7 research outputs found

    La relation entre la transformation digitale et la performance économique des entreprises : cas des entreprises de la ville d’Agadir

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    L’entreprise fait toujours face à des défis en raison de la concurrence acharnée et du changement perpétuel et continu de son environnement. Pour contrecarrer la concurrence, l’entreprise doit trouver des moyens qui lui permettent de se différencier des autres. Elle doit ainsi améliorer ses performances économiques mais aussi comprendre ses clients pour répondre à leurs attentes et à leurs besoins. La transformation digitale vient ainsi comme solution à ses obstacles et aide l’entreprise à se démarquer. La transformation digitale repose sur l’adoption de technologies digitales. Elle a pour objectif l’amélioration des processus, la gestion des risques, et l’offre de meilleure expérience pour les clients. Elle permet à l’entreprise l’amélioration de ses performances et assure sa continuité et sa pérennité. A cet égard, l’objectif de ce travail est de déterminer la participation de la transformation digitale à la performance économique des petites et moyennes entreprises. Pour faire, nous avons adopté une méthode quantitative basée sur un questionnaire auto- administré sur un échantillon de 208 entreprises de la ville d’Agadir dont la population mère est toute entreprise basée sur le territoire du grand Agadir. Pour modéliser la relation entre nos construits, nous avons opté pour la régression PLS en utilisant le logiciel SmartPLS

    Early results for active infective endocarditis

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    Introduction: Cardiac surgery is frequently needed during active phase of infective endocarditis (IE). The purpose of this study was to analyze the immediate and late results and determine the risk factors for death.Methods: We retrospectively reviewed 101 patients with IE operated in the active phase. The mean age was 40.5 ± 12.5 years. 16 patients (15.8%) were diagnosed with prosthetic valve endocarditis (PVE). 81 (80.9%) were in NYHA functional class III-IV. Blood cultures were positive in only 24 cases (23.9%).Results: in-hospital mortality rate was 17.9% (18 cases). Multivariate analysis indentified five determinant predictor factors: congestive heart failure (CHF), renal insufficiency, high Euroscore, prolonged cardiopulmonary bypass time (> 120 min) and long ICU stay. The median follow-up period was 4.2 (2-6.5) years. Overall survival rate for all patients who survived surgery was 97% at 5 years and 91% at 10 years.Conclusion: Despite high in-hospital mortality rate, when patients receive operation early in the active phase of their illness, late outcome may be good.Keywords: Infective endocarditis, valvular surgery, active phas

    The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

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    Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

    The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

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    INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

    Complications des fractures dĂ©placĂ©es du col fĂ©moral chez l’enfant : Quels sont les facteurs de risque

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    Les fractures du col fĂ©moral chez l’enfant sont rares, mais graves par les nombreuses complications qu’elles peuvent engendrer. Les facteurs de survenue de ces complications sont controversĂ©s et sujet Ă  discussion. Le but de notre travail est d’étudier la prĂ©valence des complications suite au traitement chirurgical des fractures dĂ©placĂ©es du col fĂ©moral chez l’enfant et de rechercher les facteurs de risque de leur survenue. Nous avons revu de façon rĂ©trospective les dossiers des enfants opĂ©rĂ©s au sein du service de Traumatologie et d’OrthopĂ©die de l’HĂŽpital d’enfants de Rabat entre 1999 et 2010 pour les fractures dĂ©placĂ©es du col fĂ©moral. Les Ă©lĂ©ments radio-cliniques, thĂ©rapeutiques, l’évolution et l’apparition Ă©ventuelle de complications ont Ă©tĂ© Ă©tudiĂ©s. La prĂ©sence ou non de nĂ©crose de la tĂȘte fĂ©morale a Ă©tĂ© considĂ©rĂ©e comme variable dĂ©pendante. Le modĂšle de rĂ©gression logistique binaire a Ă©tĂ© utilisĂ© pour la recherche de facteurs de risque. La sĂ©rie comportait 26 cas. La prĂ©valence de la principale complication (nĂ©crose de la tĂȘte fĂ©morale) Ă©tait de 23 %. Le seul facteur de risque statistiquement significatif de notre sĂ©rie Ă©tait la prĂ©sence de coxa vara. Dans notre sĂ©rie, la coxa vara est le principal facteur de risque de survenue de la nĂ©crose cĂ©phalique chez les enfants opĂ©rĂ©s pour une fracture dĂ©placĂ©e du col fĂ©moral. Cette notion non dĂ©crite dans la littĂ©rature devrait ĂȘtre confirmĂ©e par une Ă©tude mĂ©ta-analytique. Cependant, on recommande comme la majoritĂ© des auteurs une chirurgie percutanĂ©e dans les 48 heures avec fixation par vis cannulĂ©e

    SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

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    Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population
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