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Abstract: This work is performed to investigate the effect of using different types of sun tracking mechanisms on the flat plate photovoltaic system performances and the main parameters affecting the amount of their output electrical energy as well as those affecting their gains compared to the traditional fixed photovoltaic systems. The evaluation of different systems has been performed on the basis of hourly measured data over a complete one year obtained from Bouzareah location (Mediterranean coastal site). Considering all sky states, the monthly and yearly produced electrical energy by each one of the considered systems as well as the electrical gain of the photovoltaic panel mounted on different sun tracker systems were evaluated. From these latter, it appears that the highest gains obtained are those related to the two axes sun tracker system, which decrease gradually, from the inclined to the vertical rotating axis if the same optimum slope scheme is considered and from seasonal to the yearly optimum slope if the same rotating axis scheme is considered. So, from the obtained results, appears that if also, all sky states conditions were considered, compared to the single axis sun tracking systems, the gain obtained by the two-axis sun tracking system is relatively low and don’t exceed three percent for some cases. On the other hand, is also observed that the quantity of electrical energy produced by the different systems follows a seasonal variation and mainly related to the sun tracker mechanism under consideration, the choice of the panel slope, the availability amount of solar irradiation amount mainly the normal direct component, the day length and from the seasonal variation of the weather conditions. [Copyright &y& Elsevier]

Objectives To identify barriers and enablers that impact access to early screening, detection, and diagnosis of breast cancer both globally and more specifically in the Middle East and North Africa (MENA) region (with a specific focus on Egypt, Jordan, Oman, Saudi Arabia, United Arab Emirates [UAE], and Kuwait) with a specific focus on the health system. Study design A systematic review of literature. Methods We conducted a systematic reviewing using the PRISMA methodology. We searched PubMed, Global Index Medicus, and EMBASE for studies on ‘breast cancer’, ‘breast neoplasm,’ or ‘screening, early detection, and early diagnosis’ as well as key words related to the following barriers: religion, culture, health literacy, lack of knowledge/awareness/understanding, attitudes, fatalism/fear, shame/embarrassment, and physician gender from January 1, 2000 until September 1, 2016. Two independent reviewers screened both titles and abstracts. The application of inclusion and exclusion criteria yielded a final list of articles. A conceptual framework was used to guide the thematic analysis and examine health system barriers and enablers to breast cancer screening at the broader macro health system level, at the health provider level, and the individual level. The analysis was conducted globally and in the MENA region. Results A total of 11,936 references were identified through the initial search strategy, of which 55 were included in the final thematic analysis. The results found the following barriers and enablers to access to breast cancer screening at the health system level, the health provider level, and the individual level: health system structures such as health insurance and care coordination systems, costs, time concerns, provider characteristics including gender of the provider, quality of care issues, medical concerns, and fear. In addition, the following seven barriers and enablers were identified at the health system or provider level as significantly impacting screening for breast cancer: (1) access to insurance, (2) physician recommendation, (3) physician gender, (4) provider characteristics, (5) having a regular provider, (6) fear of the system or procedure, and (7) knowledge of the health system. More specifically, the largest increased odds for having a mammogram was from having insurance, having a physician recommendation, type of provider (mainly gynecologist), and having regular contact with a physician. Clinical breast examinations were increased by having insurance and having regular contact with a physician. The eight studies identified from the MENA region identified barriers to breast cancer screening related to service quality, fear of pain and of cancer itself, female versus male provider, having a physician recommend the screen, cost issues as well as time and convenience of the services. Conclusions There are a number of system changes that can be made to remove barriers to breast cancer screening. Some of these system changes apply directly to MENA countries. A larger health system assessment of a country is warranted to determine which health system changes should be made to most efficiently and effectively improve access to breast cancer screening. [ABSTRACT FROM AUTHOR]