Summary Paragraph Astrocytes—the most abundant non-neuronal cell type in the mammalian brain—are crucial circuit components that respond to and modulate neuronal activity via calcium (Ca 2+ ) signaling 1–8 . Astrocyte Ca 2+ activity is highly heterogeneous and occurs across multiple spatiotemporal scales: from fast, subcellular activity 3,4 to slow, synchronized activity that travels across connected astrocyte networks 9–11 . Furthermore, astrocyte network activity has been shown to influence a wide range of processes 5,8,12 . While astrocyte network activity has important implications for neuronal circuit function, the inputs that drive astrocyte network dynamics remain unclear. Here we used ex vivo and in vivo two-photon Ca 2+ imaging of astrocytes while mimicking neuronal neurotransmitter inputs at multiple spatiotemporal scales. We find that brief, subcellular inputs of GABA and glutamate lead to widespread, long-lasting astrocyte Ca 2+ responses beyond an individual stimulated cell. Further, we find that a key subset of Ca 2+ activity—propagative events—differentiates astrocyte network responses to these two major neurotransmitters, and gates responses to future inputs. Together, our results demonstrate that local, transient neurotransmitter inputs are encoded by broad cortical astrocyte networks over the course of minutes, contributing to accumulating evidence across multiple model organisms that significant astrocyte-neuron communication occurs across slow, network-level spatiotemporal scales 13–15 . We anticipate that this study will be a starting point for future studies investigating the link between specific astrocyte Ca 2+ activity and specific astrocyte functional outputs, which could build a consistent framework for astrocytic modulation of neuronal activity.

Non-rapid eye movement (NREM) sleep, characterized by slow-wave electrophysiological activity, underlies several critical functions, including learning and memory. However, NREM sleep is heterogeneous, varying in duration, depth, and spatially across the cortex. While these NREM sleep features are thought to be largely independently regulated, there is also evidence that they are mechanistically coupled. To investigate how cortical NREM sleep features are controlled, we examined the astrocytic network, comprising a cortex-wide syncytium that influences population-level neuronal activity. We quantified endogenous astrocyte activity in mice over natural sleep and wake, then manipulated specific astrocytic G-protein-coupled receptor (GPCR) signaling pathways in vivo. We find that astrocytic Gi- and Gq-coupled GPCR signaling separately control NREM sleep depth and duration, respectively, and that astrocytic signaling causes differential changes in local and remote cortex. These data support a model in which the cortical astrocyte network serves as a hub for regulating distinct NREM sleep features.

The average length of stay for a pediatric asthma exacerbation in the United States is about 2.2 days; as nearly 1 in 50 children with asthma is hospitalized with an exacerbation each year, this creates a substantial burden for patients and their families. A critical determinant of length of stay is the patient's albuterol wean; however, providers' approaches to weaning patients vary widely. The purpose of this quality improvement project was to reduce patients' lengths of stay by implementing a guideline for weaning albuterol. At a single urban academic community hospital, we conducted an initial exploration of guideline features by engaging in informal interviews with stakeholders, surveying physicians who oversee pediatric asthma cases, and reviewing asthma admissions between June 2017 and June 2018. Integrating this feedback, we developed a guideline utilizing the modified pediatric asthma severity score (MPASS) to indicate severity level and initial albuterol therapy, and to guide frequency of assessment and the albuterol wean. After educating unit staff on the new guideline, a pilot program was implemented in April 2019. After implementation of the albuterol weaning guideline, the measured average length of stay for pediatric asthma exacerbations fell by 46%, from 2.6 days (pre-implementation, 3/2018-3/2019) to 1.4 days (post-implementation, 4/2019-7/2019). We demonstrated that implementation of a standard guideline for albuterol weaning can decrease patients' length of stay. Future directions include targeted screening for patients who would most benefit from the guideline, and the addition of nurse-driven progression between treatment stages to further facilitate progression through the guideline.

Behavioral responses to a perceptual stimulus are typically faster with repeated exposure to the stimulus (behavioral priming). This implicit learning mechanism is critical for survival but impaired in a variety of neurological disorders, including Alzheimer's disease. Many studies of the neural bases for behavioral priming have encountered an interesting paradox: in spite of faster behavioral responses, repeated stimuli usually elicit weaker neural responses (repetition suppression). Several neurophysiological models have been proposed to resolve this paradox, but noninvasive techniques for human studies have had insufficient spatial-temporal precision for testing their predictions. Here, we used the unparalleled precision of electrocorticography (ECoG) to analyze the timing and magnitude of task-related changes in neural activation and propagation while patients named novel vs repeated visual objects. Stimulus repetition was associated with faster verbal responses and decreased neural activation (repetition suppression) in ventral occipito-temporal cortex (VOTC) and left prefrontal cortex (LPFC). Interestingly, we also observed increased neural activation (repetition enhancement) in LPFC and other recording sites. Moreover, with analysis of high gamma propagation we observed increased top-down propagation from LPFC into VOTC, preceding repetition suppression. The latter results indicate that repetition suppression and behavioral priming are associated with strengthening of top-down network influences on perceptual processing, consistent with predictive coding models of repetition suppression, and they support a central role for changes in large-scale cortical dynamics in achieving more efficient and rapid behavioral responses.

BCI2000 has been a popular platform for development of real-time brain computer interfaces (BCIs). Since BCI2000's initial release, web browsers have evolved considerably, enabling rapid development of internet-enabled applications and interactive visualizations. Linking the amplifier abstraction and signal processing native to BCI2000 with the host of technologies and ease of development afforded by modern web browsers could enable a new generation of browser-based BCIs and visualizations. We developed a server and filter module called BCI2000Web providing an HTTP connection capable of escalation into an RFC6455 WebSocket, which enables direct communication between a browser and a BCI2000 distribution in real-time, facilitating a number of novel applications. We also present a JavaScript module, bci2k.js, that allows web developers to create paradigms and visualizations using this interface in an easy-to-use and intuitive manner. To illustrate the utility of BCI2000Web, we demonstrate a browser-based implementation of a real-time electrocorticographic (ECoG) functional mapping suite called WebFM. We also explore how the unique characteristics of our browser-based framework make BCI2000Web an attractive tool for future BCI applications. BCI2000Web leverages the advances of BCI2000 to provide real-time browser-based interactions with human neurophysiological recordings, allowing for web-based BCIs and other applications, including real-time functional brain mapping. Both BCI2000 and WebFM are provided under open source licenses. Enabling a powerful BCI suite to communicate with today's most technologically progressive software empowers a new cohort of developers to engage with BCI technology, and could serve as a platform for internet-enabled BCIs.