Leishmaniose Cutanées À Ain Dfali, Aspects Épidémio-Cliniques Comparatifs De 132 Cas

Since the end of the 19th century, cutaneous leishmaniasis (CL) has been regarded as a public health problem in our country, Morocco. The aim of this study is to describe the clinical and epidemiological profile and posttherapeutic evolution of patients with cutaneous leishmaniasis in the Ain Dfali’s health center. We carried out a study based on the use of records and the observation of patients with cutaneous leishmaniasis between January 2006 and December 2015. Also, we collected 132 cases of cutaneous leishmaniasis. The mean age of patients was 19.8 years with extremes from 6 months to 61 years. The sex ratio was 0.76 M / F. The mean duration of lesions was 1.6 months with extremes of 2 weeks to 10 months. Fall preponderance was noted (41.6%). The most frequent clinical appearance was that of a single ulcero-pulmonary nodule (61%) (71.9%) and was seated on the face (57.5%). The diagnosis was mentioned clinically and confirmed by direct parasitological examination. Glucantime® was the treatment of choice that was used intralesionally. The post-therapeutic evolution was favourable with almost a complete disappearance of lesions. This took place in a period varying from 3 to 8 weeks at the price of unsightly scars in 19 patients. Cutaneous leishmaniasis continues to pose a real public health problem in our country. The emergence of severe and resistant forms throughout the world should encourage the multiplication and strengthening of prophylactic measures

Profil Epidemiologique De La Leishmaniose Cutanee Dans La Region Du Gharb- Maroc De 2006 À 2014

Between 2006 and 2014, 439 cases of cutaneous leishmaniasis were recorded in the region of Gharb Chrarda Beni Hssen in the north-west of Morocco. With an annual incidence of 49.1 cases per year and a sex-ratio (M / F) of 0.71. The disease has affected all age groups. The most stricken population is children and young people between the ages of 6 months and 30 years with more than 60.26 % of cases. Therefore, Cutaneous leishmaniasis almost hits the rural and urban areas but with an uneven impact. It is higher in rural areas where they are registered with a percentage of 56.7% of cases in contrast to a percentage of 43.3% in urban areas

A ESFERA DE TOMADA DE DECISÃO EM SITUAÇÕES DE CRISE: A RELAÇÃO ENTRE GESTÃO E ESPECIALISTA (O PARÂMETRO CONFIANÇA)

The health crisis, like any other crisis, is an unexpected event that has triggered a series of dysfunctions. Its emergence and spread did not allow states enough time to prepare to deal with the fallout from this crisis. The COVID phenomenon exposed the reality of the decision-making process within institutions. It revealed the dysfunction in the crisis management process, which aimed to make decisions capable of protecting states and reducing the overall impact of the crisis. However, we cannot ignore the complexity of the decision-making process, which derives its complexity from several factors such as the quality of available information, the diversity of conceivable options, and uncertainty. In a crisis situation, the decision-making process becomes increasingly complex because the factor of "time" is limited or even nonexistent. This makes the ability to make decisions delicate in the face of challenges, and the existence of a probability of failure that was hardly tolerable during a health crisis. Aware of this complexity, institutions have established an entity that we can describe as the decision-making sphere, composed of management and experts. Management provides a global vision and a strategic perspective, considering all aspects related to the organization, such as reputation, financial aspects, and operational aspects. Meanwhile, experts provide information based on their experience and expertise. Their input is crucial in a crisis situation, as experts, thanks to their expertise, have the ability to provide well-founded recommendations that management can benefit from in making informed decisions. These two components cannot operate separately and must be capable of collaborating and cooperating, showing flexibility and adaptability to achieve the desired outcome: surviving the crisis. The purpose of this article is to explore the components of the decision-making sphere in times of crisis and to demonstrate the relationship that must be formed between management and experts in a crisis situation.A crise sanitária, como qualquer outra crise, é um evento inesperado que trouxe à tona uma série de disfunções. Sua ocorrência e disseminação não deram tempo suficiente aos Estados para se prepararem para lidar com as consequências dessa crise. O fenômeno da COVID-19 revelou a realidade do processo de tomada de decisão das instituições. Foi um revelador das disfunções relacionadas ao processo de gestão de crises, que tinha como objetivo tomar decisões capazes de proteger os Estados e reduzir as consequências da crise como um todo. No entanto, não podemos ignorar a complexidade do processo de tomada de decisão, que é complexo devido a vários fatores, como a qualidade das informações disponíveis, a diversidade das opções possíveis e a incerteza. Em situações de crise, o processo de tomada de decisão se torna ainda mais complexo, pois o fator "tempo" é restrito, senão inexistente. Isso torna a capacidade de tomar decisões delicadas diante dos desafios e a existência de uma probabilidade de falha que não era tolerável durante uma crise sanitária. Conscientes dessa complexidade, as instituições criaram uma entidade que podemos descrever como a esfera de tomada de decisão, composta pela gestão e pelo especialista. A gestão fornece uma visão geral e uma perspectiva estratégica, levando em consideração todos os aspectos relacionados à organização, como reputação, aspectos financeiros e operacionais. Enquanto o especialista fornece informações com base em sua experiência e conhecimento especializado. Suas opiniões são, portanto, essenciais em situações de crise, e graças à sua experiência, os especialistas têm a capacidade de fornecer recomendações embasadas que a gestão pode utilizar para tomar decisões informadas. Esses dois componentes não podem operar separadamente e devem ser capazes de colaborar e cooperar, demonstrando flexibilidade e adaptabilidade para alcançar o resultado desejado: sobreviver à crise. O objetivo deste artigo é explorar os componentes da esfera de tomada de decisão em tempos de crise e demonstrar a relação que deve ser estabelecida entre a gestão e o especialista em situações de crise.La crise sanitaire comme tout autre crise est un événement inattendu qui a éveillé une série de dysfonctionnent, son apparition et sa propagation n'a pas laisser de temps aux etats de se préparer pour faire face au retombé de cette crise. Le phénomène du covid a dénudé la réalité sur le processus décisionnelle des institutions. C'était le révélateur du disfonctionnement lié au processus de gestion de crise, qui avait pour objectif de prendre les décisions capables de protéger les etats et de diminuer les retombées de la crise en sa globalité. Néanmoins nous ne pouvons pas ignorée la complexité liée au processus de prise de décision qui tire sa complexité de plusieurs facteurs tels que : la qualité de l'information disponible, la diversité des options envisageable et l'incertitude. En situation de crise le processus de prise de décision devin de plus en plus complexe car le facteur « temps » est restreint voir inexistent. Ce qui rend la capacité de prendre les décisions délicates face aux enjeux et l'exitance d'une probabilité d'échec qui n'était guère tolérable en période de crise sanitaire. Conscient de cette complexité les institutions ont constitué une entité que nous pouvons décrire comme étant la sphère décisionnelle, composée du management et de l'expert. Le management apporte une vision globale et perspective stratégique en prenant en considération tous les aspects liés à l'organisation tel que la réputation, l'aspect financier et l'aspect opérationnelle. Tandis que l'expert fournis des information basés sur son expérience et son expertise. Leur avis est donc primordial en situation de crise, qui grâce à leur expertise, les experts sont dotés de la capacité de fournir des recommandations fondées dont le management pourra bénéficier pour élaborer des décisions informées. Ces deux composantes ne peuvent pas opérer séparément et doivent être en capacité de collaborer et coopérer et faire preuves de flexibilité et d'adaptabilité afin d'aboutir à la finalité escomptée : survivre face à la crise. l'intérêt de cette article  est d'explorer les composantes de la sphère décisionnelle en période de crise et de démontrer la relation qui doit se former entre le management et l'expert en situation de crise.A crise sanitária, como qualquer outra crise, é um evento inesperado que trouxe à tona uma série de disfunções. Sua ocorrência e disseminação não deram tempo suficiente aos Estados para se prepararem para lidar com as consequências dessa crise. O fenômeno da COVID-19 revelou a realidade do processo de tomada de decisão das instituições. Foi um revelador das disfunções relacionadas ao processo de gestão de crises, que tinha como objetivo tomar decisões capazes de proteger os Estados e reduzir as consequências da crise como um todo. No entanto, não podemos ignorar a complexidade do processo de tomada de decisão, que é complexo devido a vários fatores, como a qualidade das informações disponíveis, a diversidade das opções possíveis e a incerteza. Em situações de crise, o processo de tomada de decisão se torna ainda mais complexo, pois o fator "tempo" é restrito, senão inexistente. Isso torna a capacidade de tomar decisões delicadas diante dos desafios e a existência de uma probabilidade de falha que não era tolerável durante uma crise sanitária. Conscientes dessa complexidade, as instituições criaram uma entidade que podemos descrever como a esfera de tomada de decisão, composta pela gestão e pelo especialista. A gestão fornece uma visão geral e uma perspectiva estratégica, levando em consideração todos os aspectos relacionados à organização, como reputação, aspectos financeiros e operacionais. Enquanto o especialista fornece informações com base em sua experiência e conhecimento especializado. Suas opiniões são, portanto, essenciais em situações de crise, e graças à sua experiência, os especialistas têm a capacidade de fornecer recomendações embasadas que a gestão pode utilizar para tomar decisões informadas. Esses dois componentes não podem operar separadamente e devem ser capazes de colaborar e cooperar, demonstrando flexibilidade e adaptabilidade para alcançar o resultado desejado: sobreviver à crise. O objetivo deste artigo é explorar os componentes da esfera de tomada de decisão em tempos de crise e demonstrar a relação que deve ser estabelecida entre a gestão e o especialista em situações de crise

A NOVA CONFIGURAÇÃO DA TRANSFORMAÇÃO DIGITAL DENTRO DAS ADMINISTRAÇÕES PÚBLICAS MARROQUINAS NA ERA DA COVID-19

The organizational change has become imperative for the survival and competitiveness of public administrations. The majority of economic actors have found themselves compelled to adapt to new factors and adjust to the new digital landscape in the face of the advent of covid-19. Conversely, every public administration without exception has undergone profound changes in their work organization methods, introducing the development of digital technology, which represents the backbone of the production process, in order to enhance its performance. The covid-19 crisis has given a boost to morocco's digital economy. Development is expected to continue. For this reason, we believe that digital transformation is a complex and challenging change process, and it is indeed a burning issue and an urgent need. Organizational change encounters resistance at the level of the target population. In order for them to realize the potential of these new technologies, they must change their current models to quickly adapt to changes in their environment. The purpose of this article is to present the contribution of organizational change that enables the transition towards digital transformation.  Le changement organisationnel est devenu impératif pour la survie et la compétitivité des administrations publiques. La majorité des acteurs économiques se sont dans l'obligation de s'acclimater à de nouveaux facteurs et de s'adapter à la nouvelle configuration numérique face à l'avènement du covid-19. En revanche, toute administration publique sans exception à mis des modifications profondes dans leurs modes d'organisations de travail, en introduisant le développement de la technologie digitale qui représente la colonne vertébrale du processus de la production dans le but de renforce sa performance. La crise covid-19 a donné un coup de pouce à l'économie numérique du Maroc. Le développement devrait se poursuivre. Pour cette raison, nous pensons que la transformation digitale est un processus de changement complexe et difficile à mettre en œuvre, et c'est en effet un sujet brûlant et un besoin urgent. Le changement organisationnel confronte des résistances au niveau de la partie de la population cible, pour qu'ils réalisent le potentiel de ces nouvelles technologies, ils doivent changer leurs modèles actuels pour s'adapter rapidement aux changements de leur environnement. L'objet de cet article est de présenter l'apport du changement organisationnel qui permet la conduite vers une transformation digitale.A mudança organizacional tornou-se imperativa para a sobrevivência e competitividade das administrações públicas. A maioria dos atores econômicos se viu obrigada a se adaptar a novos fatores e ajustar-se à nova configuração digital diante da chegada da covid-19. No entanto, todas as administrações públicas, sem exceção, realizaram mudanças profundas em seus modos de organização do trabalho, introduzindo o desenvolvimento da tecnologia digital como o pilar do processo de produção para fortalecer seu desempenho. A crise da covid-19 impulsionou a economia digital em Marrocos, e o desenvolvimento deve continuar. Por essa razão, acreditamos que a transformação digital é um processo de mudança complexo e difícil de implementar, sendo de fato um tema premente e uma necessidade urgente. A mudança organizacional enfrenta resistências por parte da população-alvo, e para que percebam o potencial dessas novas tecnologias, eles devem alterar seus modelos atuais para se adaptar rapidamente às mudanças em seu ambiente. O objetivo deste artigo é apresentar a contribuição da mudança organizacional que conduz à transformação digital

Antidiabetic potential of mucilage fraction extracted from Astragalus gyzensis seeds

The objective of the current work is to extract a new mucilage fraction from Astragalus gyzensis Bunge. seeds, which are collected from the El-Oued province (septentrional Algerian Sahara) and evaluated for their antidiabetic potential. The mucilage fraction is obtained using hot water extraction followed by alcoholic precipitation of polysaccharides by cold ethanol (96%). The primary investigation was performed by describing the main structural features of the extract through colorimetric assays, Fourier-transform infrared spectroscopy and thin-layer chromatography analysis using two systems. Biological activity was also monitored by antidiabetic activity by testing the inhibition of α-amylase and α-glucosidase enzymes in vitro. The extraction yield was 20.69%. The chemical composition mainly consisted of 78.60±0.29% carbohydrates, among them 63.92±0.67% neutral sugar, 15.78±0.76% uronic acid, 8.08±0.04% proteins and 2.57±0.05% phenolic compounds. The results obtained by thin-layer chromatography analysis showed the dominance of mannose and galactose. Fourier-transform infrared spectrum showed characteristic bands expected galactomannans. The investigations highlighted the antihyperglycemic effect in a dose-dependent manner by the inhibition of the α-amylase enzyme (IC50=0.8±0.005 mg/mL). These factors make it suitable for the industrial application of dietary supplement fiber made for diabetic individuals. DOI: http://dx.doi.org/10.5281/zenodo.761853

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Impact study of NOOR 1 project on the Moroccan territorial economic development

Morocco is one of the countries investing more and more in Renewable Energy (RE) technologies to meet the growing demand for energy and ensure the security of supply in this sector. The number of solar projects planned and implemented, as well as solar thermal projects in the form of Concentrating Solar Power (CSP) installations is steadily increasing. Many of these installations are designed as large utility systems. In order to provide strong evidence on local, regional and even national impacts, this article examines the impacts of large-scale renewable energy projects on territorial development, based on a case study of the NOOR 1 (Concentrated Solar Power (CSP)) project in Ouarzazate, Morocco. The data collected during this study, conducted through semi-structured interviews with experts, stakeholders, local community representatives and combined with an analysis of documents provided by the NOOR 1 project managers, investors and consulting firms specialized in the field of Renewable Energy, provide detailed evidence on the type and magnitude of impacts on the economic development of the Moroccan southern region where the NOOR 1 plant is located. The data collected is analyzed using NVIVO software. The study results in a consolidated list of many impacts with varying levels of significance for different stakeholder groups, including farmers, youth, women, community representatives and small and medium firms owners. It should be noted that the importance of analyzing the economic impact of large infrastructure projects is widely recognized, but so far, there is little published in the academic and professional literature on the potential impacts of these projects at the local level. Even less information is available on the local impacts of large-scale project implementation in Morocco. While many macroeconomic studies have fed the recent surge in investment in RE projects with the promise of multiple social, economic, environmental, and even geopolitical benefits at the macro level, public debates and discussions have raised considerable doubts. The question of whether these promises would also leave their marks at the local level has also arisen. Despite these uncertainties, very few academics and practitioners have conducted research to empirically develop a good understanding of the impact of RE projects at the local level. To fill this research gap, the economic impact analysis of NOOR 1 provides a detailed empirical overview, which allows a better understanding of the effects that the infrastructure developments of Concentrated Solar Power (CSP) plants can have on the economic environment in which they are located