ABMT to effectively reduce attentional bias and symptoms of mental health problems. TRIAL REGISTRATION: PROSPERO CRD42023460749; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=460749.

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BACKGROUND: Problem-based learning (PBL) is a method of learning that has been adopted in different curricula of different disciplines for more than 30 years; the assessment of the students in PBL sessions in medical schools is fundamental to ensure students' attainment of the expected outcomes of conducting PBL sessions and in providing the students with the feedback that help them to develop and encourage their learning. This study investigated the inter-rater reliability of the tutor assessment in assessing medical students' performance in their PBL tutorial sessions. MATERIALS AND METHODS: This study was conducted in the College of Medicine (COM), in the academic year 2021-2022. The study involved ten raters (tutors) of two genders who assessed 33 students in three separate PBL tutorial sessions. The PBL sessions were prerecorded and shown to the 10 raters for their assessment of PBL sessions. RESULTS: This study showed that male raters gave higher scores to students compared with female raters. In addition, this investigation showed low inter-rater reliability and poor agreement among the raters in assessing students' performance in PBL tutorial sessions. CONCLUSION: This study suggests that PBL tutor assessment should be reviewed and evaluated; this should be performed with consideration of using assessment domains and criteria of performance. Thus, we recommend that 360-degree assessment including tutor, self, and peer assessment should be used to provide effective feedback to students in PBL tutorial sessions.

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Background and aims: Unemployment rates are elevated among individuals with disordered gambling, yet the directionality of the relationship remains unclear. The present study investigated paid and unpaid unemployment as risk factors for future gambling disorder (GD). Methods: The study employed a case-control design, including all adult Norwegians receiving a GD diagnosis within specialist health services from January 2008 to December 2018 (n = 5,131). These individuals were compared with age- and sex-matched controls from the general population (n = 30,164), as well as controls with somatic and psychiatric diagnoses (n = 30,476). Results: Logistic regressions showed that those in the highest quartile of unpaid unemployment days had more than double the odds (odds ratio [OR] 2.23 (95% CI [1.96, 2.52]) of developing GD compared to those with no unpaid unemployment days. Similarly, higher levels of paid unemployment were also found to increase the odds for GD, with those in the highest quartile having an OR of 1.86 (95% CI [1.50, 2.28]) compared to those with no paid unemployment days. Moreover, an interaction analysis indicated that the association between paid unemployment days and GD was significantly stronger among men compared to women. Conclusions: The present study suggests that both paid and unpaid unemployment constitute risk factors for GD. Programs aiming at obtaining and sustaining work have been found to improve health and future studies should examine if the risk for GD can be similarly mitigated.

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The advancement of medical informatization necessitates extracting entities and their relationships from electronic medical records. Presently, research on electronic medical records predominantly concentrates on single-entity relationship extraction. However, clinical electronic medical records frequently exhibit overlapping complex entity relationships, thereby heightening the challenge of information extraction. To rectify the absence of a clinical medical relationship extraction dataset, this study utilizes electronic medical records from 584 patients in a hospital to create a compact clinical medical relationship extraction dataset. To address the pipelined relationship extraction model's limitation in overlooking the one-to-many correlation problem between entities and relationships, this paper introduces a cascading relationship extraction model. This model integrates the MacBERT pre-training model, gated recurrent network, and multi-head self-attention mechanism to enhance the extraction of text features. Simultaneously, adversarial learning is incorporated to bolster the model's robustness. In scenarios involving one-to-many relationships between entities, a two-phase task is employed. Initially, the main entity is predicted, followed by predicting the associated object and their correspondences. Employing this cascade-structured approach enables the model to flexibly manage intricate entity relationships, thereby enhancing extraction accuracy. Experimental results demonstrate the model's efficiency, yielding F1-scores of 82.8%, 76.8%, and 88.2% for fulfilling relational extraction requirements and tasks on DuIE, CHIP-CDEE, and private datasets, respectively. These scores represent improvements over the benchmark model. The findings indicate the model's applicability in practical domains, particularly in tasks such as biomedical information extraction.

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Troubleshooting is an important part of experimental research, but graduate students rarely receive formal training in this skill. In this article, we describe an initiative called Pipettes and Problem Solving that we developed to teach troubleshooting skills to graduate students at the University of Texas at Austin. An experienced researcher presents details of a hypothetical experiment that has produced unexpected results, and students have to propose new experiments that will help identify the source of the problem. We also provide slides and other resources that can be used to facilitate problem solving and teach troubleshooting skills at other institutions.

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