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Lineal Megalithic Scripts (LMS) have been found in the Alcalar Dolmen complex (Portimao, Portugal) in a stoneslab which is located close to the reconstructed Dolmen 7. Exact situation of the megalithic Alcalar Stoneslab and scripts placing are shown in this paper. Their preliminar analysis has given also finding of some Iberian-Tartessian signs common to Cumbres Mayores Dolmens (Huelva, Spain), and other signs also found in Sahara Desert (Tim Missaou, Algeria) and Canary Islands rocks. The presence of these LMS admixed with some signs contained in the Iberian-Tartessian signary suggests a transition between LMS and lineal Tartessian signary. A religious funerary transcription has been proposed to these Tartessian signs based on Basque and ancient Iberian-Tartessian language close relatedness. The fact that Tartessian culture is located at Portuguese Algarve and Spanish Andalusia fits with the finding that both in Portugal (Alcalar) and Spain (Cumbres Mayores) Dolmens are found Iberian-Tartessian signs that may be as old as the megaliths (3-4 thousand years BC). It is also proposed that this development and concentration of megaliths in Algarve (Portugal) and Andalusia (Spain) is related to Tartessos civilization in the area which would follow the South Iberia Pyrite Belt, rich in cooper (Cu), silver (Ag), gold (Au) and iron (Fe), that crosses South Portugal and Spain; Tartessos would be somewhat attached to the Iberian Pyrite Belt source of richness. Leisners archaeologists also observed and photographed “Iberian” signs in the San Bartolomé Dolmen (Huelva, Spain) in 1951 AD; they described here “Iberian” scripts in a small artifact most likely is a slinger soldier (“hondero”) projectile who could exixt since 3-4000 BC in South Spain.

Kurds are living at Middle East region comprising several countries (38 million people) and also have emigrated to Asia, Europe and America. Kurds from Iran have been HLA typed in the present work from Saqqez and Baneh towns, Kordestan province, Iran. Origin of Kurds is considered autochthonous from Anatolia and surrounding mountains :they have been referred as "the mountain people" by classic Persian, Greek and Roman authors. Present day Turks are also autochthonous from Anatolia, but they were not recognized by classical authors as living in the mountains and they speak a language of Asian origin that was imposed to Anatolia by a "elite" invasion without a noticeable high Asian gene input. Most frequent class I and class II HLA alleles found in Iranian Kurds population are: HLA-A*24:02, A*02:01 and HLA-B*35:01, and HLA-DRB1*11:01, DRB1*03:02 and HLA-DQB1*03:01; also, most frequent HLA extended haplotypes from this Iran Kurdish sample are not shared with Iranians but with Mediterranean, Turkish and Caucasus people. This is confirmed by Neighbour-Joining and correspondence analysis studied together with the corresponding populations. Finally, our studies show that both Kurds and Turks are genetically original from Anatolian Peninsula and surrounding countries and that an apparent Asian genetic or Aryan invasion does not exist in the area.

ClassicalHLA(Human Leukocyte Antigen) is the Major Histocompatibility Complex (MHC) in man. HLA genes and disease association has been studied at least since 1967 and no firm pathogenic mechanisms have been established yet.HLA-Gimmune modulation gene (and also-Eand-F) are starting the same arduous way: statistics and allele association are the trending subjects with the same few results obtained byHLAclassical genes, i.e., no pathogenesis may be discovered after many years of a great amount of researchers’ effort. Thus, we believe that it is necessary to follow different research methodologies: (1) to approach this problem, based on how evolution has worked maintaining together a cluster of immune-related genes (the MHC) in a relatively short chromosome area since amniotes to human at least, i.e., immune regulatory genes (MHC-G, -E and -F), adaptive immune classical class I and II genes, non-adaptive immune genes like (C2, C4 and Bf) (2); in addition to using new in vitro models which explain pathogenetics ofHLAand disease associations. In fact, this evolution may be quite reliably studied during about 40 million years by analyzing the evolution ofMHC-G, -E, -F, and their receptors (KIR—killer-cell immunoglobulin-like receptor, NKG2—natural killer group 2-, or TCR-T-cell receptor—among others) in the primate evolutionary lineage, where orthology of these molecules is apparently established, although cladistic studies show thatMHC-GandMHC-Bgenes are the ancestral class I genes, and that New World apesMHC-Gis paralogous and not orthologous to all other apes and manMHC-Ggenes. In the present review, we outline past and possible future research topics: co-evolution of adaptiveMHCclassical (class I and II), non-adaptive (i.e., complement) and modulation (i.e., non-classical class I) immune genes may imply that the study of full or part of MHC haplotypes involving several loci/alleles instead of single alleles is important for uncovering HLA and disease pathogenesis. It would mainly apply to starting research on HLA-G extended haplotypes and disease association and not only using single HLA-G genetic markers.

In the present paper, we show Iberian or Iberian-Guanche scripts found in the Middle of Sahara Desert, Ti-m Missaou (Tim Missao, Tim Missaw), 270 km SouthWest of Tamanrasset on Ahaggar or Hoggar Mountains (Mts.) area (Algeria). More Iberian scripts may be earthed beneath Sahara Desert sands or have been neglected by observers. We also put forward that Iberian semi-syllabary may have its origin in the Neolithic Saharo-Canarian Circle, the same as other Mediterranean, Atlantic and European lineal scripts (apart from Berber/Tuareg) like Etruscan, Runes, Old Italian languages, Minoan Lineal A, Sitovo and Gradeshnitsa (Bulgaria) writings (6,000 yearsBC) and others. In fact, Strabo wrote that Iberians had written language before since 6,000 BC. On the other hand, Sahara Desert was green and populated since before 5,000 years BC and we had proposed that most of Mediterranean culture, languages and writing, had a Saharan origin. Ti-m Missaou Sahara Iberian inscriptions, together with our previous and others researches on Canary Islands, further support this proposal, i.e.: rock scripts, Gimbutas-like Paleolithic figurines and unusual artifacts, like a lunisolar Egyptian-like calendar (“Cheeseboard/Quesera” at Lanzarote) carved in a Megalithic stone, do no support that Phoenicians and Romans carried Canarian ancient Guanche culture. Finally, a continuous lineal writing systems developing seems to have occurred during Paleolithic and Neolithic Epochs, which also harbor the related incise Lineal Megalithic Scripts that could have given rise to Iberian development and other lineal African, European and Mediterranean lineal language scripts. Our present new data is interpreted in the context of the Sahara people migration which occurred when hyperarid conditions started establishing about 6,000 years BC. Keywords: Iberian, Iberian-Guanche, Scripts, Canary Islands, Lanzarote, Fuerteventura, Prehistory, Saharo-Canarian Circle, Genetics, Megaliths, Iberia, Sahara, Atlantic, Mediterranean, Lineal Scripts, Neolithic, Tamanrasset, Hoggar, Ahaggar, Usko-Mediterranean,Etruscan, Tuareg, Berber, Lineal A.

Greeks have a Sub-Saharan gene input according to HLA and other autosomic markers. Iberians, Canarians, and North Africans show a close genetic relatedness. This is concordant with a drying humid Sahara Desert, which may have occurred about 6,000 years BC, and the subsequent northwards emigration of Saharan people may have also happened in Pharaonic times. Present study confirms this African gene input in Greeks according to 12th HLA International Workshop data, which was studied some years before by us. This genetic input into Atlantic and Mediterranean Europe/Africa is also supported with Lineal Megalithic Scripts in Canary Islands (as well as in Iberia) together with simple Iberian semi-syllabary rock inscriptions both at Canary Islands and Ti-m Missaou (Algeria, Central southern Sahara). Lineal African/European scripts are found in some language scripts like Berber/Tuareg, Iberian, Runes, Etruscan, Bulgarian (Sitovo and Gradeshnitza, 6,000 years BP), Italian Old Scripts (Lepontic, Venetic, Raetic), Minoan Lineal A, and other Aegean scripts. The possibility that Megalithic Lineal Scripts have given rise to these languages lineal writing is feasible because admixture of languages rock scripts and Megalithic Lineal Scripts may be found. Thus, resistance of Canarian aborigines (Guanches) to Cartago, Rome and Arabs left a bulk of Canarian-Saharan information which is used to study both Saharan and Canarian Prehistory, and also Atlantic and Mediterranean beginning of European and other civilizations: this preserved prehistoric inheritance may be named the “Saharo-Canarian Circle” of prehistoric knowledge. Also, linguisticsepigraphy, physical anthropology ,archaeology and domesticated cattle shows a close North Africa-Iberia Mesolithic/Neolithic relationship and demonstrates that the demic diffusion model does not exist in Iberia. Also, Tassili Sahara paintings of domesticated cattle appear 1,000 years before that agricultural practices started at Middle East. Keywords: Greeks, Macedonians, Sahara, Africa, Iberia, HLA, Genetics, Spaniards, Portuguese, Berbers, Algerians, demic, diffusion, Canary Islands, Lanzarote, Malta, Cart-ruts, Quesera, Cheesboard, Iberian, language, Guanche, Usko-Mediterranean, Phoenicians

HLA-G allele frequencies were studied in Yucatán (Mexico) Maya Amerindians by a direct exon DNA sequencing technique. It is described that Mayas are probably one of the first populations together with Olmecs that populated Meso America and that important HLA genetic differences between Mexican and Guatemalan Mayas support that Maya languages were imposed to several neighbouring Amerindian groups. HLA-G*01:01:02, HLA-G*01:01:01 and HLA-G*01:04:01 are the most frequent alleles in this population. It is remarkable that HLA-G*01:05N allele was not found in the population in accordance with similar results found in another Amerindians. Also, protein allele HLA-G*01:04 frequency is found not to differ to those found in another far or close living Amerindians in contrast to other World populations. It seems that while high HLA-G*01:05N frequency is found in Iran and Middle East populations, probably where this allele appeared within an ancestral HLA-A*19 group of alleles haplotype and it is maintained by unknown evolutionary forces, Amerindians do not have a high frequency because a founder effect or because required natural evolutionary forces do not exist in America. Finally, we believe useful to study HLA-G evolution for its physiopathology understanding in addition to the many papers on statistics on HLA-G and in vitro models that are yearly published.

A big megalithic complex has been described at Cumbres Mayores (Huelva, Spain): it is composed of menhirs, a cromlech and some other not yet fully studied structures. Lineal Megalithic Scripts are present both on the rocks and the menhirs which also contain figure engravings. Iberian signs included within Iberian-Tartessian semi-syllabary are also found mixed with Megalithic scripts; Leisner archaeologists also noticed “Iberian Megalithic scripts” in 1951 at San Bartolomé Dolmen (Huelva). They are the same signs that also appear at a Sahara Desert cave (Ti-m Missaou, Algeria) and rocks throughout all seven Canary Islands. Lineal Megalithic Scripts have also been found in other Andalusian megaliths (dolmens) and throughout Andalusia in many big or small stones both in megalithic or non-megalithic contexts. These Iberian-Tartessian semi-syllabary signs present in a megalithic context would drive Iberian-Tartessian writing dating back to 3000 to 5000 years BP with a big geographic extension, comprising South Sahara Desert, Canary Islands and South Iberia. A political unit and a common language are not known to have existed but people from former green Sahara Area emigrated because rapid desertification after 6000 years BC and also people exchange across Gibraltar Strait exists since Prehistoric times. Finally, these Iberian-Tartessian megalithic signs are found in the core of classic Tartessian Cumbres Mayores area: this may put Tartessian civilization writing formation dating back to 5,000 - 3,000 years BC as already stated by Strabo.

Rock Iberian-Guanche inscriptions have been found in all Canary Islands including La Palma: they consist of incise (with few exceptions) lineal scripts which have been done by using the Iberian semi-syllabary that was used in Iberia and France during the 1st millennium BC until few centuries AD .This confirms First Canarian Inhabitants navigation among Islands. In this paper we analyze three of these rock inscriptions found in westernmost La Palma Island: hypotheses of transcription and translation show that they are short funerary and religious text, like of those found widespread through easternmost Lanzarote, Fuerteventura and also Tenerife Islands. They frequently name “Aka” (dead), “Ama” (mother godness) and “Bake” (peace), and methodology is mostly based in phonology and semantics similarities between Basque language and prehistoric Iberian-Tartessian semi-syllabary transcriptions. These Iberian-Guanche scripts are widespread in La Palma usually together with spiral and circular typical Atlantic motifs which are similar to these of Megalithic British Isles, Brittany (France) and Western Iberia. Sometimes linear incise Iberian-Guanche inscriptions are above the circular ones (more recent) but they are also found underneath (less recent). The idea that this prehistoric Iberian semi-syllabary was originated in Africa and/or Canary Islands is not discarded. It is discussed in the frame of Saharian people migration to Mediterranean, Atlantic (i.e.: Canary Islands) and other areas, when hyperarid climate rapidly established. On the other hand, an Atlantic gene and possibly linguistic and cultural pool is shared among people from British Isles, Brittany (France), Iberia (Spain, Portugal), North Africa and Canary Islands. Keywords: La Palma, Iberian-Guanche, Latin, Inscriptions, Iberian, Celts, Sahara, Africa, Garafia, Santo Domingo, Canary Islands, Lybic British, Brittons, Basque, Irish, Lybic Canarian, Palmeses, Benahoaritas, Awaritas, Tricias, Prehistory, Guache, Tartessian.

HLA-G immune modulatory genes and molecules are presently being studied by a widespread number of research groups. In the present study, we do not aim to be exhaustive since the number of manuscripts published every year is overwhelming. Instead, our aim is pointing out facts about HLA-G function, polymorphism and pathology that have been confirmed by several different researchers, together with exposing aspects that may have been overlooked or not sufficiently remarked in this productive field of study. On the other hand, we question whether performing mainly studies on HLA-G and disease associations is going to give a clear answer in the future, since 40 years of study of classical HLA molecules association with disease has still given no definite answer on this issue.

Introduction: South American siskins (Genus Carduelis/Spinus) are the outcome of regional evolutionary radiation from an extant (or other extinct) species: C. notata, a North America siskin, which thrives in Mexico subtropical areas and is parental of one of the three described North American siskin radiations. Methods: Speciation and/or subspeciation of this South American siskin radiation have probably occurred during Pleistocene Epoch. In the present paper, a new species/subspecies akin to C./S. atrata is described by genetic and phenotypic parameters: this new species/subspecies was previously considered a subspecies of C./S. xanthogastra, which thrives further North and is separated about 1,762 km, 1,094 miles, from this described subspecies, Carduelis/ Spinus xanthogastra stejnegeri. Results: Our genetic study using mt cyt b, phenotypic and behavior observations show that this putative C./S. xanthogastra subspecies is either a different species or a C./S. atrata subspecies; we have proposed a provisional name for this finch, C./S. lapazensis, instead of C./S. x. stejnegeri. Conclusion: Species definition is movable and controversial, and it is uncertain in South American siskins, which all show a close genetic and phenotypical relationship, which may be still immersed in speciation processes since Pleistocene Epoch.

Two of the several rock script panels found at Mt. Tenezara volcano slope, Lanzarote Is. (Canary Islands) have been analyzed. Both of them contain a linear writing which corresponds to the ancient Iberian semi-sillabary discovered by Gomez-Moreno in 1949 AD, thus to Iberian-Guanche inscriptions which previously were referred as Latin. Ancient Iberian scripts have been found in France, Portugal, Spain and other Mediterranean places during the 1st millennium BC and the following four centuries AD; it may be possible that Iberian signs could have been taken or used at the same time at Africa. Even one of the semi-vertical panels considered as Lybic is in fact written in Iberian-Guanche characters. Also, Mt Tenezara shows Cart-ruts pointing to Equinoxes Sunrise. Findings are put in the context of a Sahara relatively rapid desiccation and a massive people migration to establish several classic and pre-classic civilizations, like Sumer, Egypt, Hittite, Hellenistic, Iberians, Lybic and Canary Islands Guanches, and possibly other Old Atlantic Celtic ones. Saharan Hypothesis is based on Geology, Columbia Shuttle (1981) infrared photographs that show prehistoric desert fertility, Prehistory, Anthropology and Linguistics. A fertile and heavily populated Sahara existed before 6,000 years BC. Keywords: Sahara, Latin, Scripts, Canary Islands, Iberian, Guanche, Lybic, Lanzarote, Fuerteventura, Quesera, Cheeseboard, Pyramids, Berber, Africa, Punic, Roman, Tenerife, Equinox, Tunisia, Algeria, Canarian,, Calendar, Raetian, Lepontic, Venetian, Etruscan, Basque, Cart-ruts, Sitovo, Gradeshnitsa, Usko- Mediterranean, Language, Tenezara, Juan Brito

Cart-ruts have been observed in Mediterranean Basin, Eurasia and Africa. They are rock carved stripes and channels which unexpectedly converge and/or bend, not being useful for transportation use because constant parallelism is not kept. Cart-ruts came first to scholars attention in Malta and Gozo Islands where they are abundant and dated at Bronze or Temple Age of this Archipelago. A big conjoint European investment for Cart-ruts study only got a detailed inventory in several Eurasian and African countries. Age and use of Cart-ruts remains non-discovered: it is admitted that different ages and uses may not be the same for different or even same areas. Azores Archipelago Cart-ruts were left out of this study and we have recently described them at Lanzarote (Canary Islands, Spain) volcanoes tops and slopes and suggested that they could have been useful for space and time measurements. In the present study, Lanzarote is studied and Mt. Mina and Mt. Guardilama mountains Cart-ruts azimuths points to Summer and Winter Solstices sunrises respectively as measured from Quesera/”Cheeseboard” of Zonzamas, which is a prehistoric Guanche lunisolar calendar. Mt. Tenezara Cart-ruts azimuth is pointing towards Equinoxes sunrises, as observed from Zonzamas prehistoric calendar. Thus, a use for measure time and space could be a function for some Lanzarote Cart-ruts. We explain these findings in a prehistoric Guanche aborigine culture context probably common to Atlantic megalithic Bronze Age and to all Canary Islands having prehistoric inter-navigation, because all have similar rock Iberian-Guanche inscriptions and other common cultural traits. Sahara Desert abandoning by people also influenced Mediterranean and Atlantic culture. Probability that 3 out of 7 studied volcano Cart-ruts point to Solstices and Equinoxes by chance is close to zero as calculated by factorial probability methods. Keywords: Latin, Scripts, Canary Islands, Iberian, Guanche, Lanzarote, Fuerteventura, Quesera-Cheeseboard, Pyramids, Berber, Africa, Punic, Roman, Western Sahara, Tunisia, Canaria, Calendar, Etruscan, Basque, Cart-ruts, Usko-Mediterranean, Solstice, Equinox, Zonzamas, HLA, Genetics, Sahara. Atchano, Malta

Spain was invaded in 711 CE by mostly Berber North Africans carrying Muslim religion to a mostly Christian/Catholic Kingdom. A fight to expel Muslims soon started and were apparently driven out of Iberia (Spain) starting in 1492 CE. However, many of these expelled people were of Iberian old ancestry that had become Muslims at Las Alpujarras Mts. (South-East Spain). Also, Muslim North Africans converted to Christianity either remained there or came back after they more definetively were expelled by 1609 CE. Las Alpujarras region was also repopulated by northern Spaniards mostly from Galicia. Our HLA study of present day Alpujarrans shows that typical North Spain and European Atlantic façade HLA extended haplotypes are very frequent in nowadays Las Alpujarras region, i. e.: HLA-(A*29-B*44)-DRB1*07:01-DQA1*02:01-DQB1*02:01 and (A*02-B*27)-DRB1*15:01-DQA1*01:02-DQB1*06:02. It is concluded that repopulation had a noticeable success even in today Alpujarran population.

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers "Kura" and "Ebro" or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.

Mexican Mixtec population from coastal Jamiltepec (Oaxaca) Amerindians was studied for its HLA profile. They show genetic characteristics close to Pacific Islanders and other Mexican Isthmus Amerindians (Mazatecans, Zapotecans and Mayas). Interestingly, this coastal Oaxaca Mixtec population is genetically closer to Mazatecans than to Oaxaca Mixtec from mountains according to HLA genes. Mixtec HLA frequent extended haplotype A*24:02-B*35:14-DRB1*16:02 has been also found in Jaidukama North Colombia forest Amerindians and in Guatemala Mayas; A*24:02, DRB1*04:03, DRB1*04:04 and DRB2*16:02 are frequent alleles also common to Pacific Inhabitants. Notwithstanding, Mixtecs show deep cultural and genetic roots with Mesoamerican Amerindians and all of them probably contributed to construct Monte Alban culture around an important Pyramid Complex close to Oaxaca City.

Quechua Amerindians established Inca Empire and chose Cuzco as their capital. Their language is closely related to that of Aymara ethnic group and both of them were originated from Titikaka Lake Altiplano area. In the present study we have analyzed Bolivian Quechua HLA profile and found that it has common characters with other Andean and Pacific Amerindians (Uros, Aymaras, Lamas, Mapuches, Athabascan), and Pacific Islanders, including Easter Islanders: relatively high frequency of HLA-A*24 (:02), class II haplotypes DRB1*08:02-DQB1*04:02, and DRB1*04:03-DQB1* 03:02. Titikaka Lake area prehistoric populations: Quechua, Aymaras and Uros are closely related according to HLA Nei DA genetic distances and other HLA traits: they built up Tiwanaku culture, which resembles that of Easter Island (i.e.: similar giant heads); later, Quechuas also moved to Cuzco. This genetic reletedness together with Easter Island and Titikaka Lake Tiwanaku (Bolivia, Peru) cultural common similarities support a prehistoric Pacific people/Amerindians gene flow.

Huastecos or Teenek Amerindians are presently living at North East Mexico (San Luis Potosi State). They have probably one of the most ancient culture of Mexico and Central America together with Mayas and Olmec groups with which also show close relationships. Proximity to Atlantic Ocean/Mexican Gulf originated that Spaniards had very early contact with them at about 1519 CE or before. In the present paper we have aimed to study HLA gene profile which may be useful for HLA and disease epidemiology and transplant programs in Teeneks. HLA-DRB1*04:07, -DRB1*14:06 and -DRB1*04:11 have been found in high frequency like in other Amerindian groups. High frequency typical Amerindians HLA extended haplotypes have been found, such as A*02-B*35-DRB1*04:07-DQB1*03:02; A*68-B*39-DRB1*04:07-DQB1*03:02 and A*02-B*39-DRB1*04:07-DQB1*03:02; also new haplotypes have been described, like A*02-B*52-DRB1*04:11-DQB1*03:02, A*68-B*35-DRB1*14:02-DQB1*03:01 and A*68-B*40-DRB1*16:02-DQB1*03:01. Genetic proximity is observed not only to linguistically close Mayans, but also to Mazatecans, Mixtecans and Zapotecans, who speak an altogether different languages; it shows once more that genes and languages do not correlate. This population was greatly diminished after European contact between 1500 and 1600 years CE; in fact, North and South America First Inhabitants population was brought from 80 down to 8 million people because of diseases (i.e.: measles, smallpox or influenza), slavery and war.

Mexican Mayo Amerindians live in southern Sonora and North Sinaloa states. They probably come from North or are related to First American Inhabitants established further North. A non-related sample of them have volunteered to HLA study in order to achieve a profile useful for their epidemiology and future transplant interstate programs, in addition to ascertain ancestry and anthropological studies. HLA typing was carried out by a standard methodology. HLA-B*48 allele(s) was found, which is characteristic of Pacific Amerindians and Pacific Islanders/southern Asians. Also, HLA-A*24 (most likely HLA-A*24:02) shows specific high frequencies in this population and also in indigenous people, like Aleuts, Alaska Yupik, Japan, Taiwan, Australia, New Zealand, Papua New Guinea, southern China and other Pacific Islands. Other Andean Amerindians also show a high HLA-A*24:02 frequencies. This confirms our previous results of a possible direct gene flow between Pacific Islanders/southern Asians and Amerindians. In addition, typical Amerindian haplotypes have been found in high frequency like HLA-A*24-B*39-DRB1*04:07-DQB1*03:02, HLA-A*02-B*35-DRB1*04:07-DQB1*03:02 and HLA-A*24-B*35-DRB1*04:07-DQB1*03:02, and new haplotypes are also described like HLA-A*02-B*35-DRB1*14:06-DQB1*03:01, HLA-A*02-B*48-DRB1*04:04-DQB1*03:02, and HLA-A*02-B*08-DRB1*04:07-DQB1*03:02. This study also supports that Americas peopling was not only carried out through Bering Strait but also through Pacific and Atlantic Oceans in an earlier time than proposed.

Purpose To determine whether simplification of the Eaton-Glickel (E-G) classification of trapeziometacarpal (TMC) joint arthrosis (eliminating evaluation of the scaphotrapezial [ST] joint) and information about the patient's symptoms and examination influence interobserver reliability. We also tested the null hypotheses that no patient and/or surgeon factors affect radiographic rating of TMC joint arthrosis and that no surgeon factors affect the radiographic rating of ST joint arthrosis.Methods In an on-line survey, 92 hand surgeons rated TMC joint arthrosis and ST joint arthrosis separately on 30 radiographs (Robert, true lateral, and oblique views) according to the (modified) E-G classification. We randomly assigned 42 observers to review radiographs alone and also informed 50 of the patient's symptoms and examination. Information about symptoms and examination was randomized. Interobserver reliability was determined with the s* statistic. Because of the hierarchical data structure, cross-classified ordinal multilevel regression analyses were performed to identify factors associated with the severity of arthrosis.Results Shortening the E-G classification to the first 3 stages significantly improved the interobserver reliability, which approached substantial agreement. Providing clinical information to observers marginally improved interobserver reliability. Factors associated with a lower E-G stage for TMC joint arthrosis, among observers who rated the severity of TMC joint arthrosis based on radiographs and clinical information, included female surgeon, practice setting, supervising surgical trainees in the operating room, self-reported number of patients with TMC joint arthrosis typically treated annually, male patient, higher patient age, pain limiting daily activities, and shoulder sign. A self-reported larger number of patients with TMC joint arthrosis treated annually was the only variable associated with a higher modified E-G classification to rate ST joint arthrosis.Conclusions Our findings suggest that simpler classifications that focus on a single anatomical area are reliable and that surgeon and patient factors can bias interpretation of objective pathophysiology such as radiographic findings. Copyright (C) 2016 by the American Society for Surgery of the Hand. All rights reserved.

Loss of contact between radial head fracture fragments is strongly associated with other elbow or forearm injuries. If this finding has adequate interobserver reliability, it could help examiners identify and treat associated ligament injuries and fractures (eg, forearm interosseous ligament injury or elbow dislocation). (1) What is the interobserver agreement on radiographic loss of contact between radial head fracture fragments? (2) Are there factors associated with the observer such as location of practice or subspecialization that increase interobserver reliability? Fully trained practicing orthopaedic and trauma surgeons from around the world evaluated 27 anteroposterior and lateral radiographs of radial head fractures on a web-based platform for the following characteristics: (1) loss of contact between at least one radial head fracture fragment and the remaining radial head and neck; (2) a gap between fragments of 2 mm or greater; (3) anticipated fracture instability (mobility) on operative exposure; (4) anticipated associated ligament injuries; and (5) recommendation for treatment. Agreement among observers was measured using the multirater kappa measure. Kappas for various observer characteristics were compared using 95% confidence intervals. The overall interobserver agreement was moderate (range, 0.49-0.55) for each question except associated ligament injury, which was fair (0.33). Shoulder and elbow surgeons had substantial agreement (range, 0.51-0.61) in many areas, but kappas were generally in the moderate range (0.41-0.59) based on number of years in practice, radial head fractures treated per year, and trainee supervision. Radiographic signs of radial head fracture instability such as loss of contact have moderate reliability. This characteristic seems clinically useful, because loss of contact between at least one radial head fracture fragment and the remaining radial head and neck is strongly associated with associated ligament injury or other fractures. Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence

Item does not contain fulltext PURPOSE: Surgical costs are under scrutiny and surgeons are being held increasingly responsible for cost containment. In some instances, implants are the largest component of total procedure cost, yet previous studies reveal that surgeons' knowledge of implant prices is poor. Our study aims to (1) understand drivers behind implant selection and (2) assess whether educating surgeons about implant costs affects implant selection. METHODS: We surveyed 226 orthopedic surgeons across 6 continents. The survey presented 8 clinical cases of upper extremity fractures with history, radiographs, and implant options. Surgeons were randomized to receive either a version with each implant's average selling price ("price-aware" group), or a version without prices ("price-naive" group). Surgeons selected a surgical implant and ranked factors affecting implant choice. Descriptive statistics and univariate, multivariable, and subgroup analyses were performed. RESULTS: For cases offering implants within the same class (eg, volar locking plates), price-awareness reduced implant cost by 9% to 11%. When offered different models of distal radius volar locking plates, 25% of price-naive surgeons selected the most expensive plate compared with only 7% of price-aware surgeons. For cases offering different classes of implants (eg, plate vs external fixator), there was no difference in implant choice between price-aware and price-naive surgeons. Familiarity with the implant was the most common reason for choosing an implant in both groups (35% vs 46%). Price-aware surgeons were more likely to rank cost as a factor (29% vs 21%). CONCLUSIONS: Price awareness significantly influences surgeons' choice of a specific model within the same implant class. Merely including prices with a list of implants leads surgeons to select less expensive implants. This implies that an untapped opportunity exists to reduce surgical expenditures simply by enhancing surgeons' cost awareness. TYPE OF STUDY/LEVEL OF EVIDENCE: Economic/Decision Analyses I.

Purpose To address the null hypothesis that surgeons shown radiographs of little finger metacarpal neck fractures with measured fracture angulation would recommend surgery as often as surgeons shown unmarked radiographs. Methods Members of the Science of Variation Group, an international collaboration of fully trained orthopedic and trauma surgeons, were asked to review 20 little finger metacarpal neck fracture cases, which included a vignette and 3 high-quality radiographs. Members were then randomized to review radiographs with or without measured fracture angulation on the lateral view and select operative or nonoperative management. Results Surgeons shown radiographs with measured angulation were more likely to recommend surgery, and there was less variability among these surgeons, particularly for fractures with less angular deformity. Conclusions Measured fracture angulation has a small but significant influence on treatment recommendations for little finger metacarpal neck fractures. Copyright (C) 2014 by the American Society for Surgery of the Hand. All rights reserved

Purpose To address the factors that surgeons use to decide between 2 options for treatment when the evidence is inconclusive. Methods We tested the null hypothesis that the factors surgeons use do not vary by training, demographics, and practice. A total of 337 surgeons rated the importance of 7 factors when deciding between treatment and following the natural history of the disease and 12 factors when deciding between 2 operative treatments using a 5-point Likert scale between "very important" and "very unimportant." Results According to the percentages of statements rated very important or somewhat important, the most popular factors influencing recommendations when evidence is inconclusive between treatment and following the natural course of the illness were "works in my hands," "familiarity with the treatment," and "what my mentor taught me." The most important factors when evidence shows no difference between 2 surgeries were "fewer complications," "quicker recovery," "burns fewer bridges," "works in my hands" and "familiarity with the procedure." Europeans rated "works in my hands" and "cheapest/most resourceful" of significantly greater importance and "what others are doing," "highest reimbursement," and "shorter procedure" of significantly lower importance than surgeons in the United States. Observers with fewer than 10 years in independent practice rated "what my mentor taught me," "what others are doing" and "highest reimbursement" of significantly lower importance compared to observers with 10 or more years in independent practice. Conclusions Surgeons deciding between 2 treatment options, when the evidence is inconclusive, fall back to factors that relate to their perspective and reflect their culture and circumstances, more so than factors related to the patient's perspective, although this may be different for younger surgeons. Clinical relevance Hand surgeons might benefit from consensus fallback preferences when evidence is inconclusive. It is possible that falling back to personal comfort makes us vulnerable to unhelpful commercial and societal influences.