Friday, September 05, 2025

Duke-NUS sharpens focus on population health to curb rising healthcare costs and chronic disease burden

Duke-NUS Medical School

Group Photo of HSRPH leaders — image:
(third from left) Guest-of-Honour Professor Lee Chien Earn, Deputy Group CEO, Regional Health System, SingHealth; Professor David Matchar, HSRPH Programme and inaugural Director of HSSR; Professor Patrick Tan, Dean-designate, Duke-NUS Medical School; Professor Marcus Ong, Director of HSRPH; as well as researchers and healthcare leaders spearheading the HSRPH programme
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Credit: Duke-NUS Medical School

Singapore’s health system is under growing pressure from rising costs, an ageing population, and the growing burden of chronic diseases. Duke-NUS Medical School is responding by sharpening its focus on population health and technology-enabled research — a strategy now being embedded into its rebranded Health Services Research and Population Health (HSRPH) Programme, which aims to harmonise with and shape national policies, improving patient outcomes and delivering more cost-effective care.

Examples of such research include: a potentially scalable nationwide model for controlling hypertension, which could be delivered at S$20 per patient per month. Combining algorithm-driven treatment plans for prescribing subsidised medication and motivational follow-up telephone calls from nurses, this approach not only helps patients manage blood pressure but also reduces the risk of heart diseases at a fraction of current costs.

Another example is a Duke-NUS study, in collaboration with SingHealth, that evaluates the cost-effectiveness of a 4 Dimensional Disease Outbreak Surveillance System (4D-DOSS[1]), a novel digital twin system called that functions as a “hospital infection radar” by mapping disease spread across wards. These evaluation findings are now being used to guide implementation at Singapore General Hospital, with expansion to Changi General Hospital (CGH) and other hospitals in the pipeline. (More details on the projects are available in Annex A.)

To empower more healthcare professionals and clinicians to pursue research in population health, the rebranded Health Services Research and Population Health (HSRPH) programme will be launching new education pathways to enhance professional capabilities in this key research area.

Professor Marcus Ong, Director of the Health Services Research & Population Health Programme (HSRPH) at Duke-NUS, explained:

“We are not just studying problems — we are delivering solutions policymakers can use today to keep care affordable and accessible. More high-quality, technology-driven research in population health and health services is urgently needed to inform policies and bring about faster, easier and more affordable access to healthcare.”

To cultivate the next generation of population health researchers, HSRPH is also reviewing its education offerings and plans to offer new postgraduate programmes in Population and Health Services Research. These specialised programmes will equip clinicians and healthcare professionals with advanced technological tools while honing their skills in emerging areas such as health technology and economic assessment. It will also allow them to tap into a nationwide network of clinicians and researchers to foster collaboration and empower them to effect change in healthcare policies and strategies.

Professor Nicholas Graves, Deputy Director of the HSRPH Programme at Duke-NUS and lead in designing the new postgraduate offerings, said:

“We need professionals who can harness technology, drive innovation and work seamlessly with health systems. Our new specialised programmes will grow a dynamic talent pool, cultivating expertise in emerging fields such as quantitative analysis and data science, while unlocking fresh pathways for career advancement.”

The Programme’s new direction will strengthen collaborative efforts between SingHealth and Duke-NUS, bringing together various entities from the SingHealth-Duke-NUS Academic Medical Centre and supporting researchers working on population health.

Maximising national health outcomes through collaboration, resource optimisation, and training, this focus on population health will align with Healthier SG, a national initiative by Singapore’s Ministry of Health focusing on preventive health.

Professor Thomas Coffman, Dean of Duke-NUS, said:

“To address Singapore’s healthcare challenges including its ageing population, the Ministry of Health has emphasised the importance of population health through programs such as Healthier SG. To better align with these efforts and to underscore our commitment, we are re-branding the Health Services Research and Population Health programme positioning Duke-NUS to better contribute to transforming population health across Singapore and around the world.”

As Singapore rolls out Healthier SG, the sharpened focus on population health at Duke-NUS ensures that policy-makers and hospitals have access to evidence-based, scalable, and cost-effective solutions. This is in line with the School’s ambition to help Singaporeans live longer, healthier lives while strengthening the nation’s position as a global leader in medical education, biomedical research, and healthcare innovation.

[1] https://www.singhealth.com.sg/news/healthtech/singhealth-charts-the-way-for-real-time-applications-of-digital-twin-technology-as-early-testing-shows-potential-benefits-in-healthcare-settings

New ultrasound helmet enables deep brain stimulation in people without surgery

University College London

Illustration of new ultrasound device — image:
Cross section of the water-filled ultrasound helmet showing the ultrasound sources that transmit focused waves into the brain
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Credit: Morgan Roberts

An ultrasound device that can precisely stimulate areas deep in the brain without surgery has been developed by researchers from UCL and the University of Oxford, opening up new possibilities for neurological research and treatment of disorders such as Parkinson’s disease and depression.

Scientists have long been looking for a way to modulate brain function, which could improve our understanding of how the brain works and help to treat neurological diseases, using non-invasive methods that don’t involve surgery.

One technology that could help is transcranial ultrasound stimulation (TUS), which was recently discovered to be able to modulate the activity of neurons (the brain's key communication cells) by delivering gentle mechanical pulses that influence how these cells send signals.

But to date current systems have struggled to reach deeper areas of the brain with sufficient precision to target specific brain structures. Conventional TUS systems often affect broader regions than intended, limiting their utility for targeted neuromodulation.

The study, published in Nature Communications, introduces a new ultrasound device capable of influencing deep brain regions without surgery for the first time, targeting areas around 1,000 times smaller than conventional ultrasound devices can pinpoint and 30 times smaller than previous deep brain ultrasound devices.

The new technology features 256 elements configured within a special helmet to send focused beams of ultrasound to specific parts of the brain in order to turn neuronal activity up or down. It also includes a soft plastic face mask which helps to target the ultrasound waves more precisely by keeping the head still.

The research team demonstrated the system’s capabilities on seven human volunteers by targeting a part of the thalamus, a small structure in the centre of the brain that helps to relay sensory and motor information, called the lateral geniculate nucleus (LGN). The LGN is involved in processing visual information.

In the first experiment, participants looked at a flashing checkerboard, which sent signals to the brain through the eyes. During stimulation with the ultrasound device, a functional magnetic resonance imaging (fMRI) scan showed significantly increased activity in the participants’ visual cortex, confirming precise targeting of the LGN.

A second experiment revealed sustained decreases in visual cortex activity for at least 40 minutes after ultrasound stimulation, highlighting the system’s potential for inducing lasting changes in brain function.

Though participants did not consciously perceive any changes in what they were seeing during the experiments, the brain scans revealed significant changes in neural activity. The ultimate goal is to harness these effects to produce clinically beneficial outcomes, such as stopping hand tremors.

Professor Bradley Treeby, senior author of the study from UCL Medical Physics and Biomedical Engineering, said: “This advance opens up opportunities for both neuroscience research and clinical treatment. For the first time, scientists can non-invasively study causal relationships in deep brain circuits that were previously only accessible through surgery.

“Clinically, this new technology could transform treatment of neurological and psychiatric disorders like Parkinson's disease, depression, and essential tremor, offering unprecedented precision in targeting specific brain circuits that play key roles in these conditions.

“The ability to precisely modulate deep brain structures without surgery represents a paradigm shift in neuroscience, offering a safe, reversible, and repeatable method for both understanding brain function and developing targeted therapies.”

In addition to its research applications, the system could pave the way for new clinical interventions. Deep brain stimulation (DBS), currently used to treat conditions like Parkinson’s disease, requires invasive surgery and carries associated risks. The new ultrasound system offers a non-invasive alternative with comparable precision, potentially allowing clinicians to test areas of the brain that could be used to treat disease before surgery or even replace surgical approaches altogether.

Recognising this clinical potential, several members of the research team have recently founded NeuroHarmonics, a UCL spinout company developing a portable, wearable version of the system. The company aims to make precise, non-invasive deep brain therapy accessible for both clinical treatment and broader therapeutic applications.

Dr Eleanor Martin, first author of the study from UCL Medical Physics and Biomedical Engineering, said: “We designed the system to be compatible with simultaneous fMRI, enabling us to monitor the effects of stimulation in real time. This opens up exciting possibilities for closed-loop neuromodulation and personalised therapies.”

The researchers emphasise that further studies are needed to fully understand the mechanisms underlying TUS-induced neuromodulation. However, the results mark a significant milestone in the development of safe, effective, and targeted brain stimulation technologies.

Dr Ioana Grigoras, a first author of the study from the Nuffield Department of Clinical Neurosciences, University of Oxford, said: "This novel brain stimulation device represents a breakthrough in our ability to precisely target deep brain structures that were previously impossible to reach non-invasively. We are particularly excited about its potential clinical applications for neurological disorders like Parkinson's disease, where deep brain regions are especially affected."

The study was supported by the Engineering and Physical Sciences Research Council (EPSRC), Wellcome, and the NIHR Oxford Health Biomedical Research Centre.

Notes to Editors:

For more information, please contact:

Dr Matt Midgley

+44 (0)20 7679 9064

m.midgley@ucl.ac.uk

Publication:

Eleanor Martin, Morgan Roberts, Ioana F. Grigoras, Olivia Wright, Tulika Nandi et al. ‘Ultrasound system for precise neuromodulation of human deep brain circuits’ is published in Nature Communications.

DOI: https://doi.org/10.1038/s41467-025-63020-1

About UCL – London’s Global University

UCL is a diverse global community of world-class academics, students, industry links, external partners, and alumni. Our powerful collective of individuals and institutions work together to explore new possibilities.

Since 1826, we have championed independent thought by attracting and nurturing the world's best minds. Our community of more than 50,000 students from 150 countries and over 16,000 staff pursues academic excellence, breaks boundaries and makes a positive impact on real world problems.

The Times and Sunday Times University of the Year 2024, we are consistently ranked among the top 10 universities in the world and are one of only a handful of institutions rated as having the strongest academic reputation and the broadest research impact.

We have a progressive and integrated approach to our teaching and research – championing innovation, creativity and cross-disciplinary working. We teach our students how to think, not what to think, and see them as partners, collaborators and contributors.

For almost 200 years, we are proud to have opened higher education to students from a wide range of backgrounds and to change the way we create and share knowledge.

We were the first in England to welcome women to university education and that courageous attitude and disruptive spirit is still alive today. We are UCL.

www.ucl.ac.uk | Follow @uclnews on Bluesky | Read news at www.ucl.ac.uk/news/

A volunteer wearing the new ultrasound device preparing to go into the fMRI scanner.

Credit
Brad Treeby/UCL

Journal

Nature Communications

DOI

10.1038/s41467-025-63020-1

Method of Research

Experimental study

Subject of Research

People

Article Publication Date

5-Sep-2025

New clinical trial to test sensory prostheses for people with upper-limb loss

$9.9 million grant awarded to Case Western Reserve University researchers for neuroprostheses that restore sense of touch

Case Western Reserve University

CLEVELAND—Technology developed at Case Western Reserve University can restore a sense of touch that makes a prosthetic hand feel like a part of one’s own body instead of feeling artificial and disconnected.

Now this technology will take a major step toward commercialization: in a new clinical trial, 12 people with upper limb amputation will be recruited to compare standard prosthetic arms and hands to the sensory-enabled neural-controlled prostheses developed at the university since 2015.

Researchers at Case Western Reserve and the Louis Stokes Cleveland Department of Veterans Affairs Medical Center (Cleveland VA) have received a $9.9 million award from the U.S. Department of Defense Congressionally Directed Medical Research Program for the trial.

“People with upper-limb-loss deserve to have better technologies that can improve their lives,” said Emily Graczyk, assistant professor of biomedical engineering in the Case School of Engineering and School of Medicine, who is leading the research. Graczyk is also an investigator at the Cleveland VA.

The neuroprosthesis

The neuroprosthesis, called “iSens,” for implanted Somatosensory Electrical Neurostimulation and Sensing system, uses electrodes implanted in the arm that detect muscle movement to control the hand and stimulate nerves, sending touch sensation from the fingertips of the prosthesis to the brain. An implanted neural control device communicates between the electrodes and prosthesis through Bluetooth.

The groundbreaking research was featured in a 2023 segment on 60 Minutes.

Researchers plan to begin enrolling participants early next year.

“The significant funding allows us to complete this clinical trial that wouldn't necessarily get venture capital investment at this stage,” said Dustin Tyler, the Arthur S. Holden Professor of biomedical engineering and the study’s coinvestigator. “This grant will allow us to remove one big barrier to translation.”

Tyler is also director of Case Western Reserve’s Human Fusions Institute (HFI), dedicated to expanding human capabilities through advanced, human-connected, ethically driven technology.

The university initially received an eight-year, $14 million grant through 2023 from the Defense Advanced Research Projects Agency (DARPA) for the neuroprosthetics research. Tyler and Graczyk developed the technology and stimulation techniques that allowed sensory signals to be relayed from the prosthetic hand through neural implants in the subject’s arm.

Even they were surprised in early research how much a sense of touch transformed the prosthesis from a sporadically used tool to something that really felt like having one’s own hand.

“Having a sense of touch improves so many different aspects involved in quality of life,” said Graczyk, “including the sense of connectedness to loved ones, self-sufficiency, self-image and social interaction.”

The clinical trial

The four-year study will enroll a dozen upper-limb amputees using a prosthesis. It will involve three parts, which each study participant will complete over about 18 months:

Part one: A three-month initial testing phase will document how the participants use their current prostheses. Next, each study participant will have electrodes and electronic modules implanted in their arm in an outpatient surgery. The research team will then set-up each participant's neuroprosthetic system over three to six months of laboratory visits. A controller will be built to allow the participant to intuitively control the prosthesis with their muscle signals, and the nerve stimulation will be calibrated so the sense of touch can be relayed from sensors on the prosthetic hand to the user's brain.
Part two: Participants will then either be sent home with the prosthesis they were already using or the touch-enabled, multi-functional research iSens prosthesis. Each participant will complete surveys about how much they used the prosthesis and for what types of tasks and how they felt about using it. They will return to the lab for testing monthly to demonstrate how they use the prosthesis. Then they will switch. Those who first used their normal prosthesis will get the research arm and vice versa.
Part three: In the third phase, the participants will be randomized again into a group that uses the iSens prosthesis with only touch sensation enabled or with only the advanced motor control enabled. And again, they will switch.

“We expect our neuroprosthesis to make life better for people with amputation,” said Graczyk, “but we don’t know if the biggest factor will be improved sensation or improved control, or both.”

Collaborators

Collaborators include, at CWRU: Hamid Charkhkar, assistant professor of biomedical engineering and investigator at the Cleveland VA; Ronald Triolo, professor of biomedical engineering and executive director of the Advanced Platform Technology Center at the Cleveland VA; and Ming Wang, professor of population and quantitative health sciences at the School of Medicine.

At Cleveland medical centers: Kevin Malone, chief of hand and upper extremity surgery at University Hospitals Cleveland Medical Center and associate professor of orthopedic surgery at the CWRU School of Medicine; J. Robert Anderson, orthopedic hand surgeon at University Hospitals, Director of Orthopedic Hand Surgery at the Cleveland VA, and assistant professor of orthopedic surgery at the CWRU School of Medicine; Kyle Chepla, plastic surgeon at MetroHealth Medical Center and associate professor In the CWRU School of Medicine; and Gilles Pinault, chief of vascular surgery at the Cleveland VA and assistant professor of surgery at the medical school.

At other institutions: Linda Resnik, a professor of health services, policy and practice at Brown University.

To participate

For more information about participating in the clinical trial, please contact study coordinator Jessica Jarvela, jrw20@case.edu.

###

A study participant with upper-limb loss using the CWRU-developed sensory-enabled neural-controlled iSens prosthesis. Implanted electrodes capture muscle movement in the remaining arm to control the hand and send sensory information from the fingertips to the nerves.

Leads in the amputated limb record muscle activity to control a prosthetic hand. Electrodes wrap around peripheral nerves, sending signals from the prosthetic fingertips to evoke the sense of touch. The implanted controller communicates via Bluetooth to send control commands from the muscles to the prosthesis and to send sensory signals from the prosthesis to the nerves.
Credit
Cleveland FES Center

Novel accurate approach improves understanding of brain structure in children with ADHD

Researchers demonstrate that the traveling-subject method reduces measurement bias, increasing the reliability of brain imaging studies on ADHD

University of Fukui

Traveling-subject (TS) harmonized brain imaging data shows reduced measurement bias — image:
Brain imaging methods like magnetic resonance imaging (MRI) are used to characterize structural differences in the brains of children with attention-deficit/hyperactivity disorder (ADHD). However, these results are often inconsistent, revealing different results across machines and hospitals. Researchers from Japan employed an approach called the TS method to reduce measurement bias in brain imaging datasets sourced from multiple locations. Their results reveal that, compared to the raw data, TS-corrected data significantly reduced measurement bias and revealed volumetric changes in brain regions in children with ADHD.
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Credit: Associate Professor Yoshifumi Mizuno from the University of Fukui, Japan

Over five percent of children and adolescents are diagnosed with attention deficit/hyperactivity disorder (ADHD) globally. This condition is characterized by a short attention span, hyperactivity or impulsive behavior that is age-inappropriate, making it difficult for patients to navigate interpersonal relationships, the formal education system, and social life. Researchers have used brain imaging analyses such as magnetic resonance imaging (MRI) to understand the neurological basis of ADHD. Understanding brain structure abnormalities that lead to ADHD-related pathologies is crucial for designing early assessment and intervention systems, especially for children.

Although multiple studies have used MRI to understand ADHD in children, the results have been inconclusive. While some brain imaging studies have shown decreased gray matter volume (GMV) in children with ADHD, others have either reported no change or an increase in GMV compared to subjects without ADHD. These conflicting results are mostly due to small sample sizes, differences in MRI machines used, or the variation among the subjects recruited. Previous studies have accounted for the bias caused by different MRI machines using a method called ComBat harmonization, which controls for site and MRI differences in large samples. However, ComBat overcorrects sampling bias, which may include biological characteristics of the sample; therefore, it may not be able to accurately correct the MRI differences.

The traveling-subject (TS) method is a new correction approach to account for variations in measurements across MRI machines for the same subject. In this method, measurement biases can be controlled for the same participants using MRI scans from multiple institutions, facilitating the collection of more accurate datasets. In this collaborative study, Assistant Professor Qiulu Shou and Associate Professor Yoshifumi Mizuno from the University of Fukui, Japan, Professor Yoshiyuki Hirano from Chiba University, Japan, and Professor Kuriko Kagitani-Shimono at The University of Osaka, Japan, validated the TS method in an independent dataset. Their findings were published in Molecular Psychiatry on August 8, 2025.

Dr. Shou introduces the methodological framework of the study: “MRI data of 14 TS, 178 typically developing (TD) children, and 116 children with ADHD were collected from multiple sites, and the TS method and ComBat were used to correct for measurement bias.” Fourteen healthy subjects underwent MRI scans on four different machines over a three-month period to extract measurement biases across these machines. This was then applied to an independent dataset of children from the Child Developmental MRI (CDM) database. The CDM database was jointly established by the University of Fukui, The University of Osaka, and Chiba University, with the goal of collecting brain imaging data from over 1,000 child participants for research on neurodevelopmental disorders such as ADHD. GMV was then estimated and compared between the two groups of children in the study. The research team calculated measurement and sampling biases among TS-corrected, ComBat-corrected, and raw data. The results showed that compared to raw data, the TS method significantly reduced measurement bias while maintaining sampling bias. In contrast, ComBat effectively reduced measurement bias and significantly decreased sampling bias.

“TS-corrected data showed decreased brain volumes in the frontotemporal regions in the ADHD group compared to the TD group,” explains Dr. Mizuno while discussing their findings. “Patients with ADHD displayed smaller volumes in those regions of the brain that are crucial for cognitive functions, such as information processing and emotional control, which are often affected in these patients,” adds Dr. Shou.

Furthermore, if TS-harmonized multi-site MRI data on specific brain structure patterns can be associated with ADHD, they can then be used as neuroimaging biomarkers for accurate and early ADHD diagnosis, treatment, and treatment outcome monitoring, leading to effective personalized therapeutic strategies.

“By applying the TS harmonization method to correct for site-related biases in multi-site MRI data, this study aims to identify brain structure characteristics in children with ADHD. These identified characteristics could facilitate earlier diagnosis and more precise, individualized interventions. In the long term, this approach may improve the quality of life for affected children and reduce the risk of secondary psychiatric disorders,” concludes Dr. Shou.

***

Reference

DOI: https://doi.org/10.1038/s41380-025-03142-6

About the University of Fukui, Japan

The University of Fukui is a preeminent research institution with robust undergraduate and graduate schools focusing on education, medicine and science, engineering, and global and community studies. The university conducts cutting-edge research and strives to nurture human resources capable of contributing to society on the local, national, and global levels.
Website: https://www.u-fukui.ac.jp/eng/

About Assistant Professor Qiulu Shou from the University of Fukui, Japan

Dr. Qiulu Shou serves as an Assistant Professor at the Research Centre for Child Mental Development, University of Fukui, Japan. Additionally, Assistant Professor Shou also works at the United Graduate School of Child Development, The University of Osaka, Kanazawa University, Hamamatsu University School of Medicine, and Chiba University, in Japan. Her areas of expertise include pediatric brain development, neurodevelopment, and developmental disorders of the brain.

About Associate Professor Yoshifumi Mizuno from the University of Fukui, Japan
Dr. Yoshifumi Mizuno, MD, PhD, is an Associate Professor who specializes in MRI-based neuroimaging research on attention-deficit/hyperactivity disorder (ADHD). From 2019 to 2021, he served as a JSPS Overseas Research Fellow at the Department of Psychiatry and Behavioral Sciences, Stanford University, USA, where he contributed to advancing the understanding of ADHD’s neural mechanisms. Currently, Dr. Mizuno leads groundbreaking research as the Principal Investigator of the Division of Affective and Cognitive Development at the Research Center for Child Mental Development, University of Fukui, Japan.

Funding information

This work was funded by the:

Japan Society for the Promotion of Science (JSPS) (KAKENHI; grant numbers: 24K16647, 24K21453, 21K02380, 23K12814, 23H00949, 22H01090, 23K02956, 23K07004, and 24K21493)
Kawano Masanori Memorial Public Interest Incorporated Foundation for Promotion of Pediatrics
The Mother and Child Health Foundation
The Japan-U.S. Brain Research Cooperative Program
University of Fukui, Japan
The Taiju Life Social Welfare Foundation
The Collaborative Research Program of the Collaborative Research Network for Asian Children with Developmental Disorders: MEXT Policy Initiative

Journal

Molecular Psychiatry

DOI

10.1038/s41380-025-03142-6

Method of Research

Imaging analysis

Subject of Research

People

Article Title

Brain structure characteristics in children with attention deficit/hyperactivity disorder elucidated using traveling-subject harmonization

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Friday, September 05, 2025

Duke-NUS sharpens focus on population health to curb rising healthcare costs and chronic disease burden