Deep and repetitive transcranial magnetic stimulation improves motor dysfunction after basal ganglia infarction: preliminary findings on efficacy and electrophysiological mechanisms

ObjectiveTo observe the therapeutic effects of deep transcranial magnetic stimulation (dTMS) and repetitive transcranial magnetic stimulation (rTMS) on upper and lower limb motor dysfunction in patients with basal ganglia infarction, and to preliminarily explore their underlying electrophysiological mechanisms.MethodsThirty patients with motor dysfunction secondary to basal ganglia infarction, hospitalized at the Affiliated Hospital of North Sichuan Medical College between October 2024 and December 2025, were enrolled in this study. All eligible participants were randomly assigned to one of three treatment groups: dTMS (n = 10), rTMS (n = 10), or sham stimulation (n = 10). All patients in the three groups received routine medical treatment and conventional rehabilitation training. On this basis, the dTMS group was treated with 10 Hz dTMS, the rTMS group with 10 Hz rTMS, and the sham stimulation group with sham stimulation, 5 sessions per week for 2 consecutive weeks. Before treatment, on the first day after treatment, and at 30 days after treatment, the Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS), and Modified Barthel Index (MBI) were used to evaluate motor function of the affected side and activities of daily living. The resting motor threshold (rMT) and central motor conduction time (CMCT) of the affected hemisphere were measured simultaneously.ResultsThe baseline data among the three groups were comparable (all p > 0.05); After treatment, there was a statistically significant interaction between group and time in FMA-UE, FMA-LE, MBI, and BBS scores among the three groups (all p < 0.05); Compared with baseline, FMA-UE, FMA-LE, MBI, and BBS scores were significantly increased on the first day and at 30 days after treatment in all three groups (all p < 0.001); Compared with the sham stimulation group, the dTMS group exhibited higher FMA-UE, FMA-LE, MBI, and BBS scores on the first day and at 30 days after treatment (all p < 0.05); Compared with the rTMS group, the dTMS group showed no significant differences in FMA-UE and MBI scores on the first day after treatment (all p > 0.05), but higher FMA-LE and BBS scores (all p < 0.05), at 30 days after treatment, FMA-UE, FMA-LE, MBI, and BBS scores were all higher in the dTMS group (all p < 0.05). There was a statistically significant interaction between group and time in rMT and upper limb CMCT among the three groups after treatment (all p < 0.05); Compared with baseline, rMT and upper limb CMCT were significantly decreased on the first day and at 30 days after treatment in all three groups (all p < 0.001); Compared with the sham stimulation group, the dTMS group had lower rMT and upper limb CMCT on the first day and at 30 days after treatment (all p < 0.05); Compared with the rTMS group, the dTMS group showed lower rMT and upper limb CMCT on the first day after treatment (p < 0.05), at 30 days after treatment, rMT was lower (p < 0.05), while no significant difference was found in upper limb CMCT (p > 0.05).Conclusion(1) Both high-frequency dTMS and rTMS can improve upper limb motor dysfunction after basal ganglia cerebral infarction to some extent, and the therapeutic effect of dTMS lasts longer; (2) dTMS has a certain rehabilitative effect on lower limb motor and balance function; (3) The mechanisms underlying the improvement of motor dysfunction after basal ganglia cerebral infarction by high-frequency dTMS and rTMS may be associated with increased excitability of the affected cerebral cortex, enhanced function of the corticospinal tract pathway. In addition, dTMS can directly act on deeper and wider brain regions; (4) Both high-frequency dTMS and rTMS are safe.

Efficacy Evaluation of Intelligent Rehabilitation Programs Based on AI-Powered Digital Rehabilitation System for Subacromial Impingement Syndrome

Conditions: Articular; Range of Motion

Interventions: Other: Home-based Rehabilitation Training Combined with Intelligent Rehabilitation Training; Other: Traditional Rehabilitation Training; Other: Prescribe home-based rehabilitation prescriptions for home rehabilitation training

Sponsors: Peking University Third Hospital

Not yet recruiting

Digital Pathology and the NHS: Overcoming Barriers to a More Connected Future

As demand on National Health Service (NHS) U.K. pathology services continues to rise, the shift toward digital pathology has never been more critical. While the NHS 10 Year Plan identifies it as one of the system’s most transformative enablers, digital pathology adoption remains uneven. Damian Doherty, Editor in Chief of Inside Precision Medicine, sat down with Olga Colgan, PhD, strategic marketing director at Leica Biosystems, and Darren Treanor, MB BCh, PhD, consultant histopathologist at Leeds Teaching Hospitals NHS Trust, to explore the pressures facing today’s pathology departments, the transformative potential of digital workflows, and how collaborative partnerships are helping accelerate progress and unlock the full value of digital diagnostics.

 

Q: The NHS 10 Year Health Plan identifies digital pathology as one of three fundamental shifts, yet adoption remains limited. What are the key barriers?

Olga Colgan
Olga Colgan, PhD

Olga Colgan: Many pathology departments today are already stretched thin by managing growing workloads, which can make it difficult to pause and do a thorough workflow examination and consider process improvements. Transitioning to digital pathology requires an investment and openness to change. For decades, pathology has been optimized for glass slide review under a microscope, so moving to digital is not just a technology upgrade, but a cultural shift for laboratory staff and clinicians who value the familiarity and comfort of traditional methods.

Proper capital allocation and investment are critical to unlock the benefits of digital pathology. For example, information technology (IT) infrastructure must be capable of supporting high-resolution imaging, secure storage, and rapid sharing of thousands of slides. Regulatory needs must also be considered, as each lab must validate digital workflows to ensure appropriate compliance.

While these upfront hurdles can seem daunting, they lead to significant long-term gains. Digital workflows enable faster slide sharing, improve access to subspecialists, and ultimately improve turnaround times—delivering real benefits for both laboratory teams and patients eagerly waiting for critical results.

 

Q: What are the key benefits of digital pathology that make it such a crucial step for modernizing NHS pathology services—particularly in terms of workflow efficiency, diagnostic accuracy, and collaborative decision-making?

Colgan: Digital pathology is the quintessential modernization of a pathology laboratory, driving efficiencies in workflows, accuracy, and collaboration. Centralized digital storage provides instant access to prior cases and supports predictive analytics. Eliminating physical slides from the workflow after scanning reduces breakage risks and concerns, misidentification risks, along with space and storage needs.

Beyond efficiency gains, digital pathology unleashes the power of remote collaboration. The ability to share whole-slide images instantly means pathologists can quickly leverage remote expertise within their network, or obtain second opinions in minutes rather than days, accelerating diagnostic confidence and treatment decisions. It also extends expertise beyond geographic boundaries, removing the “postcode-lottery” and providing a basis for equity in pathology diagnostics. This enables rural or underserved regions to access pathologists without the delays, costs, and concerns of physical slide transport. This connectivity transforms pathology into a truly networked resource, ensuring that expertise is available whenever and wherever it’s needed, even after hours.

Further, although in the early stages of routine usage, artificial intelligence (AI) models can add another layer of support by bringing greater quantification and reproducibility to slide analysis, highlighting subtle patterns or abnormalities that may be difficult to identify by eye. Effectively, AI can act as a second set of eyes to further build diagnostic confidence and augment—rather than replace—pathologist review.

 

Q: How are companies like Leica Biosystems supporting NHS trusts in overcoming digital pathology adoption challenges?

Colgan: It starts with listening. We understand that every laboratory and every pathology department has unique workflows, bottlenecks, and priorities, so our first step is a conversation and analysis to identify those needs and design a tailored roadmap for transformation. This isn’t just about technology; it’s about creating solutions that make the pathology workloads more sustainable, especially at a time when the profession faces significant workforce shortages.

Leica Biosystems partners with labs to deliver systems that meet their demands today, while anticipating future growth and scalability. A great example is Leeds Teaching Hospital and the National Pathology Imaging Co-operative. Combined, they make up the largest national integrated digital pathology network in Europe for routine diagnostics—a milestone that demonstrates what’s possible when technology and collaboration come together. The Leeds Guide to Digital Pathology, volume one and volume two, is packed with practical tips and pragmatic approaches to support successful digital pathology adoption.

 

Q: What influenced Leeds Teaching Hospital to adopt digital pathology, and what transformation have you experienced?

Darren Treanor
Darren Treanor, MB BCh, PhD

Darren Treanor: We’ve been involved with digital pathology since the very early days of the technology, and it has become the essential foundation of our teaching and research work at the University of Leeds. We had taken a cautious approach to clinical adoption until we were convinced that the technology was ready—both in terms of clinical safety and technical readiness—and we could ensure that it worked and was safe.

We decided that the threshold for adoption for clinical use was reached in 2015, when we established that the clinical safety was acceptable and that the scanners and viewing software were fit for purpose and would not slow us down. Working in partnership with Leica Biosystems, we adopted a phased approach to 100% digital scanning, starting with a “meaningful pilot” with our four breast pathology colleagues. This group was the most pro-digital in the department and, being located in a separate building, had experienced frustrating delays in the delivery of glass slides between the main lab and their offices. They actively pursued us to “go digital.” The pilot with them was critical for us in planning the laboratory and clinical workflow reconfigurations needed to go digital and, importantly, developing a verification and validation process that allowed us to transition from glass to digital slides while maintaining safety. This process became the foundation of the U.K. Royal College of Pathologists guidelines for digital pathology, which have been adopted in many other countries as well.

We then looked toward the further summit of “100% digital” and took a phased approach, starting with immunohistochemistry (IHC). As a separate part of the lab, this activity could be separately digitized. With digital review of IHC being a lower-risk activity clinically, it allowed us to introduce the rest of our over 40 pathology consultants to the idea of diagnosis on a digital image. Once that was completed, we moved in one final big step to 100% digital scanning, reaching that milestone on a summer’s day in 2018.

 

Q: What lessons can other NHS trusts learn from your digital transformation journey, and what should be considered as they examine their current workflows?

Treanor: Because of our academic background and partnership with Leica Biosystems, we were very keen to share our experiences of going digital and how to do it. Too many deployments would talk of the great success in using whole-slide imaging, but gloss over the challenges and effort involved in getting there.

We wrote the Leeds guides to provide really simple general-purpose assistance to other labs that are new to digital pathology and didn’t have the benefit of in-house expertise yet.

Looking back, being early adopters, we had the unique challenge of being one of the first centers to go fully digital and pave the way at a time when scanners, displays, and software were just good enough, and the combined global experience of digital pathology was low. We have run many workshops to share our experiences, and it has been interesting to see how the field has evolved in recent times and how much easier it is now to go digital. There are far fewer “unknowns” when going digital now, and modern scanners and workflows are significantly better. For example, our current setup has a very smooth transition from H&E [hematoxylin and eosin] stainer to scanner, which saves a lot of time in the lab and removes a major obstacle to lab operation that we had to work around in the early years. In our early workshops, a deployment was often a multi-year project with a lot of uncertainty and need for a lot of preparatory work; nowadays, labs are much more digital-ready, the timelines are much shorter, and success rates are much higher!

The post Digital Pathology and the NHS: Overcoming Barriers to a More Connected Future appeared first on Inside Precision Medicine.

Trajectories and predictors of self-care from pre-discharge to 12 months after discharge in people with spinal cord injury: a longitudinal study using growth mixture modeling

IntroductionSelf-care is essential for preventing secondary complications and supporting community reintegration after spinal cord injury (SCI). However, evidence is limited on how self-care changes over time after discharge and whether distinct subgroups exhibit different trajectories.MethodsUsing convenience sampling, 220 patients with SCI were recruited from a tertiary hospital in northern China between August 2023 and December 2024. Self-care was measured with the Self-Care in Spinal Cord Injuries Inventory (SC-SCII) at pre-discharge baseline and at 1, 3, 6, and 12 months after discharge. Baseline mental health literacy and perceived social support were assessed using the Multicomponent Mental Health Literacy Scale (MMHL) and the Perceived Social Support Scale (PSSS). Repeated-measures ANOVA was used to describe the population-average time trend, and growth mixture modeling (GMM) was used as the primary person-centered analysis to identify latent trajectory classes. Multinomial logistic regression examined predictors of class membership.ResultsA total of 209 patients completed all assessments (attrition rate: 5.0%). Mean SC-SCII scores peaked at 1 month post-discharge and then declined gradually over 12 months (F = 25.965, p < 0.001). GMM identified three distinct self-care trajectories: low-level decreasing (31.1%), moderate-level stable (39.7%), and high-level increasing (29.2%), with high classification accuracy (entropy = 0.965). Sex, educational level, mental health literacy, and perceived social support were associated with trajectory membership.ConclusionSelf-care trajectories after SCI are heterogeneous, and early post-discharge improvements may be transient for many individuals. The identified trajectories provide preliminary evidence for developing future prediction tools and trajectory-informed transitional nursing interventions.

STAT+: Wearables, and the flood of data they generate, inch closer to entering the clinic

A major selling point for wearable devices is the promise that they’ll help identify hidden health conditions before they lead to major harm. But a nagging issue has been the connection to clinician guidance when a smartwatch or ring raises the alarm.

To help address this issue, wearable makers Oura and Whoop recently announced they’ll make it possible for users to connect virtually with doctors directly from their apps. While the move could represent the first step in the long-awaited adoption of consumer health data by traditional clinical care, experts cautioned that the bar for data in clinical decision-making is higher than for simple wellness purposes. The Food and Drug Administration has only authorized a handful of wearable features for clinical use, and the evidence base for using wearable data to inform medical care is nascent. Widespread use by clinicians will take considerably more work.

“This was an inevitable development,” said Ida Sim, a physician and professor at the University of California, San Francisco, who studies how to make best use of consumer health data. “We’ve got these sensors that have ostensibly valuable data … but we haven’t even begun to tap into the real clinical value.”

Continue to STAT+ to read the full story…

STAT+: Trump’s health care affordability czar touts Medicaid cuts to hospital leaders

NATIONAL HARBOR, Md. — Hospital finance leaders rolled out the red carpet for the Trump administration’s new health care affordability czar at an industry conference on Monday. He promptly took the main stage to champion Medicaid cuts that threaten their bottom lines. 

Casey Mulligan, appointed by Robert F. Kennedy Jr. as the Department of Health and Human Services’ chief economist and chief regulatory officer in April, spent most of his speech at the Healthcare Financial Management Association’s conference praising the One Big Beautiful Bill Act’s cuts to state-directed payments, which the government projects could save $510 billion over 10 years. 

State-directed payments work by first taxing Medicaid providers like hospitals and nursing homes, using that money to obtain federal Medicaid match dollars, and then redistributing the money to providers, often giving them more than they paid in taxes. Since 2024, some providers have gotten reimbursed at much higher commercial rates. The One Big Beautiful Bill Act will gradually trim those payments beginning in 2028 until they’re close to or on par with Medicare rates. 

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