Compliance Problems Research Articles

TINGKAT KEPATUHAN PENGGUNAAN OBAT ANTIDIABETES DI RS PKU AISYIYAH BOYOLALI

Diabetes mellitus or DM is a degenerative disease that is often found in society. This disease is characterized by high blood sugar caused by impaired insulin production which plays a role in glucose metabolism in pancreatic function. If someone is diagnosed with diabetes, the only treatment is to control blood sugar. This treatment requires compliance because it is carried out over a long and unlimited period of time. However, there is a problem of compliance with treatment because many conditions are neglected. This study aims to determine the level of compliance of outpatients in the internal medicine polyclinic at PKU Aisyiyah Boyolali Hospital in undergoing treatment for diabetes mellitus. This research is a descriptive research. Data collection used the Morisky Medication Adherence Scale-8 (MMAS-8) questionnaire to measure patient compliance. The sample used was 60 respondents with a sampling technique using purposive sampling. The results of the study showed that 14 patients (23%) had a high level of compliance, 40 patients (67%) had a medium level of compliance, and 6 patients (10%) had a low level of compliance.

Topological derivative based sensitivity analysis for three-dimensional discrete variable topology optimization

This study introduces a novel Topological Derivative-based Sensitivity Analysis (TDSA) methodology for three-dimensional (3D) discrete variable topology optimization. Recently, the authors pointed out that the discrete variable sensitivity can be related to the topological derivative, and thus can be rationally approximated by the specially customized topological derivative for plane stress problems. However, the 3D discrete variable sensitivity requires the 3D topological derivative with element-shaped (e.g., unit cube) domain perturbation, whose analytical solution is not available in the literature. This paper proposes a unified parameter fitting framework to calculate the 3D topological derivative with arbitrary shape 3D domain perturbation. The formula for spherical hole perturbation obtained through this parameter fitting framework is identical to the well-known analytical topological derivative formula. Further, the 3D discrete variable sensitivity can be easily obtained through element-shaped domain perturbation. With the recently proposed Sequential Approximate Integer Programming (SAIP), numerical examples demonstrate that TDSA is precise not only for the self-adjoint 3D minimum compliance problems but also for the non-adjoint 3D compliant mechanism design problems. In sum, numerical examples have been conducted by feeding the derived sensitivity to the SAIP optimization algorithms, and the correctness of the sensitivity information has been well demonstrated. This research further solidifies the foundation of rational discrete variable sensitivity analysis in 3D topology optimization.

ПРАВОВЕ РЕГУЛЮВАННЯ ФІЗИЧНОГО ВИХОВАННЯ ТА СПОРТУ: МІЖНАРОДНІ Й НАЦІОНАЛЬНІ АСПЕКТИ

The article addresses to the legal regulation of physical education and sports. In the course of the analysis, the article identifies international and national aspects of such regulation, as well as trends in the development of the legal framework in the system of physical education and sports development. International standards in the field of physical education and sports were analyzed, in particular: The International Charter of Physical Education, Physical Activity and Sport, the European Charter of Sport, the European Charter of Sport for All, the Code of Sports Ethics, the Declaration of the Rights and Responsibilities of Athletes, etc. The national aspects of legal regulation of physical education and sports were identified in the context of the analysis of the Constitution of Ukraine, the Laws of Ukraine “On Physical Culture and Sports”, “On Support of the Olympic, Paralympic Movement and High Performance Sports in Ukraine”, “On Prevention of the Impact of Corruption Offenses on the Results of Official Sports Competitions”, “On Anti-Doping Activities in Sports”, and other legal acts. A retrospective analysis of the regulatory and legal support for the development of physical education and sports allowed us to trace the formation of the main priorities of social development and the requirements for regulatory implementation in the legislation of Ukraine. The basic priorities of the world’s leading experience in the development of physical education and sports and the possibility of its application in Ukraine are identified. It is concluded that today physical education and sports are an integral part of life not only of every person, but also of every country. It is noted that in modern society, the problems of compliance of our country’s domestic legislation on physical education and sports with the basic principles and norms of international law and international treaties of Ukraine are relevant. The author emphasizes that today in the field of physical education and sports there is still a problem of legal conflicts and contradictions of certain provisions of Ukrainian legislation. Key words: legal regulation, physical education, physical culture, sports, legislation.

Current Problems of Compliance with Constitutional Environmental Responsibilities Through the Lens of Constitutional Justice

The article analyzes constitutional environmental responsibilities in the Russian Federation through the prism of constitutional justice. Their non-compliance entails adverse consequences for subjects of environmental law. The purpose of the study is to identify topical issues that negatively affect compliance with constitutional environmental obligations in accordance with constitutional and legal norms, Russian legislation, as well as international law. The objectives of the study are to study constitutional environmental obligations in national and international law, to analyze the norms contained in the laws of the Russian Federation and international legal acts concerning compliance with environmental obligations, and to identify key problems related to them. Using the comparative legal method, the analysis of constitutional environmental obligations was carried out. In addition, logical and formal legal methods of scientific cognition were used. The study examines some key aspects that have an adverse impact on compliance with constitutional environmental obligations, the doctrine of environmental law. It is revealed that in the Russian Federation, the duties in the field of ecology are the preservation of the environment and respect for natural resources, entrusted to all subjects of law. In accordance with the norms of international law, the element of the ecological and legal status of a legal entity considered by us is more characteristic of the State. The study of problems in national and international law has led to the conclusion that in modern countries it is recognized that non-compliance with constitutional environmental obligations is due to a low level of environmental awareness, lack of understanding of legal responsibility and environmental nihilism.

Development and psychometric validation of a brief scale to measure environmental perception based on the 2-major environmental values model in adolescents and adults.

The worldwide ecological crisis, including global climate change, is leading to increased awareness and attitudes towards environmental problems. To address these problems, studies of human attitudes are needed. This study is based on the 2-Major Environmental Values (2-MEV) model, which measures two components of environmental attitudes: Preservation and Utilization. The model has been applied to both, adolescents and adults. After decades of use, it is necessary to review the psychometric scale and update the wording. Developing short or even super-short scales to measure well-established constructs is necessary due to time constraints, compliance or fatigue due to language issues. We applied an exploratory factor analysis (EFA) to a dataset containing 20 items from the 2-MEV model to reduce the scale to 6 items, 3 per dimension using parallel analysis, scree plot examination and eigen-value greater than 0 as criteria. The scale was then applied to adults and the sample was split for EFA and confirmatory factor analysis (CFA). Multigroup confirmatory factor analysis (MGCFA) was then used to assess invariance across age and gender. Finally, regression and linear models were used to examine the effects of age and gender in both, adults and adolescents. The 2-MEV model was replicated in the EFA and CFA and the correlated two-factor model showed the best fit. The scale showed configural and metric invariance across age and gender, and scale invariance across gender. Gender and age effects were replicated in relation to previous studies. The brief scale showed good model indices and convergent validity. The brief scale of the 2-MEV model can be applied in situations where environmental attitudes are important, but time constraints (internet surveys), compliance, or language problems may hinder the use of longer scales.

The use of a polygraph in the investigation of criminal offences: problems of tactics and legal regulation

The use of a polygraph in the investigation of criminal offences: problems of tactics and legal regulation

STATE AND PROSPECTS FOR THE DEVELOPMENT OF ISLAMIC FINANCE INSTRUMENTS (SUKUK) IN RUSSIA AND ABROAD

The search for new sources of financing investment projects in modern Russia in the context of external sanctions and the implementation of geopolitical threats actualizes the problem of incorporating Islamic finance instruments into the structure of the financial market. The early twentieth century development experience of a number of foreign countries shows the steady growth of the assets of Islamic banks, investment funds and the volume of issuance of investment certificates (sukuk), which constitute the main segments of Islamic finance in the world. Islamic financial assets are widely represented in the Gulf countries, Southeast Asia, the Middle East and South Asia, and Africa. The implementation of the principles of Islamic finance in the Russian Federation is hampered by legal, cultural, historical and political factors. While there are certain Islamic financial products in Russia, there is no issue of sukuk at all. In this regard, the purpose of this paper is to study the principles of Islamic finance and the functioning mechanism of the market for the investment certificates (sukuk), possibilities and limitations of their implementation in the modern Russian economy. The author defines sukuk as an Islamic financial instrument used for securitization of assets, and identifies its differences from traditional bonds. Alternative approaches to solving the problem of compliance of sukuk with Sharia principles are analyzed. The prerequisites for realizing the potential of sukuk in modern Russia are determined and the obstacles to their issuance are formulated. It is concluded that the adoption of the Federal Law of 04.08.2023 N 417-FZ "On Conducting an Experiment to Establish Special Regulation in Order to Create the Necessary Conditions for Carrying out Partnership Financing Activities in Certain Constituent Entities of the Russian Federation and on Introducing Amendments to Certain Legislative Acts of the Russian Federation" and its implementation, taking into account its provisions of pilot projects in a number of Russian regions, will make it possible to intensify the process of incorporation of project financing instruments into the structure of the financial markets of modern Russia.

Orthodontic treatment in adults: Challenges, outcomes, and factors affecting compliance and satisfaction.

The demand for orthodontic treatment among adults has witnessed a substantial rise in recent years. This study aims to explore the complexities of adult orthodontics, focusing on challenges faced, treatment outcomes, and the influence of factors such as age, gender, and education on patient compliance and satisfaction. A multi-dimensional approach was employed, combining a review of clinical records with structured patient surveys. Descriptive statistics summarized demographic characteristics, treatment duration, and orthodontic problems addressed. Inferential statistics included Pearson correlation, Chi-squared tests, and analysis of variance to examine age compliance, gendersatisfaction, and education-orthodontic problem relationships. Qualitative analysis enriched findings, and statistical software facilitated data processing. The analysis revealed a statistically significant negative correlation between age and compliance (r = -0.28, P < 0.05), indicating that younger participants demonstrated higher compliance rates. Gender emerged as a significant factor influencing patient satisfaction (P = 0.024), with females reporting notably higher levels of satisfaction than males. Furthermore, participants with advanced education levels (Master's/Ph.D.) were significantly more likely to have orthodontic issues related to malocclusion (P = 0.041). The study provides an insight into the multi-dimensional aspects of adult orthodontics, recognizing the challenges, compliance, and satisfaction levels. Tailored approaches considering age, gender, and education are essential. This research contributes to a deeper understanding of orthodontic treatment in adults and its potential implications for enhanced patient care.

An Ultra-soft Thermal Diode

The controlling of heat flow direction stands as a prominent methodological approach within the domain of thermal management, and this can be accomplished through the utilization of thermal diodes. However, if the thermal diode lacks mechanical compliance, hindering its intimate contact with heat source/sink surfaces, the thermal rectification performance is limited. In this work, we propose a method to solve the mechanical compliance problem that is introducing phase change material (PCM) consisting of dual alkanes (hexadecane and paraffine wax) and polyurethane to fabricate the heterojunction thermal diode. The fabricated thermal diode exhibits an ultra-soft mechanical feature, with a low elastic modulus of 0.4 KPa and >300 % elongation until failure – the best values reported to date for thermal diodes. The measured thermal rectification factor is as high as 1.42 – in line with the theoretical model prediction. Molecular dynamic simulations reveal that the thermal rectification mechanism of the PCM-based thermal diode originates from the crystal-amorphous phase transition of the hexadecane terminal as the temperature bias flips. Therefore, the heat flow in the forward direction is greater than the flux in the reverse direction. A series of experiments and finite element analyses are employed to verify the feasibility of thermal diodes for applications in real contexts like the civil engineering.

Toward static and transient stress-constrained topology optimization for shell-infill structures

This paper contributes to a stress-constrained topology optimization approach for the design of shell-infill structures. Based on the density method, we utilize the two-step filtering and projection scheme and local volume constraint for generating the shell and non-uniform infills, respectively. The topology optimization formulation is defined as a Robust Minimum Compliance problem with Volume and Stress constraints (RMCVS), where the robust method is used to eliminate undesired topological characteristics. We globalize the static and transient stress constraints through the p-norm function, and tailor material interpolation and stress relaxation schemes for both cases, respectively, to avoid numerical difficulties. Sensitivity analysis is provided, and the derivatives of the objective function and constraints with respect to the design variable fields are derived. We then validate the suggested method through several 2D and 3D benchmarks. The results illustrate that the method is robust to generate various shell-infill structures while limiting the maximum static and transient stress.

Investigation of Teaching Gallery in Clinical Teaching of Ultrasonic Medicine

In the course of ultrasonic medical teaching, disease images are indispensable. However, the randomness of real-time teaching case resources often affects the smooth development of clinical ultrasound teaching. Based on the picture archiving communication system, the audio-visual images and clinical data of cases were collected and the teaching gallery was established. The gallery can be used for teaching common diseases, rare diseases, new ultrasonic technology and interventional ultrasound to ensure that the teaching content is consistent with the teaching process. It can overcome the uneven distribution of diseases, some patients poor teaching compliance and other practical clinical teaching problems, so as to improve the effect of ultrasonic clinical teaching.

Социально незащищенные категории семей: проблемы соблюдения норм противопожарного режима в местах их проживания

The article provides the first scientific and practical commentary on the norm set out in paragraph 851 of the Rules of Fire Protection in the Russian Federation, approved by the Decree of the Government of the Russian Federation No. 1479 of September 16, 2020, which entered into force on March 1, The problem of ensuring fire safety of large families, families in a difficult life situation, in a socially dangerous situation, living in residential premises (rooms, apartments, residential buildings) belonging to them by right of ownership or being in their use is considered, as well as legal acts regulating fire safety issues are analyzed. As a result of the analysis, the problems of compliance with the new norm of these Rules, as well as the implementation of state fire supervision, were identified. In order to solve the task set by the state to reduce the number of fires, save the population, correct and unambiguous understanding by individuals and public authorities of their responsibilities, the authors formulated proposals to amend the Family Code of the Russian Federation and the Housing Code of the Russian Federation.

The Impact of Wage Levels on the Quality of Employment and Economic Sustainability of Households

The problem of compliance of the wage level of employees with social standards of living standards, having undoubted regional features, is relevant for all subjects of the Russian Federation. When determining the wage of organizations funded from regional budgets, we believe they should proceed from the general methodological basis for determining its size. In the article is analyzed the situation with the wage level of employees in the sector of organizations, which is the main segment of Russian employment. It has been revealed that the level of wages most strongly affects its quality and is one of the main indicators of precarious employment. The peculiarities of the distribution of employees by wage level are revealed, depending on the level of qualification of employees and their working conditions, taking into account the forms of ownership and the size of organizations. Based on the author’s tools, the analysis of the impact of wage levels on the economic sustainability of households due to (not) achieving socially acceptable and higher standards of living is carried out. It is shown that for more than 80% of employees, the wage level currently does not allow to ensure such standards. A radical increase in the wage level is proposed based on the development of industry-specific social wage standards. This will improve the quality of employment: reduce the scale of precarious employment, link the level of wages with the qualifications of employees and their working conditions, taking into account the characteristics of sectors of the Russian economy, as well as significantly increase the economic sustainability of households.

Regulatory frameworks and experience in designing interiors and equipment of premises for holding persons in isolation

The article highlights the acute problem of the formation of architectural and object-spatial environments of penitentiary institutions in Ukraine. Today the correctional system in the state is improving and bringing Ukrainians closer to a safer and more tolerant society, but the problem of functioning of existing places of detention remains. Predominantly they are morally and materially obsolete buildings with problems of compliance with technical, sanitary, and hygienic standards, as well as the unsatisfactory functional and aesthetic organization of space. The article considers the problems of harmonizing the architectural environment of domestic correctional complexes, in particular, the design of interiors and furnishing of premises for the detention of persons deprived of their liberty. There is no objection that the complex design of a correctional facility building and interior design of premises for the detention of arrested (imprisoned) persons should be based on versatile requirements reflected in the normative documentation. Today in Ukraine there is a development of normative construction documentation for the design of premises for the detention (accommodation) of persons subject to isolation, based on the current state documents of the Ministry of Internal Affairs of Ukraine, the National Police of Ukraine, the State Migration Service and the like. This rather wide range of documents, relying in turn on international provisions, puts forward requirements not only for the design of sites and buildings for the detention of persons in isolation but also for a certain interior design and equipment of the premises. The study and analysis of the available examples of world experience in the design and construction of penitentiary institutions can show a direct link between the design of the premises where prisoners are kept and the methods of re-socialization and re-education, the positive results of which are an important goal of the functioning of such institutions in socio-economically developed countries. The experience of designing, constructing, and operating foreign prisons and correctional centers of various security levels has been studied and analyzed, and the peculiarities of interior design and equipment of premises (cells) for the detention of the contingent have been revealed. It was found that the more qualitative the process of socialization in a safe and humane environment of places of deprivation of liberty, the lower the percentage of recidivism achieved under the influence of this environment, the higher the justification of state expenditures in this subsidized sphere. The article highlights several regulatory requirements and provides recommendations on the formation of a subject-spatial environment for the detention of persons in correctional institutions in Ukraine. The result of this research can be several conclusions, guided by which, it is possible to form a full-fledged object-spatial environment for the detention of prisoners (arrested) in a correctional institution, as well as to design interiors and furnishings for the staff, whose work is difficult and stressful.

Internal-interfacial cracking interaction: Combined phase-field and discontinuous Galerkin/cohesive zone modeling

Interaction simulations between internal and interfacial cracks arising in laminated composites have remained a challenging task in the computational mechanics community. Toward this end, this paper proposes a novel explicit approach that combines a length scale-insensitive phase-field model and a discontinuous Galerkin/cohesive zone model to respectively account for brittle or cohesive fracture of bulk materials and interfacial debonding. The presented approach advocates the incorporation of a discontinuous Galerkin term to overcome the artificial compliance problem inherent in existing phase-field methods that normally adopt intrinsic cohesive zone models for interfacial debonding. The capacity of our approach is further exploited by innovatively integrating the approach with an efficient six-node pentahedral solid-shell element, enabling a natural simulation of through-thickness cracks in thin shell structures with high-aspect-ratio elements. Implementation challenge, arising from the stress decomposition of the solid-shell element, of such integration is well addressed. In light of the considerable computational cost required for a phase-field-based method, the proposed approach is mapped to graphics processing units to improve the computational efficiency. Representative numerical examples have demonstrated the capability of the proposed approach in simulating mode-I and mixed-mode cohesive cracks, as well as brittle fractures in solids and shells. It is also shown that the presented approach is capable of effectively addressing the artificial compliance issue and capturing the competitive behavior between internal and interfacial cracks in a physically consistent manner.

An adaptive phase-field method for structural topology optimization

In this work, we develop an adaptive algorithm for the efficient numerical solution of the minimum compliance problem in topology optimization. The algorithm employs the phase field approximation and continuous density field. The adaptive procedure is driven by two residual type a posteriori error estimators, one for the state variable and the other for the first-order optimality condition of the objective functional. The adaptive algorithm is provably convergent in the sense that the sequence of numerical approximations generated by the adaptive algorithm contains a subsequence convergent to a solution of the continuous first-order optimality system. We provide several numerical simulations to show the distinct features of the algorithm.

Long-term continuous instrumented insole-based gait analyses in daily life have advantages over longitudinal gait analyses in the lab to monitor healing of tibial fractures.

Introduction: Monitoring changes in gait during rehabilitation allows early detection of complications. Laboratory-based gait analyses proved valuable for longitudinal monitoring of lower leg fracture healing. However, continuous gait data recorded in the daily life may be superior due to a higher temporal resolution and differences in behavior. In this study, ground reaction force-based gait data of instrumented insoles from longitudinal intermittent laboratory assessments were compared to monitoring in daily life. Methods: Straight walking data of patients were collected during clinical visits and in between those visits the instrumented insoles recorded all stepping activities of the patients during daily life. Results: Out of 16 patients, due to technical and compliance issues, only six delivered sufficient datasets of about 12weeks. Stance duration was longer (p = 0.004) and gait was more asymmetric during daily life (asymmetry of maximal force p < 0.001, loading slope p = 0.001, unloading slope p < 0.001, stance duration p < 0.001). Discussion: The differences between the laboratory assessments and the daily-life monitoring could be caused by a different and more diverse behavior during daily life. The daily life gait parameters significantly improved over time with union. One of the patients developed an infected non-union and showed worsening of force-related gait parameters, which was earlier detectable in the continuous daily life gait data compared to the lab data. Therefore, continuous gait monitoring in the daily life has potential to detect healing problems early on. Continuous monitoring with instrumented insoles has advantages once technical and compliance problems are solved.

An improved proportional topology optimization method combining a polarized material interpolation scheme and Heaviside threshold function

An improved proportional topology optimization (IPTO) method is proposed in this work. The main improvement of this method is that the conventional solid isotropic material with penalization (SIMP)-based material interpolation scheme is replaced by a polarized material interpolation scheme, and the Heaviside threshold function is adopted based on the original proportional topology optimization (PTO) method. By using this approach, the minimum compliance problem can be solved without requiring the numerical derivation of the sensitivity function. To verify the feasibility and effectiveness of the proposed method, two-dimensional (2D) and three-dimensional (3D) cantilevers and L-bracket beams are used as examples. The 2D results obtained by the IPTO method are compared with those obtained by the PTO and SIMP methods. Numerical examples demonstrate that IPTO can acquire better objective function values and more ideal topology structures compared to PTO and SIMP. Furthermore, IPTO offers significant advantages over PTO and SIMP in terms of convergence speed and the ability to suppress intermediate density elements. Additionally, this method enables topology optimization design under multiple working conditions. Therefore, it provides an effective approach for structural topology optimization in research and engineering applications. With appropriate adjustment, this method can also be applied to composite material design and heat conduction design.

Modified proportional topology optimization algorithm for multiple optimization problems

Three modified proportional topology optimization (MPTO) algorithms are presented in this paper, which are named MPTOc, MPTOs and MPTOm, respectively. MPTOc aims to address the minimum compliance problem with volume constraint, MPTOs aims to solve the minimum volume fraction problem under stress constraint, and MPTOm aims to tackle the minimum volume fraction problem under compliance and stress constraints. In order to get rid of the shortcomings of the original proportional topology optimization (PTO) algorithm and improve the comprehensive performance of the PTO algorithm, the proposed algorithms modify the material interpolation scheme and introduce the Heaviside threshold function based on the PTO algorithm. To confirm the effectiveness and superiority of the presented algorithms, multiple optimization problems for the classical MBB beam are solved, and the original PTO algorithm is compared with the new algorithms. Numerical examples show that MPTOc, MPTOs and MPTOm enjoy distinct advantages over the PTO algorithm in the matter of convergence efficiency and the ability to obtain distinct topology structure without redundancy. Moreover, MPTOc has the fastest convergence speed among these algorithms and can acquire the smallest (best) compliance value. In addition, the new algorithms are also superior to PTO concerning suppressing gray-scale elements.

Application Progress of Shared Decision Making Model in Patients with Thoracic Cancer

As a new diagnosis and treatment decision-making model, shared decision making (SDM) can effectively solve the problem of patient compliance in the diagnosis and treatment of thoracic tumors, balance the status of both doctors and patients, and gradually get attention and application in the clinical practice of thoracic surgery. The application of SDM in the diagnosis and treatment of thoracic tumors is conducive to improve doctors' diagnosis and treatment level and alleviating the pressure of responsibility, reduce patients' psychological pressure and improve patients' compliance and also improve medical trust and reduce doctor-patient conflict. Due to the limited medical literacy and autonomy of patients, the time for diagnosis and treatment is short due to the imbalance of doctor-patient ratio. Meanwhile, due to the limited sample size of existing studies, SDM model cannot be proved to have a clear gain for the treatment of thoracic tumors, and the implementation of SDM model still faces resistance. In the future, the development of auxiliary decision-making system and the improvement of doctors' humanistic care ability will be conducive to promote the practical application of SDM model in thoracic surgery. .