Automatic image and text-based description for colorectal polyps using BASIC classification

Colorectal polyps (CRP) are precursor lesions of colorectal cancer (CRC). Correct identification of CRPs during in-vivo colonoscopy is supported by the endoscopist's expertise and medical classification models. A recent developed classification model is the Blue light imaging Adenoma Serrated International Classification (BASIC) which describes the differences between non-neoplastic and neoplastic lesions acquired with blue light imaging (BLI). Computer-aided detection (CADe) and diagnosis (CADx) systems are efficient at visually assisting with medical decisions but fall short at translating decisions into relevant clinical information. The communication between machine and medical expert is of crucial importance to improve diagnosis of CRP during in-vivo procedures. In this work, the combination of a polyp image classification model and a language model is proposed to develop a CADx system that automatically generates text comparable to the human language employed by endoscopists. The developed system generates equivalent sentences as the human-reference and describes CRP images acquired with white light (WL), blue light imaging (BLI) and linked color imaging (LCI). An image feature encoder and a BERT module are employed to build the AI model and an external test set is used to evaluate the results and compute the linguistic metrics. The experimental results show the construction of complete sentences with an established metric scores of BLEU-1 = 0.67, ROUGE-L = 0.83 and METEOR = 0.50. The developed CADx system for automatic CRP image captioning facilitates future advances towards automatic reporting and may help reduce time-consuming histology assessment.

The bile acid-sensitive ion channel (BASIC) mediates bile acid-dependent currents in bile duct epithelial cells

The bile acid-sensitive ion channel (BASIC) is a member of the Deg/ENaC family of ion channels that is activated by bile acids. Despite the identification of cholangiocytes in the liver and unipolar brush cells in the cerebellum as sites of expression, the physiological function of BASIC in these cell types is not yet understood. Here we used a cholangiocyte cell line, normal rat cholangiocytes (NRCs), which expresses BASIC to study the role of the channel in epithelial transport using Ussing chamber experiments. Apical application of bile acids induced robust and transient increases in transepithelial currents that were carried by Na⁺ and partly blocked by the BASIC inhibitor diminazene. Genetic ablation of the BASIC gene in NRC using a CRISPR-cas9 approach resulted in a decrease of the bile acid-mediated response that matched the diminazene-sensitive current in NRC WT cells, suggesting that cholangiocytes respond to bile acids with a BASIC-mediated Na⁺ influx. Taken together, we have identified BASIC as a component of the cholangiocyte transport machinery, which might mediate a bile acid-dependent modification of the bile and thus control bile flux and composition.

Evaluation of emission reduction targets contributed by BASIC countries from the perspective of global temperature control targets

In this paper, the BASIC (Brazil, South Africa, India, and China) countries, which play an increasingly significant role in combating climate change, are selected as the research objects. First, we investigate the driving factors of the evolution of carbon emissions in the BASIC group from 2000 to 2016. Second, we use the Monte Carlo simulation to analyze the potential evolution trend of carbon emissions in the benchmark scenario, optimization scenario, and enhanced scenario in the BASIC group from 2017 to 2030 to judge whether the countries can achieve their own autonomous contribution goals. Third, we evaluate whether the BASIC INDC can provide practical support for making the global temperature control goals described in the Paris Agreement. The results show that first, the contribution rate of the energy consumption structure and population size to the carbon emissions of the BASIC are low, and the contributions of R&D efficiency, R&D intensity, and investment intensity to the carbon emission change in the BASIC group are more prominent. Second, under the benchmark scenario, Brazil, South Africa, India, and China from the difference between the complete INDC targets respectively is 265.50 Mt, 207.86 Mt, 1034.70 Mt, and 4660.82 Mt. Under the optimization scenario, China could meet the INDC goals. The gap between Brazil, South Africa, and India is 60.06 Mt, 9.50 Mt, and 413.74 Mt, respectively. Under the enhanced scenario, China and South Africa could meet the INDC target, while Brazil and India are 15.69 Mt and 228.28 Mt away from the INDC target, respectively. Third, although the INDC goals of Brazil and India can achieve the carbon reduction allocated under the 2 °C targets, the INDC targets submitted by the BASIC are not enough to reach the carbon reduction allocated under the global 1.5 °C destination; Brazil, South Africa, India, and China's gap is 64.14 Mt, 246.15 Mt, 236.84 Mt, 3399.64 Mt, respectively. Fourth, Brazil, South Africa, and China should increase its R&D on energy-saving and emission reduction technologies, and India should develop reasonable population policies and green economic development policies.

Validation of the Brief Assessment of Impaired Cognition and the Brief Assessment of Impaired Cognition Questionnaire for identification of mild cognitive impairment in a memory clinic setting

OBJECTIVES

The aim of this study was to validate the Brief Assessment of Impaired Cognition (BASIC) and the Brief Assessment of Impaired Cognition Questionnaire (BASIC-Q) for identification of mild cognitive impairment (MCI) in a memory clinic setting.

METHODS

A total of 163 sociodemographically matched patients (MCI, n = 42, and dementia, n = 121) and 83 control participants were included in the study. Two instruments were validated: (a) BASIC, including the components self-report, informant report, and two brief cognitive tests, and (b) BASIC-Q, including the components self-report, informant report, and orientation. BASIC can be administered in 5 minutes and BASIC-Q in less than 5 minutes.

RESULTS

A high discriminative validity for MCI vs control participants was found for both BASIC (sensitivity 0.86, specificity 0.89) and BASIC-Q (sensitivity 0.88, specificity 0.88). In comparison, the MMSE had low sensitivity (0.61) and moderate specificity (0.72). All components of BASIC and BASIC-Q contributed significantly to differentiate MCI from control participants. The components of BASIC and BASIC-Q also contributed significantly to differentiate MCI from dementia, except for self-report, which was identical in the two groups.

CONCLUSIONS

Both BASIC and BASIC-Q are brief, valid, and effective instruments for identification of patients with possible MCI in a memory clinic setting. Further cross-validation of the instruments in a general practice or primary care setting is needed.

Brief Assessment of Impaired Cognition Questionnaire (BASIC-Q)-Development and validation of a new tool for identification of cognitive impairment in community settings

OBJECTIVES

Brief Assessment of Impaired Cognition (BASIC), which combines self- and informant report with cognitive testing, was previously found to be highly accurate in identification of dementia and cognitive impairment. The aim of the present study was to develop and validate a questionnaire version of BASIC, the BASIC-Q, for use in community settings.

METHODS

In order to construct a questionnaire version of BASIC, we substituted cognitive testing with questions regarding orientation. BASIC-Q was validated based on further analysis of data from the primary BASIC validation study, where patients consecutively referred from general practice were tested at their first memory clinic admission prior to diagnosis. Control participants were primarily recruited among participating patients' relatives. Expert clinical diagnosis was subsequently used as reference standard for estimation of classification accuracy.

RESULTS

A high discriminative validity (sensitivity 0.92, specificity 0.97) for cognitive impairment (n = 159) vs socio-demographically matched control participants (n = 109) was found. In comparison, the MMSE had 0.76 sensitivity and 0.81 specificity. Administration time for BASIC-Q was less than 5 minutes compared to approximately 10 minutes for the MMSE.

CONCLUSIONS

BASIC-Q is a brief, efficient and valid tool for identification of cognitive impairment in a clinical setting. Further validation in a community setting is needed.

Brief Assessment of Impaired Cognition (BASIC)-Validation of a new dementia case-finding instrument integrating cognitive assessment with patient and informant report

OBJECTIVES

The aim of this study was to develop and validate a new brief and accurate case-finding instrument for dementia and cognitive impairment. Previous research indicates that combining cognitive tests with informant and/or patient report may improve accuracy in dementia case-finding. The Brief Assessment of Impaired Cognition (BASIC) integrates these three sources of information.

METHODS

BASIC was prospectively validated in five memory clinics. Patients consecutively referred from general practice were tested at their initial visit prior to diagnosis. Control participants were primarily recruited among participating patients' relatives. Expert clinical diagnosis was subsequently used as gold standard for estimation of the classification accuracy of BASIC.

RESULTS

A very high discriminative validity (specificity 0.98, sensitivity 0.95) for dementia (n = 122) versus socio-demographically matched control participants (n = 109) was found. In comparison, the MMSE had 0.90 specificity and 0.82 sensitivity. Extending the discriminative validity analysis to cognitive impairment (both dementia and MCI, n = 162) only slightly reduced the discriminative validity of BASIC whereas the discriminative validity of the MMSE was substantially attenuated. Administration time for BASIC was approximately 5 minutes compared with 10 to 15 minutes for the MMSE.

CONCLUSIONS

BASIC was found to be an efficient and valid case-finding instrument for dementia and cognitive impairment in a memory clinic setting.

Comparative electrophysiological analysis of the bile acid-sensitive ion channel (BASIC) from different species suggests similar physiological functions

Despite the identification of cholangiocytes in the liver and unipolar brush cells in the cerebellum as sites of expression, the physiological function of the bile acid-sensitive ion channel (BASIC) remains unknown. Rat BASIC (rBASIC) and mouse BASIC (mBASIC) share 97% of their amino acid sequence but show strikingly different biophysical properties. rBASIC is inactive at rest while mBASIC is constitutively active, when expressed in Xenopus oocytes. This conundrum rendered the identification of the physiological function even more difficult. In this study, we investigated the electrophysiological and pharmacological properties of BASIC from rat, mouse, and human in Hek293 cells using the patch clamp technique. Surprisingly, in Hek293 cells, rBASIC and mBASIC showed almost completely identical properties. Both are blocked by extracellular Ca²⁺ and thus are inactive at rest; both are selective for Na⁺, show similar affinities for extracellular Ca²⁺, were inhibited by diminazene, and activated by various bile acids. This is in contrast to previous results derived from Xenopus oocytes as expression system and suggests that the cell type is important for shaping the biophysical properties of BASIC. Furthermore, we compared hBASIC with rBASIC and mBASIC and observed similar properties between these channels with one exception: the bile acid sensitivity profile of hBASIC is different from rBASIC and mBASIC; hBASIC is more sensitive to bile acids which are abundant in human bile but not in rodent bile. Taken together, these results suggest similar physiological roles for BASIC in different species.

The degenerin region of the human bile acid-sensitive ion channel (BASIC) is involved in channel inhibition by calcium and activation by bile acids

The bile acid-sensitive ion channel (BASIC) is a member of the ENaC/degenerin family of ion channels. It is activated by bile acids and inhibited by extracellular Ca²⁺. The aim of this study was to explore the molecular mechanisms mediating these effects. The modulation of BASIC function by extracellular Ca²⁺ and tauro-deoxycholic acid (t-DCA) was studied in Xenopus laevis oocytes heterologously expressing human BASIC using the two-electrode voltage-clamp and outside-out patch-clamp techniques. Substitution of aspartate D444 to alanine or cysteine in the degenerin region of BASIC, a region known to be critically involved in channel gating, resulted in a substantial reduction of BASIC Ca²⁺ sensitivity. Moreover, mutating D444 or the neighboring alanine (A443) to cysteine significantly reduced the t-DCA-mediated BASIC stimulation. A combined molecular docking/simulation approach demonstrated that t-DCA may temporarily form hydrogen bonds with several amino acid residues including D444 in the outer vestibule of the BASIC pore or in the inter-subunit space. By these interactions, t-DCA may stabilize the open state of the channel. Indeed, single-channel recordings provided evidence that t-DCA activates BASIC by stabilizing the open state of the channel, whereas extracellular Ca²⁺ inhibits BASIC by stabilizing its closed state. In conclusion, our results highlight the potential role of the degenerin region as a critical regulatory site involved in the functional interaction of Ca²⁺ and t-DCA with BASIC.

A Cytosolic Amphiphilic α-Helix Controls the Activity of the Bile Acid-sensitive Ion Channel (BASIC)

The bile acid-sensitive ion channel (BASIC) is a member of the degenerin/epithelial Na⁺ channel (Deg/ENaC) family of ion channels. It is mainly found in bile duct epithelial cells, the intestinal tract, and the cerebellum and is activated by alterations of its membrane environment. Bile acids, one class of putative physiological activators, exert their effect by changing membrane properties, leading to an opening of the channel. The physiological function of BASIC, however, is unknown. Deg/ENaC channels are characterized by a trimeric subunit composition. Each subunit is composed of two transmembrane segments, which are linked by a large extracellular domain. The termini of the channels protrude into the cytosol. Many Deg/ENaC channels contain regulatory domains and sequence motifs within their cytosolic domains. In this study, we show that BASIC contains an amphiphilic α-helical structure within its N-terminal domain. This α-helix binds to the cytosolic face of the plasma membrane and stabilizes a closed state. Truncation of this domain renders the channel hyperactive. Collectively, we identify a cytoplasmic domain, unique to BASIC, that controls channel activity via membrane interaction.

Multidimensional Analysis of Magnetic Resonance Imaging Predicts Early Impairment in Thoracic and Thoracolumbar Spinal Cord Injury

Literature examining magnetic resonance imaging (MRI) in acute spinal cord injury (SCI) has focused on cervical SCI. Reproducible systems have been developed for MRI-based grading; however, it is unclear how they apply to thoracic SCI. Our hypothesis is that MRI measures will group as coherent multivariate principal component (PC) ensembles, and that distinct PCs and individual variables will show discriminant validity for predicting early impairment in thoracic SCI. We undertook a retrospective cohort study of 25 patients with acute thoracic SCI who underwent MRI on admission and had American Spinal Injury Association Impairment Scale (AIS) assessment at hospital discharge. Imaging variables of axial grade, sagittal grade, length of injury, thoracolumbar injury classification system (TLICS), maximum canal compromise (MCC), and maximum spinal cord compression (MSCC) were collected. We performed an analytical workflow to detect multivariate PC patterns followed by explicit hypothesis testing to predict AIS at discharge. All imaging variables loaded positively on PC1 (64.3% of variance), which was highly related to AIS at discharge. MCC, MSCC, and TLICS also loaded positively on PC2 (22.7% of variance), while variables concerning cord signal abnormality loaded negatively on PC2. PC2 was highly related to the patient undergoing surgical decompression. Variables of signal abnormality were all negatively correlated with AIS at discharge with the highest level of correlation for axial grade as assessed with the Brain and Spinal Injury Center (BASIC) score. A multiple variable model identified BASIC as the only statistically significant predictor of AIS at discharge, signifying that BASIC best captured the variance in AIS within our study population. Our study provides evidence of convergent validity, construct validity, and clinical predictive validity for the sampled MRI measures of SCI when applied in acute thoracic and thoracolumbar SCI.

The bile acid-sensitive ion channel (BASIC), the ignored cousin of ASICs and ENaC

The DEG/ENaC gene family of ion channels is characterized by a high degree of structural similarity and an equally high degree of diversity concerning the physiological function. In humans and rodents, the DEG/ENaC family comprises 2 main subgroups: the subunits of the epithelial Na(+) channel (ENaC) and the subunits of the acid sensing ion channels (ASICs). The bile acid-sensitive channel (BASIC), previously known as BLINaC or INaC, represents a third subgroup within the DEG/ENaC family. Although BASIC was identified more than a decade ago, very little is known about its physiological function. Recent progress in the characterization of this neglected member of the DEG/ENaC family, which is summarized in this focused review, includes the discovery of surprising species differences, its pharmacological characterization, and the identification of bile acids as putative natural activators.

Strong activation of bile acid-sensitive ion channel (BASIC) by ursodeoxycholic acid

Bile acid-sensitive ion channel (BASIC) is a member of the DEG/ENaC gene family of unknown function. Rat BASIC (rBASIC) is inactive at rest. We have recently shown that cholangiocytes, the epithelial cells lining the bile ducts, are the main site of BASIC expression in the liver and identified bile acids, in particular hyo- and chenodeoxycholic acid, as agonists of rBASIC. Moreover, it seems that extracellular divalent cations stabilize the resting state of rBASIC, because removal of extracellular divalent cations opens the channel. In this addendum, we demonstrate that removal of extracellular divalent cations potentiates the activation of rBASIC by bile acids, suggesting an allosteric mechanism. Furthermore, we show that rBASIC is strongly activated by the anticholestatic bile acid ursodeoxycholic acid (UDCA), suggesting that BASIC might mediate part of the therapeutic effects of UDCA.