Background: Sepsis-induced myocardial injury (SIMI) is a common organ dysfunction and is associated with higher mortality in patients with sepsis. We aim to construct a nomogram prediction model to assess the 28-day mortality in patients with SIMI. . Method: We retrospectively extracted data from Medical Information Mart for Intensive Care (MIMIC-IV) open-source clinical database. SIMI was defined by Troponin T (higher than the 99th percentile of upper reference limit value) and patients with cardiovascular disease were excluded. A prediction model was constructed in the training cohort by backward stepwise Cox proportional hazards regression model. The concordance index (C-index), area under the receiver operating characteristics curve (AUC), net reclassification improvement (NRI), integrated discrimination improvement (IDI), calibration plotting and decision-curve analysis (DCA) were used to evaluate the nomogram. Results: 1312 patients with sepsis were included in this study and 1037 (79%) of them presented with SIMI. The multivariate Cox regression analysis in all septic patients revealed that SIMI was independently associated with 28-day mortality of septic patients. The risk factors of diabetes, Apache II score, mechanical ventilation, vasoactive support, Troponin T and creatinine were included in the model and a nomogram was constructed based on the model. The C-index, AUC, NRI, IDI, calibration plotting and DCA showed that the performance of the nomogram was better than the single SOFA score and Troponin T. Conclusion: SIMI is related to the 28-day mortality of septic patients. The nomogram is a well-performed tool to predict accurately the 28-day mortality in patients with SIMI.

This study investigates the global epidemiological burden of lower respiratory infections (LRI) attributable to Klebsiella pneumoniae from 1990–2021, using data from the Global Burden of Disease Study (GBD) 2021. The findings reveal that globally, disability-adjusted life years (DALYs) from Klebsiella pneumoniae-associated LRI decreased from 16,701,044 (95% UI: 14,220,055–19,183,469) in 1990–6,935,440 (95% UI: 5,953,328–8,007,786) in 2021, while deaths declined from 239,367 (95% UI: 212,553–268,072) –175,783 (95% UI: 158,749–193,924). The age-standardized DALYs rate dropped from 313.1 (95% UI: 266.6–359.7)–87.9 (95% UI: 75.4–101.5), and the death rate decreased from 4.5 (95% UI: 4.0–5.0)–2.2 (95% UI: 2.0–2.5). In 2021, the highest rates were observed in Oceania and Sub-Saharan Africa, particularly in Central African Republic, Niger, and Zimbabwe, while the lowest rates were found in Australasia, High-income North America, Eastern Europe, and East Asia, especially in the UAE, Australia, and Qatar. Higher rates were noted among both males and females under 10 and over 65 years old. Although most regions experienced decreases in age-standardized rates(ASR) from 1990–2021, Southern Latin America exhibited an increase. Additionally, age-standardized DALYs and death rates generally declined with increasing socio-demographic index (SDI). The global burden of LRI due to Klebsiella pneumoniae significantly decreased over the study period, but lower SDI regions, children, and the elderly remain vulnerable and require targeted interventions to further reduce this burden.

Background: Gallstones are common and have been associated with nutritional and immune status. The Prognostic Nutritional Index (PNI) reflects both nutritional and immune‐related conditions, but its association with gallstones remains unclear. This study examined this association in U.S. adults. Methods: This study analyzed data from 5060 individuals in the National Health and Nutrition Examination Survey (NHANES), with a mHean age of 48.62 years. Multivariable logistic regression was used to assess the association between PNI and gallstones. Restricted cubic spline (RCS) analysis was used to assess potential nonlinearity. Robustness was evaluated using subgroup analyses, interaction tests, and a sensitivity model with additional adjustment for fatty liver. Results: The prevalence of gallstones was 11.36%. In the fully adjusted model, each 1‐unit increase in PNI was associated with 2% lower odds of gallstones (odds ratio [OR] = 0.98, 95% confidence interval [CI] 0.96–0.99, p = 0.0185). Compared with the lowest quartile, participants in the highest quartile had lower odds of gallstones (OR = 0.72, 95% CI 0.55–0.95, p = 0.0194). RCS analysis showed an overall association between PNI and gallstone prevalence ( p for overall = 0.019), with no evidence of nonlinearity ( p for nonlinearity = 0.165). After Bonferroni correction ( α ′ ≈ 0.0015), no subgroup association remained statistically significant, and no significant interactions were detected. Conclusion: An inverse association between PNI and gallstone prevalence remained after multivariable adjustment. PNI may serve as a potential complementary immunonutritional marker associated with gallstone prevalence.

Depressive symptoms are common in mid-to-late adulthood in China. Evidence linking living environments to depression has often focused on single exposures,