Barriers to ISO 9001 Implementation in Moroccan Organizations: Empirical Study

Purpose: The purpose of this paper is to explore obstacles to ISO 9001 quality management system implementation in Moroccan firms. Design/methodology/approach: A questionnaire survey has been conducted among a heterogeneous sample of 200 organizations, operating in different sectors in Morocco, yielding a response rate of 57.5%. The authors have studied barriers to quality initiatives in general and obstacles to QMS implementation in particular through an extensive literature review. Questions related to profiles of respondents, reasons of seeking certification, external consultancy and barriers to ISO 9001 implementation experienced by surveyed organizations. For the purpose of this study, authors considered three categories of quality inhibiting factors: organizational, technical and costs related barriers. Findings: Results indicate that surveyed companies sought ISO 9001 certification mainly for marketing reasons and experienced many difficulties during the implementation process. Barriers reported by respondents were mostly organizational. Resistance to change headed the list according to participants’ opinion. Also, findings highlighted the prominence of bureaucracy and poor interdependence between departments in organizations. Lack of communication, poor top management commitment and insufficient trainings were also ascertained to be obstacles to QMS implementation in Morocco. Originality/value: Earlier studies were led by different researchers in different countries about barriers to quality initiatives in general and to ISO 9001 implementation in particular. Few of those studies were conducted in Arab speaking countries but no research has been carried in Morocco. This study on obstacles to QMS implementation in Morocco will help in completing the jigsaw of difficulties faced by organizations worldwide when preparing to ISO 9001 certification. Research limitations/implications: This research is limited by the geographic context of the study Morocco, although results can be extrapolated to Arab speaking countries in general. Practical implications: The findings of this paper provide Moroccan managers with a practical understanding of the factors that are likely to obstruct ISO 9001 QMS implementation. Managers should overcome these barriers to achieve a successful implementation and higher QMS performance.Peer Reviewe

Gestion du risque de liquidité bancaire : Mise en place d’un programme de Stress Tests et quantification des besoins en fonds propres liés au risque de liquidité

Les établissements de crédits, étant acteurs majeurs de l’environnement économique et financier, sont des institutions qui demeurent exposés à plusieurs risques dont le risque de liquidité occupe une place centrale dans le dispositif de gestion globale des risques bancaires du fait que la gestion dudit risque permet d’assurer une certaine pérennité à l’activité bancaire en sa globalité. C’est dans ce cadre que ce travail explore les problématiques liées à la gestion du risque de liquidité bancaire en proposant un processus de mesure dudit risque et de quantification des besoins en fonds propres y-afférents. Dans cette optique, ce travail traite  d’une part,  la quantification de l’impact du risque de liquidité sur les fonds propres de la banque selon une approche dynamique reposant sur le suivi quotidien de la trésorerie, d’autre part, de compléter les résultats obtenus par l’application des scénarios de stress tests. En effet, ces deniers permettront de ressortir l’impact de ce risque sur la santé financière de la banque en cas de tensions de liquidité. Enfin, les résultats des deux approches constitueront le coussin de fonds propres à allouer pour une couverture exhaustive du risque de liquidité.    &nbsp

Les complications de l’ECMES dans le traitement des fractures des 2 os de l’avant-bras chez l’enfant (à propos de 87 cas)

Le but de notre étude est de décrire les complications de l'embrochage centromédullaire élastique stable (ECMES) dans le traitement des fractures diaphysaires des deux os de l'avant-bras chez l'enfant. Entre janvier 2009 et décembre 2013, 87 enfants présentant des fractures diaphysaires des os de l'avant-bras ont été traités par embrochage centro-médullaire élastique stable par des broches de Métaizeau. Il s'agissait de 76 garçons et 11 filles d'âge moyen 12 ans. L'embrochage a été réalisé d'emblée dans 50 cas et suite à un déplacement secondaire sous plâtre dans les autres. Les deux os ont été embrochés dans tous les cas. L'immobilisation plâtrée était systématique pour tous les malades pendant une durée moyenne d'un mois. Les broches ont été enlevées au bout d'environ 6 mois en moyenne. Les résultats fonctionnels ont été étudiés avec un recul moyen de 10 mois. Les complications ont été marquées par 14 infections superficielles, 2 cas d'ostéites sur matériel, 3 cas de refracture, 3 cas de pseudarthrose, 2 cas de retard de consolidation et une synostose radio-cubitale proximale. Bien que l'embrochage centro-médullaire soit une méthode d'ostéosynthèse idéalement adaptée aux enfants, il reste plus invasif que le traitement orthopédique. Ses indications doivent rester dans les limites de celui ci.Mots clés: Fracture, avant-bras, embrochage centromédullaire élastique stable, enfantEnglish Title: Elastic stable intramedullary nailing (ESIN) in the treatment of both-bone forearm fractures in the child: about 87 casesEnglish AbstractThis study aims to describe the complications of elastic stable intramedullary nailing (ESIN) in the treatment of both-bone forearm diaphyseal fractures in the child. Between January 2009 and December 2013, 87 children with both-bone forearm diaphyseal fractures were treated by elastic stable intramedullary nailing with Métaizeau nails. 76 boys and 11 girls, with an average age of 12 years, were enrolled in the study. Nailing was promptly performed in 50 cases and after secondary displacement during plaster-cast treatment in the other cases. Both bones were nailed in all cases. All patients underwent systematic plaster immobilization for a period of about one month. On average, nails were removed after about 6 months. Functional outcomes were studied over a mean follow-up period of 10 months. Complications were marked by 14 superficial infections (14 cases), osteitis associated with material (2 cases), refracture (3 cases), pseudarthrosis (3 cases), delayed fracture consolidation (2 cases) and proximal radioulnar synostosis (1 case). Although intramedullary nailing ideally is an osteosynthesis technique suitable for the treatment of fractures in children, it is more invasive than orthopaedic treatment.Indications for treatment should remain within well-established limits.Keywords: Fracture, forearm, elastic stable intramedullary nailing, chil

Meckel’s diverticulum causing intestinal obstruction in the newborn

The causes of neonatal bowel obstruction are variable and dominated by malformations and the Meckel diverticulum must remain exceptional. We report a case of neonatal bowel obstruction in a six day old male neonate admitted on account of inability to pass stool, abdominal distension and bilious vomiting. The radiologic additional examinations are non-specific. Exploratory laparotomy found obstruction at the site of a Meckel's diverticulum

Aspect Clinique Atypique De La Tuberculose Oculaire A Propos D'un Cas

Introduction: The ophthalmological manifestation of tuberculosis varies significantly, and almost all the elements of the globe and orbit can be reached. Methods and Results: The aim of this work was to report a clinical aspect of ocular tuberculosis in a young woman who has a notion of tuberculous contagion and who was presented at the fundus of a macular papillary membrane with a tubercle of Bouchut or papillary tubercle. The diagnosis was retained on a bundle of clinical, biological, and radiological arguments. The evolution under treatment was favorable with an improvement of its visual acuity. Conclusion: It is necessary to know how to evoke the tuberculous etiology in view of all ocular inflammation, even atypical. This is required considering the great polymorphism of its clinical characteristics

Effect of creatine supplementation on kidney stones recurrence in an athlete: a case report

INTRODUCTION Several studies examined the effects of creatine monohydrate supplementation on renal function, but no previous study has investigated its effects on kidney stones in humans. OBSERVATION A renal ultrasound in a healthy young athlete (without a known renal morphological anomaly, normal kidney function, normal phospholipid and uric acid data) revealed a kidney stone of 11 mm in the lower right calyx. Extracorporeal shock wave lithotripsy was applied in order to break the down stone. Twentyone days later, a follow-up renal ultrasound showed the absence of stones in the kidney. One week later, the athlete started creatine monohydrate supplementation for two months. Fourteen months after stopping creatine monohydrate supplementation, a third renal ultrasound confirmed the absence of stones in the kidney. CONCLUSION Two months of creatine monohydrate supplementation in an athlete with a history of kidney stones could not be associated with kidney stone recurrence in the long run

Association of Ramadan Participation with Psychological Parameters: A Cross-Sectional Study during the COVID-19 Pandemic in Iran

COVID-19 restrictions are associated with poor physical-activity (PA). Less is known about the relationship between the combination of these restrictions with Ramadan intermittent fasting (RIF), PA, mental health, and sleep-quality. The present study aimed to evaluate whether COVID-19 restrictions and RIF during the fourth wave of the COVID-19 pandemic in Iran are associated with poor PA, anxiety, well-being, and sleep-quality outcomes. A total of 510 individuals participated in an online questionnaire that was disseminated to adults (≥18 years) residing in Iran from 13 May 2021 to 16 May 2021 (~3 days), just after the end of Ramadan 2021. PA behavior (Godin-Shephard Leisure-Time Exercise Questionnaire), anxiety (General Anxiety Disorder-7), well-being (Mental Health Continuum-Short Form), and sleep-quality (Pittsburgh Sleep Quality Index). Of 510 individuals included in the study (331 female (64.9%); mean ± SD, 31 ± 12 years), 172 (33.7%) reported less PA during the Ramadan 2021. PA was associated with better well-being and sleep-quality outcomes. Regardless of PA, participants who fasted for all of Ramadan had less anxiety and better well-being outcomes than those who fasted part of Ramadan or did not fast at all. However, the fasting part of Ramadan decreased the sleep-quality of active participants. The Ramadan 2021 was associated with poor PA, well-being, and sleep-quality of Iranians. However, PA was associated with better well-being and sleep-quality outcomes, and those who fasted all Ramadan had better anxiety and well-being outcomes. Therefore, PA during Ramadan might be an essential and scalable mental health resilience builder during COVID-19 restrictions which should be encouraged. Keywords: SARS-CoV-2; exercise training; feasting; holy month; lockdown; mental health; sleep-quality

Dynamic semiempirical PEMFC model for prognostics and fault diagnosis

This article introduces a dynamic semiempirical model that predicts the degradation of a proton exchange membrane fuel cell (PEMFC) by introducing time-based terms in the model. The concentration voltage drop is calculated using a new statistical equation based on the load current and working time, whereas the ohmic and activation voltage drops are updated using time-based equations borrowed from the existing literature. Furthermore, the developed model calculates the membrane water content in the PEMFC, which indicates the membrane hydration state and indirectly diagnoses the flooding and drying faults. Moreover, the model parameters are optimized using a recently developed butterfly optimization algorithm. The model is simple and has a short runtime; therefore, it is suitable for monitoring. Voltage degradation under various loading currents was observed for long working hours. The obtained results indicate a significant degradation in PEMFC performance. Therefore, the proposed model is also useful for prognostics and fault diagnosis

Assessment of the competence in electrocardiographic interpretation among Arabic resident doctors at the emergency medicine and internal medicine departments: A multi-center online cross-sectional study

BackgroundThis study aims to assess the electrocardiographic interpretation abilities of resident doctors at internal medicine and emergency medicine departments in eight Arabic countries.MethodsAn online cross-sectional study was conducted between October 7, 2022 and October 21, 2022 in eight Arabic countries. The questionnaire consisted of two main sections: the first section included sociodemographic information, while the second section contained 12 clinical case questions of the most severe cardiac abnormalities with their electrocardiography (ECG) recordings.ResultsOut of 2,509 responses, 630 were eligible for the data analysis. More than half of the participants were males (52.4%). Internal medicine residents were (n = 530, 84.1%), whereas emergency medicine residents were (n = 100, 15.9%). Almost participants were in their first or second years of residency (79.8%). Only 36.2% of the inquired resident doctors had attended an ECG course. Most participants, 85.6%, recognized the ECG wave order correctly, and 50.5% of the participants scored above 7.5/10 on the ECG interpretation scale. The proportions of participants who were properly diagnosed with atrial fibrillation, third-degree heart block, and atrial tachycardia were 71.1, 76.7, and 56.6%, respectively. No statistically significant difference was defined between the internal and emergency medicine residents regarding their knowledge of ECG interpretation (p value = 0.42). However, there was a significant correlation between ECG interpretation and medical residency year (p value < 0.001); the fourth-year resident doctors had the highest scores (mean = 9.24, SD = 1.6). As well, participants in the third and second years of postgraduate medical residency have a probability of adequate knowledge of ECG interpretation more than participants in the first year of residency (OR = 2.1, p value = 0.001) and (OR = 1.88, p value = 0.002), respectively.ConclusionAccording to our research findings, resident doctors in departments of internal medicine and emergency medicine in Arabic nations have adequate ECG interpretation abilities; nevertheless, additional development is required to avoid misconceptions about critical cardiac conditions

RNF8 ubiquitylation of XRN2 facilitates R-loop resolution and restrains genomic instability in BRCA1 mutant cells

Breast cancer linked with BRCA1/2 mutations commonly recur and resist current therapies, including PARP inhibitors. Given the lack of effective targeted therapies for BRCA1-mutant cancers, we sought to identify novel targets to selectively kill these cancers. Here, we report that loss of RNF8 significantly protects Brca1-mutant mice against mammary tumorigenesis. RNF8 deficiency in human BRCA1-mutant breast cancer cells was found to promote R-loop accumulation and replication fork instability, leading to increased DNA damage, senescence, and synthetic lethality. Mechanistically, RNF8 interacts with XRN2, which is crucial for transcription termination and R-loop resolution. We report that RNF8 ubiquitylates XRN2 to facilitate its recruitment to R-loop-prone genomic loci and that RNF8 deficiency in BRCA1-mutant breast cancer cells decreases XRN2 occupancy at R-loop-prone sites, thereby promoting R-loop accumulation, transcription-replication collisions, excessive genomic instability, and cancer cell death. Collectively, our work identifies a synthetic lethal interaction between RNF8 and BRCA1, which is mediated by a pathological accumulation of R-loops