Intraperitoneal microbial contamination drives post-surgical peritoneal adhesions by mesothelial EGFR-signaling.

Abdominal surgeries are lifesaving procedures but can be complicated by the formation of peritoneal adhesions, intra-abdominal scars that cause intestinal obstruction, pain, infertility, and significant health costs. Despite this burden, the mechanisms underlying adhesion formation remain unclear and no cure exists. Here, we show that contamination of gut microbes increases post-surgical adhesion formation. Using genetic lineage tracing we show that adhesion myofibroblasts arise from the mesothelium. This transformation is driven by epidermal growth factor receptor (EGFR) signaling. The EGFR ligands amphiregulin and heparin-binding epidermal growth factor, are sufficient to induce these changes. Correspondingly, EGFR inhibition leads to a significant reduction of adhesion formation in mice. Adhesions isolated from human patients are enriched in EGFR positive cells of mesothelial origin and human mesothelium shows an increase of mesothelial EGFR expression during bacterial peritonitis. In conclusion, bacterial contamination drives adhesion formation through mesothelial EGFR signaling. This mechanism may represent a therapeutic target for the prevention of adhesions after intra-abdominal surgery

Autopilot, Mind Wandering, and the Out of the Loop Performance Problem

International audienceTo satisfy the increasing demand for safer critical systems, engineers have integrated higher levels of automation, such as glass cockpits in aircraft, power plants, and driverless cars. These guiding principles relegate the operator to a monitoring role, increasing risks for humans to lack system understanding. The out of the loop performance problem arises when operators suffer from complacency and vigilance decrement; consequently, when automation does not behave as expected, understanding the system or taking back manual control may be difficult. Close to the out of the loop problem, mind wandering points to the propensity of the human mind to think about matters unrelated to the task at hand. This article reviews the literature related to both mind wandering and the out of the loop performance problem as it relates to task automation. We highlight studies showing how these phenomena interact with each other while impacting human performance within highly automated systems. We analyze how this proximity is supported by effects observed in automated environment, such as decoupling, sensory attention, and cognitive comprehension decrease. We also show that this link could be useful for detecting out of the loop situations through mind wandering markers. Finally, we examine the limitations of the current knowledge because many questions remain open to characterize interactions between out of the loop, mind wandering, and automation

Towards a mechanistic understanding of the human subcortex

The human subcortex is a densely populated part of the brain, of which only 7% of the individual structures are depicted in standard MRI atlases. In vivo MRI of the subcortex is challenging owing to its anatomical complexity and its deep location in the brain. The technical advances that are needed to reliably uncover this 'terra incognita' call for an interdisciplinary human neuroanatomical approach. We discuss the emerging methods that could be used in such an approach and the incorporation of the data that are generated from these methods into model-based cognitive neuroscience frameworks