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In this study we introduce a likelihood-based method, via the Weibull and piecewise exponential distributions, capable of accommodating the dependence between failure and censoring times. The methodology is developed for the analysis of clustered survival data and it assumes that failure and censoring times are mutually independent conditional on a latent frailty. The dependent censoring mechanism is accounted through the frailty effect and this is accomplished by means of a key parameter accommodating the correlation between failure and censored observations. The full specification of the likelihood in our work simplifies the inference procedures with respect to Huang and Wolfe since it reduces the computation burden of working with the profile likelihood. In addition, the assumptions made for the baseline distributions lead to models with continuous survival functions. In order to carry out inferences, we devise a Monte Carlo EM algorithm. The performance of the proposed models is investigated through a simulation study. Finally, we explore a real application involving patients from the Dialysis Outcomes and Practice Patterns Study observed between 1996 and 2015.
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http://dx.doi.org/10.1002/bimj.201800391 | DOI Listing |
N Engl J Med
September 2025
Rwanda Biomedical Center, Kigali.
Background: On September 27, 2024, Rwanda reported an outbreak of Marburg virus disease (MVD), after a cluster of cases of viral hemorrhagic fever was detected at two urban hospitals.
Methods: We report key aspects of the epidemiology, clinical manifestations, and treatment of MVD during this outbreak, as well as the overall response to the outbreak. We performed a retrospective epidemiologic and clinical analysis of data compiled across all pillars of the outbreak response and a case-series analysis to characterize clinical features, disease progression, and outcomes among patients who received supportive care and investigational therapeutic agents.
Epidemiol Serv Saude
September 2025
Universidade Estadual do Norte do Paraná, Programa de Pós-Graduação em Enfermagem em Atenção Primária à Saúde Bandeirantes, PR, Brazil.
Objectives: To analyze the temporal trend and identify spatial clusters of breast cancer mortality in Paraná state between 2012 and 2021.
Methods: This was a time series study, with spatial analysis of breast cancer mortality rates in the 399 municipalities of Paraná. Data were selected from the Mortality Information System.
Cien Saude Colet
August 2025
Faculdade de Farmácia Odontologia e Enfermagem, Universidade Federal do Ceará. Fortaleza CE Brasil.
Population-based studies related to pre-eclampsia are scarce. The aim was to analyze the spatial and temporal distribution of deaths due to pre-eclampsia in Brazil from 2009 to 2020, characterizing the sociodemographic profile, distribution pattern, and presence of spatio-temporal clusters. It involved an ecological, population-based study using the Brazilian territory as the unit of analysis.
View Article and Find Full Text PDFAm J Physiol Cell Physiol
September 2025
Department of Cancer Biology, Wake Forest University School of Medicine, Winston-Salem, NC.
Cachexia, the loss of skeletal muscle mass and function with cancer, contributes to reduced life quality and worsened survival. Skeletal muscle fibrosis leads to disproportionate muscle weakness; however, the role of infiltrating immune cells and fibro-adipogenic progenitors (FAPs) in cancer-induced muscle fibrosis is not well understood. Using the C26 model of cancer cachexia, we sought to examine the changes to skeletal muscle immune cells and FAPs which contribute to excessive extracellular matrix (ECM) collagen deposition.
View Article and Find Full Text PDFPLOS Glob Public Health
September 2025
Department of International Health, Center for Humanitarian Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America.
Humanitarian crises, particularly in conflict zones, create cascading disruptions that impact every aspect of daily life, including health and disease outcomes. While international humanitarian frameworks categorize these crises into discrete operational clusters, affected populations experience them as interwoven, systemic failures. This study examines how conflict-induced disruptions transform a preventable and typically self-limiting disease-Hepatitis A-into a fatal outcome.
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