J. Martin

Friedrich-Schiller-University Jena, Jena, Thuringia, Germany

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Publications (175)176.27 Total impact

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    ABSTRACT: Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75 000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less than 50% to more than 70%; regional variations are much wider, and improvements between 1995-99 and 2005-09 have generally been slight. For women diagnosed with ovarian cancer in 2005-09, 5-year survival was 40% or higher only in Ecuador, the USA, and 17 countries in Asia and Europe. 5-year survival for stomach cancer in 2005-09 was high (54-58%) in Japan and South Korea, compared with less than 40% in other countries. By contrast, 5-year survival from adult leukaemia in Japan and South Korea (18-23%) is lower than in most other countries. 5-year survival from childhood acute lymphoblastic leukaemia is less than 60% in several countries, but as high as 90% in Canada and four European countries, which suggests major deficiencies in the management of a largely curable disease. International comparison of survival trends reveals very wide differences that are likely to be attributable to differences in access to early diagnosis and optimum treatment. Continuous worldwide surveillance of cancer survival should become an indispensable source of information for cancer patients and researchers and a stimulus for politicians to improve health policy and health-care systems. Canadian Partnership Against Cancer (Toronto, Canada), Cancer Focus Northern Ireland (Belfast, UK), Cancer Institute New South Wales (Sydney, Australia), Cancer Research UK (London, UK), Centers for Disease Control and Prevention (Atlanta, GA, USA), Swiss Re (London, UK), Swiss Cancer Research foundation (Bern, Switzerland), Swiss Cancer League (Bern, Switzerland), and University of Kentucky (Lexington, KY, USA). Copyright © 2014 Allemani et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd. All rights reserved.
    The Lancet 03/2015; 385:977-1010. DOI:10.1016/50140-6736(14)62038-9 · 39.21 Impact Factor
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    ABSTRACT: We present a measurement of the cosmic ray e+ + e- flux in the range 0.5 GeV to 1 TeV based on the analysis of 10.6 million e+ + e- events collected by AMS. The statistics and the resolution of AMS provide a precision measurement of the flux. The flux is smooth and reveals new and distinct information. Above 30.2 GeV, the flux can be described by a single power law with a spectral index γ = −3.170 +- 0.008 (stat þ syst) +- 0.008 (energy scale).
    Physical Review Letters 11/2014; 113(22). DOI:10.1103/PhysRevLett.113.221102 · 7.73 Impact Factor
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    ABSTRACT: A facility that can deliver beams of electron and muon neutrinos from the decay of a stored muon beam has the potential to unambiguously resolve the issue of the evidence for light sterile neutrinos that arises in short-baseline neutrino oscillation experiments and from estimates of the effective number of neutrino flavors from fits to cosmological data. In this paper, we show that the nuSTORM facility, with stored muons of 3.8 GeV/c $\pm$ 10%, will be able to carry out a conclusive muon neutrino appearance search for sterile neutrinos and test the LSND and MiniBooNE experimental signals with 10$\sigma$ sensitivity, even assuming conservative estimates for the systematic uncertainties. This experiment would add greatly to our knowledge of the contribution of light sterile neutrinos to the number of effective neutrino flavors from the abundance of primordial helium production and from constraints on neutrino energy density from the cosmic microwave background. The appearance search is complemented by a simultaneous muon neutrino disappearance analysis that will facilitate tests of various sterile neutrino models.
    Physical Review 04/2014; D89:071301. DOI:10.1103/PhysRevD.89.071301
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    ABSTRACT: Background Infections are a leading cause of death in patients with advanced cirrhosis, but there are relatively few data on the epidemiology of infection in intensive care unit (ICU) patients with cirrhosis. AimsWe used data from the Extended Prevalence of Infection in Intensive Care (EPIC) II one-day point-prevalence study to better define the characteristics of infection in these patients. Methods We compared characteristics, including occurrence and types of infections in non-cirrhotic and cirrhotic patients who had not undergone liver transplantation. ResultsThe EPIC II database includes 13,796 adult patients from 1,265 ICUs: 410 of the patients had cirrhosis. The prevalence of infection was higher in cirrhotic than in non-cirrhotic patients (59 vs. 51%, p<0.01). The lungs were the most common site of infection in all patients, but abdominal infections were more common in cirrhotic than in non-cirrhotic patients (30 vs. 19%, p<0.01). Infected cirrhotic patients more often had Gram-positive (56 vs. 47%, p<0.05) isolates than did infected non-cirrhotic patients. Methicillin-resistant Staphylococcus aureus (MRSA) was more frequent in cirrhotic patients. The hospital mortality rate of cirrhotic patients was 42%, compared to 24% in the non-cirrhotic population (p<0.001). Severe sepsis and septic shock were associated with higher in-hospital mortality rates in cirrhotic than in non-cirrhotic patients (41% and 71% vs. 30% and 49%, respectively, p<0.05). Conclusions Infection is more common in cirrhotic than in non-cirrhotic ICU patients and more commonly due to Gram-positive organisms, including MRSA. Infection in patients with cirrhosis was associated with higher mortality rates than in non-cirrhotic patients.This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2014; DOI:10.1111/liv.12520 · 4.41 Impact Factor
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    ABSTRACT: The nuSTORM facility has been designed to deliver beams of electron neutrinos and muon neutrinos (and their anti-particles) from the decay of a stored muon beam with a central momentum of 3.8 GeV/c and a momentum acceptance of 10%. The facility is unique in that it will: 1. Allow searches for sterile neutrinos of exquisite sensitivity to be carried out; 2. Serve future long- and short-baseline neutrino-oscillation programs by providing definitive measurements of electron neutrino and muon neutrino scattering cross sections off nuclei with percent-level precision; and 3. Constitutes the crucial first step in the development of muon accelerators as a powerful new technique for particle physics. The document describes the facility in detail and demonstrates its physics capabilities. This document was submitted to the Fermilab Physics Advisory Committee in consideration for Stage I approval.
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    ABSTRACT: ABSTRACT BACKGROUND: In a recent multicenter randomized trial comparing unfractionated heparin (UFH) with low-molecular-weight heparin (dalteparin) for thromboprophylaxis in 3746 critically-ill patients, 17 (0.5%) patients developed heparin-induced thrombocytopenia (HIT) based on serotonin-release assay-positive (SRA+) status. A trend to lower frequency of HIT with dalteparin vs UFH was observed in the intention-to-treat analysis (5 vs 12 patients; P=0.14), which was statistically significant (3 vs 12 patients; P=0.046) in a prespecified per-protocol analysis which excluded patients with deep-vein thrombosis (DVT) at study entry. We sought to characterize HIT outcomes and to determine how dalteparin thromboprophylaxis might reduce HIT frequency in ICU patients. METHODS: In 17 patients with HIT, we analyzed platelet counts and thrombotic events in relation to study drug and other open-label heparin, to determine whether study drug plausibly explained seroconversion to SRA+ status and/or breakthrough of thrombocytopenia/thrombosis. We also compared antibody frequencies (dalteparin vs UFH) in 409 patients serologically investigated for HIT. RESULTS: HIT-associated thrombosis occurred in 10/17 (58.8%) patients (8:1:1 venous:arterial:both). Dalteparin was associated with fewer study drug-attributable HIT-related events (P=0.020), including less seroconversion (P=0.058) and less breakthrough of thrombocytopenia/thrombosis (P=0.032). Anti-PF4/heparin IgG antibodies by ELISA were less frequent among patients receiving dalteparin vs UFH (13.5% vs 27.3%; P<0.001). One patient with HIT-associated DVT died post-UFH bolus, whereas platelet counts recovered in two others with HIT-associated VTE despite continuation of therapeutic-dose UFH. CONCLUSIONS: The lower risk of HIT in ICU patients receiving dalteparin appears related to both decreased antibody formation and decreased clinical breakthrough of HIT among patients forming antibodies.
    Chest 05/2013; DOI:10.1378/chest.13-0057 · 7.13 Impact Factor
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    ABSTRACT: The nuSTORM facility has been designed to deliver beams of electron and muon neutrinos from the decay of a stored muon beam with a central momentum of 3.8 GeV/c and a momentum spread of 10%. The facility is unique in that it will: serve the future long- and short-baseline neutrino-oscillation programmes by providing definitive measurements of electron-neutrino- and muon-neutrino-nucleus cross sections with percent-level precision; allow searches for sterile neutrinos of exquisite sensitivity to be carried out; and constitute the essential first step in the incremental development of muon accelerators as a powerful new technique for particle physics. Of the world's proton-accelerator laboratories, only CERN and FNAL have the infrastructure required to mount nuSTORM. Since no siting decision has yet been taken, the purpose of this Expression of Interest (EoI) is to request the resources required to: investigate in detail how nuSTORM could be implemented at CERN; and develop options for decisive European contributions to the nuSTORM facility and experimental programme wherever the facility is sited. The EoI defines a two-year programme culminating in the delivery of a Technical Design Report.
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    ABSTRACT: To provide a global, up-to-date picture of the prevalence, treatment, and outcomes of Candida bloodstream infections in intensive care unit patients and compare Candida with bacterial bloodstream infection. A retrospective analysis of the Extended Prevalence of Infection in the ICU Study (EPIC II). Demographic, physiological, infection-related and therapeutic data were collected. Patients were grouped as having Candida, Gram-positive, Gram-negative, and combined Candida/bacterial bloodstream infection. Outcome data were assessed at intensive care unit and hospital discharge. EPIC II included 1265 intensive care units in 76 countries. Patients in participating intensive care units on study day. None. Of the 14,414 patients in EPIC II, 99 patients had Candida bloodstream infections for a prevalence of 6.9 per 1000 patients. Sixty-one patients had candidemia alone and 38 patients had combined bloodstream infections. Candida albicans (n = 70) was the predominant species. Primary therapy included monotherapy with fluconazole (n = 39), caspofungin (n = 16), and a polyene-based product (n = 12). Combination therapy was infrequently used (n = 10). Compared with patients with Gram-positive (n = 420) and Gram-negative (n = 264) bloodstream infections, patients with candidemia were more likely to have solid tumors (p < .05) and appeared to have been in an intensive care unit longer (14 days [range, 5-25 days], 8 days [range, 3-20 days], and 10 days [range, 2-23 days], respectively), but this difference was not statistically significant. Severity of illness and organ dysfunction scores were similar between groups. Patients with Candida bloodstream infections, compared with patients with Gram-positive and Gram-negative bloodstream infections, had the greatest crude intensive care unit mortality rates (42.6%, 25.3%, and 29.1%, respectively) and longer intensive care unit lengths of stay (median [interquartile range]) (33 days [18-44], 20 days [9-43], and 21 days [8-46], respectively); however, these differences were not statistically significant. Candidemia remains a significant problem in intensive care units patients. In the EPIC II population, Candida albicans was the most common organism and fluconazole remained the predominant antifungal agent used. Candida bloodstream infections are associated with high intensive care unit and hospital mortality rates and resource use.
    Critical care medicine 12/2010; 39(4):665-70. DOI:10.1097/CCM.0b013e318206c1ca · 6.15 Impact Factor
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    ABSTRACT: Practice guidelines are systematically developed statements and recommendations that assist the physicians and patients in making decisions about appropriate health care measures for specific clinical circumstances taking into account specific national health care structures. The 1(st) revision of the S-2k guideline of the German Sepsis Society in collaboration with 17 German medical scientific societies and one self-help group provides state-of-the-art information (results of controlled clinical trials and expert knowledge) on the effective and appropriate medical care (prevention, diagnosis, therapy and follow-up care) of critically ill patients with severe sepsis or septic shock. The guideline had been developed according to the "German Instrument for Methodological Guideline Appraisal" of the Association of the Scientific Medical Societies (AWMF). In view of the inevitable advancements in scientific knowledge and technical expertise, revisions, updates and amendments must be periodically initiated. The guideline recommendations may not be applied under all circumstances. It rests with the clinician to decide whether a certain recommendation should be adopted or not, taking into consideration the unique set of clinical facts presented in connection with each individual patient as well as the available resources.
    German medical science : GMS e-journal 06/2010; 8:Doc14. DOI:10.3205/000103
  • Der Anaesthesist 04/2010; 59(4):347-70. DOI:10.1007/s00101-010-1719-5 · 0.74 Impact Factor
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    Intensivmedizin + Notfallmedizin 04/2010; 47(3):185-207. DOI:10.1007/s00390-010-0169-2
  • Intensiv- und Notfallbehandlung 01/2010; 35(04):56-104. DOI:10.5414/IBP35056
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    ABSTRACT: Shorter pre-operative fasting improves clinical outcome without an increased risk. Since October 2004, German Anaesthesiology Societies have officially recommended a fast of 2 h for clear fluids and 6 h for solid food before elective surgery. We conducted a nationwide survey to evaluate the current clinical practice in Germany. Between July 2006 and January 2007, standardized questionnaires were mailed to 3751 Anaesthesiology Society members in leading positions requesting anonymous response. The overall response rate was 66% (n=2418). Of those, 2148 (92%) claimed familiarity with the new guidelines. About a third (n=806, 34%) reported full adherence to the new recommendations, whereas 1043 (45%) reported an eased fasting practice. Traditional Nil per os after midnight was still recommended by 157 (7%). Commonest reasons reported for adopting the new guidelines were: 'improved pre-operative comfort' (84%), and 'increased patient satisfaction' (83%); reasons against were: 'low flexibility in operation room management' (19%), and 'increased risk of aspiration' (13%). Despite the apparent understanding of the benefits from reduced pre-operative fasting, full implementation of the guidelines remains poor in German anaesthesiology departments.
    Acta Anaesthesiologica Scandinavica 09/2009; 54(3):313-20. DOI:10.1111/j.1399-6576.2009.02123.x · 2.31 Impact Factor
  • Value in Health 11/2008; 11(6). DOI:10.1016/S1098-3015(10)66269-9 · 2.89 Impact Factor
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    ABSTRACT: The Compact Muon Solenoid (CMS) detector is described. The detector operates at the Large Hadron Collider (LHC) at CERN. It was conceived to study proton-proton (and lead-lead) collisions at a centre-of-mass energy of 14 TeV (5.5 TeV nucleon-nucleon) and at luminosities up to 1034 cm−2 s−1 (1027 cm−2 s−1). At the core of the CMS detector sits a high-magnetic-field and large-bore superconducting solenoid surrounding an all-silicon pixel and strip tracker, a lead-tungstate scintillating-crystals electromagnetic calorimeter, and a brass-scintillator sampling hadron calorimeter. The iron yoke of the flux-return is instrumented with four stations of muon detectors covering most of the 4π solid angle. Forward sampling calorimeters extend the pseudorapidity coverage to high values (|η| ≤ 5) assuring very good hermeticity. The overall dimensions of the CMS detector are a length of 21.6 m, a diameter of 14.6 m and a total weight of 12500 t.
    Journal of Instrumentation 08/2008; 3(08):S08004. DOI:10.1088/1748-0221/3/08/S08004 · 1.53 Impact Factor
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    ABSTRACT: The aim of this study was to determine the actual cost per intensive care unit (ICU) day in Germany based on routine data from an electronic patient data management system as well as analysis of cost-driving factors. A differentiation between days with and without mechanical ventilation was performed. On the ICU of a German focused-care hospital (896 beds, 12 anesthesiology ICU beds), cost per treatment day was calculated with or without mechanical ventilation from the perspective of the hospital. Costs were derived retrospectively with respect to the period between January and October 2006 by cost-unit accounting based on routine data collected from the ICU patients. Patients with a length of stay of at least 2 days on the ICU were included. Demographic, clinical and economical data were analyzed for patient characterization. Data of 407 patients (217 male and 190 female) were included in the analysis, of which 159 patients (100 male, 59 female) were completely or partially mechanically ventilated. The mean simplified acute physiology (SAPS) II score at the onset of ICU stay was 28.2. Average cost per ICU day was 1,265 EUR and costs for ICU days with and without mechanical ventilation amounted to 1,426 EUR and 1,145 EUR, respectively. Personnel costs (50%) showed the largest cost share followed by drugs plus medicinal products (18%) and infrastructure (16%). For the first time, a cost analysis of intensive care in Germany was performed with routine data based on the matrix of the institute for reimbursement in hospitals (InEK). The results revealed a higher resource use on the ICU than previously expected. The large share of personnel costs on the ICU was evident but is comparable to other medical departments in the hospital. The need for mechanical ventilation increases the daily costs of resources by approximately 25%.
    Der Anaesthesist 06/2008; 57(5):505-12. · 0.74 Impact Factor
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    ABSTRACT: ZielZiele dieser Studie waren die Bestimmung der tatsächlichen Kosten pro Intensivbehandlungstag in Deutschland auf der Basis von Routinedaten eines computergestützten Patienten-Daten-Management-Systems sowie die Analyse der hauptsächlichen Kostenverursacher. Dabei sollte zwischen Tagen mit und ohne maschineller Beatmung differenziert werden. MethodikIn einem Krankenhaus der Zentralversorgungsstufe (896Betten, davon 12 anästhesiologische Intensivbetten) wurden die Kosten pro Behandlungstag mit und ohne maschinelle Beatmung auf der Erwachsenenintensivstation aus der Krankenhausperspektive berechnet. Diese wurden mit einer Kostenträgerrechnung anhand von detaillierten Routinedaten der intensivmedizinisch behandelten Patienten im Zeitraum Januar bis Oktober 2006 retrospektiv bestimmt. In die Analyse wurden Patienten mit einer Liegedauer von mindestens 2Tagen auf der Intensivstation einbezogen. Zur Charakterisierung der Patienten wurden demographische, klinische und ökonomische Parameter analysiert. ErgebnisseDie Daten von 407Patienten (217 männlich und 190 weiblich) wurden in die Analyse einbezogen. Von den Untersuchten wurden 159Patienten (100 männlich, 59 weiblich) zeitweise oder durchgehend beatmet. Der Simplified-Acute-Physiology-Score- (SAPS-)II-Wert zu Beginn des Aufenthalts auf der Intensivstation (ITS) betrug im Mittel 28,2. Die durchschnittlichen Kosten/ITS-Tag betrugen 1265EUR, für ITS-Tage ohne maschinelle Beatmung 1145EUR und 1426EUR für ITS-Tage mit maschineller Beatmung. Personalkosten (50%) stellen vor medizinischen Sachkosten (18%) und Infrastrukturkosten (16%) die größten Kostenfaktoren dar. SchlussfolgerungenErstmals wird eine Analyse der Kosten der intensivmedizinischen Behandlung in Deutschland mit Routinedaten auf Basis der Matrix des Instituts für das Entgeltsystem im Krankenhaus (InEK) durchgeführt. Die Ergebnisse deuten auf einen höheren Ressourcenverbrauch auf der ITS hin, als bisher angenommen. Der relative Anteil von Personalkosten an den Gesamtkosten einer ITS ist zwar hoch, liegt aber auch im Vergleich zu anderen medizinischen Abteilungen nicht über dem Durchschnitt. Die vorgelegten Daten zeigen darüber hinaus einen um fast 25% erhöhten Ressourcenverbrauch im Fall von erforderlicher maschineller Beatmung. ObjectiveThe aim of this study was to determine the actual cost per intensive care unit (ICU) day in Germany based on routine data from an electronic patient data management system as well as analysis of cost-driving factors. A differentiation between days with and without mechanical ventilation was performed. MethodsOn the ICU of a German focused-care hospital (896 beds, 12 anesthesiology ICU beds), cost per treatment day was calculated with or without mechanical ventilation from the perspective of the hospital. Costs were derived retrospectively with respect to the period between January and October 2006 by cost-unit accounting based on routine data collected from the ICU patients. Patients with a length of stay of at least 2 days on the ICU were included. Demographic, clinical and economical data were analyzed for patient characterization. ResultsData of 407 patients (217 male and 190 female) were included in the analysis, of which 159 patients (100 male, 59 female) were completely or partially mechanically ventilated. The mean simplified acute physiology (SAPS)II score at the onset of ICU stay was 28.2. Average cost per ICU day was 1,265EUR and costs for ICU days with and without mechanical ventilation amounted to 1,426EUR and 1,145EUR, respectively. Personnel costs (50%) showed the largest cost share followed by drugs plus medicinal products (18%) and infrastructure (16%). ConclusionsFor the first time, a cost analysis of intensive care in Germany was performed with routine data based on the matrix of the institute for reimbursement in hospitals (InEK). The results revealed a higher resource use on the ICU than previously expected. The large share of personnel costs on the ICU was evident but is comparable to other medical departments in the hospital. The need for mechanical ventilation increases the daily costs of resources by approximately 25%.
    Der Anaesthesist 05/2008; 57(5):505-512. DOI:10.1007/s00101-008-1353-7 · 0.74 Impact Factor
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    ABSTRACT: The operating room (OR) is one of the most expensive facilities in most hospitals. The demands on a professional and process-oriented controlling and reporting in the OR are increased due to the increasingly more limited financial margins at the end of the diagnosis related groups (DRG) convergence phase. This study gives an overview of the current situation for cost calculation, controlling and reporting in OR management in German hospitals in 2007. The data from 69 hospitals were evaluated and this represents the largest currently available data pool on this topic.
    Der Anaesthesist 04/2008; 57(3):269-74. · 0.74 Impact Factor
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    Critical Care 03/2008; 12(Suppl 2). DOI:10.1186/cc6747 · 5.04 Impact Factor
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    MJ Al, J Martin, J Bakker, R Welte
    Critical Care 03/2008; 12(Suppl 2). DOI:10.1186/cc6494 · 5.04 Impact Factor

Publication Stats

2k Citations
176.27 Total Impact Points

Institutions

  • 2010
    • Friedrich-Schiller-University Jena
      • Department of Anaesthesiology and Intensive Care Medicine
      Jena, Thuringia, Germany
  • 2004
    • Universitätsklinikum Schleswig - Holstein
      • Klinik für Anästhesiologie und Operative Intensivmedizin (Kiel)
      Kiel, Schleswig-Holstein, Germany
  • 1982–2000
    • Indiana University Bloomington
      Bloomington, Indiana, United States
    • Aichi University of Education
      Kariya-chō, Aichi, Japan
  • 1998
    • CERN
      • Physics Department (PH)
      Genève, Geneva, Switzerland
  • 1992
    • The University of Edinburgh
      • School of Physics and Astronomy
      Edinburgh, Scotland, United Kingdom
  • 1990–1992
    • Universität Siegen
      Siegen, North Rhine-Westphalia, Germany
  • 1983
    • University of Ottawa
      • Department of Physics
      Ottawa, Ontario, Canada