Identification of genetic variants that influence atherosclerosis in young persons

Atherosclerosis is widely accepted as a complex genetic phenotype and is the usual cause of cardiovascular disease, the world’s leading killer. Genetic factors have been proven to be important risk contributors for atherosclerosis and much work has been done to identify promising candidates that might play a role in the development of atherosclerosis. It is well known that many independent replications are needed to unequivocally establish a valid genotype-phenotype association across different populations before the findings are extended to clinical settings and to the expensive follow-up studies designed to identify causal genetic variants. Aiming to replicate the association with atherosclerosis in the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) study, we assessed the relationship of 32 atherosclerosis candidate SNPs to atherosclerosis in the PDAY cohort, consisting of AA and EA young people aged 15-34 years who died of non-medical causes. Two association studies, a whole sample study and a 1:1 matched case control study were performed by use of multiple linear regression and logistic regression analyses, respectively. For the whole sample association study, 32 SNPs among 2,650 individuals (1,369 AA and 1,281 EA) were tested for the association with six early atherosclerosis phenotypes: abdominal aorta fatty streaks, abdominal aorta raised lesions, right coronary artery fatty streaks, right coronary artery raised lesions, thoracic aorta fatty streaks, and thoracic aorta raised lesions. For the matched case-control association study, 337 case-control paired samples were included; cases were chosen with the highest total raised lesion scores from the studied population, while controls were randomly selected from individuals that had no raised lesions and matched to cases by age, gender and race. Sixteen SNPs in 13 genes were found to be significantly associated with atherosclerosis in at least one of the PDAY association studies. Among these 16 findings: eight SNPs (rs9579646, rs6053733, rs3849150, rs10499903, rs2148079, rs5073691, rs10116277, and rs17228212) successfully replicated previous results, six SNPs (rs17222814, rs10811661, rs7028570, rs7291467, rs16996148 and rs10401969) were reported as new findings exclusive to our study, the last two of the 16 SNPs, rs501120 and rs6922269, showed either intriguing or conflicting result. SNP rs17222814 in ALOX5AP and SNP rs3849150 in LRRC18 were consistently associated with atherosclerosis in both prior and the two PDAY association studies. SNP rs3849150 was also identified to be highly correlated with a non-synonymous coding SNP, rs17772611, which may damage the protein (polyphen score = 0.996), suggesting that SNP rs17772611 may be the causal functional variant.^ In conclusion, our study added more support for the association of these candidate genes with atherosclerosis. SNPs rs3849150 and rs17772611 of LRRC18, as well as SNP rs17222814 of ALOX5AP, were the most significant findings from our study, and may be ranked among the best for further study.^

Biomedical informatics applications for epilepsy management: A systematic review

Epilepsy is a very complex disease which can have a variety of etiologies, co-morbidities, and a long list of psychosocial factors4. Clinical management of epilepsy patients typically includes serological tests, EEG's, and imaging studies to determine the single best antiepileptic drug (AED). Self-management is a vital component of achieving optimal health when living with a chronic disease. For patients with epilepsy self-management includes any necessary actions to control seizures and cope with any subsequent effects of the condition9; including aspects of treatment, seizure, and lifestyle. The use of computer-based applications can allow for more effective use of clinic visits and ultimately enhance the patient-provider relationship through focused discussion of determinants affecting self-management. ^ The purpose of this study is to conduct a systematic literature review on informatics application in epilepsy self-management in an effort to describe current evidence for informatics applications and decision support as an adjunct to successful clinical management of epilepsy. Each publication was analyzed for the type of study design utilized. ^ A total of 68 publications were included and categorized by the study design used, development stage, and clinical domain. Descriptive study designs comprised of three-fourths of the publications and indicate an underwhelming use of prospective studies. The vast majority of prospective studies also focused on clinician use to increase knowledge in treating patients with epilepsy. ^ Due to the chronic nature of epilepsy and the difficulty that both clinicians and patients can experience in managing epilepsy, more prospective studies are needed to evaluate applications that can effectively increase management activities. Within the last two decades of epilepsy research, management studies have employed the use of biomedical informatics applications. While the use of computer applications to manage epilepsy has increased, more progress is needed.^

The relationship between hospital financial performance and information technology integration strategy selection

In light of the new healthcare regulations, hospitals are increasingly reevaluating their IT integration strategies to meet expanded healthcare information exchange requirements. Nevertheless, hospital executives do not have all the information they need to differentiate between the available strategies and recognize what may better fit their organizational needs. ^ In the interest of providing the desired information, this study explored the relationships between hospital financial performance, integration strategy selection, and strategy change. The integration strategies examined – applied as binary logistic regression dependent variables and in the order from most to least integrated – were Single-Vendor (SV), Best-of-Suite (BoS), and Best-of-Breed (BoB). In addition, the financial measurements adopted as independent variables for the models were two administrative labor efficiency and six industry standard financial ratios designed to provide a broad proxy of hospital financial performance. Furthermore, descriptive statistical analyses were carried out to evaluate recent trends in hospital integration strategy change. Overall six research questions were proposed for this study. ^ The first research question sought to answer if financial performance was related to the selection of integration strategies. The next questions, however, explored whether hospitals were more likely to change strategies or remain the same when there was no external stimulus to change, and if they did change, they would prefer strategies closer to the existing ones. These were followed by a question that inquired if financial performance was also related to strategy change. Nevertheless, rounding up the questions, the last two probed if the new Health Information Technology for Economic and Clinical Health (HITECH) Act had any impact on the frequency and direction of strategy change. ^ The results confirmed that financial performance is related to both IT integration strategy selection and strategy change, while concurred with prior studies that suggested hospital and environmental characteristics are associated factors as well. Specifically this study noted that the most integrated SV strategy is related to increased administrative labor efficiency and the hybrid BoS strategy is associated with improved financial health (based on operating margin and equity financing ratios). On the other hand, no financial indicators were found to be related to the least integrated BoB strategy, except for short-term liquidity (current ratio) when involving strategy change. ^ Ultimately, this study concluded that when making IT integration strategy decisions hospitals closely follow the resource dependence view of minimizing uncertainty. As each integration strategy may favor certain organizational characteristics, hospitals traditionally preferred not to make strategy changes and when they did, they selected strategies that were more closely related to the existing ones. However, as new regulations further heighten revenue uncertainty while require increased information integration, moving forward, as evidence already suggests a growing trend of organizations shifting towards more integrated strategies, hospitals may be more limited in their strategy selection choices.^

Ozone and fine particulate matter association with CVD and COPD emergency room visits in Harris County, Texas: Spatiotemporal analysis

This study represents a secondary analysis of the merging of emergency room visits and daily ozone and PM2.5. Although the adverse health effects of ozone and fine particulate matter have been documented in the literature, evidence regarding the health risks of these two pollutants in Harris County, Texas, is limited. Harris County (Houston) has sufficiently unique characteristics that analysis of these relationships in this setting and with the ozone and industry issues in Houston is informative. The objective of this study was to investigate the association between the joint exposure to ozone and fine particulate matter, and emergency room diagnoses of chronic obstructive pulmonary disease and cardiovascular disease in Harris County, Texas, from 2004 to 2009, with zero and one day lags. ^ The study variables were daily emergency room visits for Harris County, Texas, from 2004 to 2009, temperature, relative humidity, east wind component, north wind component, ozone, and fine particulate matter. Information about each patient's age, race, and gender was also included. The two dichotomous outcomes were emergency room visits diagnoses for chronic obstructive pulmonary disease and cardiovascular disease. Estimates of ozone and PM2.5 were interpolated using kriging, in which estimates of the two pollutants were predicted from monitoring data for every case residence zip code for every day of the six years, over 3 million estimates (one of each pollutant for each case in the database). ^ Logistic regressions were conducted to estimate odds ratios of the two outcomes. Three analyses were conducted: one for all records, another for visits during the four months of April and September of 2005 and 2009, and a third one for visits from zip codes that are close to PM2.5 monitoring stations (east area of Harris County). The last two analyses were designed to investigate special temporal and spatial characteristics of the associations. ^ The dataset included all ER visits surveyed by Safety Net from 2004 to 2009, exceeding 3 million visits for all causes. There were 95,765 COPD and 96,596 CVD cases during this six year period. A 1-μg/m3 increase in PM2.5 on the same day was associated with a 1.0% increase in the odds of chronic obstructive pulmonary disease emergency room diagnoses, a 0.4% increase in the odds of cardiovascular disease emergency room diagnoses, and a 0.2% increase in the odds of cardiovascular disease emergency room diagnoses on the following day. A 1-ppb increase in ozone was associated with a 0.1% increase in the odds of chronic obstructive pulmonary disease emergency room diagnoses on the same day. These four percentages add up to 1.7% of ER visits. That is, over the period of six years, one unit increase for both ozone and PM2.5 (joint increase), resulted in about 55,286 (3,252,102 * 0.017) extra ER visits for CVD or COPD, or 9,214 extra ER visits per year. ^ After adjustment for age, race, gender, day of the week, temperature, relative humidity, east wind component, north wind component, and wind speed, there were statistically significant associations between emergency room chronic obstructive pulmonary disease diagnosis in Harris County, Texas, with joint exposure to ozone and fine particulate matter for the same day; and between emergency room cardiovascular disease diagnosis and exposure to PM2.5 of the same day and the previous day. ^ Despite the small association between the two air pollutants and the health outcomes, this study points to important findings. Namely, the need to identify reasons for the increase of CVD and COPD ER visits over the course of the project, the statistical association between humidity (or whatever other variables for which it may serve as a surrogate) and CVD and COPD cases, and the confirmatory finding that males and blacks have higher odds for the two outcomes, as consistent with other studies. ^ An important finding of this research suggests that the number and distribution of PM2.5 monitors in Harris County - although not evenly spaced geographically—are adequate to detect significant association between exposure and the two outcomes. In addition, this study points to other potential factors that contribute to the rising incidence rates of CVD and COPD ER visits in Harris County such as population increases, patient history, life style, and other pollutants. Finally, results of validation, using a subset of the data demonstrate the robustness of the models.^

Effects of overweight and obesity on economic outcomes among U.S. adults with kidney disease

Background. Kidney disease is a growing public health phenomenon in the U.S. and in the world. Downstream interventions, dialysis and renal transplants covered by Medicare's renal disease entitlement policy in those who are 65 years and over have been expensive treatments that have been not foolproof. The shortage of kidney donors in the U.S. has grown in the last two decades. Therefore study of upstream events in kidney disease development and progression is justified to prevent the rising prevalence of kidney disease. Previous studies have documented the biological route by which obesity can progress and accelerate kidney disease, but health services literature on quantifying the effects of overweight and obesity on economic outcomes in the context of renal disease were lacking. Objectives . The specific aims of this study were (1) to determine the likelihood of overweight and obesity in renal disease and in three specific adult renal disease sub-populations, hypertensive, diabetic and both hypertensive and diabetic (2) to determine the incremental health service use and spending in overweight and obese renal disease populations and (3) to determine who financed the cost of healthcare for renal disease in overweight and obese adult populations less than 65 years of age. Methods. This study was a retrospective cross-sectional study of renal disease cases pooled for years 2002 to 2009 from the Medical Expenditure Panel Survey. The likelihood of overweight and obesity was estimated using chi-square test. Negative binomial regression and generalized gamma model with log link were used to estimate healthcare utilization and healthcare expenditures for six health event categories. Payments by self/family, public and private insurance were described for overweight and obese kidney disease sub-populations. Results. The likelihood of overweight and obesity was 0.29 and 0.46 among renal disease and obesity was common in hypertensive and diabetic renal disease population. Among obese renal disease population, negative binomial regression estimates of healthcare utilization per person per year as compared to normal weight renal disease persons were significant for office-based provider visits and agency home health visits respectively (p=0.001; p=0.005). Among overweight kidney disease population health service use was significant for inpatient hospital discharges (p=0.027). Over years 2002 to 2009, overweight and obese renal disease sub-populations had 53% and 63% higher inpatient facility and doctor expenditures as compared to normal weight renal disease population and these result were statistically significant (p=0.007; p=0.026). Overweigh renal disease population had significant total expenses per person per year for office-based and outpatient associated care. Overweight and obese renal disease persons paid less from out-of-pocket overall compared to normal weight renal disease population. Medicare and Medicaid had the highest mean annual payments for obese renal disease persons, while mean annual payments per year were highest for private insurance among normal weight renal disease population. Conclusion. Overweight and obesity were common in those with acute and chronic kidney disease and resulted in higher healthcare spending and increased utilization of office-based providers, hospital inpatient department and agency home healthcare. Healthcare for overweight and obese renal disease persons younger than 65 years of age was financed more by private and public insurance and less by out of pocket payments. With the increasing epidemic of obesity in the U.S. and the aging of the baby boomer population, the findings of the present study have implications for public health and for greater dissemination of healthcare resources to prevent, manage and delay the onset of overweight and obesity that can progress and accelerate the course of the kidney disease.^

A simulation study of the standard design, the rolling six design, the CRM, and the modified CRM in Phase I clinical trials

The Phase I clinical trial is considered the "first in human" study in medical research to examine the toxicity of a new agent. It determines the maximum tolerable dose (MTD) of a new agent, i.e., the highest dose in which toxicity is still acceptable. Several phase I clinical trial designs have been proposed in the past 30 years. The well known standard method, so called the 3+3 design, is widely accepted by clinicians since it is the easiest to implement and it does not need a statistical calculation. Continual reassessment method (CRM), a design uses Bayesian method, has been rising in popularity in the last two decades. Several variants of the CRM design have also been suggested in numerous statistical literatures. Rolling six is a new method introduced in pediatric oncology in 2008, which claims to shorten the trial duration as compared to the 3+3 design. The goal of the present research was to simulate clinical trials and compare these phase I clinical trial designs. Patient population was created by discrete event simulation (DES) method. The characteristics of the patients were generated by several distributions with the parameters derived from a historical phase I clinical trial data review. Patients were then selected and enrolled in clinical trials, each of which uses the 3+3 design, the rolling six, or the CRM design. Five scenarios of dose-toxicity relationship were used to compare the performance of the phase I clinical trial designs. One thousand trials were simulated per phase I clinical trial design per dose-toxicity scenario. The results showed the rolling six design was not superior to the 3+3 design in terms of trial duration. The time to trial completion was comparable between the rolling six and the 3+3 design. However, they both shorten the duration as compared to the two CRM designs. Both CRMs were superior to the 3+3 design and the rolling six in accuracy of MTD estimation. The 3+3 design and rolling six tended to assign more patients to undesired lower dose levels. The toxicities were slightly greater in the CRMs.^

The Extended Family: Reviewing an Invaluable Resource

During the last two decades, the extended family has been rediscovered as a viable and meaningful resource for nurturing and protecting children. The purpose of this article is to provide an historical context for involving the extended family in child welfare cases and to identify key factors influencing that involvement.

Abundance of phytoplankton, heterotrophic nanoflagellates and bacteria through the water column at time series station L4 in the Western English Channel. 2007-2011

The marine laboratories in Plymouth have sampled at two principle sites in the Western English Channel for over a century in open-shelf (station E1; 50° 02'N, 4° 22'W) and coastal (station L4; 50° 15'N, 4° 13'W) waters. These stations are seasonally stratified from late-April until September, and the variable biological response is regulated by subtle variations in temperature, light, nutrients and meteorology. Station L4 is characterized by summer nutrient depletion, although intense summer precipitation, increasing riverine input to the system, results in pulses of increased nitrate concentration and surface freshening. The winter nutrient concentrations at E1 are consistent with an open-shelf site. Both stations have a spring and autumn phytoplankton bloom; at station E1, the autumn bloom tends to dominate in terms of chlorophyll concentration. The last two decades have seen a warming of around 0.6°C per decade, and this is superimposed on several periods of warming and cooling over the past century. In general, over the Western English Channel domain, the end of the 20th century was around 0.5°C warmer than the first half of the century. The warming magnitude and trend is consistent with other stations across the north-west European Shelf and occurred during a period of reduced wind stress and increased levels of insolation (+20%); these are both correlated with the larger scale climatic forcing of the North Atlantic Oscillation.

Amílcar Urbano Sosa : el enseñar deleitando en Antología de meñique

En el panorama de la literatura infantil y juvenil muy enriquecido en la Argentina en las dos últimas décadas con obras de autores de gran trayectoria, cabe destacar en nuestra provincia el aporte a la poesía para la infancia de Amílcar Urbano Sosa con Antología de Meñique (1963). Profundamente comprometido con su quehacer docente y con la tierra cuyana, este poeta olvidado de las antologías, de los diccionarios específicos y de los estudios académicos hace propio el docere delectans de la tradición clásica. Es por ello que en su libro, teniendo en cuenta el joven destinatario, canta a las primeras vivencias del niño en su encuentro con el mundo de los afectos y con el mundo circundante. En este recorrido por los paulatinos despertares - las estaciones, la casa, las fiestas patrias - acierta a seguirse preguntando por la significación del maestro que es, entre otras, “aprender lo que se ha dado por sabido [...] y alumbrarnos, siendo hombres/ de aquellas cosas que tuvimos al ser niños". En este trabajo, además de recordar los doce títulos que componen su obra especialmente poética, desde la publicación de La rosa y la abeja (1947) hasta Melesca y Canto del descubrimiento, ambas de 1996, nos interesa recuperar para la literatura argentina, mendocina en especial, a quien en su momento fuera galardonado con diferentes premios provinciales y estimado por la crítica como poeta auténtico de la vida y del terruño.

Water temperature reconstruction for Terminations I and II of sediment core MD01-2378

We present centennial records of sea surface and upper thermocline temperatures in Core MD01-2378 from the Timor Sea, which provide new insights into the variability of the Indonesian outflow across the last two glacial terminations. Mg/Ca in Globigerinoides ruber (white s. s.) indicates an overall increase of 3.2 °C in sea surface temperature (SST) over Termination I. Following an early Holocene plateau at 11.3-6.4 ka, SSTs cooled by 0.6 °C during the middle to late Holocene (6.4-0.7 ka). The early Holocene warming occurred in phase with increasing northern hemisphere summer insolation, coinciding with northward displacement of the Intertropical Convergence Zone, enhanced boreal summer monsoon and expansion of the Indo-Pacific Warm Pool. Thermocline temperatures (Pulleniatina obliquiloculata Mg/Ca) gradually decreased from 24.5 to 21.5 °C since 10.3 ka, reflecting intensification of a cool thermocline throughflow. The vertical structure of the upper ocean in the Timor Sea evolved in similar fashion during the Holocene and MIS5e, although the duration of SST plateaux differed (11.3 to 6.4 ka in Termination I and from 129 to 119 ka in Termination II), which was probably due to the more intense northern hemisphere summer insolation during MIS 5e. During both terminations, SST increased simultaneously in the southern high latitudes and the tropical eastern Indian Ocean, suggesting virtually instantaneous atmospheric climate feedbacks between the high and low latitudes.

Classification criteria and commercial profile re-definition of the Family Farm Agriculture in Chile, Maule region

In Chile, small-scale farmers are classified according to old approaches from 1993 that do not include changes occurred in the last two decades. Maule is the region with most rural population in Chile which represents a significant stratum for development, innovation and competitiveness. This study explores a new approach of small-scale farmers -associated with Family Farm Agriculture (AFC) - classification in Chile and it describes a commercial profile or AFC-1 for famers of the Maule Region. A Cluster analysis to determine AFC-1 farmers is used. The analysis includes four association variables: Total Assets, Farm Income, Production Costs and Management Indicators. The results suggest that 16.4% of the farmers have a commercial profile and they could stay out support provided by the National Institute for Agricultural Development (INDAP). This group of farmers would not belong to AFC in short terms. This fact could bring restriction to AFC-1 farmers such as lack of credit access, less investment incentives and technical assistance. Thus, it would expect low process of technology adoption and welfare improvement. New agrarian policies must be warranted to support this important group of famers with a commercial profile.

Sedimentology on 19 cores from the South China Sea

Based on the study of 10 sediment cores and 40 core-top samples from the South China Sea (SCS) we obtained proxy records of past changes in East Asian monsoon climate on millennial to bidecadal time scales over the last 220,000 years. Climate proxies such as global sea level, estimates of paleotemperature, salinity, and nutrients in surface water, ventilation of deep water, paleowind strength, freshwater lids, fluvial and/or eolian sediment supply, and sediment winnowing on the sea floor were derived from planktonic and benthic stable-isotope records, the distribution of siliciclastic grain sizes, planktonic foraminifera species, and the UK37 biomarker index. Four cores were AMS-14C-dated. Two different regimes of monsoon circulation dominated the SCS over the last two glacial cycles, being linked to the minima and maxima of Northern Hemisphere solar insolation. (1) Glacial stages led to a stable estuarine circulation and a strong O2-minimum layer via a closure of the Borneo sea strait. Strong northeast monsoon and cool surface water occurred during winter, in part fed by an inflow from the north tip of Luzon. In contrast, summer temperatures were as high as during interglacials, hence the seasonality was strong. Low wetness in subtropical South China was opposed to large river input from the emerged Sunda shelf, serving as glacial refuge for tropical forest. (2) Interglacials were marked by a strong inflow of warm water via the Borneo sea strait, intense upwelling southeast of Vietnam and continental wetness in China during summer, weaker northeast monsoon and high sea-surface temperatures during winter, i.e. low seasonality. On top of the long-term variations we found millennial- to centennial-scale cold and dry, warm and humid spells during the Holocene, glacial Terminations I and II, and Stage 3. The spells were coeval with published variations in the Indian monsoon and probably, with the cold Heinrich and warm Dansgaard-Oeschger events recorded in Greenland ice cores, thus suggesting global climatic teleconnections. Holocene oscillations in the runoff from South China centered around periodicities of 775 years, ascribed to subharmonics of the 1500-year cycle in oceanic thermohaline circulation. 102/84-year cycles are tentatively assigned to the Gleissberg period of solar activity. Phase relationships among various monsoon proxies near the onset of Termination IA suggest that summer-monsoon rains and fluvial runoff from South China had already intensified right after the last glacial maximum (LGM) insolation minimum, coeval with the start of Antarctic ice melt, prior to the d18O signals of global sea-level rise. Vice versa, the strength of winter-monsoon winds decreased in short centennial steps only 3000-4000 years later, along with the melt of glacial ice sheets in the Northern Hemisphere.

Fundamentos biológicos para el uso de la mucosa oral como vía de aplicación de métodos inmunoterápicos

El transporte de medicamentos a través de la mucosa oral ha sido objeto de particular atención, especialmente en las ultimas dos décadas. Entre las distintas regiones de la mucosa oral, la mucosa sublingual es el sitio primario utilizado para la administración de diferentes sustancias incluidos algunos tipos de antígenos. La estructura histológica de esta área muestra la existencia de numerosas células inmunocompetentes capaces de activar el sistema inmunológico. Previo a la descripción de las diferentes rutas de absorción de fármacos y experiencias sobre permeabilidad de la región sublingual, se realiza una breve reseña de la histología y anatomía del área sublingual. En este trabajo también se tratan las ventajas y desventajas de la vía sublingual y el potencial aprovechamiento de la inmunoterapia sublingual para el tratamiento de patologías sistémicas y orales.

Water temperature measured in Independence Bay, Pisco, Peru

Independencia Bay can be considered as one of the most productive invertebratc fishing grounds worldwide. One of the most important exploited species is the scallop (Argopecten purpuratus) with strong catching fluctuations related to El Nino and La Nina events and to inadequate Management strategies. During strong warming periods annual landings reach up to 50000 t in an area of about 150 km**2 and during cold years they remain around 500 to 1000 t. This study analyses the changes in scallop landings at Independencia Bay observed during the last two decades and discusses the main factors affecting the scallop proliferations during the EI Nino events. In this way data on landings, sea surface temperature and those related to growth, reproduction, predation, mean density and oxygen concentration from published and unpublished Papers are used. The relationship between annual catches and average water temperature over the preceding reproductive period of the scallop over the past 20 year's period, showed that scallop production is affected positively only with strong EI Nino such as those of 1983 and 1998. Our review showed that the scallop stock proliferation can be traced to the combined effect of (1) an increase in reproductive output through an acceleration of gonad maturation and a higher spawning frequency; (2) a shortening of the larval period and an increase in larval survival; (3) an increase in the individual growth performance; (4) an increase in the juvenile and adult survival through reduction of predator biomass; (5) an increase in carrying capacity of the scallop banks due to elevated oxygen levels.

Western Arabian Sea SST estimation

Millennial-scale records of planktonic foraminiferal Mg/Ca, bulk sediment UK37', and planktonic foraminiferal d18O are presented across the last two deglaciations in sediment core NIOP929 from the Arabian Sea. Mg/Ca-derived temperature variability during the penultimate and last deglacial periods falls within the range of modern day Arabian Sea temperatures, which are influenced by monsoon-driven upwelling. The UK37'-derived temperatures in MIS 5e are similar to modern intermonsoon values and are on average 3.5°C higher than the Mg/Ca temperatures in the same period. MIS 5e UK37' and Mg/Ca temperatures are 1.5°C warmer than during the Holocene, while the UK37'-Mg/Ca temperature difference was about twice as large during MIS 5e. This is surprising as, nowadays, both proxy carriers have a very similar seasonal and depth distribution. Partial explanations for the MIS 5e UK37'-Mg/Ca temperature offset include carbonate dissolution, the change in dominant alkenone-producing species, and possibly lateral advection of alkenone-bearing material and a change in seasonal or depth distribution of proxy carriers. Our findings suggest that (1) Mg/Ca of G. ruber documents seawater temperature in the same way during both studied deglaciations as in the present, with respect to, e.g., season and depth, and (2) UK37'-based temperatures from MIS 5 (or older) represent neither upwelling SST nor annual average SST (as it does in the present and the Holocene) but a higher temperature, despite alkenone production mainly occurring in the upwelling season. Further we report that at the onset of the deglacial warming, the Mg/Ca record leads the UK37' record by 4 ka, of which a maximum of 2 ka may be explained by postdepositional processes. Deglacial warming in both temperature records leads the deglacial decrease in the d18O profile, and Mg/Ca-based temperature returns to lower values before d18O has reached minimum interglacial values. This indicates a substantial lead in Arabian Sea warming relative to global ice melting.