Red Hill Research Articles

Passenger Rolling Stock of Indian Railways in the First Half-Century of Their Operation

In India, as in many countries, railways originated as industrial gauge tracks for the transportation of ore, timber, stone, and other building materials. These were the first industrial railways in India to deliver supplies to construction sites, in particular, Chintadripet in Madras (1835), Red Hill Railroad line (1837), Godavari Dam Construction Railway (1845), and others. Initially, the promoters of the construction of railways, based on the general social and economic situation in the country, did not count on the development of passenger traffic, taking into account the virtually impoverished situation of the vast majority of the population. Efforts were focused on freight transportation. The colonialists proceeded from the need to develop railways as an important exploitation tool for exporting the country’s natural resources to the parent country and to the world market. Throughout almost the entire period of British colonial rule, passenger transportation was intended for a narrow stratum of colonizers and a few of the richest representatives of the country’s indigenous population. By the 1860s, there was a system of dividing passenger traffic on the railways of India into four classes. Saloon coaches were used to serve the ruling elite. The difference in travel conditions in luxury saloon coaches and first-class compartment carriages in comparison with third- and fourth-class carriages was huge. It reflected the social class structure of Indian society. At the same time, railway passenger transportation did not affect the interests of the majority of the population at all, as with their level of wealth they could not afford to travel by rail at all, remaining outside the line of progress in transport of the 19th century.

Morphological Diversity and Genetic Parameter of Okra (Abelmoschus esculentus L. Moench) Genotypes.

<b>Background and Objective:</b> Considering that the potential for okra as an anti-diabetic is very high, while okra productivity in Indonesia is still low, a plant breeding program through variety development is needed. One of the initial activities that needs to be carried out is the characterization of various genotypes, both quantitative and qualitative characters. This research aimed to obtain information on the diversity of morpho-agronomic characters in okra genotypes. <b>Materials and Methods:</b> The experiment was conducted as a randomized block design, one factor is genotype with three replications. The materials used in this research were 20 okra genotypes. The experimental units used in this research were 60 units. Each experimental unit consists of 10 sample plants. Analysis of quantitative character variations used PKBT-STAT 3.1. Cluster analysis was carried out with PBSTAT-CL 2.1.2 with the Gower dissimilarity and average linkage clustering methods. Furthermore, analysis was carried out using SAS OnDemand for Academics to see the distinguishing characteristics between clusters. <b>Results:</b> There were differences in okra genotypes based on qualitative and quantitative characteristics. The most diverse quantitative character is the yield component, which is the fruit character. Variance in genetic and heritability showed broad and high criteria, respectively. Based on cluster analysis results, okra genotypes were grouped into 3 clusters with a cophenetic distance value of 0.40. Cluster 1 consists of 9 genotypes. Cluster 2 consists of 10 genotypes. Cluster 3 consists of 1 genotype the Red Hill Country genotype. The grouping in cluster analysis was carried out based on leaf width, number of fruits, fruit weight, fruit diameter and carpel thickness character. <b>Conclusion:</b> This diversity of okra germplasm can facilitate plant breeding activities in the future by selecting genotypes to serve as parents according to the objectives carried out.

Basin Structure for Earthquake Ground Motion Estimates in Urban Los Angeles Mapped with Nodal Receiver Functions

We constrained sedimentary basin structure using a nodal seismic array consisting of ten dense lines that overlie multiple basins in the northern Los Angeles area. The dense array consists of 758 seismic nodes, spaced ~250–300 m apart along linear transects, that recorded ground motions for 30–35 days. We applied the receiver function (RF) technique to 16 teleseismic events to investigate basin structure. Primary basin-converted phases were identified in the RFs. A shear wave velocity model produced in a separate study using the same dataset was incorporated to convert the basin time arrivals to depth. The deepest part of the San Bernardino basin was identified near the Loma Linda fault at a depth of 2.4 km. Basin depths identified at pierce points for separate events reveal lateral changes in basin depth across distances of ~2–3 km near individual stations. A significant change in basin depth was identified within a small distance of ~4 km near the San Jacinto fault. The San Gabriel basin exhibited the largest basin depths of all three basins, with a maximum depth of 4.2 km. The high lateral resolution from the dense array helped to reveal more continuous structures and reduce uncertainties in the RFs interpretation. We discovered a more complex basin structure than previously identified. Our findings show that the basins’ core areas are not the deepest, and significant changes in basin depth were observed near some faults, including the San Jacinto fault, Fontana fault, Red Hill fault and Indian Hill fault.

Is greenery green? An analytical comparison between the planned, visual, and perceived green

This research established a comprehensive evaluation system for urban ecological assessment. Through research in the fields of urban planning, urban design, and cognitive psychology, this paper defines three ecological evaluation indexes correspondingly. They measure the vegetation coverage of land (planning green), the visibility of vegetation from the pedestrian’s viewpoint (visual green), and the psychological perception of greenery by human (perceived green). This study uses computerized parametric analysis, computerized deep learning, data visualization, and statistical methods to achieve an accurate description of the three evaluation indicators. This study assumes that the three green values may behave consistently or inconsistently at each point. Therefore, this study, on the one hand, tries to analyze the potential factors affecting each green indicator. On the other hand, by analysing the consistency or discrepancy of the three green values, this research revealed the potential link between urban spatial type and integrated ecological properties. Four areas of Brisbane dominated by different functions were selected for this study (Red Hill and Bardon for residential areas, Brisbane City for downtown CBD, and Woolloongabba for industrial areas). The results of the study demonstrate the credibility and applicability of the three green indicators in different areas, examine the various factors affecting ecology, and provide new design strategies and ideas for urban designers.

Does non-stationarity induced by multiyear drought invalidate the paired-catchment method?

Abstract. Multiyear drought has been demonstrated to cause non-stationary rainfall–runoff relationship. But whether this change can occur in catchments that have also experienced vegetation change and whether it invalidates the most widely used methods for estimating impacts of vegetation change – i.e., the paired-catchment method (PCM), the time–trend method (TTM), and the sensitivity-based method (SBM) – on runoff is still unknown and rarely discussed. Estimated inconsistent afforestation impacts were 32.8 %, 93.5 %, and 76.1 % of total runoff changes in the Red Hill paired experimental catchments in Australia during the period of 1990–2015 by the PCM, TTM, and SBM, respectively. In addition to afforestation, the Red Hill paired experimental catchments have experienced a 10-year drought (2000–2009) and have been demonstrated to lead to non-stationary rainfall–runoff relationships of paired catchments. Estimated impacts of vegetation change by the PCM (32.8 %) is still reliable and is not invalided by multiyear drought-induced non-stationarity, because the PCM can eliminate all impacts by different factors on paired catchments (multiyear drought and climate variability), except the purposed treatment (afforestation). For the TTM and SBM, traditional application did not further differentiate different drivers of non-stationary rainfall–runoff relationship (i.e., multiyear drought and vegetation change), which led to significant overestimation of afforestation effects. A new framework was further proposed to separate the effects of three factors on runoff changes, including vegetation change, climate variability, and hydroclimatic non-stationarity (i.e., multiyear drought). Based on the new framework, impacts of multiyear drought and climate variability on runoff of the control catchment (Kileys Run) were 87.2 % and 12.8 %, respectively. Impacts of afforestation, multiyear drought, and climate variability on runoff of the treated catchment (Red Hill) were 32.8 %, 54.7 %, and 23.9 %, respectively. Impacts of afforestation on runoff were 38.8 % by the TTM and 21.4 % by the SBM, agreeing well with that by the PCM (32.8 %). This study not only demonstrated that multiyear drought can induce non-stationary rainfall–runoff relationship using field observations, but also proposed a new framework to better separate the impact of vegetation change on runoff under climate-induced non-stationary condition. More importantly, it is shown that non-stationarity induced by multiyear drought does not invalidate the PCM, and PCM is still the most reliable method even though the control catchment experienced climate-induced shift in the rainfall–runoff relationship.

1450. Trends in hospitalizations and outpatient visits with early or delayed antibiotic treatment initiation in nontuberculous mycobacterial lung disease

Abstract Background The 2020 treatment guidelines for patients diagnosed with nontuberculous mycobacterial lung disease (NTMLD) recommend antibiotic treatment initiation rather than “watchful waiting” for most patients. Little is known regarding how delayed treatment (DT) may impact healthcare resource utilization (HRU). The goal of this study was to assess HRU with early antibiotic treatment (ET) or DT in NTMLD. Methods We conducted a retrospective observational cohort study using MarketScan claims from July 2014 to June 2020. Inclusion criteria were: ≥ 2 NTMLD medical claims (with date of first NTMLD claim as index date); continuous enrollment spanning 12 months pre–index date (baseline) to ≥ 24 months post–index date; concomitant treatment with antibiotics used in NTMLD, ie, from ≥ 2 drug classes within 28 days of each other; and no tuberculosis diagnosis. Mean time to antibiotic initiation (TT) from index date was used to define ET (TT ≤ 3 months) and DT (TT > 3 months) groups. Trends in hospitalizations (any, respiratory-related) and any outpatient visits at baseline, year 1 (Y1), and year 2 (Y2) post–index date were described. Results A total of 518 patients with NTMLD were included: 395 (76%) ET and 123 (24%) DT patients. ET patients tended to be younger and male; DT patients had a higher prevalence of emphysema, asthma, and bronchiectasis. ET patients had a decrease from baseline in the proportion of patients hospitalized and the mean number of hospitalizations at Y1 and Y2 (Figure 1A and 1B). DT patients had an increase from baseline in the proportion of patients hospitalized and the mean number of hospitalizations at Y1, followed by a decrease in Y2, although the mean number of hospitalizations at Y2 remained higher than at baseline. Similar trends in respiratory-related hospitalizations were observed per patient group (Figure 1C and 1D). ET patients had a decrease from baseline in the proportion of patients and the mean number of emergency room visits at Y1 and Y2, whereas DT patients showed little to no improvement (Figure 2A and 2B). Figure 1.Proportion of patients with (A) any hospitalization and (C) respiratory disease–related hospitalizations with early or delayed treatment for NTMLD. Mean number of (B) any hospitalizations and (D) respiratory disease–related hospitalizations per patient with early or delayed treatment for NTMLDFigure 2.(A) Proportion of patients with any ER visits with early or delayed treatment for NTMLD. (B) Number of ER visits per patient with early or delayed treatment for NTMLD Conclusion During the first 2 years after diagnosis, improvements in hospitalizations and ER visits were observed in patients who received ET, whereas patients who received DT showed little to no improvement from baseline. Disclosures Kevin L. Winthrop, MD, MPH, AN2: Advisor/Consultant|AN2: Grant/Research Support|Insmed: Advisor/Consultant|Insmed: Grant/Research Support|Paratek: Advisor/Consultant|Paratek: Grant/Research Support|Red Hill Biopharma: Advisor/Consultant|Red Hill Biopharma: Grant/Research Support|Spero Therapeutics: Advisor/Consultant Catherine Waweru, PhD, Insmed Incorporated: Employee|Insmed Incorporated: Stocks/Bonds Mariam Hassan, PhD, B. Pharm, Insmed Incorporated: Employee|Insmed Incorporated: Stocks/Bonds Sara Burns, MS, Panalgo: Employee Anjan Chatterjee, MD, MPH, Insmed Incorporated: Employee|Insmed Incorporated: Stocks/Bonds.

Артефакты из раскопок Кармир блура и новая интерпретация урартского термина šišuhani

In 2021, during the excavations on the territory of Karmir Blur (Red Hill), a huge complex of the Urartian period was discovered by the Armenian and Austrian archaeologists who evidenced it had been the royal stable. In 782 BC the Urartian king Argishti I founded the city of Er(e)buni, the present capital of Armenia Yerevan. And since in his legend he stated that he had built this city in order to subdue the rival countries (i.e., “for horrifying them”), it is ensued that the fortress of the Teisheba (Teshub, the God of war) situated in Karmir Blur, as well as the newly discovered stable had been built by the same belligerent Urartian king Argishti, the son of Menua. My scientific surveys have shown that the discovered construction is not a stable, but in a wider interpretation, it is a “billet (իջևանատուն)for the royal cavalry (այրուձի)” for an overnight lodging and replacing the tired horses with more vigorous ones to continue the incursion, sometimes right before the battle with the enemy. The fact of discovering a stable with the remains of horses fully coincides with my disclosure of the meaning of the Urartian term “šišuhani”, which formerly has been translated by all urartologists with almost a zero meaning, namely – «again». According to the new semantic interpretation, this is a compound word consisting of two roots: “šišu” (= a horse, a mare, a race-horse, a stallion) and “han” (= an inn). My new interpretation is based on an episode from Movses Khorenatsi’s "History of Armenia". The brilliant Armenian historian of the 5th century amazingly preserved for the future descendants not only the word “khan” (inn), but also described the scene of the Armenian king Yervand’s escape (201 BC), during which the latter took advantage of the possibility of replacing horses in a khan. This narrative, proving the existence of the havens for horses in the capital of Armenia, Yervandashat, in the 3rd century BC, fully confirms the meaning and the purpose of the historical constructions discovered in Karmir Blur, moreover, it testifies the unshakable unity of Urartu and Armenia․

A reassessment of Arundian–Holkerian (Viséan) carbonates in South Cumbria, UK

Despite the importance of south Cumbrian sections for the Arundian–Holkerian (mid Viséan) boundary, beyond the stratotype proposed at Barker Scar in 1976, little else is known regionally about this boundary and its relationship to adjacent formations. We re-evaluate the Dalton Formation, making its upper and lower boundaries regionally more consistent and precisely-defined, in good quality outcrops with associated biostratigraphy. The Dalton Formation is formally divided into the Blackstone Member and overlying Raven's Member. Rich foraminiferal assemblages of the Cf4δ subzone are recognized in the Blackstone Member and the lower to mid Raven's Member in nine sections. The Cf4γ–Cf4δ boundary is recognized in the underlying Red Hill Limestone Formation in 3 sections. The upper part of the Raven's Member shows the first appearance of taxa assigned to the Cf5α and Cf5β subzones of the Holkerian in three of the sections. Bentonitic shales in the mid and upper-most part of the Raven's Member were evaluated for zircon and apatite geochronology, although only 4 out of 504 analyses yielded Carboniferous ages, indicating an almost entirely detrital source. This detritus was northerly or northeasterly-derived and predominantly from the Southern Uplands Terrane with subsidiary input from the Lewisian Complex or eastern Greenland sources. Petrographic analysis identified 13 microfacies indicating that the Dalton Formation represents the inner to outer part of a southward inclined shelf, in which east–west changes in microfacies were generated by synsedimentary faulting inherited from northwest–southeast aligned basement structures.

Terrestrial Signature of a Recently-Tidewater Glacier and Adjacent Periglaciation, Windy Glacier (South Shetland Islands, Antarctic)

Contemporary retreat of glaciers is well visible in the West Antarctic region. The aim of this study is to identify, map and quantify terrestrial glacial and periglacial landforms developed in front of Windy Glacier (Warszawa Icefield, King George Island, South Shetlands), which recently turned from being tidewater to land-terminating, and on near-by Red Hill. The study is based on an orthophoto map and a DEM elaborated with a use of images obtained during a UAV BVLOS photogrammetric survey in 2016, Google Earth Pro images from 2006 and an orthophoto map from 1978/1979. The geomorphological map obtained includes 31 types of landforms and water bodies, grouped into: (1) glacial depositional landforms, (2) fluvial and fluvioglacial landforms, (3) littoral and lacustrine landforms, (4) solifluction landforms, (5) other mass movement landforms, (6) patterned ground, (7) debris flows, landslides and mudflows, (8) water bodies, (9) other (bedrock, boulders, glacial ice, snow patches, and not recognized surface). Most area is occupied by glacial lagoon, fluvial and fluvioglacial landforms, not recognized surfaces and littoral landforms. Between 2006 and 2016 the glacier deposited a well-developed patch of fluted moraine with small drumlins. We recognize the glacial-periglacial transition zone between 41 and 47 m GPS height above which solifluction landforms and sorted patterned ground dominate. Advantages of UAV and BVLOS missions are highlighted and problems with vectorization of landforms are discussed. Distinction between flutes and small drumlins is shown on length-to-elongation and length-to-width diagrams and critical reference to previous geomorphological mappings on King George Island is presented.

Ghosting in the outback Noir

Who was the ‘jolly swagman’ in Waltzing Matilda, Australia’s unofficial national anthem? In this essay I argue that the ghost of the swagman can be heard in a number of recent de-colonising crime narratives. Outback Noir is a relatively recent genre category that describes a new wave of Australian crime films that highlight Indigenous and white relations and take a revisionist approach to traditional history. These films often feature redemption stories that highlight effective collaborations between Indigenous and white policing practices. Uncovering a rural communities’ dark, repressed secrets in order to solve a current problem is a common trend in Outback Noir cinema. I examine Patrick Hughes’ 2010 film Red Hill as an early provocative example of Outback Noir and as modern reimaging of the Waltzing Matilda narrative with the swagman’s avenging ghost exposing the social fractures and corruption that are destroying rural communities. I argue that the Outback Noir genre with its focus on revenge-redemption narratives shapes the cultural dialogue around putting the ghosts of the colonial past to rest.

The geophysical response of the Goldrush-Fourmile orebody and implications for camp-scale Carlin-type deposit exploration, Cortez District, Nevada

Since discovery of the Goldrush and Fourmile deposits, numerous geophysical surveys have been acquired over the footprint of mineralization and surrounding areas to focus exploration. The Goldrush-Fourmile system extends more than 7 km in strike length and averages approximately 300 m wide. Most of the orebody lies more than 300 m below ground surface and continues to depths of more than 900 m. Direct detection of the ore system using geophysical tools is impeded by several factors. The system is relatively flat lying and sits in the hinge of a doubly plunging anticline. This gives the shallowest zones a very small lateral footprint. The ore consists of thin strata-bound zones of silica-sulfide mineralization with a tight alteration selvage. Structural controls along faults are limited, with only small displacements. Strong petrophysical contrasts exist between unaltered rock units. Finally, the terrain is rugged. Resistivity inversions of airborne electromagnetic data show that mineralization sits within a complex zone of resistivity responses. Close to intrusions, the host stratigraphy is resistive. Away from intrusions, the same stratigraphic units show highly variable but commonly very low resistivities. This suggests the possibility of redistribution of carbon around intrusions during premineralization metasomatism. Within the orebody, sulfide content increases conductivity within individual formations related to the distribution of fine-grained sooty pyrite. The geometry of the Red Hill Anticline is imaged as a positive density contrast in the observed gravity and geologically constrained gravity inversions. The positive density contrast represents the gross geophysical signature of denser carbonates within the Paleozoic stratigraphy. Magnetic surveys are crucial for mapping the distribution of igneous rocks and potentially hornfelsed sedimentary rocks. The challenges associated with exploring for deeply buried Carlin mineralization notwithstanding, the application of innovative geophysical tools tuned to assess specific geologic questions, combined with best-practice geologic and geochemical modeling, is helping drive exploration for additional Carlin-type mineralization across the Cortez District.

Wetting/drying cycles increase arsenic bioaccessibility in mine-impacted sediments

Physical and chemical weathering of arsenic-enriched mine wastes can lead to the mobilization and dispersal of contaminated sediments into surrounding (residential) areas. Additionally, seasonal effects during dry and rainy seasons affect contaminant bioaccessibility in ways that may significantly influence risk estimates of chronic arsenic exposure for residents living near mining sites. Rainwater-transported sediments from the Red Hill Mercury Mine in Tustin, California were collected monthly over a period of 25 months and the ingestible size fraction (≤250 μm) analyzed for bulk arsenic concentration (239 ± 149 mg/kg, n = 32, 114 to 678 mg/kg), assessed for arsenic bioaccessibility (11.2 ± 6.3%, n = 32, 2.7 to 24.9%), and compared with realtime rainfall data. Arsenic bioaccessibility was highly variable and strongly negatively correlated with cumulative rainfall over the preceding 40 days (r2 = 0.51, P < 0.001). Controlled wetting/drying experiments and As speciation analyses demonstrated that this correlation primarily arose through the removal of soluble/surface-bound arsenic phases from sediments during rainwater exposure/transport, but also suggested the secondary formation of soluble arsenic phases resulting from diel humidity and temperature fluctuations during dry periods, which gradually increases the proportion of bioaccessible arsenic with time. These findings demonstrate significant seasonal variability in arsenic bioaccessibility and indicate that arsenic exposure risks through incidental ingestion in these and similar systems are highest following extended dry periods.

Poe in Richmond: Conserving Poe's Papers

Poe in Richmond: Conserving Poe's Papers

The Idiot as Artist:The Fantasy Boats of James Henry Pullen

The Idiot as Artist:The Fantasy Boats of James Henry Pullen

A New Species of Megalichthys (Sarcopterygii, Megalichthyidae) from the Upper Devonian (Famennian) of Pennsylvania, U.S.A., and a Report on the Cosmine-Covered Osteolepiform Fossils of the Catskill Formation

ABSTRACT New material from the Upper Devonian (Famennian) Catskill Formation of Pennsylvania, U.S.A., indicates the presence of a new species of Megalichthys. A large collection of complete and well-preserved fossil material from the Red Hill field locality enables a thorough anatomical description that is not commonly available in Megalichthyidae. The cranial material includes skull roof, partial cheek, lower jaw, opercular-gular elements, palatoquadrate, and dermal palatal elements. The postcranial material includes pectoral fin elements including cleithrum, mesomeres, and lepidotrichia; pelvic fin including lepidotrichia; and body scales in articulation. The new species is distinguished from other species of Megalichthys by the presence of a pineal series of bones, a triangular-shaped principal gular, and a lack of sensory canal pores on the postparietal. We review the taxonomic history and status of Megalichthyidae and Megalichthys and provide revised diagnoses for each that include only discrete features demonstrated to be sufficient for taxonomic assignment. We discuss additional cosmine-covered osteolepiform fossils from other Catskill Formation exposures. These include the type and only specimen of Sterropterygion brandei and seven new specimens (including a partial snout, a partial parietal shield, a partial postparietal shield, a partial cheek, and complete lower jaws) that potentially represent megalichthyid species in addition to the one at the focus of this study. With this description of new megalichthyid material, the Catskill Formation continues to produce, in some cases, the only known Devonian occurrence of otherwise younger taxa.

A GIS Analysis of Intra-Site Spatial Patterning at the Early Paleoindian Mt. Albion West Site (AhGw-131)

The Mt. Albion West (AhGw-131) Early Paleoindian site is one of only a handful of Late Pleistocene sites in Ontario. Excavated by Archaeological Services Inc. (ASI) between 1998 and 2004, the site is situated adjacent to the Red Hill valley on the Niagara Escarpment in Hamilton, Ontario. The project yielded detailed analyses concerning the tools and debitage recovered from the four discrete artifact concentration areas at this site in addition to a brief assessment of potentially significant intra-site patterning within one locus. In this paper, the four activity areas from Mt. Albion West are analyzed using Geographic Information Systems (GIS) to investigate these spatial relationships with an eye toward interpreting the duration and frequency of the site’s occupation(s) as well as its function(s) within the broader Gainey settlement system.

“Borderland Translation”

Abstract This paper explores the complexity of translation of borderland literature through a case study of the Japanese and Chinese translations of the Korean short story “The Red Hill.” Written by the renowned Korean writer Kim Tong-in (김동인, 1900–1951) in 1932, this story features the Korean agrarian community in the Northeast Asian borderland of Manchuria and is conventionally considered a masterpiece of Korean national literature. When it was translated into Japanese and Chinese and anthologized in inland Japan and the Japanese Manchukuo respectively, the three texts of the same story in three languages conveyed different and contradictory national/imperial claims over Manchuria, a Northeast Asian frontier. This case study demonstrates how the very act of translating and anthologizing, as a process of linguistic transposition across cultural and national constituencies, may crystallize the sense of territorial competition through revealing, reshuffling, and redefining the covert intricacy of national relations in the original text.

1198P - FPA150 (B7-H4 antibody) phase I update in advanced solid tumours: Monotherapy and in combination with pembrolizumab

1198P - FPA150 (B7-H4 antibody) phase I update in advanced solid tumours: Monotherapy and in combination with pembrolizumab

Reclaiming space at Red Hill Camp: Community archaeology with urban indigenous groups

ABSTRACTCommunity archaeology can contribute to positive social outcomes for urban Indigenous communities by focusing on the recent history of the modern city. We report on a community archaeology project undertaken in Canberra, Australia, which focused on the 1940–50s campsite of one of the authors’ Indigenous Ngambri/Ngunnawal family. Project outcomes showed that even despite a lack of material culture, community archaeology has the ability to shift narratives of place in an urban centre to include sites of contemporary significance to local Indigenous people. We consider methodological limitations, the concept of parallel conversations and the possibility that such projects are able to reclaim land in historically marginalized groups’ struggles for recognition. We argue that a focus on recent Indigenous history has the potential to be particularly transformative in this regard.

780. Incidence and Prevalence of Nontuberculous Mycobacterial Lung Disease in US Medicare, 2008–2015

BackgroundPrevious research has reported nontuberculous mycobacterial lung disease (NTMLD) prevalence of 47 per 100,000 among Medicare beneficiaries ≥65 years in 2007, with an average increase of 8.2% annually between 1997 and 2007. In this study, we have evaluated NTMLD incidence and prevalence in Medicare between 2008 and 2015.MethodsPatients diagnosed for NTMLD with an ICD9 031.0 were identified from the Medicare database (N≈30 million yearly), not including the Part C portion. Individuals who incurred at least 2 medical claims ≥30 days apart between 2007 and 2015 were considered as a positive NTMLD case, yielding 58,294 patients. All individuals fulfilling the case definition each calendar year were considered as prevalent cases. Incident cases included those meeting case criteria and who did not have a Medicare claim for NTMLD in the prior year. Poisson regression was used to estimate yearly confidence intervals. ARIMA models were used to forecast incidence and prevalence over 2016–2025.ResultsPatients with NTMLD in the Medicare database had a mean age of 74 (standard deviation: ±10) years. Sixty-nine percent were women and 89% white. Yearly NTMLD incidence increased from 20.7 (95% CI: 20.2–21.3) in 2008 to 28.1 (27.5–28.7) in 2013 per 100,000 Medicare beneficiaries and leveled to 27.6 (26.9–28.2) in 2014 and 25.9 (25.3–26.5) in 2015 per 100,000. Yearly NTMLD prevalence increased throughout the observation period from 41.6 (40.9–42.3) in 2008 to 63.1 (62.2–64.0) in 2015 per 100,000 Medicare beneficiaries. Incidence was 28.1 vs. 14.7 per 100,000 in 2015 in Medicare beneficiaries ≥65 years vs. those <65 years, respectively. Prevalence was 70.2 vs. 27.9 per 100,000 in 2015 in Medicare beneficiaries ≥65 years vs. those <65 years, respectively. In 2015, incidence and prevalence were higher in women than men (33.9 vs. 16.0/100,000 and 86.2 vs. 34.6/100,000, respectively) and among individuals of Asian origin compared with White (41.1 vs. 27.6/100,000 and 89.4 vs. 68.7/100,000, respectively). The 10-year incidence and prevalence forecasts were presented in figures.ConclusionIn US Medicare beneficiaries, NTMLD incidence increased from 2008 through 2013 and leveled off in more recent years, while NTMLD prevalence continued to rise through 2015. Disclosures K. L. Winthrop, Insmed Incorporated: Scientific Advisor, Consulting fee and Research grant. T. Marras, Insmed Incorporated: Investigator, Consulting fee and Research grant, Horizon Pharmaceuticals: Consultant, Consulting fee, Red Hill: Consultant, Consulting fee, AstraZeneca: CME, Speaker honorarium. G. Eagle, Insmed Incorporated: Employee, Salary. R. Zhang, Insmed Incorporated: Consultant, Consulting fee. P. Wang, Insmed Incorporated: Employee, Salary. E. Chou, Insmed Incorporated: Employee, Salary. Q. Zhang, Insmed Incorporated: Employee, Salary.