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The authors have effectively addressed all comments.
Accepted
Accepted
Accepted
The authors addressed the main concerns of the reviews. However, the revised manuscript still deserves attention. Please provide point-to-point responses according to the comments made by the Reviewer in the new version of your manuscript. I agree with the Reviewers that crucial information about the Informed Consent and Ethics approval is required. The manuscript could be enhanced with a more critical analysis of the study's limitations and the main findings in comparison to existing data published in the literature. The English language and writing still require improvement.
**PeerJ Staff Note:** Please ensure that all review and editorial comments are addressed in a response letter and that any edits or clarifications mentioned in the letter are also inserted into the revised manuscript where appropriate.
**Language Note:** The review process has identified that the English language must be improved. PeerJ can provide language editing services - please contact us at [email protected] for pricing (be sure to provide your manuscript number and title). Alternatively, you should make your own arrangements to improve the language quality and provide details in your response letter. – PeerJ Staff
The English of the authors needs much improvement, and so is generally unclear and very ambiguous. For instance, the use of reported speech is needed in lines 4 and 6. In the Abstract (lines 8-11) authors gave the impression that they collected patients retrospectively. They talked of using clinical data of patients (lines 11, 12, and 62) and at the same time, 569 patients (line 67). Still in the Abstract, clear and quantitative results are lacking. There are several confusing statements throughout the manuscript. It is suggested that the authors use a professional English editor.
Literature references are insufficient. For instance, the authors wrote, "Studies have confirmed the high incidence of renal insufficiency in patients ....". Yet only one reference was given. Authors should also include information on what is already known in the study area.
The professional article structure was largely followed. Raw data were shared.
There was no evidence of slime slicing. The manuscript is self-contained.
The experimental design was significantly improved. However, the author may need to clarify how informed consent was obtained from non-survivors. Again, it boils down to poor reporting/writing style. See also line 79
The authors utilized electronic data. To a large extent, the findings are deemed valid. However, the presentation in the Abstract needs improvement.
Conclusions drawn are in line with the study hypothesis
Some improvement is needed to make the language clearer, and grammar could be improved throughout.
A strong justification should be stated for the use of a single-center retrospective study where external validity is limited.
“Bootstrap resampling” was mentioned but provided no details (number of resamples, internal vs. external validation).
1. Line 18: “hypocalcaemia Mortality” should likely read “hypocalcaemia, mortality…” clarify this sentence, please.
2. Line 23: “By establishing a nomogram prediction model…” — sentence structure is awkward and could be revised for clarity.
3. Consistency in capitalization and tense is needed throughout (e.g., "Nomogram" vs. "nomogram").
4. How was informed consent obtained from the participant?
5. Mention the ethics approval code for the study.
6. It’s unclear how variables were selected for inclusion in the multivariate model (e.g., based on clinical relevance or univariate p-value cutoff?).
7. Replace or remove redundant expressions like “which is of great significance as a reference and guide to the clinic” (Line 28).
8. Format abbreviations uniformly and define at first use.
9. Improve figure captions — provide more interpretive detail rather than just describing what’s shown (e.g., Fig. 2–4).
**PeerJ Staff Note:** Please ensure that all review and editorial comments are addressed in a response letter and that any edits or clarifications mentioned in the letter are also inserted into the revised manuscript where appropriate.
**Language Note:** The review process has identified that the English language must be improved. PeerJ can provide language editing services - please contact us at [email protected] for pricing (be sure to provide your manuscript number and title). Alternatively, you should make your own arrangements to improve the language quality and provide details in your response letter. – PeerJ Staff
The sentence structures were poor. There are several incomprehensible sentences. It is suggested that authors use clear sentences and make good use of full stops to improve the understanding of the report. For instance, the Result and conclusion sections of the Abstract is not clear. Paragraph 3 in the introduction is not understandable due to poor sentence structure. Microorganisms should be italicized.
The introduction did not state the purpose of the study nor why the study is necessary. It also lack information on why the study differs from previous studies
The study falls within the scope of the journal. Unfortunately, the experimental design was not rigorous with research questions not defined
The findings are valid, impactful and novel. Underlying data were provided in the supporting documents and statistical analysis was robust. Conclusion should be modified to reflect study aim/research question(s)
The study holds much promise for publication but poorly written and designed
The manuscript has several awkwardly phrased or grammatically incorrect sentences, and, therefore, the manuscript needs to be proofread by a Native English speaker. Scientific names should be italicised. Check throughout the manuscript. In addition, some sentences in the introduction section need to be reviewed. "Numerous studies have confirmed the high incidence of renal insufficiency in patients with bloodstream infections and its negative impact on prognosis." You cited only a single study that you earlier suggested multiple studies were conducted.
I suggest you rewrite this section. Instead of using "demographic characteristics (age, gender, underlying disease, etc.), clinical manifestations (coma, hypotension, etc.), laboratory findings (blood routine, liver and kidney function, electrolytes, etc.), and prognosis (mortality, etc.)," You can use some information that is suitable to convey proper description; "Patient data included: (1) demographic characteristics (age, gender, underlying conditions); (2) clinical manifestations (coma, hypotension); (3) laboratory findings (complete blood count, liver and kidney function, electrolytes); and (4) prognosis (mortality)."
Elaborate on how verbal consent was sorted retrospectively.
What are the criteria for grouping the participants in the study?
The use of Logistic regression is appropriate. However, the results should report adjusted odds ratios (ORs) with confidence intervals (CIs) to provide a clearer understanding of effect sizes.
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