The R package mice imputes incomplete multivariate data by chained equations. The software mice 1.0 appeared in the year 2000 as an S-PLUS library, and in 2001 as an R package. mice 1.0 introduced predictor selection, passive imputation and automatic pooling. This article documents mice, which extends the functionality of mice 1.0 in several ways. In mice, the analysis of imputed data is made completely general, whereas the range of models under which pooling works is substantially extended. mice adds new functionality for imputing multilevel data, automatic predictor selection, data handling, post-processing imputed values, specialized pooling routines, model selection tools, and diagnostic graphs. Imputation of categorical data is improved in order to bypass problems caused by perfect prediction. Special attention is paid to transformations, sum scores, indices and interactions using passive imputation, and to the proper setup of the predictor matrix. mice can be downloaded from the Comprehensive R Archive Network. This article provides a hands-on, stepwise approach to solve applied incomplete data problems.

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mice: Multivariate Imputation by Chained Equations in R

Secret History: Return of the Black Death Channel 4, 7-8pm In 1348 the Black Death swept through London, killing people within days of the appearance of their first symptoms. Exactly how many died, and why, has long been a mystery. This Secret History documentary follows experts as they pick through the evidence and reveal why the plague killed on such a scale. And they ask, what might be coming next?

Medscape

Werner, Sabine, and Richard Grose. Regulation of Wound Healing by Growth Factors and Cytokines. Physiol Rev 83: 835–870, 2003; 10.1152/physrev.00032.2002.—Cutaneous wound healing is a complex proce...

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Regulation of Wound Healing by Growth Factors and Cytokines

This document represents the first collaboration between 2 organizations-the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine-to describe best practices in nutrition therapy in critically ill children. The target of these guidelines is intended to be the pediatric critically ill patient (>1 month and 2-3 days in a PICU admitting medical, surgical, and cardiac patients. In total, 2032 citations were scanned for relevance. The PubMed/MEDLINE search resulted in 960 citations for clinical trials and 925 citations for cohort studies. The EMBASE search for clinical trials culled 1661 citations. In total, the search for clinical trials yielded 1107 citations, whereas the cohort search yielded 925. After careful review, 16 randomized controlled trials and 37 cohort studies appeared to answer 1 of the 8 preidentified question groups for this guideline. We used the GRADE criteria (Grading of Recommendations, Assessment, Development, and Evaluation) to adjust the evidence grade based on assessment of the quality of study design and execution. These guidelines are not intended for neonates or adult patients. The guidelines reiterate the importance of nutrition assessment-particularly, the detection of malnourished patients who are most vulnerable and therefore may benefit from timely intervention. There is a need for renewed focus on accurate estimation of energy needs and attention to optimizing protein intake. Indirect calorimetry, where feasible, and cautious use of estimating equations and increased surveillance for unintended caloric underfeeding and overfeeding are recommended. Optimal protein intake and its correlation with clinical outcomes are areas of great interest. The optimal route and timing of nutrient delivery are areas of intense debate and investigations. Enteral nutrition remains the preferred route for nutrient delivery. Several strategies to optimize enteral nutrition during critical illness have emerged. The role of supplemental parenteral nutrition has been highlighted, and a delayed approach appears to be beneficial. Immunonutrition cannot be currently recommended. Overall, the pediatric critical care population is heterogeneous, and a nuanced approach to individualizing nutrition support with the aim of improving clinical outcomes is necessary.

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.)

Morbidity and mortality from sepsis remains unacceptably high. Large variability in clinical practice, plus the increasing awareness that certain processes of care associated with improved critical...

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Severe sepsis and septic shock

The Methamphetamine Burn Patient: A Retrospective Study and Literature Review: 137.

Pruritus is a commonly reported symptom after burn injury Valid and reliable scales to measure itch in pediatric burn survivors are important for treatment and epidemiological studies This study sought to develop psychometrically sound, publicly available self- and proxy-report measures of itch for use in pediatric burn survivors suitable for use in research and clinical practice A panel of burn experts developed a definition of itch interference and a set of parallel self- and proxy-report candidate items that covered important activities affected by itch Candidate items were evaluated in cognitive interviews with pediatric burn survivors (n = 4) and proxies (n = 2) Items were translated to Spanish and administered in both English and Spanish to a sample (N = 264) of pediatric burn survivors and/or their proxy enrolled in the Burn Model System (BMS) longitudinal database The mean age of the pediatric sample was 13 years and average time since burn 5 years The final itch interference measures each included 5 parallel items calibrated using a one-parameter graded response item response theory model, with a mean of 50 representing the average itch interference of the sample Reliability of the scores is excellent between the mean and two standard deviations above Initial analyses provide support for validity of the score Concordance between the self- and proxy-report scores was moderate (ICC = 068) The results support the reliability and validity of the itch scale in children and youth with burn injury The new BMS Pediatric Itch Interference scales are freely and publicly available at https://burndatawashingtonedu/itch

Development of proxy and self-report Burn Model System Pediatric Itch Interference scales: A National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System Study.

Substance P(SP) modulates cytokine synthesis and adhesion molecule expression by inflammatory and endothelial cells in response to injury. A major proinflammatory effect includes nitric oxide(NO) production. Three nitric oxide synthase(NOS) isoforms include neuronal(nNOS), inducible(iNOS), and endothelial(eNOS). In this study, we determined which NOS enzymes mediate SP-induced NO upregulation in endothelial cells. Confluent human microvascular endothelial cells (HMECs) were treated with SP(10−8 M) for 48 h with and without the nonspecific NOS inhibitor N-nitro l-arginine methyl ester (L-NAME; 4 uM) or specific inhibitors against nNOS (L-thiocitrulline;60 nM), iNOS (n-3-aminomethyl benzyl acetamidine;7 nM), eNOS (N-5-1-iminoethyl-L-ornithine; 0.5 uM). Inhibitors were added for 3 h prior to and continued throughout SP stimulation. Nitrate/nitrite levels were measured in cell extracts using Greiss reagents and standardized with protein concentration for each sample. Results are expressed as uM nitrate/mg protein. Statistical analysis was determined using ANOVA. Result are expressed as mean ± sd; p < 0.05 was considered statistically significant. SP effectively elevated nitrate levels (2.96 uM/mg protein;p ≤ 0.05) compared to control treatment (2.1 uM/mg protein). All NOS inhibitors showed some inhibitory effect on substance P induced NO production. However, only L-NAME (1.9 uM/mg protein) and the specific eNOS inhibitor (2.32 uM/mg protein) demonstrated a significant decrease (p < 0.05.) Our data suggest that SP up-regulation of NO in HMECs is primarily mediated by eNOS, but that other NOS enzymes may also contribute. Further studies are warranted to better understand the role of NOS in SP signaling.

Nicole S. Gibran

Papers

The Methamphetamine Burn Patient: A Retrospective Study and Literature Review: 137.

Development of proxy and self-report Burn Model System Pediatric Itch Interference scales: A National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System Study.

122 Substance P Induce Nitric Oxide Production in Human Microvascular Endothelial Cells

Letter to the Editor #2: Description of the Burn Model System National Database sample

Corrigendum to “12-Year within-wound study of the effectiveness of custom pressure garment therapy” [Burns 36 (2010) 975–983]