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Photovoltaic (PV) systems are designed for both communal and self-installation. PV systems are intended for both communal and standalone installations. Installation is required not only in industry and commerce, but also in the growth of energy potential at Universitas Jenderal Achmad Yani. The focus of this research is rooftop PV modelling and analysis at Universitas Jenderal Achmad Yani. Because the ground mounting system could not be done due to limited land, a rooftop solar power-producing system was created. Data gathering is done as part of unique research that takes into account numerous technological criteria for efficiency. System analysis conducted by modelling and simulation, which will make use of a variety of tools linked to this PV system. Data was gathered from similar studies while accounting for numerous technological variables such as modelling and efficiency. K2Base system was used to model flat roofs with concrete roof types and gable roofs with tile roof types. The mounting type, wind load, truss load, and ballast were all taken into account in the design. This article also calculates PV panel configurations and component capacities. There are many different panels that can be constructed from each model. With a maximum roof area of 837.52 m2, 33 to 350 PV panels may be used. The number of inverters is changed to provide outputs of 10 kW, 25 kW, and 50 kW based on the calculations' findings. With differences in autonomous days, the number of batteries obtained has an average of more than 200 batteries.

Indonesia's renewable energy mix offers an alternative to conventional fossil fuels. Indonesia has made a significant commitment to the role of exploiting this new energy in accordance with the Paris Agreement. This paper proposes the design of a microgrid architecture for a solar and wind hybrid power plant with grid-connected configuration and micro-scale power plant modeling in Ciheras Village, Cipatujah District, Tasikmalaya Regency, West Java. This architecture is divided into three scenarios in order to determine the best design qualities. The first scenario involves 50% photovoltaic (PV) and 50% wind turbine (WT), the second 60% PV and 40% WT, and the third 70% PV and 30% WT. The findings of the grid-connected microgrid were compared using supporting software, HOMER Pro. The various scenarios yielded performance analysis and renewable energy contribution. Modeling, calculation, simulation, and analysis demonstrate that the first scenario's potential energy output produces 25,655 kWh/year with an 88.2% Renewable Fraction (RF). The second scenario generates 26,194 kWh of energy per year, with a renewable fraction of 87.8%. The third scenario is the best based on the participation and role of distributed energy (PV-WT), with a higher amount of energy output of 30,691 kWh/year and a higher renewable proportion of 89%.

Currently, the Electrical Engineering Laboratory (EEL) of Universitas Jenderal Achmad Yani has a 1 kWp photovoltaic (PV) system. However, in order to fulfill the overall load, the hybrid link to the grid must be improved. The PV system and the grid must be synchronized in terms of voltage, frequency, and phase. This article presents comparative simulations of AC-AC converter models of power electronics component variants using MATLAB 2019a. Among other stages is to model the DC-DC Converter in order to enhance the output voltage of the solar panel by identifying the circuit characteristics. The second stage involves simulating the MOSFET-based DC-AC Converter circuit, which is used to convert DC to AC. The use of switching Thyristor, Gate Turn-Off Thyristor (GTO), and Insulated Gate Bipolar Transistor (IGBT) in an AC-AC phase converter to connect to the grid is examined in this range. Non-linear and linear loads are used to represent the load on the AC Cycloconverter range. Based on the results of the modeling and analysis of the PV 1 kWp system, the AC Cycloconverter in the first stage may provide a frequency of 50 Hz with a voltage drop of 235.4 V for the line and 231.9 V for the non-linear, which meets the AC Cycloconverter criterion.

The photovoltaic system is used and utilized as electricity demand in many developed countries, including Indonesia. Nowadays, the photovoltaic system is an alternative source of inexpensive, reasonably priced electricity and easily applied in public facilities until laboratory usage. In Electrical Engineering Laboratory (EEL), Faculty of Engineering (FoE), Universitas Jenderal Achmad Yani is 1 kWp peak photovoltaic application available. The PV system is planned to be connected to the grid and produces 220VAC / 50Hz characteristics to meet the existing load capacity. The PV systems modeled include Pulse Width Modulation (PWM) controlled DC/DC Boost Converter, and DC/AC converter circuit. This study's experimental architecture is proposed to meet the electrical load following the characteristics of the photovoltaic device. The three types of electronic switching control, namely Metal Oxide Semiconductor Field Effect Transistor (MOSFET), Insulated Gate Bipolar Transistor (IGBT) and Gate Turn-off Thyristor (GTO), are used to achieve the highest performance. Based on the 1 kWp photovoltaic system's simulation results from the three types of electronic power switching, a minimum output voltage range of 210-230 VDC is produced. DC/AC Converter testing has been carried out and can be tested on a grid-connected 220VAC/50Hz single phase with the highest output using MOSFET equal to 96.7%.

Viral diseases caused by CTV and CVEV induce dwarfing on plants and severe damage and yield loss to the citrus crop. The virus transmitted through infected plant material and by the same vectors, aphid. Problems cited in the field are complex of symptoms of the two diseases that are difficult to distinguish. This study aimed to determine the effect of single and dual infections of CTV and CVEV on Purut (Citrus hystrix) and Lime (Citrus aurantifolia). The research was conducted at the screen house and laboratory of Balitjestro, Batu and University of Brawijaya in October 2014 to April 2015. CTV and CVEV isolates used were from Balitjestro’s collection. Treatments conducted were single inoculation for CTV and CVEV, 3 combinations of CTV and CVEV dual inoculation. Each treatment was carried out both on Purut and Lime. A total of 6 treatments and 5 replications were arranged in a Randomized Complete Design; each replication comprised of two plants. The results showed that the symptoms on Purut appeared faster and more severe than those on Lime. Both single and dual infections of CTV and CVEV affected the incubation period of CTV on vein clearing symptoms, cupping and vein enation. Symptom of vein clearing was found the fastest at dual infections treatment of CTV followed by CVEV. Cupping symptom was seen the fastest in the treatment of dual infections of CVEV followed by CTV, and symptom of vein enation was found only in a single infection of CVEV. The highest disease intensity and infection of vein clearing and cupping were observed on dual infections of CVEV followed by CTV while the highest infections of vein clearing and stem pitting were obtained from simultaneous dual infection of CTV and CVEV. The results of serologic testing by DAS ELISA on three observations (44 days after inoculation (dai), 86 dai, and 142 dai) showed that a dual-infection showed greater absorbance value than single infection treatment did. Plants growths on dual infections treatment were slower than those on single infection.

This study investigates the shading on PV systems. Shading has considerable influence on the solar cells characteristics, temperature and radiation on site need to be considered as the basis for designing PV systems. Modeling conducted on a 1 kWp PV system at a latitude of 6°53ˈ2.69̎S and a longitude of 107°32ˈ28.69̎, to find the magnitude of solar radiation, surface temperature, and tilt angle, and partial shadow simulation using PVsyst software. Testing result shows the characteristic PV 1 kWp is obtained with the angle of solar cell shade at 18˚, and azimuth 0˚, the shading per year generates 4.71 kWh/m2in a solar active area at 6.9m2, the power losses of 20.8% of its nominal power.

Objective: Despite suppression of HIV-1 replication in the periphery by antiretroviral therapy (ART), up to 10% of treated individuals have quantifiable HIV-1 in the CSF, termed CSF escape. CSF escape may be asymptomatic but has also been linked to progressive neurological disease, and may indicate persistence of HIV in the central nervous system (CNS). CSF escape has not yet been assessed after initiation of ART during acute HIV-1 infection (AHI)., Design: Prospective cohort study., Setting: Major voluntary counseling and testing site in Bangkok, Thailand., Participants: Participants identified and initiated on ART during AHI who received an optional study lumbar puncture at pre-ART baseline or after 24 or 96 weeks of ART., Main Outcome Measures: Paired levels of CSF and plasma HIV-1 RNA, with CSF greater than plasma HIV-1 RNA defined as CSF escape., Results: Two hundred and four participants had paired blood and CSF sampling in at least one visit at baseline, week 24, or week 96. Twenty-nine participants had CSF sampling at all three visits. CSF escape was detected in 1/90 at week 24 (CSF HIV-1 RNA 2.50 log10 copies/ml, plasma HIV-1 RNA <50 copies/ml), and 0/55 at week 96., Conclusion: Although levels of CSF HIV-1 RNA in untreated AHI are high, initiating treatment during AHI results in a very low rate of CSF escape in the first 2 years of treatment. Early treatment may improve control of HIV-1 within the CNS compared with treatment during chronic infection, which may have implications for long-term neurological outcomes and CNS HIV-1 persistence., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Background: There are limited data on immune restoration of young adults living with virologically suppressed human immunodeficiency virus (HIV). We investigated recovery rates of CD4/CD8 ratio among Thai children and adolescents after they initiated combination antiretroviral therapy (cART)., Methods: Children and adolescents who started cART at age of ≥ 5 years were eligible in this study if they achieved HIV RNA < 50 copies/mL and had a CD4/CD8 ratio < 0.8 at the time of virological suppression. Normalization of CD4/CD8 ratio was defined as 2 consecutive values ≥ 1. Using group-based trajectory analysis, low- and high-recovery groups were identified in terms of CD4/CD8 ratio recovery., Results: One hundred thirty-eight children and adolescents (101 perinatally infected and 37 behaviorally infected) with median age of 10.6 years at cART treatment initiation were included. After 559 person-years of follow-up (PYFU), overall incidence rate of CD4/CD8 ratio normalization was 4.1 (95% confidence interval, 2.7-6.2) per 100 PYFU. The probabilities of normalization at 2, 5, and 10 years after HIV suppression were 5.2%, 22.6%, and 35.6%, respectively. The low-recovery group had lower median pre-cART CD4 count (146 vs 304 cells/μL, P = .01), pre-cART CD4/CD8 ratio (0.15 vs 0.23, P = .03) and at first viral suppression (0.38 vs 0.65, P = .0001), compared to the high-recovery group., Conclusions: Less than half of children and adolescents living with HIV on cART with viral suppression had CD4/CD8 ratio normalization. Those with older age at cART initiation, lower pre-cART CD4 count, or CD4/CD8 ratio had slower ratio recovery. Long-term prognoses such as ongoing immune activation and clinical outcomes among children and adolescents on suppressive cART without CD4/CD8 ratio normalization need to be further investigated., (© The Author(s) 2020. Published by Oxford University Press on behalf of The Journal of the Pediatric Infectious Diseases Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Healthcare workers (HCW) treating COVID-19 patients are at high risk for infection and may also spread infection through their contact with vulnerable patients. Smell loss has been associated with SARS-CoV-2 infection, but it is unknown whether monitoring for smell loss can be used to identify asymptomatic infection among high risk individuals. In this study we sought to determine if tracking smell sensitivity and loss using an at-home assessment could identify SARS-CoV-2 infection in HCW., Methods and Findings: We performed a prospective cohort study tracking 473 HCW across three months to determine if smell loss could predict SARS-CoV-2 infection in this high-risk group. HCW subjects completed a longitudinal, behavioral at-home assessment of olfaction with household items, as well as detailed symptom surveys that included a parosmia screening questionnaire, and real-time quantitative polymerase chain reaction testing to identify SARS-CoV-2 infection. Our main measures were the prevalence of smell loss in SARS-CoV-2-positive HCW versus SARS-CoV-2-negative HCW, and timing of smell loss relative to SARS-CoV-2 test positivity. SARS-CoV-2 was identified in 17 (3.6%) of 473 HCW. HCW with SARS-CoV-2 infection were more likely to report smell loss than SARS-CoV-2-negative HCW on both the at-home assessment and the screening questionnaire (9/17, 53% vs 105/456, 23%, P < .01). 6/9 (67%) of SARS-CoV-2-positive HCW reporting smell loss reported smell loss prior to having a positive SARS-CoV-2 test, and smell loss was reported a median of two days before testing positive. Neurological symptoms were reported more frequently among SARS-CoV-2-positive HCW who reported smell loss compared to those without smell loss (9/9, 100% vs 3/8, 38%, P < .01)., Conclusions: In this prospective study of HCW, self-reported changes in smell using two different measures were predictive of SARS-CoV-2 infection. Smell loss frequently preceded a positive test and was associated with neurological symptoms., Competing Interests: The authors have declared that no competing interests exist.

Background: Cognitive and behavioral impairment are common in children living with perinatally acquired HIV (pHIV) and children exposed to HIV in utero but uninfected (HEU)., Methods: We sought to determine the prevalence of adverse behavioral symptomatology using a Thai-translated and validated version of the SNAP-IV questionnaire and assess cognitive function utilizing the Children's Color Trails Test, Delis-Kaplan Executive Function System, and the Wechsler Intelligence Scales, in our cohort of Thai adolescents (10-20 years old) with well-controlled pHIV compared to HEU and HIV-unexposed, uninfected youth. We then evaluated the interaction between HIV status, behavioral impairment, and executive function outcomes independent of demographic variables., Results: After controlling for demographic factors of age and household income, adolescents with pHIV had higher inattentive symptomatology and poorer neuropsychological test scores compared to uninfected controls. Significant interactions were found between inattention and executive function across multiple neurocognitive tests., Conclusions: Behavioral impairment and poor executive functioning are present in adolescents with well-controlled pHIV compared to HIV-uninfected matched peers. The SNAP-IV questionnaire may be a useful tool to identify those with attentional impairment who may benefit from further cognitive testing in resource-limited settings., Competing Interests: None., (© The Author(s) 2021.)

Introduction: Up to 30% of individuals treated with antiretroviral therapy (ART) during chronic HIV fail to recover CD4 counts to >500 cells/mm 3 despite plasma viral suppression. We investigated the frequency and associations of suboptimal CD4 recovery after ART started during acute HIV infection (AHI)., Methods: Participants who started ART in Fiebig I to V AHI with ≥48 weeks of continuous documented HIV-RNA < 50 copies/mL were stratified by CD4 count at latest study visit to suboptimal immune recovery (SIR; CD4 < 350 cells/mm 3 ), intermediate immune recovery (IIR; 350 ≤ CD4 < 500) and complete immune recovery (CIR; CD4 ≥ 500). Clinical and laboratory parameters were assessed at pre-ART baseline and latest study visit. Additional inflammatory and neurobehavioral endpoints were examined at baseline and 96 weeks., Results: Of 304 participants (96% male, median 26 years old) evaluated after median 144 (range 60 to 420) weeks of ART initiated at median 19 days (range 1 to 62) post-exposure, 3.6% (n = 11) had SIR and 14.5% (n = 44) had IIR. Pre-ART CD4 count in SIR compared to CIR participants was 265 versus 411 cells/mm 3 (p = 0.002). Individuals with SIR or IIR had a slower CD4 rate of recovery compared to those with CIR. Timing of ART initiation by Fiebig stage did not affect CD4 count during treatment. Following ART, the CD8 + T cell count (p = 0.001) and CD4/CD8 ratio (p = 0.047) were lower in SIR compared to CIR participants. Compared to the CIR group at week 96, the combined SIR and IIR groups had higher sCD14 (p = 0.008) and lower IL-6 (p = 0.04) in plasma, without differences in neuropsychological or psychiatric indices., Conclusions: Despite immediate and sustained treatment in AHI, suboptimal CD4 recovery occurs uncommonly and is associated with low pre-ART CD4 count as well as persistent low CD8 count and CD4/CD8 ratio during treatment., (© 2020 The Authors. Journal of the International AIDS Society published by John Wiley & Sons Ltd on behalf of International AIDS Society.)

Treatment of neurological, neurocognitive, and neuropsychiatric impairment in the setting of human immunodeficiency virus (HIV) infection remains a complex problem, given several possible mechanisms of pathogenesis. The etiology must be determined based on clinical judgment and objective evidence, including cerebrospinal fluid (CSF) data from lumbar puncture and neuroimaging information from magnetic resonance imaging, when available and indicated. Other neuroinfectious etiologies must be ruled out, including central nervous system (CNS) opportunistic infections. HIV replication in the CNS (including CSF escape) should be evaluated for and excluded. If CSF HIV is detected, we recommend a treatment switch to antiretrovirals (ARVs) targeted to address any CSF HIV resistance mutations identified, or empiric treatment intensification using ARVs with high CNS penetration. If CSF HIV is not detected, treatment intensification with CCR5 inhibitors may be considered as an adjunct to reduce neuroinflammation. Finally, the current ARV regimen must be examined for possible neurotoxicity. Efavirenz has been well-recognized for its neuropsychiatric adverse effects and potential for causing sleep disturbances. Similar concerns have recently been raised with integrase inhibitors, especially dolutegravir and raltegravir, although further studies are needed to determine the risks for clinically relevant neuropsychiatric side effects from these medications, given their overall high potency and proven success in treating systemic HIV., Competing Interests: Dr. Spudich reports grants from NIH, NIMH, and NINDS, during the conduct of the study; other from ViiV Healthcare, Inc, outside the submitted work., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

We report the case of an individual from Nigeria seeking asylum in the USA on the basis of persecution for being gay, who was physically and sexually assaulted in Nigeria and detained upon arrival to the USA. We present physical examination findings and the results of a brief mental health evaluation performed at Elizabeth Detention Center in New Jersey for his asylum evaluation. Individuals are able to seek asylum as members of a "particular social group", in this case, being gay. They seek asylum in the USA as they will continue to be at risk for harm if they stay in their home countries. However, the detention of asylum seekers often violates US human rights obligations and can occur without formal oversight. We explore the unique complications and experiences of lesbian, gay, bisexual, transgender and queer asylum seekers throughout the asylum process, from Nigeria to a detention centre in the USA., Competing Interests: Competing interests: KCM has the following conflict of interest: Relationships related to asylum work - KCM is a volunteer for Physicians for Human Rights and had been paid in the past for being a lead trainer in asylum training sessions. KCM volunteers for many nonprofit organizations such as American Friends Service Committee, Connecticut Institute for Immigrants and Refugees, Integrated Refugee and Immigrant Services, New Haven Legal Assistance Association and HealthRight International. When traveling to detention facilities, KCM is paid for her travel expenses. KCM was paid to speak at Stony Brook University Grand Rounds. Family financial interests (unrelated to asylum work): KCM’s family owns stock in Arvinas, Inc, a pharmaceutical company KCM’s husband founded that works on technologies to create cancer medications. KCM’s husband Craig Crews receives royalties from Amgen, a company that makes a cancer medication called Kyprolis that he helped create. KCM’s husband is paid to speak frequently at conferences about his work as a cancer biologist., (© BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Non-urgent healthcare problems are responsible for more than 9 million visits to the emergency department (ED) in US hospitals each year, largely due to patients' lack of access to a primary care physician. To avoid costly and unnecessary ED usage for non-urgent health problems, a walk-in clinic run by nurses (CHEER Clinic) was developed as an extension of the services provided by an existing free clinic in a low-income neighborhood of Providence, RI, with the goal of providing uninsured patients with a convenient, no-cost means of accessing healthcare. An evaluation and cost-effectiveness analysis of the clinic's first 5 months of operation were performed. During this pilot period, 256 patients were seen. When incorporating the quality-adjusted-life-year value of preventive services rendered, an estimated $1.28 million in future healthcare costs was avoided. Dividing these cost-savings by the clinic's operational cost yielded a mean return on investment of $34 per $1 invested. Adding nurse-run walk-in hours at a free clinic significantly expanded access to healthcare for uninsured patients and was cost-effective for both the clinic and the patient. Ultimately, replication of this model in community clinics serving the uninsured could reduce ED burden by treating a substantial number of non-urgent medical concerns at a lower cost than would be incurred for treatment of the same problems in EDs.