L’innovation inverse : vers un nouveau modèle d’innovation globale pour les entreprises

RÉSUMÉ : Les grandes entreprises occidentales ne peuvent plus se limiter à leurs marchés historiques (les États-Unis, le Canada ou encore l’Europe de l’Ouest). Ces derniers, affectés par les récentes crises économiques et le manque de croissance, sont aujourd’hui saturés et ne présentent donc plus un potentiel de développement suffisant. À l’inverse, d’autres marchés sont en plein essor. Les pays émergents tels que le Brésil, la Chine ou l’Inde voient leurs classes moyennes se développer considérablement, créant ainsi de nouveaux marchés très attractifs. Conscientes de ces enjeux, un grand nombre d’entreprises occidentales se sont alors mises à innover pour ces nouveaux marchés. Les fortes contraintes locales, à savoir le besoin de produits non dispendieux répondant à des critères d’autonomie ou de durabilité élevés, et ce, sans compromis en termes de qualité, ont stimulé l’innovation. Les entreprises occidentales ont alors développé des solutions tout à fait originales et de grande valeur pour ces marchés émergents. Réalisant que les axes de valeur de ces nouveaux produits pourraient également permettre de créer des marchés ou de répondre à de nouveaux besoins dans les économies développées, ces multinationales se sont alors mises à faire de l’innovation inverse. Une innovation est dite inverse si elle est d’abord adoptée dans une économie émergente avant d’être ensuite ramenée et commercialisée dans une économie développée. L’innovation inverse étant un phénomène récent, la thèse de doctorat contribue à la compréhension et au positionnement théorique de ce nouveau modèle d’innovation. Sur le plan pratique, ce travail s’efforce d’identifier les facteurs clés du succès d’une telle stratégie. L’accent est mis sur les multinationales occidentales et plus spécifiquement sur le secteur de la santé. Une revue systématique de la littérature sur l’innovation inverse permet initialement de faire l’état de l’art et d’identifier les axes de recherche les plus pertinents pour améliorer la connaissance globale de ce nouveau phénomène (article 1). Trois des pistes de recherches établies par cette étude sont ensuite adressées dans la thèse (articles 2, 3 et 4). Une analyse quantitative et de contenu permet tout d’abord de valider que les entreprises du secteur de la santé pratiquent l’innovation inverse ainsi que l’impact de ce phénomène en termes de transferts technologiques (article 2). Une étude de cas permet ensuite d’identifier les challenges rencontrés par les entreprises qui pratiquent l’innovation inverse. Plusieurs mitigateurs de risques permettant de surmonter ou de prévenir ces challenges sont proposés (article 3). Finalement, un tout premier cadre théorique de l’innovation inverse est construit. Il permet le repositionnement du concept selon la perspective réseau de la multinationale et ouvre ainsi la voie à de nouvelles études empiriques (article 4). Pour élargir le débat, une discussion générale résume les principaux travaux de la thèse et ouvre la discussion sur le lien entre innovation inverse, innovation sociale et créativité. Une conclusion identifie finalement les principales contributions ainsi que les limites de la thèse et donne quelques recommandations pour les futures recherches dans ce domaine.----------ABSTRACT : Western multinationals can no longer limit themselves to their historic markets (the United States, Canada or Western Europe). Indeed, these markets, affected by the recent economic crises and lack of growth, are today saturated and therefore no longer have sufficient development potential. Conversely, other markets are booming. The middle class of several emerging economies such as Brazil, China, and India are growing considerably, creating very attractive new markets. Aware of these issues, a large number of Western companies have then begun to innovate for these new markets. Strong local constraints, i.e. the need for low-priced products meeting high standards of autonomy or sustainability without compromising quality, have stimulated innovation. This has led western companies to develop very original and valuable solutions for these emerging markets. By realizing that the added value of these new products could also create markets or meet new demands in developed economies these multinationals started to do reverse innovation. An innovation is called reverse if it is first adopted in an emerging economy before being trickled up in a developed economy. Since reverse innovation is a recent phenomenon, the doctoral thesis contributes to the theoretical understanding and positioning of this new innovation model. In practical terms, this work aims at identifying the key factors for successful of such a strategy. The focus is on western multinationals and more specifically on the health sector. A systematic review of the literature on reverse innovation initially provides a state of the art and identifies the most relevant research focus to improve the overall knowledge of this new phenomenon (Article 1). Three of the research axis established by this study are then addressed in the thesis (Articles 2, 3 and 4). A quantitative and content analysis first allows verifying the practice of reverse innovation in the health sector industry and its impact in terms of technology transfer (Article 2). Then, using a case study, the challenges encountered by firms that practice reverse innovation are identified and risk mitigators are proposed (Article 3). At last, a very first theoretical framework of reverse innovation is built. It allows the repositioning of the concept according to the network perspective of the multinational and opens the way to new empirical studies (Article 4). In order to broaden the debate, a general discussion summarizes the main results of the thesis and opens the discussion on the link between reverse innovation, social innovation and creativity. A conclusion finally identifies the main contributions and limitations of the thesis and gives some recommendations for future research in this field

Impact of Treatment with Human Immunodeficiency Virus (HIV) Protease Inhibitors on Hepatitis C Viremia in Patients Coinfected with HIV

The impact of human immunodeficiency virus (HIV) protease inhibitors on hepatitis C (HCV) viremia was assessed in 19 patients infected with both HIV and HCV. HIV and HCV RNA levels were measured before and during treatment with protease inhibitors. before treatment, mean levels of HCV RNA were 5.3 log for HCV RNA and 5.0 log for HIV RNA. CD4 lymphocyte counts were 63/mm3. after 6 weeks of treatment, a mean reduction of 2.1 log10 in HIV RNA (P < .001) and a mean (±SE) increase of 73 (±21) CD4 and 296 (±70) CD8 cells were observed (P < .05). In contrast, both HCV viremia (+0.4 log ± 0.1) and alanine aminotransferase increased (P < .04). HCV RNA levels returned to baseline after 17 and 32 weeks of treatment. Thus, potent anti-HIV regimens with protease inhibitors may temporarily worsen HCV status despite improvement of HIV parameter

Anticoagulant therapy for nodular regenerative hyperplasia in a HIV-infected patient

<p>Abstract</p> <p>Background</p> <p>Nodular regenerative hyperplasia (NRH) has been recently recognized as an emergent cause of liver disease in HIV-infected patients. NRH may cause non-cirrhotic portal hypertension with potentially severe consequences such as refractory ascites, variceal bleeding and hypersplenism. Obliteration of the small intrahepatic portal veins in association with prothrombotic disorders linked to HIV infection itself or anti-retroviral therapy seem to be the causes of NRH and thus the term HIV-associated obliterative portopathy has been proposed.</p> <p>Case Presentation</p> <p>Here we describe a case of a HIV-infected patient with biopsy-proven NRH and listed for liver transplantation (LT) because of refractory ascites and repeated upper gastrointestinal bleedings. A transjugular intrahepatic portosystemic shunt was placed as a bridge to LT and did not improve liver function. However, anticoagulant therapy with low-molecular-weight heparin (LMWH) was associated with rapid improvement in the liver condition and allowed to avoid LT in this patient.</p> <p>Conclusions</p> <p>Thus, this case underscores the relation between thrombophilia and HIV-associated NRH and emphasizes anticoagulant therapy as possible treatment.</p

Performance and dynamics of active greywater heat recovery in buildings

In the effort to de-carbonize the building stock, heat pumps are increasingly utilized in Switzerland, with 70% of the fast-growing heat pump market using ambient air as heat source. Inexpensive and easy to implement, these heat pumps are, however, less efficient than their ground- or water-source counterparts. In this modeling study, we aim at increasing the efficiency of air-source heat pumps using domestic greywater-contained heat. We assess the performance improvement relative to standard heat pump configurations across various climates, seasons, building envelopes, and domestic hot water consumption patterns. The results show that the annually-averaged coefficient of performance improves by 4.1% on average – ranging from 0.6% to 7.5%. This efficiency gain translates on average to 1.8 kWh/week of compressor electricity savings. Although attractive due to its simplicity, the proposed open-loop configuration – preheating of an external heat source – only leads to moderate performance improvement of air-source heat pumps. Based on these results, we extensively discuss and compare alternative system configurations and identify several fundamental differences in the heat recovery dynamics of each configuration. We show that closed-loop systems – using greywater as direct heat source – show the largest performance improvement potential, although being more expensive and complex to implement