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 of Hot Arid Climate on Optimal Placement of Electric Vehicle Charging Stations

Electric vehicles (EVs) are becoming more commonplace as they cut down on both fossil fuel use and pollution caused by the transportation sector. However, there are a number of major issues that have arisen as a result of the rapid expansion of electric vehicles, including an inadequate number of charging stations, uneven distribution, and excessive cost. The purpose of this study is to enable EV drivers to find charging stations within optimal distances while also taking into account economic, practical, geographical, and atmospheric considerations. This paper uses the Fez-Meknes region in Morocco as a case study to investigate potential solutions to the issues raised above. The scorching, arid climate of the region could be a deterrent to the widespread use of electric vehicles there. This article first attempts to construct a model of an EV battery on MATLAB/Simulink in order to create battery autonomy of the most widely used EV car in Morocco, taking into account weather, driving style, infrastructure, and traffic. Secondly, collected data from the region and simulation results were then employed to visualize the impact of ambient temperature on EV charging station location planning, and a genetic algorithm-based model for optimizing the placement of charging stations was developed in this research. With this method, EV charging station locations were initially generated under the influence of gas station locations, population and parking areas, and traffic, and eventually through mutation, the generated initial placements were optimized within the bounds of optimal cost, road width, power availability, and autonomy range and influence. The results are displayed to readers in a node-link network to help visually represent the impact of ambient temperatures on EV charging station location optimization and then are displayed in interactive GIS maps. Finally, conclusions and research prospects were provided

Erratum: Traduction et Validation transculturelle du Baromètre E-satis 48 h MCO de mesure de la satisfaction des patients

Patient satisfaction is now considered an essential indicator for measuring healthcare quality. With this in mind, the aim of this study is to translate and cross-culturally validate a satisfaction barometer from French into dialectal Arabic, thereby providing Moroccan hospital managers with a reliable tool for evaluating patients’ hospitalization experiences. The study was carried out on a sample of 110 patients fulfilling the inclusion criteria, using the questionnaire translated and adapted to Moroccan dialectics in compliance with the cross-cultural validation process. This was followed by an analysis of the psychometric, consistency and homogeneity tests for all the items on the scale. During the adaptation process, certain items were removed to adapt to the specific context of Moroccan hospitals. The results of the various psychometric parameters were largely acceptable, confirming the validity and reliability of the satisfaction barometer in Morocco. Inter-item correlations were good, with the Kaiser-Meyer-Olkin (KMO) index> 0.5. The translated tool showed good internal consistency, with Cronbach’s α having a value of around 0.882. As far as satisfaction is concerned, users were more dissatisfied with the services provided by the surgical department than those of the medical department. The version of the "E-Satis" adapted to the Moroccan context has very acceptable psychometric values, meaning that healthcare professionals can use it as a measuring instrument to assess patient satisfaction. Furthermore, this adapted version will provide decision-makers with reliable data specific to the Moroccan context, facilitating informed decision-making and the implementation of measures to improve quality of care and patient satisfaction.   Keywords: patient satisfaction, e-satis, barometer, hospitalization experience, transcultural validation. JEL Classification: G21, L25, L26. Paper type: Empirical research   Erratum note:After being contacted by the author of the correspondence on 22 December 2023 to inform us of an inadvertent omission of authors, we investigated by requesting information on each author's contribution.After examining the information provided, the Committee decided to add the authors to safeguard their right to be cited as authors in the text.Decision made on 29-02-2024La satisfaction des patients est désormais considérée comme un indicateur essentiel pour mesurer la qualité des soins de santé. Dans cette perspective, l’objectif de la présente étude consiste à procéder à une traduction et une validation transculturelle d’un baromètre de satisfaction du français vers l’Arabe dialectale, visant ainsi à mettre à la disposition des responsables hospitaliers marocains un dispositif fiable pour évaluer les expériences d’hospitalisation vécues par les patients. L’étude a été conduite sur un échantillon de 110 patients remplissant les critères d’inclusion. Le questionnaire « e-satis 48 h MCO » a été traduit et adapté à la dialectique marocaine respectant le processus de validation transculturelle. Cette démarche a été suivie d’une analyse des tests psychométriques, de cohérence et d’homogénéité de l’ensemble des items de cette échelle. Lors de la démarche d’adaptation, il y a eu une suppression de certains items en vue de s’adapter au contexte particulier des hôpitaux marocains. Les résultats des différents paramètres psychométriques étaient largement acceptables pour confirmer la validité et la fiabilité du baromètre de satisfaction au Maroc. Les corrélations inter items étaient bonnes, en effet, l’indice de Kaiser-Meyer-Olkin (KMO) était > 0,5. L’outil traduit présente une bonne cohérence interne, ainsi l’α de Cronbach avait une valeur d’environ de 0,882. En ce qui concerne la mesure de satisfaction, les usagers sont plus insatisfaits des prestations du service de chirurgie que ceux du service de médecine. La version du « E-Satis » adaptée au contexte marocain présente des valeurs psychométriques très acceptables, ce qui signifie que les professionnels de la santé peuvent l’utiliser comme un instrument de mesure pour évaluer la satisfaction des patients. En excédent, cette version adaptée permettra aux décideurs de disposer de données fiables et spécifiques au contexte marocain, facilitant ainsi la prise de décisions éclairées et la mise en place des mesures visant à améliorer la qualité des soins et la satisfaction des patients.   Mots-clés : satisfaction des patients, baromètre, e-satis, expérience d’hospitalisation, validation. Classification JEL : G21, L25, L26. Type de l’article : Recherche empirique.   Notice d’erratum : Après avoir été contactés par l’auteur de correspondance le 22 décembre 2023 pour nous informer qu’une omission involontaire des auteurs a été commise, nous avons mené des investigations en demandant des informations sur la contribution de chaque auteur. Après vérification des informations fournies, le comité décide d’ajouter les auteurs pour sauvegarder leur droit d’être cités dans le texte comme auteurs. Décision prise le 29-02-202

Thing federation as a service: foundations and demonstration

This paper presents the design and implementation guidelines of thing federation-as-a-service. The large and growing number of things compliant with the Internet-of-Things (IoT) principles need to be “harnessed” so, that, things’ collective over individual behaviors prevail. A federation gathers necessary things together according to the needs and requirements of the situation that this federation is tasked to handle. Two types of federations exist: planned whose things are all known at design-time and ad-hoc whose things are known after a competitive selection at run-time. In this paper, federations handle situations about emergency services that involve different stakeholders with different backgrounds raising the complexity of ensuring a successful delivery of these services. A system for patient emergency transfer following a tunnel closure is implemented demonstrating the technical doability of thing federation-as-a-service