RESUMEN
Background: Childcare leave extensions can sometimes negatively affect the professional clinical training of early-career psychiatrists in Japan. During childcare leave, being able to learn in the examination room while staying at home would be useful. Therefore, we developed a training system using a teleoperated robot (Sota) for young psychiatrists who wanted to participate in the examination room during childcare leave while remaining at home. Case Presentation: We report the case of a patient with autism spectrum disorder (ASD) comorbid with Tourette's disorders (P). A young female psychiatrist (D) used the training system to learn from a board-certified psychiatrist. In this case, the board-certified psychiatrist, P, and the robot were placed in the examination room. D teleoperated Sota from home, allowing her to talk to the board-certified psychiatrist and P. She learned about the clinical features of Tourette's syndrome by observing the examination of the board-certified psychiatrist and hearing the patient's distress. P was satisfied with the fact that he was seen not only by a board-certified psychiatrist but also by D. Conclusion: These case findings suggest that our system is helpful for young psychiatrists who want to study in the examination room during childcare leave while staying at home. Future studies should include a single-case experimental design with information regarding key outcome variables and other relevant variables gathered regularly over time.
RESUMEN
Background: Providing medical care on isolated islands can be challenging in several ways. Telepsychiatry can potentially offer a solution for accessible psychiatric services on isolated islands. When video conferencing is used in telepsychiatry, the psychiatry specialist, who is remotely located, may find it difficult to establish trust. To address this, we developed a teleoperated robot system termed "Sota 100," which is equipped to convey various elements of nonverbal communication, such as eye contact, in remote settings. Case Presentation: In this report, we introduce the case of a patient with alcohol use disorder who lived on an isolated island and received medical care from a primary care physician at the island's medical clinic and from Sota 100 teleoperated by a psychiatry specialist. Using this system, the patient admitted that he had developed a physical illness and had damaged his relationships partly because of alcohol abuse. At the conclusion of the three-way conversation, the patient understood that stopping drinking alcohol was the only way to prevent worsening his physical condition and damaging his relationships further. Concurrently, the primary care physician gained a deeper understanding of the etiology of alcohol use disorder and of how to support patients with alcohol dependency. Conclusion: These case findings suggest that our system is helpful for patients with alcohol use disorder who need to receive telepsychiatry services. Future studies should include single-case experimental designs with regular measurements of key outcome variables and other relevant variables over time.
RESUMEN
Previous studies have demonstrated the expression of specific members of the glial cell line-derived neurotrophic factor (GDNF) receptor family alpha (GFRalpha) in subsets of motoneurons (MNs) in the developing mouse spinal cord. We examined the expression pattern of GFRalpha and RET in the avian lumbar spinal cord during the period of programmed cell death (PCD) of MNs by using double labeling in situ hybridization and immunohistochemistry. In the lateral motor column (LMC) of the lumbar spinal cord, a laminar organization of GFRalpha expression was observed: GFRalpha1-positive MNs were located in the medial LMC; GFRalpha1-, 2-, and 4-positive MNs were situated in the lateral LMC; and GFRalpha4-positive MNs were located in the intermediate LMC. The species of GFRalpha receptor that was expressed in MNs was found to be related to their birthdates. The expression of subpopulation-specific transcriptional factors was also used to define MNs that express a specific pattern of GFRalpha. This analysis suggests that motor pools as defined by these transcriptional factors have unique expression patterns of GFRalpha receptor. Early limb bud ablation did not affect the expression of GFRalpha in the spinal cord, indicating that regulation of receptor expression is independent of target-derived signals. Finally, GDNF mRNA expression was found in the limb during the PCD period of MNs. In conclusion, these results indicate that time of withdrawal from the mitotic cycle may specify the expression pattern of GFRalpha in subsets of MNs and that GDNF may function as a target-derived neurotrophic factor for specific subpopulations of MNs.