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Article: Aplastic Anaemia in Pregnancy: A Case-Based Comprehensive Review of the Literature.

Perolla, Adela / Cela, Blerina / Semanaj, Valentina / Dedej-Kurti, Teuta / Caja, Tatjana

2024 Volume 16, Issue 4, Page(s) e58365

Abstract: Aplastic anaemia (AA) is a rare and life-threatening haematologic disorder characterised by pancytopenia and bone marrow failure. Its occurrence during pregnancy is exceedingly rare, posing significant risks and management challenges for both the mother ... ...

Abstract	Aplastic anaemia (AA) is a rare and life-threatening haematologic disorder characterised by pancytopenia and bone marrow failure. Its occurrence during pregnancy is exceedingly rare, posing significant risks and management challenges for both the mother and the foetus. We present here the case of a 23-year-old female, six months pregnant, diagnosed with severe aplastic anaemia (AA), aiming to highlight the diagnostic challenges and management considerations of AA in pregnancy. Our case underscores the critical nature of considering aplastic anaemia in differential diagnosis for pregnant patients presenting with unexplained pancytopenia. Based on that, we performed a comprehensive literature review of the past 20 years of papers published in the English language identified through searches in PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), Embase and the Cochrane Library, to provide an in-depth analysis of the current understanding of AA in pregnancy. We emphasise the necessity for cautious yet thorough investigation in such cases to avoid complications in both maternal and foetal health, focusing attention on the need for further research into safe and effective treatment protocols for managing AA in pregnancy, given the complexities introduced by the condition and its treatment on pregnancy outcomes.
Language	English
Publishing date	2024-04-16
Publishing country	United States
Document type	Case Reports
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.58365
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Alterations in homeostasis after open surgery. A prospective randomized study.

Dedej, T / Lamaj, E / Marku, N / Ostreni, V / Bilali, S

Il Giornale di chirurgia

2013 Volume 34, Issue 7-8, Page(s) 202–209

Abstract: Introduction: Alterations in homeostasis, and a subsequent increased risk for postoperative thromboembolic complications, are observed as a result of open surgery. Additionally, the stress response to surgical trauma precipitates a transient ... ...

Abstract	Introduction: Alterations in homeostasis, and a subsequent increased risk for postoperative thromboembolic complications, are observed as a result of open surgery. Additionally, the stress response to surgical trauma precipitates a transient hypercoagulable state as well as inflammation. This study was conducted to evaluate the patterns in postoperative alterations of blood coagulation, and to detect their correlations with inflammatory markers. Patients and methods: The study included 50 patients with comparable demographic data, who were randomly assigned to undergo abdominal surgery. No previous coagulation disorders were noted. Blood samples were collected preoperatively and 72 h postoperatively. The following parameters were measured: prothrombin time (PT) and activated partial thromboplastin time (APTT); fibrinogen (FIB), D-dimer (D-D), and C-reactive protein (CRP) levels; and platelet (PLT) count. Prophylactic doses of low molecular weight heparin were administered to all patients. Results: The PT mean value significantly changed from 90.38% before surgery to 81.25% after surgery. No statistical difference was observed between APTT values before and after surgery. FIB levels significantly increased from 381.50 mg/dL preoperatively to 462.57 mg/dL postoperatively. Mean D-D levels also significantly increased from 235.54 μg/L preoperatively to 803.59 μg/L postoperatively. PLT count significantly declined after surgery. Mean CRP levels significantly increased from 12.33 mg/L preoperatively to 44.28 mg/L postoperatively. A strong correlation was observed between D-D and C-RP levels after surgery. Conclusion: These results indicate that, despite administering antithromboembolic prophylaxis, a hypercoagulable state was observed following surgery. This state was enhanced by inflammation.
MeSH term(s)	Abdomen/surgery ; Blood Coagulation ; Blood Coagulation Tests ; Homeostasis ; Humans ; Middle Aged ; Prospective Studies
Language	English
Publishing date	2013-07-26
Publishing country	Italy
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	605974-0
ISSN	1971-145X ; 0391-9005
ISSN (online)	1971-145X
ISSN	0391-9005
DOI	10.11138/gchir/2013.34.7.202
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Article: Hematological Changes in Patients Undergoing Coronary Artery Bypass Surgery: a Prospective Study.

Lako, Sotir / Dedej, Teuta / Nurka, Tatjana / Ostreni, Vera / Demiraj, Aurel / Xhaxho, Roland / Prifti, Edvin

Medical archives (Sarajevo, Bosnia and Herzegovina)

2015 Volume 69, Issue 3, Page(s) 181–186

Abstract: Objectives: Removal of pro inflammatory stimuli after CABG, wound closure and the regenerative ability of the bone marrow will ensure a gradual recovery of hematological parameters. The aim of this study was to assess the hematological changes after ... ...

Abstract	Objectives: Removal of pro inflammatory stimuli after CABG, wound closure and the regenerative ability of the bone marrow will ensure a gradual recovery of hematological parameters. The aim of this study was to assess the hematological changes after CABG. Materials and methods: A prospective cohort study included 164 consecutive patients undergoing on pump CABG surgery between January 2012 and January 2013. Patients with primary hematologic disease, emergent or urgent CABG and off-pump CABG were not included. A time line protocol was employed. Results: All patients survived surgery. Average values of erythrocytes, hemoglobin and hematocrit declined, to reach lower values on day 3 after surgery (-33.6 %, -33.1 %, -32.6 % versus preoperative value, p<0.001) and then gradually increased to reach normal values after one month and the preoperative values after three months. The average values of leukocytes and neutrophils increased rapidly to achieve the highest value on day 2, while the average value of lymphocytes decreased quickly to achieve lower value on day 1 after surgery (+74.7 %, +127.1 %, -52.4 % respectively from the preoperative value, p<0.001). The average platelet count decreased to the lowest value on day 2 after surgery (-26.4 % from the preoperative value, p<0.001), after which gradually increased up to +100.8 % of preoperative value on day 14 (p<0.001) and then gradually decreased to reach normal values on day 21 and preoperative values after three months. Conclusions: Average values of the three peripheral blood cells parameters undergo important changes after CABG, but not life threatening, and regain normal and preoperative values after 1-3 months after surgery.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Coronary Artery Bypass/adverse effects ; Erythrocyte Count ; Female ; Hematocrit ; Hemoglobins/analysis ; Humans ; Leukocyte Count ; Male ; Middle Aged ; Platelet Count ; Postoperative Period ; Prospective Studies ; Time Factors
Chemical Substances	Hemoglobins
Language	English
Publishing date	2015-06-10
Publishing country	Bosnia and Herzegovina
Document type	Journal Article
ZDB-ID	128782-5
ISSN	1986-5961 ; 0350-199X ; 0025-8083
ISSN (online)	1986-5961
ISSN	0350-199X ; 0025-8083
DOI	10.5455/medarh.2015.69.181-186
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Article: The impact of blood use on patients undergoing coronary artery bypass surgery: a prospective study.

Lako, A / Bilali, S / Memishaj, S / Daka, A / Dedej, T / Nurka, T / Bilali, V / Gjylameti, V

Il Giornale di chirurgia

2014 Volume 35, Issue 1-2, Page(s) 20–26

Abstract: Objectives: This survey aimed at assessing the incidence of blood use and the impact of cardiopulmonary bypass (CBP), sex, age, number of grafts, combined cardiac interventions, and hematocrit level in patients who undergo coronary artery bypass graft ( ... ...

Abstract	Objectives: This survey aimed at assessing the incidence of blood use and the impact of cardiopulmonary bypass (CBP), sex, age, number of grafts, combined cardiac interventions, and hematocrit level in patients who undergo coronary artery bypass graft (CABG) surgery. Patients and methods: A prospective study included patients in the department of cardiac surgery at the American Hospital, in Tirana, Albania. We studied 164 consecutive patients who underwent CABG surgery over a 2-year period (2011-2013). Results: We analyzed 164 patients: 138 men and 26 women. The average age was 61.8 years (range, 34-82 years). Of these, 116 patients (101 men/15 women) and 48 patients (37 men/11 women) were operated on-pump and off-pump, respectively. Packed red blood cells (PRBC) were administered to 79.87% of patients (131/164). In total, 334 units were transfused. The average number of PRBC units per patient was 2.03 ± 1.5 (range, 0-8 units). Blood transfusion was administered to 87.06% and 62.5% of on-pump and off-pump patients, respectively. On-pump and off-pump patients received 2.4 and 1 unit of PRBC, respectively (p < 0.001). Female and male patients received 2.2 and 2 units, respectively (p = 0.1). Patients aged ≥ 62.5 years received 2.3 units on average versus the average of 1.7 units received by patients aged < 62.5 years (p < 0.001). Interventions with 4-6 grafts (79/164) received an average 2.5 units, while those with 1-3 grafts (85/164) received 1.5 units (p < 0.001). Patients requiring other cardiac surgical interventions (35/164) received an average of 2.6 units, while those without other cardiac surgical interventions (129/164) received an average of 1.8 units (p < 0.001). Patients with preoperative hematocrit < 35% received an average 1.2 units of PRBC intraoperatively, and 2.8 units throughout the hospital stay, while patients with preoperative hematocrit ≥ 35% received an average of 0.75 units intraoperatively (p < 0.001) and 1.9 units throughout the hospital stay (p < 0.001). Conclusion: Blood transfusion was required for 79.87% of patients. Five variables were important factors in the use of blood in patients undergoing CABG: using CBP, a higher number of grafts, age ≥ 62.5 years, combined heart interventions and preoperative hematocrit< 35%. Female patients required more PRBC than male patients, although it was not statistically significant. Knowledge of these risk factors enables better prediction of the probability of patients who might require more blood, better distribution of blood in CABG procedures, use by the blood bank, and evaluation of cost-effectiveness in the use of blood products.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Coronary Artery Bypass ; Erythrocyte Transfusion/statistics & numerical data ; Female ; Hematocrit ; Humans ; Male ; Middle Aged ; Prospective Studies
Language	English
Publishing date	2014-04-02
Publishing country	Italy
Document type	Evaluation Study ; Journal Article ; Observational Study
ZDB-ID	605974-0
ISSN	1971-145X ; 0391-9005
ISSN (online)	1971-145X
ISSN	0391-9005
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Prevalence of microalbuminuria and risk factor analysis in type 2 diabetes patients in Albania: the need for accurate and early diagnosis of diabetic nephropathy.

Pasko, N / Toti, F / Strakosha, A / Thengjilli, E / Shehu, A / Dedej, T / Ylli, A / Thereska, N

Hippokratia

2014 Volume 17, Issue 4, Page(s) 337–341

Abstract: Background: Microalbuminuria is often the first sign of renal dysfunction in diabetes. This study aimed to investigate the prevalence of microalbuminuria in Albanian type 2 diabetes patients and its association with other cardiovascular risk factors.: ...

Abstract	Background: Microalbuminuria is often the first sign of renal dysfunction in diabetes. This study aimed to investigate the prevalence of microalbuminuria in Albanian type 2 diabetes patients and its association with other cardiovascular risk factors. Methods: Three hundred and twenty-one patients with type 2 diabetes attending, diabetes centers in Albania were enrolled in this cross-sectional, multicenter study. The subjects, aged 40-70 years, had no known proteinuria or other kidney disease. Pregnant women and patients with acute infections were excluded. Data including waist circumference, duration of diabetes and history of hypertension were obtained by questionnaire. Blood samples were drawn after 12 h overnight fasting to measure glycosylated hemoglobin (HbA1c), serum cholesterol, triglyceride and creatinine. Microalbuminuria was assessed using dipstick kits in early morning urine samples. Results: The prevalence of normoalbuminuria was 56.3%, microalbuminuria 40.8% and macroalbuminuria 2.8%. Systolic and diastolic blood pressure (p<0.01), HbA1c (p<0.01) and fasting plasma glucose (p<0.001) were significantly higher in microalbuminuric than in normoalbuminuric subjects. Independent risk factors for microalbuminuria were duration of diabetes (OR: 2.785, 95% CI: 1.156-3.759), systolic blood pressure (OR: 2.88, 95% CI: 1.85-6.85) and waist circumference (OR: 2.15, 95% CI: 1.01-5.45) in males and poor glycemic control (OR: 4.51, 95% CI: 1.45-13.98), duration of diabetes (OR: 2.568, 95% CI: 1.702-3.778) and waist circumference (OR: 4.87, 95% CI: 1.80-13.11) in females. Conclusions: The high proportion of type 2 diabetes patients with microalbuminuria raises implications for health policy in Albania. Screening programs and optimized control of modifiable risk factors are needed to reduce the risk of diabetic nephropathy.
Language	English
Publishing date	2014-06-26
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2491943-3
ISSN	1790-8019 ; 1108-4189
ISSN (online)	1790-8019
ISSN	1108-4189
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Article ; Online: Klebsiella pneumoniae blaKPC-3 nosocomial epidemic: Bayesian and evolutionary analysis.

Angeletti, Silvia / Lo Presti, Alessandra / Cella, Eleonora / Fogolari, Marta / De Florio, Lucia / Dedej, Etleva / Blasi, Aletheia / Milano, Teresa / Pascarella, Stefano / Incalzi, Raffaele Antonelli / Coppola, Roberto / Dicuonzo, Giordano / Ciccozzi, Massimo

Infection, genetics and evolution : journal of molecular epidemiology and evolutionary genetics in infectious diseases

2016 Volume 46, Page(s) 85–93

Abstract: K. pneumoniae isolates carrying blaKPC-3 gene were collected to perform Bayesian phylogenetic and selective pressure analysis and to apply homology modeling to the KPC-3 protein. A dataset of 44 ... ...

Abstract	K. pneumoniae isolates carrying blaKPC-3 gene were collected to perform Bayesian phylogenetic and selective pressure analysis and to apply homology modeling to the KPC-3 protein. A dataset of 44 bla
MeSH term(s)	Bacterial Proteins/classification ; Bacterial Proteins/genetics ; Bayes Theorem ; Cross Infection/epidemiology ; Cross Infection/microbiology ; DNA, Bacterial/analysis ; DNA, Bacterial/genetics ; Epidemics/statistics & numerical data ; Evolution, Molecular ; Humans ; Italy/epidemiology ; Klebsiella Infections/epidemiology ; Klebsiella Infections/microbiology ; Klebsiella pneumoniae/classification ; Klebsiella pneumoniae/genetics ; Molecular Epidemiology ; Phylogeny ; beta-Lactamases/classification ; beta-Lactamases/genetics
Chemical Substances	Bacterial Proteins ; DNA, Bacterial ; beta-Lactamases (EC 3.5.2.6) ; beta-lactamase KPC-3, Klebsiella pneumoniae (EC 3.5.2.6)
Language	English
Publishing date	2016-11-01
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2037068-4
ISSN	1567-7257 ; 1567-1348
ISSN (online)	1567-7257
ISSN	1567-1348
DOI	10.1016/j.meegid.2016.10.031
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Article ; Online: The Diagnostic Value of Flow Cytometry Imunophenotyping in an Albanian Patient Population with a Preliminary Clinical Diagnosis of Chronic Lymphocytic Leukemia

Valentina Semanaj / Arbi Pecani / Teuta Dedej / Alma Barbullushi / Zamira Ylli / Teuta Curaj / Polikron Pulluqi / Tatjana Caja / Adela Perolla / Arben Ivanaj / Pal Xhumari / Genc Sulcebe

Open Access Macedonian Journal of Medical Sciences, Vol 2, Iss 1, Pp 51-

2014 Volume 55

Abstract: ... tested, 2 out of them (2.4%) resulted with a abnormal T-cell population while 82 (97.6%) showed ...

Abstract	Objective: Based on the flow cytometry multiparametric immunophenotyping methodology we studied some useful cell marker criteria needed for the practical differentiation of the chronic lymphocytic leukemia from other chronic limphoproliferative diseases with a leukemic component. Materials and Methods: The applied methodology is a four color flow cytometry multiparametric immunophenotyping technique using EDTA blood samples taken from 84 consecutive patients diagnosed with CLL through a preliminary clinical and white blood cell examination. The following fluorescent stained monoclonal antibodies were used: CD3, CD4, CD5, CD8, CD11c, CD19, CD20, CD23, CD25, FMC7 and kappa/lambda light chains. Results: From the 84 individuals tested, 2 out of them (2.4%) resulted with a abnormal T-cell population while 82 (97.6%) showed a pathological B cell line. 58 (69.1%) patients resulted with typical CLL markers (CD19+CD5+CD23+) while 5 (5.9%) of them presented a non typical chronic lymphocytic leukemia profile (CD19+CD5+CD23-). 19 (22.6%) out of patients displayed an abnormal CD19+CD5- B cell population. A statistically significant correlation was found between the clinical stage of CLL and the positivity for the CD38 marker (p=0.04). Conclusion: Flow cytometry immunophenotyping is a fundamental examination for the final diagnosis of chronic lymphocytic leukemia. The expression of CD38+ in CLL patients stands for a more advanced clinical stage.
Keywords	Chronic lymphocytic leukemia ; immunophenotyping ; flow cytometry ; monoclonal antibodies ; lymphoma. ; Medicine ; R
Subject code	610 ; 616
Language	English
Publishing date	2014-03-01T00:00:00Z
Publisher	ID Design 2012/DOOEL Skopje
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Effect of flower-applied Serenade biofungicide (Bacillus subtilis) on pollination-related variables in rabbiteye blueberry

Ngugi, H.K / Dedej, S / Delaplane, K.S / Savelle, A.T / Scherm, H

Biological control : theory and application in pest management. 2005 Apr., v. 33, no. 1

2005

Abstract: Application of Serenade, a commercial biofungicide formulation containing the bacterium Bacillus subtilis, to the stigmatic surface of open blueberry flowers suppresses floral infection by the mummy berry fungus Monilinia vaccinii-corymbosi. The ... ...

Abstract	Application of Serenade, a commercial biofungicide formulation containing the bacterium Bacillus subtilis, to the stigmatic surface of open blueberry flowers suppresses floral infection by the mummy berry fungus Monilinia vaccinii-corymbosi. The deliberate targeting of the stigma with the biocontrol agent in this pathosystem prompted us to evaluate potential negative impacts on pollination and pollination-related fruit characteristics. Application of Serenade to the stigmatic surface of detached blueberry flowers in the laboratory had no effect (P > 0.05) on the number of pollen tubes entering the style or their growth rates within the stylar canal. There was also no reciprocal effect, i.e., population dynamics of B. subtilis were unaltered by the presence of pollen. Application of the biocontrol product to open flowers, regardless of whether it was done 1 day before or immediately prior to pollination, did not impact fruit set or the number of seeds per berry, but marginally (P = 0.048) affected fruit weight in one of two experimental runs in the greenhouse; fruit weights in the two Serenade timing treatments were significantly different from each other but neither was different from that of the control that received pollen only. In a field experiment in which honey bees were utilized to vector the biocontrol product to open flowers, application of Serenade did not affect fruit weight but significantly reduced fruit set from 49.1 to 38.1% (P = 0.0382) and seed number to about half of that of the untreated control (P = 0.0109). However, fruit weights and seed numbers in the experiment were low even in treatments receiving no Serenade, indicative of poor pollination overall. Taken together, these results indicate that application of Serenade has no inherently adverse effects on pollination and associated fruit characteristics, but caution should be exercised in applying this product in conditions otherwise unfavorable for adequate pollination.
Keywords	Vaccinium virgatum ; plant pathogenic fungi ; Sclerotinia vaccinii-corymbosi ; microbial pesticides ; Bacillus subtilis ; biological control agents ; application timing ; flowers ; pollination ; fruit set ; seed productivity ; population dynamics ; risk assessment ; Georgia
Language	English
Dates of publication	2005-04
Size	p. 32-38.
Document type	Article
ZDB-ID	1149971-0
ISSN	1049-9644
ISSN	1049-9644
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Spatial and temporal distribution of Trichodesmium spp. in the stratified Gulf of Aquaba, Red Sea

Post, A. F. / Dedej, Z. / Gottlieb, R. / Li, H. / Thomas, D. N. / El-Absawi, E. I. / El-Naggar, A. / El-Gharabawi, M. / Sommer, Ulrich

2002

Abstract: ... more prominent as the stratification period progressed; 5 Trichodesmium species were identified: T ... thiebautii, T. erythraeum with tuft-shaped colonies and Trichodesmium sp. with puff-shaped colonies were ... common at ~102 colonies m-3 throughout the stratification period, whereas T. tenue and T. hildebrandtii ...

Abstract	Phytoplankton (>100 µm) abundance was studied in the open waters of the Gulf of Aqaba during the summer stratification period of 1996. A succession took place among the major phytoplankton groups, with diatom numbers decreasing throughout the summer. The diazotrophic cyanobacteria Trichodesmium spp. became more prominent as the stratification period progressed; 5 Trichodesmium species were identified: T. thiebautii, T. erythraeum with tuft-shaped colonies and Trichodesmium sp. with puff-shaped colonies were common at ~102 colonies m-3 throughout the stratification period, whereas T. tenue and T. hildebrandtii were more rare. A bloom of T. thiebautii and T. erythraeum with >106 tuft colonies m-3 was observed in coastal waters of the Gulf during fall 1997. Tuft-shaped colonies were dominant near the surface, while puff-shaped colonies of Trichodesmium sp. were mainly found in the bottom half of the photic zone. These depth distributions were maintained for more than 2 mo, suggesting that the 2 colony types occupied distinct niches. Puff-shaped colonies were found to have higher chlorophyll a contents than tufts, but their photosynthetic activities were not significantly different. Fatty acid analysis of dominant plankton species yielded new trophic relationships for Trichodesmium spp. The Trichodesmium spp.-specific fatty acid C22:2 ω6 was found in Macrosetella gracilis (the sole copepod to graze on Trichodesmium spp.) and in chaetognaths, suggesting that these carnivorous zooplankton fed on M. gracilis. Furthermore, this fatty acid was observed in the filter-feeding Salpa maxima, which was abundantly present in the Gulf of Aqaba during June 1997.
Subject code	590
Language	English
Publisher	Inter Research
Publishing country	de
Document type	Article ; Online
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Article: Proceedings of the International Forum on Grasscutter. Theme: Promoting Grasscutter as a business in West Africa

Antoh, T. (ed.) / Weidinger, R. (ed.) / Ahiaba, J. (ed.) / Carrillo, A. (ed.) / Sefa-Dedej, S. (ed.) / Nkrumah, C. (ed.) / Agyepong, A.K. (ed.) / Mensah, G. (ed.) / Bakker, L. (ed.)

Keywords	BUSHMEAT ; ANIMAL BREEDING ; ANIMAL PRODUCTION ; MARKETING ; ECONOMIC ANALYSIS ; PRODUCTIVITY ; VIANDE DE BROUSSE ; AMELIORATION DES ANIMAUX ; PRODUCTION ANIMALE ; COMMERCIALISATION ; ANALYSE ECONOMIQUE ; PRODUCTIVITE ; AFRIQUE OCCIDENTALE ; CARNE DE CAZA ; MEJORAMIENTO ANIMAL ; PRODUCCION ANIMAL ; MERCADEO ; ANALISIS ECONOMICO ; PRODUCTIVIDAD ; AFRICA OCCIDENTAL
Language	english
Document type	Article
Database	AGRIS - International Information System for the Agricultural Sciences and Technology

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