Changes In Compliance Research Articles

Sexual Distancing During 5 Periods Around and During the COVID-19 Pandemic, Amsterdam, the Netherlands.

Social and sexual distancing (ie, abstaining from sex with persons outside one's household) was important in the control of the COVID-19 pandemic. Compliance to distancing measures can change over time. We assessed changes in compliance to the sexual distancing measures during five periods of the COVID-19 pandemic in the Netherlands. Between November 2021 and March 2022, we used a structured questionnaire containing questions about sexual behavior and factors that could have influenced compliance with sexual distancing. Variables related to sexual behavior were measured for 5 periods, before and during the pandemic, delineated by imposement and relaxation of lockdown measures. Eight hundred seventy participants (predominantly MSM) completed the questionnaire. We found that compliance to the sexual distancing measures decreased over time. The number of casual partners was highest after the lockdown measures were relaxed for the second time (April 2021 to March 2022), and even higher than before the first lockdown. Factors positively associated with sexual distancing compliance were: having confidence in the information provided by the government and experiencing less or similar need for physical contact compared with before the pandemic. Factors that lowered compliance over time were: previously having had COVID-19, perceiving the lockdown measures as overstated, having sex with casual partners and similar drug use during the pandemic as before. Our findings suggest that sexual distancing measures are difficult to maintain for a long period. Other measures, such as confinement to a small network of known partners, might be more effective for longer pandemics in minimizing the spread of infectious diseases.

P010 Delivery of volume assured pressure support (VAPS) through tracheostomy in paediatric patients

Abstract INTRODUCTION Volume assured pressure support (VAPS) allows the ventilator to deliver a constant pre-set tidal volume or alveolar ventilation by automatically adjusting the inspiratory pressures within a set range, providing targeted pressure support. Data on its use in children are limited. We describe a series of four children effectively and safely ventilated using VAPS mode through tracheostomy. METHODS Retrospective review of patient notes. PROGRESS TO DATE Four paediatric patients were identified in our cohort who were successfully and safely ventilated using the VAPS mode through tracheostomy. The patients were between 6-14 years of age inclusive, with four differing underlying disease processes – Prader-Willi syndrome, congenital central hypoventilation syndrome, Guillain-Barré syndrome and Moebius-type syndrome. INTENDED OUTCOME AND IMPACT Whilst there have been previous paediatric case reports and case series which have demonstrated efficacy of VAPS mode used non-invasively, the use of VAPS mode to provide effective and safe ventilation through tracheostomy in children has been described in only one recent case series. The advantages of its use over conventional bilevel positive airway pressure support include its ability to compensate for changes in tidal volume, which can occur with changes in lung compliance and during different stages of sleep. This case series highlights safe and effective use of VAPS mode in children with tracheostomy.

Perubahan Perilaku Masyarakat Terhadap Kepatuhan Menjalankan Protokol Kesehatan Setelah Dilakukan Penegakan Disiplin Oleh Satpol PP

This study aims to provide a description of changes in people's behavior towards compliance with health protocols after discipline is enforced by Satpol PP based on Tegal Regent Regulation No. 62 of 2020. In this study, the approach used was a combination of qualitative and quantitative. A qualitative approach is used to describe whether the enforcement of discipline carried out by Satpol PP related to compliance with health protocols results in changes in community behavior, while the quantitative approach used is hypothesis testing on signs used to analyze changes in community behavior compliance in carrying out health protocols after enforcement. disciplined by Satpol PP, while in order to ensure whether or not there is a change in the state of compliance with community behavior in carrying out health protocols, before and after treatment (before and after treatment research design) a hypothesis testing method on growth is used using the Mac Nemar change test. The enforcement of discipline carried out by the Satpol PP on compliance with community behavior in carrying out health protocols as an effort to overcome the spread of Covid 19 in Tegal Regency is able to make changes to people's behavior in carrying out health protocols for the better. This conclusion is obtained from statistical testing which states that from this study (1) the enforcement of discipline by Satpol PP can increase the level of compliance of community behavior in carrying out health protocols in Tegal Regency, (2) there is a change in the state of compliance with community behavior in carrying out health protocols in Kabupaten Tegal. Tegal after the enforcement of discipline by the Tegal Regency Satpol PP.

Effect of community based nutritional education on knowledge, attitude and compliance to IFA supplementation among pregnant women in rural areas of southwest Ethiopia: a quasi experimental study

BackgroundCompliance with the iron folic acid supplementation is low and not at the required level to prevent anaemia during pregnancy in many countries, including Ethiopia, even though an iron-folic acid supplementation program is being implemented. The aims of this study were to determine the effect of community-based nutritional education on knowledge, attitude, and compliance to IFA supplementation in Ilu Aba Bor zone of southwest Ethiopia.MethodA pretest–posttest quasi-experimental study design consisting of intervention and control group was conducted among pregnant women. The total sample size of 472, therefore, 236 pregnant women for each interventional and control group from 16 kebeles were randomly selected in two districts. A multi-stage sampling technique was used to select the study participants. Then, individual study units were selected using a simple random sampling technique and followed until the end of the study period. Effect of community-based nutritional education on knowledge, attitude, and compliance to IFA supplementation among pregnant women in rural areas were measured.ResultsA total of 472 pregnant women participated in the study during the baseline and 437 (92.6%) were in the study until the end. The majority (49.2%) of respondents were 21–25 years of age, with a mean age of 23.4 (SD = 3.7) years. Community-based nutrition has resulted in a statistically significant increase in levels of maternal knowledge of IFAS by 15.2% in the intervention group compared to 5.1% in the control group. Similarly, the intervention group had odds of developing a positive attitude toward IFA 5.6 (4.01, 7.85) times higher than the control group. Moreover, in this study, the odds of compliance towards IFA supplementation were 3.9 (2.67, 5.57) times higher among those who received nutrition education than those women who did not.ConclusionThis study revealed that community-based nutritional education can result in a significant change in knowledge, attitude, and compliance towards IFA supplementation and supports the literature suggesting the importance of the intervention to overcome the problem of poor compliance and its associated consequences.

Pronation Reveals a Heterogeneous Response of Global and Regional Respiratory Mechanics in Patients With Acute Hypoxemic Respiratory Failure.

Experimental models suggest that prone position and positive end-expiratory pressure (PEEP) homogenize ventral-dorsal ventilation distribution and regional respiratory compliance. However, this response still needs confirmation on humans. Therefore, this study aimed to assess the changes in global and regional respiratory mechanics in supine and prone positions over a range of PEEP levels in acute respiratory distress syndrome (ARDS) patients. A prospective cohort study. Twenty-two intubated patients with ARDS caused by COVID-19 pneumonia. Electrical impedance tomography and esophageal manometry were applied during PEEP titrations from 20 cm H2O to 6 cm H2O in supine and prone positions. Global respiratory system compliance (Crs), chest wall compliance, regional lung compliance, ventilation distribution in supine and prone positions. Compared with supine position, the maximum level of Crs changed after prone position in 59% of ARDS patients (n = 13), of which the Crs decreased in 32% (n = 7) and increased in 27% (n = 6). To reach maximum Crs after pronation, PEEP was changed in 45% of the patients by at least 4 cm H2O. After pronation, the ventilation and compliance of the dorsal region did not consistently change in the entire sample of patients, increasing specifically in a subgroup of patients who showed a positive change in Crs when transitioning from supine to prone position. These combined changes in ventilation and compliance suggest dorsal recruitment postpronation. In addition, the subgroup with increased Crs postpronation demonstrated the most pronounced difference between dorsal and ventral ventilation distribution from supine to prone position (p = 0.01), indicating heterogeneous ventilation distribution in prone position. Prone position modifies global respiratory compliance in most patients with ARDS. Only a subgroup of patients with a positive change in Crs postpronation presented a consistent improvement in dorsal ventilation and compliance. These data suggest that the response to pronation on global and regional mechanics can vary among ARDS patients, with some patients presenting more dorsal lung recruitment than others.

Measurements of elastic properties and their dependencies within a damage mechanics workflow

Experimental rock mechanics testing provides a controlled and effective method for measuring physical properties, their dependencies, and their evolution due to the addition of localized microcracks. To understand the contributions of microcracks to first order changes in compliance, the behavior of initial undamaged properties of a material should be comprehensively investigated as a function of stress, load path, and load history. We perform a comprehensive study of elastic properties and their dependence on a variety of materials exhibiting nonlinearity, and varying levels of anisotropy in elastic stiffnesses. We programmatically perturb the testing environment of the specimens under triaxial stresses. Elastic moduli are measured within each test, and along multiple discrete loading paths for multistage tests as a function of stress, focusing on a set launch point. Four single stage triaxial tests per rock type are performed to calculate Mohr-Coulomb failure criteria, and ultrasonic velocities are captured during compression for establishing the upper bound of elastic behavior. Shear wave velocity for granite experiences a maximum value at a lower differential stress than maximum volumetric strain. Sandstone displays a similar trend at the highest confining pressure, while these two maxima converge under the lowest confining pressure.

Quality Review Committee Audit Improves Thoracic Enhanced Recovery After Surgery Protocol Compliance

IntroductionCompliance with thoracic Enhanced Recovery After Surgery (ERAS) protocols is critical to achieving their maximum benefits. We sought to examine utilization of quality review meetings as a method to improve protocol compliance through identification and resolution of barriers with compliance. MethodsA multidisciplinary committee implemented a thoracic ERAS protocol for anatomic lung resections across five hospitals within our health system. Compliance data at one institution were tracked for 4 mo after initiation of the ERAS protocol; a quality review meeting was held at one hospital, and two additional months of compliance data were recorded. Outcomes of interest were compliance changes to five protocol elements. Pathway elements deferred due to “mindful deviation” were excluded. Chi-square and Fisher’s exact tests were used to compare compliance differences. ResultsWe included 81 patients: 53 patients before the quality review meeting and 28 after. There were 405 compliance opportunities; 68 (17%) were excluded for mindful deviation, leaving 337 (83%) for inclusion. Overall compliance improved from 53% before to 84% after the quality review meeting. Compliance to avoiding intraoperative urinary catheters, placing chest tubes to water seal in postanesthesia care unit, liberal chest tube removal, and postoperative multimodal pain regimen use improved after the quality review meeting (P values <0.05). Use of preoperative pain bundles was not significantly different (87% versus 96%, P = 0.25). ConclusionsConducting a quality review meeting significantly improved ERAS protocol element use at our intervention healthcare region. This methodology should be considered at other institutions implementing surgical protocols.

Sensitivity of shear wave splitting to fracture connectivity

SUMMARY Shear wave splitting (SWS) is currently considered to be the most robust seismic attribute to characterize fractures in geological formations. Despite its importance, the influence of fluid pressure communication between connected fractures on SWS remains largely unexplored. Using a 3-D numerical upscaling procedure based on the theory of poroelasticity, we show that fracture connectivity has a significant impact on SWS magnitude and can produce a 90° rotation in the polarization of the fast quasi-shear wave. The simulations also indicate that SWS can become insensitive to the type of fluid located within connected fractures. These effects are due to changes of fracture compliance in response to wave-induced fluid pressure diffusion. Our results improve the understanding of SWS in fractured formations and have important implications for the detection and monitoring of fracture connectivity in hydrocarbon and geothermal reservoirs as well as for the use of SWS as a forecasting tool for earthquakes and volcanic eruptions.

Reinventing How We Teach Venous Return.

We propose a simple, intuitive model to progressively explain the principles underlying venous return. At stop-flow, mean circulatory filling pressure (MCFP) can be defined by the filling of the cardiovascular system from internal and external environments, blood vessel compliance, and oncotic pressure. The dynamic distribution of blood within a regular cardiac system and the establishment of central venous pressure (CVP) and mean arterial pressure (MAP) can then be explained by cardiac output and factors controlling distribution. Lastly, control of the cardiovascular system can be explained by changes in resistances and compliances of the blood vessels and their effect on CVP and cardiac output while briefly considering how these are controlled.

Out of Site, Out of Mind? The Role of the Government‐Appointed Corporate Monitor

ABSTRACTWe study the role of a relatively new type of external firm monitor, an on‐site government‐appointed Corporate Monitor, and assess whether such appointments reduce firms' propensity to violate laws. Using a sample of deferred and nonprosecution agreements, we first document the determinants of Monitor appointment. We find firms that voluntarily disclose wrongdoing and have more independent directors are less likely to have Corporate Monitors, whereas those with more severe infractions, mandated board changes, and increased cooperation requirements are more likely to have Monitors. We find such appointments are associated with an 18%–25% reduction in violations while the Monitor is on site, however, the effect does not persist after the Monitorship ends. Using a semisupervised machine learning method to measure changes in firms' ethics and compliance norms, we find that the reduction in violations is associated with changes in ethics and compliance that also do not persist. Finally, we document that firms under Monitorship experience a persistent reduction in innovation, highlighting a previously unexplored cost of these interventions. Overall, our results suggest that, although Corporate Monitors on site are associated with fewer violations, firms revert to previous levels of violations following Monitors' departure.

Fluid-structure interactions of peripheral arteries using a coupled in silico and in vitro approach

Vascular compliance is considered both a cause and a consequence of cardiovascular disease and a significant factor in the mid- and long-term patency of vascular grafts. However, the biomechanical effects of localised changes in compliance cannot be satisfactorily studied with the available medical imaging technologies or surgical simulation materials. To address this unmet need, we developed a coupled silico-vitro platform which allows for the validation of numerical fluid-structure interaction results as a numerical model and physical prototype. This numerical one-way and two-way fluid-structure interaction study is based on a three-dimensional computer model of an idealised femoral artery which is validated against patient measurements derived from the literature. The numerical results are then compared with experimental values collected from compliant arterial phantoms via direct pressurisation and ring tensile testing. Phantoms within a compliance range of 1.4–68.0%/100 mmHg were fabricated via additive manufacturing and silicone casting, then mechanically characterised via ring tensile testing and optical analysis under direct pressurisation with moderately statistically significant differences in measured compliance ranging between 10 and 20% for the two methods. One-way fluid-structure interaction coupling underestimated arterial wall compliance by up to 14.7% compared with two-way coupled models. Overall, Solaris™ (Smooth-On) matched the compliance range of the numerical and in vivo patient models most closely out of the tested silicone materials. Our approach is promising for vascular applications where mechanical compliance is especially important, such as the study of diseases which commonly affect arterial wall stiffness, such as atherosclerosis, and the model-based design, surgical training, and optimisation of vascular prostheses.

Vascular Aging Is Accelerated in Hematological Cancer Survivors Who Undergo Allogeneic Stem Cell Transplant.

Survivors of allogeneic stem cell transplant (SCT) receive intensive cancer treatments that are associated with cardiovascular dysfunction. Markers of vascular age can indicate early signs of adverse (cardio)vascular changes; however, the impact of SCT on these makers is unknown. We aimed to determine the short (3 months) and longer-term (≥2 years) effect of SCT on markers of vascular age in hematologic cancer survivors compared with an age-matched noncancer control group. The short-term effects of SCT, markers of vascular age (aortic compliance, arterial elastance, and ventricular-vascular coupling) were assessed via cardiac magnetic resonance imaging (cardiac and aortic volumes) before and ≈3 months post-SCT in 13 short-term survivors and compared with 11 controls. The longer-term impact was assessed by comparing 14 long-term survivors (6.5 [2-20] years post-SCT) to the short-term survivors (post-SCT) and controls (n=16). The groups were similar for age and body mass index. In the short-term survivors, no significant group-by-time interactions were observed for any markers of vascular aging from pretransplant to posttransplant (net difference for change in compliance between groups -0.07 [95% CI, -1.49 to 1.35]). For the time-course analysis, aortic compliance was significantly lower in both SCT groups (overall P=0.007) compared with controls, whereas ventricular-vascular coupling was higher in both survivor groups as was arterial elastance in long-term SCT survivors (ie, worse; P<0.01 for all). This study provides evidence of an accelerated vascular aging phenotype in allogeneic SCT survivors and provides insight into the increased burden of cardiovascular disease among hematologic cancer survivors.

Development and Initial Characterisation of a Localised Elastin Degradation Ex Vivo Porcine Aortic Aneurysm Model

Aortic aneurysms (AA) occur in 4.8% of people causing 150,000 deaths annually. While endovascular aneurysm repairs reduce surgical morbidity, device-related failures (leak/displacement) are frequent highlighting the need for test models that better represent the mural geometry and compliance changes in human AAs. We aimed to develop and characterise an ex vivo porcine aortic model of AA. The optimal duration of tissue elastase exposure to emulate AA changes in elastin microstructure and content was determined using porcine aortic rings. Elastase-induced changes were quantified morphologically, and mechanical properties assessed via ring tensile testing. Subsequent experiments tested the potential for localised elastase treatment in a 1 cm segment of porcine aorta using a specially designed 3D printed rig. The effect on pressure-diameter behaviour was investigated via inflation-extension testing. Elastase treatment produced time dependent decreases in elastin, resulting in an increased tensile modulus and circumferential length in the ring samples in the final phase of the J-shaped tissue stress-strain curves. In whole aortic segments, localised elastase-induced luminal degradation was successfully limited to a central region. The degree of elastin degradation achieved was sufficient to cause localised dilation with respect to controls under physiological pressures. Localised elastin degradation in porcine aortic segments is feasible and emulates the changes seen clinically in aortic aneurysms.

FTP4.1 Compliance With Antimicrobial Prescribing Guideline Recommendations

Abstract Aims Due to concerns regarding the quality of antimicrobial prescribing in the General Surgery department at a District General Hospital, a prospective quality improvement project was undertaken to guide local antimicrobial stewardship. To assess the compliance of the General Surgery department with local antimicrobial prescribing guidelines and policies, and recommendations in the BNF and electronic medicines compendium (EMC). The aim was to evaluate the extent of change in compliance of the General Surgery junior doctors during after intervention. Methodology Prospectively collected data on the patients admitted and started on antimicrobial agents over two 3-week periods under the General Surgery department. Educational interventions were initiated in the interval between the periods of data collection. Results 91 patients were audited in Cycle 1 with a median age of 57 (9-93) years including 36 males and 55 females. Cycle 2 involved 89 patients with a median age of 60 (9-87) with 48 males and 41 females. After intervention, there was an increase in correct prescribing regime (51.6 to 56.2%), correct dose (91.2 to 98.9%), correct frequency (59.3 to 79.8%), and correct duration; when included (78.8 to 83.3%). There was a decrease in the duration being included on the prescription (36.3 to 33.7%). The increases in correct antimicrobial dosing and correct antimicrobial frequency prescriptions were statistically significant at p ≤ 0.05. Conclusion Areas for improvement in the compliance to prescribing guidelines in the department could be influenced successfully through appropriate intervention. The audit highlighted particular areas to be targeted by education.

Comorbidities and the occurrence of changes in Intracranial Compliance in elderly

Population aging is reality and indicates the need for a better quality of life. Aging brings loss of functions, neurological changes and comorbidities. Studies have sought to reduce the progression of diseases in the elderly and some suggest diseases may have their development related to high intracranial pressures (ICP). The aim of this study was to evaluate for the first time ICP morphology in residents of a Long-Term Institution for the Elderly, using a non-invasive technology. Of the 91 elderly people evaluated, 88% had ICP alterations, 58% are dependent to daily activities, 23% are wheelchair users and 79% have a mental state as compromised. As for comorbidities, frequently identified chronic-degenerative diseases were arterial hypertension (50%), depression (27%), diabetes (24%) and dementia (14%), in addition to polypharmacy. There was a significant difference in the prevalence of altered ICP for wheelchair users and for residents who do not walk . A high rate of altered ICP was observed in the population studied, highlighting the importance of assessing intracranial compliance in understanding the aging and future follow-up studies of the elderly at different stages of diseases, especially neurological ones.

Pengaruh Pengetahuan Wajib Pajak, Kesadaran Wajib Pajak, Dan Sanksi Pajak Terhadap Kepatuhan Wajib Pajak Kendaraan Bermotor Di Semarang

Motor vehicle tax consists of annual tax and tax once every five years. Taxpayer compliance is the fulfillment of their tax obligations through tax regulations. This study was conducted to obtain information and analyze several causes of changes in taxpayer compliance in Semarang, such as taxpayer knowledge and consciousness, as well as tax sanctions. Research sampling technique with accidental sampling technique. The use of this type of data in the study is primary data. The population in the study includes taxpayers who own and control motor vehicles included in the list at SAMSAT Semarang 1 in 2022. The results of taxpayer knowledge testing showed that it did not have a significant reaction on taxpayer compliance. For the moment, taxpayer consciousness testing and tax sanctions show a significant influence on taxpayer compliance.&#x0D; Keywords: knowledge, consciousness, sanctions, compliance

Characterization of cerebral macro- and microvascular hemodynamics during transient hypotension.

The aim of the current study was to establish the interplay between blood flow patterns within a large cerebral artery and a downstream microvascular segment under conditions of transiently reduced mean arterial pressure (MAP). We report data from nine young, healthy participants (5 women; 26 ± 4 yr) acquired during a 15-s bout of sudden-onset lower body negative pressure (LBNP; -80 mmHg). Simultaneous changes in microvascular cerebral blood flow (CBF) and middle cerebral artery blood velocity (MCAvmean) were captured using diffuse correlation spectroscopy (DCS) and transcranial Doppler ultrasound (TCD), respectively. Brachial blood pressure (finger photoplethysmography) and TCD waveforms were extracted at baseline and during the nadir blood pressure (BP) response to LBNP and analyzed using a modified Windkessel model to calculate indices of cerebrovascular resistance (Ri) and compliance (Ci). Compared with baseline, rapid-onset LBNP decreased MAP by 22 ± 16% and Ri by 14 ± 10% (both P ≤ 0.03). Ci increased (322 ± 298%; P < 0.01) but MCAvmean (-8 ± 16%; P = 0.09) and CBF (-2 ± 3%; P = 0.29) were preserved. The results provide evidence that changes in both vascular resistance and compliance preserve CBF, as indexed by no significant changes in MCAvmean or DCS microvascular flow, during transient hypotension.NEW & NOTEWORTHY To characterize the relationship between cerebrovascular patterns within the large middle cerebral artery (MCA) and a downstream microvascular segment, we used a novel combination of transcranial Doppler ultrasound of the MCA and optical monitoring of a downstream microvascular segment, respectively, under conditions of transiently reduced mean arterial pressure (i.e., lower body negative pressure, -80 mmHg). A rapid increase in vessel compliance accompanied the maintenance of MCA blood velocity and downstream microvascular flow.

THEORETICAL INSIGHTS INTO ACCOUNTING AND RECORD-KEEPING REQUIREMENTS UNDER THE GOODS AND SERVICES TAX ACT IN INDIA

In India, the implementation of the Goods and Services Tax has an effect on a wide range of businesses. Goods and Services Tax reform eliminated Indias major indirect taxes such as Excise, Service Tax, and VAT, among others. It has also led to a change in the system of finalisation of accounts. Accounting treatment of GST is simpler than that for the older regime, due to the lesser number of taxes to account for. However, institutions need to be wary of GST record-keeping and GST Accounting measures to maintain compliance. GST implementation will have profound and far-reaching effects on a companys operations, necessitating a complete overhaul of the companys business, finance, financial reporting, and accounting systems. As management teams continue to assess these changes, they will need to consider changes in financial reporting as well as indirect tax accounting. The purpose of this research is to discuss the various types of business transactions involving Goods and Services Tax and their accounting treatment in the books of accounts and their compliances. This article also examines some of the most significant GST accounting and compliance changes. KEYWORDS: GST, Accounting, Compliances, Accounts and records.

Enterprise standardization and convergence of large-volume infusion pump drug libraries.

With the implementation of a new electronic health record (EHR) system across Mayo Clinic, a project was approved to standardize and converge 9 region-specific large-volume infusion pump (LVP) drug libraries for Baxter SIGMA Spectrum pumps. The objectives of the project were to (1) develop recommendations for identified variances in practice, (2) consolidate regional drug libraries into a converged enterprise library, (3) improve the drug library management process, and (4) maintain or exceed previous Dose Error Reduction System (DERS) compliance for infusions administered. Harmonization efforts with infusion pumps decreased the number of drug libraries maintained, reduced content maintenance time, and increased readiness for smart infusion pump-EHR interoperability. Seven of the 8 regions for which change in DERS compliance was assessed showed improved compliance relative to baseline in the 30-day postwashout period. Furthermore, when comparing pre- and postimplementation DERS compliance, the number of regions meeting the minimum compliance rate of 95% increased from 5 to 6 regions. The project improved the drug library management process, allowed for DERS compliance to be accurately compared across regions, and ensured that patients across the enterprise receive the same standard of care with the administration of intravenous medications.

Topology optimization of isotropic elastic materials in the two-dimensional design domain with changes in characteristic boundary conditions

Topology optimization (TO) has become increasingly popular as a useful tool for designers and engineers during the initial stages of design. TO aims to optimize the geometry of a design to achieve a specific objective, which can range from discrete grid-like structures to continuum structures. In essence, the geometry is parameterized pixel-by-pixel, with the material density of each element or mesh point serving as a design variable. After that, the optimization problem is addressed using mathematical programming and analytic gradient calculation-based optimization approaches. In this paper, we investigate the material distribution when performing topology optimization for an isotropic material with boundary conditions including fixed structures, supports, or external forces changing. In addition, we investigate more cases where there are material holes in the design domain, meaning that the density of the material is zero. In this study, the modified SIMP method and filter sensitivity are used for topology optimization. The results of the study are the optimized structural domains and the change in compliance according to the number of iterations. The results indicate that the compliance value of most structures reaches convergence after optimization up to the 20th iteration. Moreover, if the force applied to the design domain is symmetrical, the optimal structure also exhibits symmetry. Thus, the distribution of material is concentrated at the positions of the supports. Topology optimization produces designs that both meet boundary conditions while saving material and reducing their mass. The results obtained are important data for structural optimization design for isotropic elastomeric materials. From there, it can be applied to real objects with different requirements and conditions