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Resume L’invagination intestinale aigue (IIA) est l’urgence abdominale la plus frequente du jeune enfant. La penetration d’un segment intestinal dans l’intestin d’aval entraine une obstruction digestive et une compression vasculaire au niveau du collet. L’echographie est l’examen diagnostique. Elle detecte une masse digestive de 20–45 mm de diametre anteroposterieur en « cocarde » ou en « cible » centree par le segment invagine et son meso. Elle permet de determiner le type anatomique du boudin, d’identifier une souffrance digestive, de depister une lesion primitive, et donc de guider la prise en charge therapeutique. La forme ileocolique « idiopathique » (80 % des cas) due a une hyperplasie lymphoide du carrefour ileocaecal, est habituellement reduite par lavement ou insufflation gazeuse. La forme ileoileocolique (10 % des cas) est reperee en cas de souffrance digestive grâce a l’association des deux criteres de gravite : l’occlusion du grele et le liquide piege a la tete du boudin. L’IIA grelo-grelique occlusive (8 % des cas) survient sur un terrain particulier et/ou sur une lesion primitive. Le traitement est chirurgical excepte en cas de lymphome de Burkitt dissemine prouve histologiquement. L’IIA colocolique (2 % des cas) non occlusive facilement reduite par le lavement, recidive en l’absence d’exerese de la cause.

Life Cycle Costing (LCC) is a cost estimating approach for project and asset planning and delivery that considers the direct and indirect costs incurred over the entire life cycle of an asset. This approach can be expanded to the concept of Whole Life Cost (WLC), which additionally considers externalities and benefits. WLC can demonstrate the financial impacts, both positive and negative, of a project on its environment, in other words it can show its complete value. Despite its potential, the approach is still perceived as complex because, among other things, access to data can be difficult and the approach is still not supported by a standardized methodology. Building Information Modeling (BIM) could be used to address these issues as both WLC and BIM are deemed complementary. BIM provides WLC with better data management, improved calculation accuracy and visualization of project impacts. In return, WLC improves project understanding, decision making and reinforces life cycle thinking. This paper aims to study the potential synergies between BIM and WLC through a systematic literature review. The identification of these synergies helped form a frame of reference to better understand the opportunities that this combination can offer. Future studies would be needed to explore the application of BIM and WLC at different project scales and identify the context in which the combination of BIM and WLC is the most beneficial.

Smooth Muscle Cells (SMC) are unique amongst all muscle cells in their capacity to modulate their phenotype. Indeed, SMCs do not terminally differentiate but instead harbour a remarkable capacity to dedifferentiate, switching between a quiescent contractile state and a highly proliferative and migratory phenotype, a quality often associated to SMC dysfunction. However, phenotypic plasticity remains poorly examined in the field of gastroenterology in particular in pathologies in which gut motor activity is impaired. Here, we assessed SMC status in biopsies of infants with chronic intestinal pseudo‐obstruction (CIPO) syndrome, a life‐threatening intestinal motility disorder. We showed that CIPO‐SMCs harbour a decreased level of contractile markers. This phenotype is accompanied by an increase in Platelet‐Derived Growth Factor Receptor‐alpha (PDGFRA) expression. We showed that this modulation occurs without origin‐related differences in CIPO circular and longitudinal‐derived SMCs. As we characterized PDGFRA as a marker of digestive mesenchymal progenitors during embryogenesis, our results suggest a phenotypic switch of the CIPO‐SMC towards an undifferentiated stage. The development of CIPO‐SMC culture and the characterization of SMC phenotypic switch should enable us to design therapeutic approaches to promote SMC differentiation in CIPO.

Objectives The aim of this study was to evaluate the prevalence, the prenatal, and postnatal evolution of isolated fetal splenic cysts. Methods All cases of suspected fetal splenic cyst or abdominal unidentified cyst discovered during routine ultrasound scan, from 2007 to 2017, and referred to a French tertiary care center, were retrospectively collected. For each case, several prenatal parameters and postnatal evolution were reported. Results Among 5450 cases of fetal anomalies, 14 patients (0.3%) had a prenatal diagnosis of fetal splenic cysts. Median gestational age at diagnosis was 30.1 weeks. A unique cyst was present in 78.6%, whereas 2 cysts were observed in 14.3% and 3 cysts in 7.1%. During the pregnancy, cysts remained the same (78.6%) or disappeared (21.4%). Ultrasound scans at 6 months of age found total disappearance of the cysts (36.4%), spontaneous reduction from 2 to 1 cyst (18.2%) or persistence of the cysts (45.4%). Conclusion Fetal splenic cysts are rare images, always isolated, usually unique and mainly found during third trimester of pregnancy. Their evolution is to disappear spontaneously during pregnancy or at 6 months of age leaving only half of them to remain beyond that age but without any symptoms.

In the lifecycle of a building, the longest phase is generally that of operation and maintenance (O&M). The data needed to support O&M is mainly generated during the design, construction, and commissioning of the built asset phases. However, the extraction and transfer of relevant O&M data from the project documents remain a major issue in that it is time consuming and error prone. Nowadays, Building Information Modeling (BIM) allows different project team members to collaborate and share building data in real time. However, as-built models handed-over to the asset management team are quite voluminous and usually lack the necessary information for the O&M phase. This is due to an absence of O&M information requirements specification, and the lack of compliance monitoring and control during the project. This paper presents an action research focused on the issues encountered by a public building owner to manage their BIM processes. It demonstrates issues of BIM readiness and capabilities, both at the project and O&M levels, by mapping the gaps in the existing processes. Building owners rely on the design professionals’ expertise to guide them but do not have the adequate resources, knowledge, and tools to ensure the quality of the models delivered regarding O&M requirements. Major issues in the management of information for O&M were identified, and some recommendations are proposed.

The built asset industry’s notorious productivity gap is being targeted through digitalization, operationalized through Building Information Modelling (BIM), and the application of Lean philosophy to the planning, design, delivery, maintenance, and management of the built environment. While both approaches grow in popularity, their development has remained largely on parallel tracks. Both approaches have existed, for the most part, as two independent initiatives aimed at improving performance and productivity. An increasing amount of work however is pointing to the significant potential that can be achieved through the integration of both approaches. This paper investigates the mutual relations and synergies between BIM and Lean from an information management perspective. The paper also presents the key similarities, differences, synergies, and interactions between these two main drivers of built asset industry reform, while providing an investigation into the principles guiding the application of both within the construction industry.

International audience; OBJECTIVE:To assess specific, direct, and indirect prenatal ultrasound features in cases of fetal midgut volvulus.METHODS:Retrospective case series of neonatal volvulus, based on postnatal and prenatal imaging findings that occurred from 2006-2017. Prenatal and postnatal signs including the specific "whirlpool sign" were computed. Postnatal volvulus was confirmed by pathology examination after surgery or neonatal autopsy.RESULTS:Thirteen cases of midgut volvulus were identified. Though not a specific sign, a decrease in active fetal movements was reported in eight patients (61.5%). The prenatal whirlpool sign was directly seen in 10 cases, while an indirect but suggestive sign, a fluid-filled level within the dilated loops, was present in five cases. No intestinal malrotation was observed. Pregnancy outcomes were two terminations of pregnancy, both associated with cystic fibrosis, one early neonatal death, three prenatal spontaneous regressions, and seven favorable outcomes after neonatal surgery with resection of midgut atresia.CONCLUSIONS:Identification of the whirlpool sign or of a fluid-filled level within the dilated loops improves the accuracy of ultrasound findings for suspected volvulus. In the absence of total volvulus (in cases of intestinal malrotation) or association with cystic fibrosis, the prognosis appears good.