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  1. Article ; Online: Geographic access to pediatric neurosurgeons in the USA: an analysis of sociodemographic factors.

    Farivar, Daniel / Peterman, Nicholas J / Narendran, Nakul / Illingworth, Kenneth D / Nuckols, Teryl K / Bonda, David / Skaggs, David L

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

    2023  Volume 40, Issue 3, Page(s) 905–912

    Abstract: Purpose: Geographic access to physicians has been shown to be unevenly distributed in the USA, with those in closer proximity having superior outcomes. The purpose of this study was to describe how geographic access to pediatric neurosurgeons varies ... ...

    Abstract Purpose: Geographic access to physicians has been shown to be unevenly distributed in the USA, with those in closer proximity having superior outcomes. The purpose of this study was to describe how geographic access to pediatric neurosurgeons varies across socioeconomic and demographic factors.
    Methods: Actively practicing neurosurgeons were identified by matching several registries and membership logs. This data was used to find their primary practice locations and the distance the average person in a county must travel to visit a surgeon. Counties were categorized into "surgeon deserts" and "surgeon clusters," which were counties where providers were significantly further or closer to its residents, respectively, compared to the national average. These groups were also compared for differences in population characteristics using data obtained from the 2020 American Community Survey.
    Results: A total of 439 pediatric neurosurgeons were identified. The average person in a surgeon desert and cluster was found to be 189.2 ± 78.1 miles and 39.7 ± 19.6 miles away from the nearest pediatric neurosurgeon, respectively. Multivariate analyses showed that higher Rural-Urban Continuum (RUC) codes (p < 0.001), and higher percentages of American Indian (p < 0.001) and Hispanic (p < 0.001) residents were independently associated with counties where the average person traveled significantly further to surgeons.
    Conclusion: Patients residing in counties with greater RUC codes and higher percentages of American Indian and Hispanic residents on average need to travel significantly greater distances to access pediatric neurosurgeons.
    MeSH term(s) Humans ; Child ; United States ; Neurosurgeons ; Sociodemographic Factors ; Surgeons ; Multivariate Analysis ; Registries
    Language English
    Publishing date 2023-10-04
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 605988-0
    ISSN 1433-0350 ; 0302-2803 ; 0256-7040
    ISSN (online) 1433-0350
    ISSN 0302-2803 ; 0256-7040
    DOI 10.1007/s00381-023-06172-z
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    Zs.A 2036: Show issues Location:
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  2. Article: Asleep Speech Mapping Using Orofacial Muscles as Surrogates for Motor Speech in Patients Who Cannot Tolerate Awake Surgery: A Case Series.

    Bonda, David / Silverstein, Justin W / Katz, Joshua / Ellis, Jason A / Boockvar, John / D'Amico, Randy

    Cureus

    2021  Volume 13, Issue 6, Page(s) e15861

    Abstract: Background Bi-polar electrical cortical stimulation during awake craniotomy has been the gold standard for mapping eloquent cortex to preserve speech. Unfortunately, not all patients can tolerate awake surgery. Monopolar hi-frequency electrical ... ...

    Abstract Background Bi-polar electrical cortical stimulation during awake craniotomy has been the gold standard for mapping eloquent cortex to preserve speech. Unfortunately, not all patients can tolerate awake surgery. Monopolar hi-frequency electrical stimulation can be conducted while a patient is under general anesthesia. Utilizing this technique and targeting the orofacial muscles as surrogates for motor speech may provide a limited alternative to awake cortical mapping in patients unable to undergo surgery awake. Objective To evaluate the utility of asleep motor speech mapping during dominant hemisphere craniotomy for lesion resection in patients who cannot tolerate awake surgery. Methods We describe a series of seven patients who underwent craniotomy for resection of intra-axial lesion in eloquent cortex for whom a novel "asleep speech" cortical stimulation paradigm was used for motor speech preservation. Results Compound muscle action potentials (CMAPs) from orofacial muscles involved in motor speech were recorded during direct cortical stimulation of eloquent cortex prior to and during lesion resection. Planned resections proceeded in all cases with no adverse neuromonitoring events. Speech was preserved in all patients. Conclusions To preserve motor speech functionality in patients unable to tolerate awake speech mapping, we employed a technique in which asleep neurophysiological mapping is specifically applied to motor cortex controlling the orofacial muscles of phonation and articulation. Further study is necessary regarding the safety and efficacy of this technique for motor speech preservation when awake surgery cannot be performed.
    Language English
    Publishing date 2021-06-23
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.15861
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  3. Article ; Online: Robot-assisted stereoelectroencephalography electrode placement in twenty-three pediatric patients: a high-resolution analysis of individual lead placement time and accuracy at a single institution.

    Bonda, David J / Pruitt, Rachel / Theroux, Liana / Goldstein, Todd / Stefanov, Dimitre G / Kothare, Sanjeev / Karkare, Shefali / Rodgers, Shaun

    Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery

    2021  Volume 37, Issue 7, Page(s) 2251–2259

    Abstract: Purpose: We describe a detailed evaluation of predictors associated with individual lead placement efficiency and accuracy for 261 stereoelectroencephalography (sEEG) electrodes placed for epilepsy monitoring in twenty-three children at our institution.! ...

    Abstract Purpose: We describe a detailed evaluation of predictors associated with individual lead placement efficiency and accuracy for 261 stereoelectroencephalography (sEEG) electrodes placed for epilepsy monitoring in twenty-three children at our institution.
    Methods: Intra- and post-operative data was used to generate a linear mixed model to investigate predictors associated with three outcomes (lead placement time, lead entry error, lead target error) while accounting for correlated observations from the same patients. Lead placement time was measured using electronic time-stamp records stored by the ROSA software for each individual electrode; entry and target site accuracy was measured using postoperative stereotactic CT images fused with preoperative electrode trajectory planning images on the ROSA computer software. Predictors were selected from a list of variables that included patient demographics, laterality of leads, anatomic location of lead, skull thickness, bolt cap device used, and lead sequence number.
    Results: Twenty-three patients (11 female, 48%) of mean age 11.7 (± 6.1) years underwent placement of intracranial sEEG electrodes (median 11 electrodes) at our institution over a period of 1 year. There were no associated infections, hemorrhages, or other adverse events, and successful seizure capture was obtained in all monitored patients. The mean placement time for individual electrodes across all patients was 6.56 (± 3.5) min; mean target accuracy was 4.5 (± 3.5) mm. Lesional electrodes were associated with 25.7% (95% CI: 6.7-40.9%, p = 0.02) smaller target point errors. Larger skull thickness was associated with larger error: for every 1-mm increase in skull thickness, there was a 4.3% (95% CI: 1.2-7.5%, p = 0.007) increase in target error. Bilateral lead placement was associated with 26.0% (95% CI: 9.9-44.5%, p = 0.002) longer lead placement time. The relationship between placement time and lead sequence number was nonlinear: it decreased consistently for the first 4 electrodes, and became less pronounced thereafter.
    Conclusions: Variation in sEEG electrode placement efficiency and accuracy can be explained by phenomena both within and outside of operator control. It is important to keep in mind the factors that can lead to better or worse lead placement efficiency and/or accuracy in order to maximize patient safety while maintaining the standard of care.
    MeSH term(s) Child ; Electrodes, Implanted ; Electroencephalography ; Female ; Humans ; Robotics ; Seizures ; Stereotaxic Techniques
    Language English
    Publishing date 2021-03-18
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 605988-0
    ISSN 1433-0350 ; 0302-2803 ; 0256-7040
    ISSN (online) 1433-0350
    ISSN 0302-2803 ; 0256-7040
    DOI 10.1007/s00381-021-05107-w
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    Zs.A 2036: Show issues Location:
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  4. Article ; Online: Deep Brain Stimulation of Bilateral Centromedian Thalamic Nuclei in Pediatric Patients with Lennox-Gastaut Syndrome: An Institutional Experience.

    Bonda, David / Kelly, Katherine A / Boop, Scott / Feroze, Abdullah H / Randle, Stephanie C / Bindschadler, Mike / Marashly, Ahmad / Owens, James / Lockrow, Jason / Bozarth, Xiuhua / Novotny, Edward / Friedman, Seth / Goldstein, Hannah E / Grannan, Benjamin L / Durfy, Sharon / Ojemann, Jeffrey G / Ko, Andrew L / Hauptman, Jason S

    World neurosurgery

    2024  

    Abstract: Background: Surgical management of pediatric patients with nonlesional, drug-resistant epilepsy, including patients with Lennox-Gastaut syndrome (LGS), remains a challenge given the lack of resective targets in most patients and shows seizure freedom ... ...

    Abstract Background: Surgical management of pediatric patients with nonlesional, drug-resistant epilepsy, including patients with Lennox-Gastaut syndrome (LGS), remains a challenge given the lack of resective targets in most patients and shows seizure freedom rates <50% at 5 years. The efficacy of deep brain stimulation (DBS) is less certain in children than in adults. This study examined clinical and seizure outcomes for pediatric patients with LGS undergoing DBS targeting of the centromedian thalamic nuclei (CMTN).
    Methods: An institutional review board-approved retrospective analysis was performed of patients aged ≤19 years with clinical diagnosis of LGS undergoing bilateral DBS placement to the CMTN from 2020 to 2021 by a single surgeon.
    Results: Four females and 2 males aged 6-19 years were identified. Before surgery, each child experienced at least 6 years of refractory seizures; 4 children had experienced seizures since infancy. All took antiseizure medications at the time of surgery. Five children had previous placement of a vagus nerve stimulator and 2 had a previous corpus callosotomy. The mean length of stay after DBS was 2 days. No children experienced adverse neurologic effects from implantation; the mean follow-up time was 16.3 months. Four patients had >60% reduction in seizure frequency after surgery, 1 patient experienced 10% reduction, and 1 patient showed no change. No children reported worsening seizure symptoms after surgery.
    Conclusions: Our study contributes to the sparse literature describing CMTN DBS for children with drug-resistant epilepsy from LGS. Our results suggest that CMTN DBS is a safe and effective therapeutic modality that should be considered as an alternative or adjuvant therapy for this challenging patient population. Further studies with larger patient populations are warranted.
    Language English
    Publishing date 2024-02-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2024.02.099
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    Zs.A 1159: Show issues Location:
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  5. Article ; Online: Robotic Surgical Assistant Rehearsal: Combining 3-Dimensional-Printing Technology With Preoperative Stereotactic Planning for Placement of Stereoencephalography Electrodes.

    Bonda, David J / Pruitt, Rachel / Goldstein, Todd / Varghese, Anish / Shah, Amar / Rodgers, Shaun

    Operative neurosurgery (Hagerstown, Md.)

    2019  Volume 19, Issue 2, Page(s) 190–194

    Abstract: Background: The use of frameless stereotactic robotic technology has rapidly expanded since the Food and Drug Administration's approval of the Robotic Surgical Assistant (ROSA) in 2012. Although the use of the ROSA robot has greatly augmented ... ...

    Abstract Background: The use of frameless stereotactic robotic technology has rapidly expanded since the Food and Drug Administration's approval of the Robotic Surgical Assistant (ROSA) in 2012. Although the use of the ROSA robot has greatly augmented stereotactic placement of intracerebral stereoelectroencephalography (sEEG) for the purposes of epileptogenic focus identification, the preoperative planning stages remain limited to computer software.
    Objective: To describe the use of a 3-dimensionally (3D)-printed patient model in the preoperative planning of ROSA-assisted depth electrode placement for epilepsy monitoring in a pediatric patient.
    Methods: An anatomically accurate 3D model was created and registered in a preoperative rehearsal session using the ROSA platform. After standard software-based electrode trajectory planning, sEEG electrodes were sequentially placed in the 3D model.
    Results: Utilization of the 3D-printed model enabled workflow optimization and increased staff familiarity with the logistics of the robotic technology as it relates to depth electrode placement. The rehearsal maneuvers enabled optimization of patient head positioning as well as identification of physical conflicts between 2 electrodes. This permitted revision of trajectory planning in anticipation of the actual case, thereby improving patient safety and decreasing operative time.
    Conclusion: Use of a 3D-printed patient model enhanced presurgical positioning and trajectory planning in the placement of stereotactic sEEG electrodes for epilepsy monitoring in a pediatric patient. The ROSA rehearsal decreased operative time and increased efficiency of electrode placement.
    MeSH term(s) Child ; Electrodes, Implanted ; Electroencephalography ; Humans ; Printing, Three-Dimensional ; Robotic Surgical Procedures ; Technology ; United States
    Language English
    Publishing date 2019-11-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2767575-0
    ISSN 2332-4260 ; 2332-4252
    ISSN (online) 2332-4260
    ISSN 2332-4252
    DOI 10.1093/ons/opz372
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    Zs.A 1424 -ON-: Show issues Location:
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  6. Article ; Conference proceedings: Cerebral Revascularization for Aneurysm Treatment in the Era of Endovascular Flow Diversion

    Nouri, Mohsen / Schneider, Julia R. / Shah, Kevin / Bonda, David J. / Dehdashti, Amir R.

    Journal of Neurological Surgery Part B: Skull Base

    2020  Volume 81, Issue S 01

    Event/congress 30th Annual Meeting North American Skull Base Society, La Cantera Resort & Spa San Antonio, Texas, 2020-02-07
    Language English
    Publishing date 2020-02-01
    Publisher Georg Thieme Verlag KG
    Publishing place Stuttgart ; New York
    Document type Article ; Conference proceedings
    ZDB-ID 2654269-9
    ISSN 2193-634X ; 2193-6331
    ISSN (online) 2193-634X
    ISSN 2193-6331
    DOI 10.1055/s-0040-1702428
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    Zs.A 3425: Show issues Location:
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  7. Article ; Online: Robotic Surgical Assistant (ROSA™) Rehearsal: Using 3-Dimensional Printing Technology to Facilitate the Introduction of Stereotactic Robotic Neurosurgical Equipment.

    Bonda, David J / Pruitt, Rachel / Goldstein, Todd / Varghese, Anish / Mittler, Mark / Schneider, Steven / Shah, Amar / Rodgers, Shaun

    Operative neurosurgery (Hagerstown, Md.)

    2019  Volume 19, Issue 1, Page(s) 94–97

    Abstract: Background: The use of frameless stereotactic robotic technology has rapidly expanded since the Food and Drug Administration's approval of the Robotic Surgical Assistant (ROSA™) in 2012. Although the safety and accuracy of the ROSA platform has been ... ...

    Abstract Background: The use of frameless stereotactic robotic technology has rapidly expanded since the Food and Drug Administration's approval of the Robotic Surgical Assistant (ROSA™) in 2012. Although the safety and accuracy of the ROSA platform has been well-established, the introduction of complex robotic technology into an existing surgical practice poses technical and logistical challenges particular to a given institution.
    Objectives: To better facilitate the integration of new surgical equipment into the armamentarium of a thriving pediatric neurosurgery practice by describing the use of a three-dimensional (3D)-printed patient model with in situ 3D-printed tumor for presurgical positioning and trajectory optimization in the stereotactic biopsy of a pontine lesion in a pediatric patient.
    Methods: A 3D model was created with an added silicone mock tumor at the anatomical position of the lesion. In a preoperative rehearsal session, the patient model was pinned and registered using the ROSA platform, and a mock biopsy was performed targeting the in Situ silicone tumor.
    Results: Utilization of the 3D-printed model enabled workflow optimization and increased staff familiarity with the logistics of the robotic technology. Biopsy trajectory successfully reached intralesional tissue on the 3D-printed model. The rehearsal maneuvers decreased operative and intubation time for the patient and improved operative staff familiarity with the robotic setup.
    Conclusion: Use of a 3D-printed patient model enhanced presurgical positioning and trajectory planning in the biopsy of a difficult to reach pontine lesion in a pediatric patient. The ROSA rehearsal decreased operative time and increased staff familiarity with a new complex surgical equipment.
    MeSH term(s) Child ; Humans ; Imaging, Three-Dimensional ; Neurosurgery ; Neurosurgical Procedures ; Printing, Three-Dimensional ; Robotic Surgical Procedures ; United States
    Language English
    Publishing date 2019-10-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2767575-0
    ISSN 2332-4260 ; 2332-4252
    ISSN (online) 2332-4260
    ISSN 2332-4252
    DOI 10.1093/ons/opz281
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    Zs.A 1424 -ON-: Show issues Location:
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  8. Article ; Online: The Recent Revolution in the Design and Manufacture of Cranial Implants: Modern Advancements and Future Directions.

    Bonda, David J / Manjila, Sunil / Selman, Warren R / Dean, David

    Neurosurgery

    2014  Volume 77, Issue 5, Page(s) 814–24; discussion 824

    Abstract: Large format (i.e., >25 cm) cranioplasty is a challenging procedure not only from a cosmesis standpoint, but also in terms of ensuring that the patient's brain will be well-protected from direct trauma. Until recently, when a patient's own cranial flap ... ...

    Abstract Large format (i.e., >25 cm) cranioplasty is a challenging procedure not only from a cosmesis standpoint, but also in terms of ensuring that the patient's brain will be well-protected from direct trauma. Until recently, when a patient's own cranial flap was unavailable, these goals were unattainable. Recent advances in implant computer-aided design and 3-dimensional (3-D) printing are leveraging other advances in regenerative medicine. It is now possible to 3-D-print patient-specific implants from a variety of polymer, ceramic, or metal components. A skull template may be used to design the external shape of an implant that will become well integrated in the skull, while also providing beneficial distribution of mechanical force in the event of trauma. Furthermore, an internal pore geometry can be utilized to facilitate the seeding of banked allograft cells. Implants may be cultured in a bioreactor along with recombinant growth factors to produce implants coated with bone progenitor cells and extracellular matrix that appear to the body as a graft, albeit a tissue-engineered graft. The growth factors would be left behind in the bioreactor and the graft would resorb as new host bone invades the space and is remodeled into strong bone. As we describe in this review, such advancements will lead to optimal replacement of cranial defects that are both patient-specific and regenerative.
    MeSH term(s) Animals ; Computer-Aided Design/trends ; Craniotomy/methods ; Forecasting ; Humans ; Prostheses and Implants/trends ; Skull/surgery ; Surgical Flaps/trends ; Tomography, X-Ray Computed/methods
    Language English
    Publishing date 2014-06-20
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 135446-2
    ISSN 1524-4040 ; 0148-396X
    ISSN (online) 1524-4040
    ISSN 0148-396X
    DOI 10.1227/NEU.0000000000000899
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  9. Article ; Online: Intracranial Bypass of Posterior Inferior Cerebellar Artery Aneurysms: Indications, Technical Aspects, and Clinical Outcomes.

    Bonda, David J / Labib, Mohamad / Katz, Jeffrey M / Ortiz, Rafael A / Chalif, David / Setton, Avi / Langer, David J / Dehdashti, Amir R

    Operative neurosurgery (Hagerstown, Md.)

    2017  Volume 13, Issue 5, Page(s) 586–595

    Abstract: Background: For some posterior inferior cerebellar artery (PICA) aneurysms, there is no constructive endovascular or direct surgical clipping option. Intracranial bypass is an alternative to a deconstructive technique.: Objective: To evaluate the ... ...

    Abstract Background: For some posterior inferior cerebellar artery (PICA) aneurysms, there is no constructive endovascular or direct surgical clipping option. Intracranial bypass is an alternative to a deconstructive technique.
    Objective: To evaluate the clinical features, surgical techniques, and outcome of PICA aneurysms treated with bypass and obliteration of the diseased segment.
    Methods: Retrospective review of PICA aneurysms treated via intracranial bypass was performed. Outcome measurements included postoperative stroke, cranial nerve deficits, gastrostomy/tracheostomy requirement, bypass patency, modified Rankin scale (mRS) at discharge, and mRS at 6 mo.
    Results: Seven patients with PICA aneurysms treated with intracranial bypass were identified. Five had fusiform aneurysms (4 ruptured, 1 unruptured), 1 had a giant partially thrombosed saccular aneurysm (unruptured), and 1 had a dissecting traumatic aneurysm (ruptured). Two aneurysms were at the anteromedullary segment, 4 at the lateral medullary segment, and 1 at the tonsillomedullary segment. Three patients underwent PICA-to-PICA side to side anastomoses, 2 PICA-to-PICA reanastomosis, 1 vertebral artery-to-PICA bypass, and 1 occipital artery-PICA bypass. Six out of 7 aneurysms were obliterated surgically and 1 with additional endovascular occlusion after the bypass. All bypasses were patent intraoperatively; 2 were later demonstrated occluded without radiological signs or symptoms of stroke. No patients had new cranial nerve deficit postoperatively. With the exception of 1 death due to pulmonary emboli 3 mo postoperatively, all others remain at a mRS ≤ 2.
    Conclusion: Constructive bypass and aneurysm obliteration remains a viable alternative for treatment of PICA aneurysms not amenable to direct surgical clipping or to a vessel-preserving endovascular option.
    MeSH term(s) Adult ; Cerebellum/diagnostic imaging ; Cerebellum/surgery ; Cerebral Angiography ; Cerebral Revascularization/methods ; Female ; Glasgow Coma Scale ; Humans ; Intracranial Aneurysm/surgery ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2017-05-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2767575-0
    ISSN 2332-4260 ; 2332-4252
    ISSN (online) 2332-4260
    ISSN 2332-4252
    DOI 10.1093/ons/opx064
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  10. Article ; Online: Neuronal failure in Alzheimer's disease: a view through the oxidative stress looking-glass.

    Bonda, David J / Wang, Xinglong / Lee, Hyoung-Gon / Smith, Mark A / Perry, George / Zhu, Xiongwei

    Neuroscience bulletin

    2014  Volume 30, Issue 2, Page(s) 243–252

    Abstract: Considerable debate and controversy surround the cause(s) of Alzheimer's disease (AD). To date, several theories have gained notoriety, however none is universally accepted. In this review, we provide evidence for the oxidative stress-induced AD cascade ... ...

    Abstract Considerable debate and controversy surround the cause(s) of Alzheimer's disease (AD). To date, several theories have gained notoriety, however none is universally accepted. In this review, we provide evidence for the oxidative stress-induced AD cascade that posits aged mitochondria as the critical origin of neurodegeneration in AD.
    MeSH term(s) Alzheimer Disease/physiopathology ; Humans ; Neurons/metabolism ; Neurons/pathology ; Oxidative Stress/physiology
    Language English
    Publishing date 2014-04-15
    Publishing country Singapore
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2419741-5
    ISSN 1995-8218 ; 1673-7067
    ISSN (online) 1995-8218
    ISSN 1673-7067
    DOI 10.1007/s12264-013-1424-x
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