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

Influence des constituants du cognac sur la cancérogenèse colique chimiquement induite chez le rat

Selon de nombreuses données épidémiologiques et expérimentales, les aliments d'origine végétale tels que les fruits et légumes et dans une moindre mesure le thé et le vin rouge pourraient intervenir dans la prévention du cancer colo-rectal. Ces aliments étant riches en substances polyphénoliques, il est légitime de chercher à préciser l'action des polyphénols dans cette prévention. Après un rappel bibliographique sur le cancer col-rectal et le rôle de l'alimentation, de l'alcool et des polyphénols, l'auteur décrit une étude expérimentale réalisée en vue d'évaluer les effets des constituants du cognac, un spiritueux riche en polyphénols issus des fûts de chêne. Pour cela, des boissons à base de différents constituants du cognac (éthanol 6% et/ou polyphénols 1g/l), ainsi que du vin rouge et de l'acide ellagique, ont été administrés à des rats au cours d'un protocole de cancérogenèse colique induite à la dyméthylhydrazine. Les dommages à l'ADN extrait du foie et du côlon ont été évalués au moyen du test 3D (DNA Damage Detection) avant et après l'induction, et à la fin du protocole de 13 semaines. Les foyers de cryptes aberrantes ont été dénombrés à la fin du protocole. Aucun effet significatif n'a pu être mis en évidence sur ces marqueurs de la cancérogenèse colique

Spontaneous Resolution of Brain Edema in Fulminant Hepatic Failure due to Hepatitis E

Fulminant hepatic failure is characterized by the presence of hepatic encephalopathy in the setting of acute liver injury that occurs in a noncirrhotic organ. Brain edema is the ultimate complication of advanced hepatic encephalopathy as it often leads to cerebral herniation and death. Thus, the presence of fulminant hepatic failure indicates the need for urgent liver transplantation to prevent death or irreversible brain damage. We report a very unusual evolution of fulminant hepatic failure complicated by brain edema and hepatic coma in a 45-year-old woman admitted with acute viral hepatitis E infection

A novel hepatitis C virus (HCV) subtype from Somalia and its classification into HCV clade 3.

Hepatitis C virus (HCV) sequences from throughout the world have been grouped into six clades, based on recently proposed criteria. Here, the partial sequences and clade assignment are reported for three HCV isolates from chronic hepatitis C patients from Somalia, for whom conventional assays failed to identify the genotype. Phylogenetic analysis of the sequences of the core, envelope 1 and part of the non- structural 5b regions suggests that all three isolates belong to a distinct HCV genetic group, tentatively classified as subtype 3h. This novel HCV subtype shows the highest sequence similarity with HCV isolates from Indonesia. Despite the fact that these patients were infected with HCV clade 3, none of them responded to standard interferon treatment

The alcohol use disorders identification test (AUDIT): validation of a Nepali version for the detection of alcohol use disorders and hazardous drinking in medical settings

BACKGROUND: Alcohol problems are a major health issue in Nepal and remain under diagnosed. Increase in consumption are due to many factors, including advertising, pricing and availability, but accurate information is lacking on the prevalence of current alcohol use disorders. The AUDIT (Alcohol Use Disorder Identification Test) questionnaire developed by WHO identifies individuals along the full spectrum of alcohol misuse and hence provides an opportunity for early intervention in non-specialty settings. This study aims to validate a Nepali version of AUDIT among patients attending a university hospital and assess the prevalence of alcohol use disorders along the full spectrum of alcohol misuse. METHODS: This cross-sectional study was conducted in patients attending the medicine out-patient department of a university hospital. DSM-IV diagnostic categories (alcohol abuse and alcohol dependence) were used as the gold standard to calculate the diagnostic parameters of the AUDIT. Hazardous drinking was defined as self reported consumption of ≥21 standard drink units per week for males and ≥14 standard drink units per week for females. RESULTS: A total of 1068 individuals successfully completed the study. According to DSM-IV, drinkers were classified as follows: No alcohol problem (n=562; 59.5%), alcohol abusers (n= 78; 8.3%) and alcohol dependent (n=304; 32.2%). The prevalence of hazardous drinker was 67.1%. The Nepali version of AUDIT is a reliable and valid screening tool to identify individuals with alcohol use disorders in the Nepalese population. AUDIT showed a good capacity to discriminate dependent patients (with AUDIT ≥11 for both the gender) and hazardous drinkers (with AUDIT ≥5 for males and ≥4 for females). For alcohol dependence/abuse the cut off values was ≥9 for both males and females. CONCLUSION: The AUDIT questionnaire is a good screening instrument for detecting alcohol use disorders in patients attending a university hospital. This study also reveals a very high prevalence of alcohol use disorders in Nepal

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