Phylogeography of Human T-lymphotropic Virus Type 1 (HTLV-1) Lineages Endemic to Japan

We conducted phylogenetic analyses and an estimation of coalescence times for East Asian strains of HTLV-1. Phylogenetic analyses showed that the following three lineages exist in Japan: "JPN", primarily com-prising Japanese isolates; "EAS", comprising Japanese and two Chinese isolates, of which one originated fromChengdu and the other from Fujian; and "GLB1", comprising isolates from various locations worldwide, includinga few Japanese isolates. It was estimated that the JPN and EAS lineages originated as independent lineages approx-imately 3,900 and 6,000 years ago, respectively. Based on archaeological findings, the "Out of Sunda" hypothesiswas recently proposed to clarify the source of the Jomon (early neolithic) cultures of Japan. According to thishypothesis, it is suggested that the arrival of neolithic people in Japan began approximately 10,000 years ago, witha second wave of immigrants arriving between 6,000 and 4,000 years ago, peaking at around 4,000 years ago. Esti-mated coalescence times of the EAS and JPN lineages place the origins of these lineages within this 6,000-4,000 year period, suggesting that HTLV-1 was introduced to Japan by neolithic immigrants, not Paleo-Mongoloids.Moreover, our data suggest that the other minor lineage, GLB1, may have been introduced to Japan by Africansaccompanying European traders several centuries ago, during or after "The Age of Discovery." Thus, the resultsof this study greatly increase our understanding of the origins and current distribution of HTLV-1 lineages in Japanand provide further insights into the ethno-epidemiology of HTLV-1

A questionnaire survey of pharmacists regarding the clinical practice guidelines for the appropriate use of granulocyte-colony stimulating factors

Abstract Background Clinical practice guidelines should be user-friendly and confirming their penetration rate and compliance are critical. Methods We conducted a nationwide web-based questionnaire survey among pharmacists regarding the 2013 guidelines for the appropriate use of granulocyte-colony stimulating factors (G-CSFs) (version 2, published by the Japan Society of Clinical Oncology [JSCO]) between August 24 and September 6, 2015. Results A total of 301 pharmacists responded; 96.0% belonged to hospitals and were board-certified pharmacists in oncology pharmacy (n = 133) and palliative pharmacy (n = 78). In addition, 61.5% of respondents (n = 185) worked for designated cancer care hospitals. The observation that 75.7% of respondents knew that the JSCO guidelines are available on the internet indicated that several pharmacists used this guideline. A high degree of usability by pharmacists was also demonstrated, as 98.0% and 51.5% of respondents, respectively, agreed with the statements “it is useful for the work of pharmacists” and “it is referred to in the actual work of pharmacists”. However, more than half of the respondents (58.4%) agreed with the phrase “there are differences from the actual work of pharmacists”. Conclusions Their responses indicated that the respondents used the G-CSF guidelines and viewed them positively; however, the observation that about half of the respondents reported feeling that the guidelines do not match their current practice requires additional follow-up in future studies. The use of these guidelines should be routinely assessed in order to introduce novel cancer chemotherapy regimens and long-acting G-CSF in clinical practice