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Article: Healthcare-Associated Bloodstream Infections Due to Multidrug-Resistant

Dobrović, Karolina / Škrobo, Tea / Selec, Katarina / Jelić, Marko / Čivljak, Rok / Peršec, Jasminka / Sakan, Sanja / Bušić, Nikolina / Mihelčić, Antonija / Hleb, Sonja / Andrašević, Arjana Tambić

Microorganisms

2023 Volume 11, Issue 3

Abstract: Healthcare-associated infections are an emerging cause of morbidity and mortality in COVID-19 intensive care units (ICUs) worldwide, especially those caused by multidrug-resistant (MDR) pathogens. The objectives of this study were to assess the incidence ...

Abstract	Healthcare-associated infections are an emerging cause of morbidity and mortality in COVID-19 intensive care units (ICUs) worldwide, especially those caused by multidrug-resistant (MDR) pathogens. The objectives of this study were to assess the incidence of bloodstream infections (BSIs) among critically ill COVID-19 patients and to analyze the characteristics of healthcare-associated BSIs due to MDR
Language	English
Publishing date	2023-03-17
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720891-6
ISSN	2076-2607
ISSN	2076-2607
DOI	10.3390/microorganisms11030774
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Article ; Online: In vitro activity of tigecycline and comparators against Gram-negative pathogens isolated from blood in Europe (2004-2009).

Andrasevic, Arjana Tambic / Dowzicky, Michael J

International journal of antimicrobial agents

2012 Volume 39, Issue 2, Page(s) 115–123

Abstract: Here we report on the antimicrobial resistance amongst Gram-negative isolates (excluding Acinetobacter spp.) collected from blood culture sources at European study sites as part of the global Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) from ... ...

Abstract	Here we report on the antimicrobial resistance amongst Gram-negative isolates (excluding Acinetobacter spp.) collected from blood culture sources at European study sites as part of the global Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) from the study start in 2004 until August 2009. All isolates were collected and tested for minimum inhibitory concentrations using Clinical and Laboratory Standards Institute methodology. Over the collection period, extended-spectrum β-lactamase (ESBL) production was recorded in 21.1% of Klebsiella pneumoniae, 2.6% of Klebsiella oxytoca and 11.3% of Escherichia coli, primarily in Croatia, Greece, Hungary, Italy, Poland, Romania and the Slovak Republic. ESBL rates stabilised amongst K. pneumoniae over 2006-2009, but doubled amongst E. coli in 2008-2009. The patterns of antimicrobial resistance changed accordingly for both organisms. Generally, Greece had the highest antimicrobial resistance for K. pneumoniae, Italy for E. coli, Serratia marcescens and Enterobacter spp., and Croatia for Pseudomonas aeruginosa. High resistance rates amongst K. pneumoniae were also seen in Croatia and Italy. Imipenem resistance amongst K. pneumoniae was reported exclusively in Greece (13.8%); amongst other Enterobacteriaceae, imipenem resistance was absent or low. Similarly, meropenem resistance was low amongst the Enterobacteriaceae except K. pneumoniae from Greece (42.6%). Across Europe, the most active antimicrobial agents against the Enterobacteriaceae were tigecycline, amikacin and the carbapenems, each with <10% resistance each year. Against the other antimicrobials, significant increases in non-susceptibility were reported for K. pneumoniae and E. coli, both important causative pathogens of bacteraemia.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Bacteremia/microbiology ; Blood/microbiology ; Europe ; Gram-Negative Bacteria/drug effects ; Gram-Negative Bacteria/isolation & purification ; Gram-Negative Bacterial Infections/microbiology ; Humans ; Microbial Sensitivity Tests ; Minocycline/analogs & derivatives ; Minocycline/pharmacology ; beta-Lactamases/secretion
Chemical Substances	Anti-Bacterial Agents ; tigecycline (70JE2N95KR) ; beta-Lactamases (EC 3.5.2.6) ; Minocycline (FYY3R43WGO)
Language	English
Publishing date	2012-02
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1093977-5
ISSN	1872-7913 ; 0924-8579
ISSN (online)	1872-7913
ISSN	0924-8579
DOI	10.1016/j.ijantimicag.2011.10.010
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Article ; Online: Successful containment of the first KPC-producing Klebsiella pneumoniae outbreak in Croatia.

Brkic, Dijana Varda / Pristas, Irina / Cipris, Ivan / Jelic, Marko / Butic, Iva / Andrasevic, Arjana Tambic

Future microbiology

2017 Volume 12, Page(s) 967–974

Abstract: Aim: We report the first outbreak caused by Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae sequence type 258 (ST 258) clone that occurred in Croatia from May to December 2012.: Materials & methods: 23 carbapenem-resistant K. ... ...

Abstract	Aim: We report the first outbreak caused by Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae sequence type 258 (ST 258) clone that occurred in Croatia from May to December 2012. Materials & methods: 23 carbapenem-resistant K. pneumoniae isolates were recovered from clinical and screening specimens of 12 patients hospitalized in a regional hospital. The first isolates from the 12 patients were typed using pulsed-field gel electrophoresis and multilocus sequence typing. Results: PCR detection showed that all isolates harbored the bla Conclusion: The rapid detection of KPC-producing K. pneumoniae and vigorous implementation of infection control measures were necessary to successfully control the outbreak.
MeSH term(s)	Bacterial Proteins/genetics ; Bacterial Proteins/isolation & purification ; Bacterial Typing Techniques ; Carbapenems/pharmacology ; Croatia/epidemiology ; DNA, Bacterial ; Disease Outbreaks ; Drug Resistance, Bacterial ; Electrophoresis, Gel, Pulsed-Field ; Genes, Bacterial/genetics ; Hospitals ; Humans ; Klebsiella Infections/diagnosis ; Klebsiella Infections/epidemiology ; Klebsiella pneumoniae/enzymology ; Klebsiella pneumoniae/genetics ; Klebsiella pneumoniae/isolation & purification ; Klebsiella pneumoniae/pathogenicity ; Microbial Sensitivity Tests ; Molecular Epidemiology ; Multilocus Sequence Typing ; Polymerase Chain Reaction ; beta-Lactam Resistance/genetics ; beta-Lactamases/genetics ; beta-Lactamases/isolation & purification
Chemical Substances	Bacterial Proteins ; Carbapenems ; DNA, Bacterial ; beta-lactamase SHV-11 (EC 3.5.2.-) ; beta-Lactamases (EC 3.5.2.6) ; beta-lactamase TEM-116, Pseudomonas aeruginosa (EC 3.5.2.6) ; carbapenemase (EC 3.5.2.6) ; carbapenemase-2, Klebsiella pneumoniae (EC 3.5.2.6)
Language	English
Publishing date	2017
Publishing country	England
Document type	Journal Article
ISSN	1746-0921
ISSN (online)	1746-0921
DOI	10.2217/fmb-2016-0143
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Article: In vitro activity of tigecycline and comparators against Gram-negative pathogens isolated from blood in Europe (2004–2009)

Andrasevic, Arjana Tambic / Dowzicky, Michael J

International journal of antimicrobial agents. 2012 Feb., v. 39, no. 2

2012

Abstract	Here we report on the antimicrobial resistance amongst Gram-negative isolates (excluding Acinetobacter spp.) collected from blood culture sources at European study sites as part of the global Tigecycline Evaluation and Surveillance Trial (T.E.S.T.) from the study start in 2004 until August 2009. All isolates were collected and tested for minimum inhibitory concentrations using Clinical and Laboratory Standards Institute methodology. Over the collection period, extended-spectrum β-lactamase (ESBL) production was recorded in 21.1% of Klebsiella pneumoniae, 2.6% of Klebsiella oxytoca and 11.3% of Escherichia coli, primarily in Croatia, Greece, Hungary, Italy, Poland, Romania and the Slovak Republic. ESBL rates stabilised amongst K. pneumoniae over 2006–2009, but doubled amongst E. coli in 2008–2009. The patterns of antimicrobial resistance changed accordingly for both organisms. Generally, Greece had the highest antimicrobial resistance for K. pneumoniae, Italy for E. coli, Serratia marcescens and Enterobacter spp., and Croatia for Pseudomonas aeruginosa. High resistance rates amongst K. pneumoniae were also seen in Croatia and Italy. Imipenem resistance amongst K. pneumoniae was reported exclusively in Greece (13.8%); amongst other Enterobacteriaceae, imipenem resistance was absent or low. Similarly, meropenem resistance was low amongst the Enterobacteriaceae except K. pneumoniae from Greece (42.6%). Across Europe, the most active antimicrobial agents against the Enterobacteriaceae were tigecycline, amikacin and the carbapenems, each with <10% resistance each year. Against the other antimicrobials, significant increases in non-susceptibility were reported for K. pneumoniae and E. coli, both important causative pathogens of bacteraemia.
Keywords	Acinetobacter ; Enterobacter ; Escherichia coli ; Klebsiella oxytoca ; Klebsiella pneumoniae ; Pseudomonas aeruginosa ; Serratia marcescens ; amikacin ; antibiotic resistance ; bacteremia ; beta-lactamase ; blood ; imipenem ; minimum inhibitory concentration ; monitoring ; pathogens ; tigecycline ; Croatia ; Greece ; Hungary ; Italy ; Poland ; Romania ; Slovakia
Language	English
Dates of publication	2012-02
Size	p. 115-123.
Publishing place	Elsevier B.V.
Document type	Article
ZDB-ID	1093977-5
ISSN	0924-8579
ISSN	0924-8579
DOI	10.1016/j.ijantimicag.2011.10.010
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Article: MRSA surveillance programmes worldwide: moving towards a harmonised international approach

Baede, Valérie O. / David, Michael Z. / Andrasevic, Arjana Tambic / Blanc, Dominique S. / Borg, Michael / Brennan, Grainne / Catry, Boudewijn / Chabaud, Aurélie / Empel, Joanna / Enger, Hege / Hallin, Marie / Ivanova, Marina / Kronenberg, Andreas / Kuntaman, Kuntaman / Larsen, Anders Rhod / Latour, Katrien / Lindsay, Jodi A. / Pichon, Bruno / Santosaningsih, Dewi /

Schouls, Leo M. / Vandenesch, François / Werner, Guido / Żabicka, Dorota / Žemličková, Helena / Seifert, Harald / Vos, Margreet C.

International journal of antimicrobial agents. 2022 Mar., v. 59, no. 3

2022

Abstract: Multinational surveillance programmes for methicillin-resistant Staphylococcus aureus (MRSA) are dependent on national structures for data collection. This study aimed to capture the diversity of national MRSA surveillance programmes and to propose a ... ...

Institution	MRSA Surveillance Worldwide Study Group (ISAC), the ESCMID Study Group for Nosocomial Infections (ESGNI), the ESCMID Study Group for Staphylococci and Staphylococcal Diseases (ESGS)
Abstract	Multinational surveillance programmes for methicillin-resistant Staphylococcus aureus (MRSA) are dependent on national structures for data collection. This study aimed to capture the diversity of national MRSA surveillance programmes and to propose a framework for harmonisation of MRSA surveillance. The International Society of Antimicrobial Chemotherapy (ISAC) MRSA Working Group conducted a structured survey on MRSA surveillance programmes and organised a webinar to discuss the programmes’ strengths and challenges as well as guidelines for harmonisation. Completed surveys represented 24 MRSA surveillance programmes in 16 countries. Several countries reported separate epidemiological and microbiological surveillance. Informing clinicians and national policy-makers were the most common purposes of surveillance. Surveillance of bloodstream infections (BSIs) was present in all programmes. Other invasive infections were often included. Three countries reported active surveillance of MRSA carriage. Methodology and reporting of antimicrobial susceptibility, virulence factors, molecular genotyping and epidemiological metadata varied greatly. Current MRSA surveillance programmes rely upon heterogeneous data collection systems, which hampers international epidemiological monitoring and research. To harmonise MRSA surveillance, we suggest improving the integration of microbiological and epidemiological data, implementation of central biobanks for MRSA isolate collection, and inclusion of a representative sample of skin and soft-tissue infection cases in addition to all BSI cases.
Keywords	antibiotic resistance ; blood flow ; data collection ; drug therapy ; genotyping ; metadata ; methicillin-resistant Staphylococcus aureus ; monitoring ; surveys ; virulence
Language	English
Dates of publication	2022-03
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	1093977-5
ISSN	1872-7913 ; 0924-8579
ISSN (online)	1872-7913
ISSN	0924-8579
DOI	10.1016/j.ijantimicag.2022.106538
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Article ; Online: Characterization of macrolide resistance in bacteria isolated from macrolide-polluted and unpolluted river sediments and clinical sources in Croatia.

Milaković, Milena / Križanović, Stela / Petrić, Ines / Šimatović, Ana / González-Plaza, Juan J / Gužvinec, Marija / Andrašević, Arjana Tambić / Pole, Lucia / Fuka, Mirna Mrkonjić / Udiković-Kolić, Nikolina

The Science of the total environment

2020 Volume 749, Page(s) 142357

Abstract: Environments polluted with excessively high levels of antibiotics released from manufacturing sites can act as a source of transferable antibiotic resistance (AR) genes to human commensal and pathogenic bacteria. The aim of this study was to evaluate AR ... ...

Abstract	Environments polluted with excessively high levels of antibiotics released from manufacturing sites can act as a source of transferable antibiotic resistance (AR) genes to human commensal and pathogenic bacteria. The aim of this study was to evaluate AR of bacteria isolated from the Sava river sediments (Croatia) at the discharge site of effluents from azithromycin production compared to those from the upstream site and isolates collected in Croatian hospitals. A total of 228 environmental strains of azithromycin-resistant bacteria were isolated and identified, with 124 from the discharge site and 104 from the upstream site. In addition, a total of 90 clinical, azithromycin-resistant streptococcal and staphylococcal isolates obtained from the Croatian Reference Center for Antibiotic Resistance Surveillance were analyzed. PCR screening of isolates on 11 relevant macrolide-resistance genes (MRGs) showed that discharge isolates had greater detection frequencies for 4 gene targets (ermB, msrE, mphE and ermF) compared to upstream isolates. Among clinical isolates, the most frequently detected gene was ermB, followed by msrD, mefE and mefC. The discharge site demonstrated a greater abundance of isolates with co-occurrence of two different MRGs (predominantly msrE-mphE) than the upstream site, but a lower abundance than the clinical sources (most commonly msrD-mefE). The simultaneous presence of three or even four MRGs was specific for the discharge and clinical isolates, but not for the upstream isolates. When MRG results were sorted by gene mechanism, the ribosomal methylation (erm) and protection genes (msr) were the most frequently detected among both the discharge and the clinical isolates. Following sequencing, high nucleotide sequence similarity was observed between ermB in the discharge isolates and the clinical streptococcal isolates, suggesting a possible transfer of the ermB gene between bacteria of clinical and environmental origin. Our study highlights the importance of environmental bacterial populations as reservoirs for clinically relevant macrolide-resistance genes.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Bacteria ; Croatia ; Drug Resistance, Bacterial/genetics ; Humans ; Macrolides ; Microbial Sensitivity Tests ; Rivers
Chemical Substances	Anti-Bacterial Agents ; Macrolides
Language	English
Publishing date	2020-09-14
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	121506-1
ISSN	1879-1026 ; 0048-9697
ISSN (online)	1879-1026
ISSN	0048-9697
DOI	10.1016/j.scitotenv.2020.142357
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Article ; Online: Staphylococcus aureus

Gagliotti, Carlo / Högberg, Liselotte Diaz / Billström, Hanna / Eckmanns, Tim / Giske, Christian G / Heuer, Ole E / Jarlier, Vincent / Kahlmeter, Gunnar / Lo Fo Wong, Danilo / Monen, Jos / Murchan, Stephen / Simonsen, Gunnar Skov / Šubelj, Maja / Andrašević, Arjana Tambić / Żabicka, Dorota / Žemličková, Helena / Monnet, Dominique L

Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin

2021 Volume 26, Issue 46

Abstract: BackgroundInvasive infections caused ... ...

Abstract	BackgroundInvasive infections caused by
MeSH term(s)	European Union ; Humans ; Methicillin/pharmacology ; Methicillin-Resistant Staphylococcus aureus ; Sepsis ; Staphylococcal Infections/diagnosis ; Staphylococcal Infections/drug therapy ; Staphylococcal Infections/epidemiology ; Staphylococcus aureus
Chemical Substances	Methicillin (Q91FH1328A)
Language	English
Publishing date	2021-10-18
Publishing country	Sweden
Document type	Journal Article
ZDB-ID	1338803-4
ISSN	1560-7917 ; 1025-496X
ISSN (online)	1560-7917
ISSN	1025-496X
DOI	10.2807/1560-7917.ES.2021.26.46.2002094
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Article ; Online: MRSA surveillance programmes worldwide: moving towards a harmonised international approach.

Baede, Valérie O / David, Michael Z / Andrasevic, Arjana Tambic / Blanc, Dominique S / Borg, Michael / Brennan, Grainne / Catry, Boudewijn / Chabaud, Aurélie / Empel, Joanna / Enger, Hege / Hallin, Marie / Ivanova, Marina / Kronenberg, Andreas / Kuntaman, Kuntaman / Larsen, Anders Rhod / Latour, Katrien / Lindsay, Jodi A / Pichon, Bruno / Santosaningsih, Dewi /

Schouls, Leo M / Vandenesch, François / Werner, Guido / Żabicka, Dorota / Žemličková, Helena / Seifert, Harald / Vos, Margreet C

International journal of antimicrobial agents

2022 Volume 59, Issue 3, Page(s) 106538

Abstract	Multinational surveillance programmes for methicillin-resistant Staphylococcus aureus (MRSA) are dependent on national structures for data collection. This study aimed to capture the diversity of national MRSA surveillance programmes and to propose a framework for harmonisation of MRSA surveillance. The International Society of Antimicrobial Chemotherapy (ISAC) MRSA Working Group conducted a structured survey on MRSA surveillance programmes and organised a webinar to discuss the programmes' strengths and challenges as well as guidelines for harmonisation. Completed surveys represented 24 MRSA surveillance programmes in 16 countries. Several countries reported separate epidemiological and microbiological surveillance. Informing clinicians and national policy-makers were the most common purposes of surveillance. Surveillance of bloodstream infections (BSIs) was present in all programmes. Other invasive infections were often included. Three countries reported active surveillance of MRSA carriage. Methodology and reporting of antimicrobial susceptibility, virulence factors, molecular genotyping and epidemiological metadata varied greatly. Current MRSA surveillance programmes rely upon heterogeneous data collection systems, which hampers international epidemiological monitoring and research. To harmonise MRSA surveillance, we suggest improving the integration of microbiological and epidemiological data, implementation of central biobanks for MRSA isolate collection, and inclusion of a representative sample of skin and soft-tissue infection cases in addition to all BSI cases.
MeSH term(s)	Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Epidemiological Monitoring ; Humans ; Methicillin-Resistant Staphylococcus aureus ; Soft Tissue Infections/drug therapy ; Staphylococcal Infections/drug therapy
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2022-01-26
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	1093977-5
ISSN	1872-7913 ; 0924-8579
ISSN (online)	1872-7913
ISSN	0924-8579
DOI	10.1016/j.ijantimicag.2022.106538
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Article: RATIONAL THERAPY OF URINARY TRACT INFECTIONS IN CHILDREN IN CROATIA.

Milošević, Danko / Batinić, Danica / Trkulja, Vladimir / Andrašević, Arjana Tambić / Grčić, Borislav Filipović / Vrljičak, Kristina / Nogalo, Boro / Turudić, Daniel / Spajić, Marija

Acta clinica Croatica

2016 Volume 55, Issue 3, Page(s) 428–439

MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Anti-Infective Agents, Urinary/therapeutic use ; Antibiotic Prophylaxis/statistics & numerical data ; Child ; Child Welfare/statistics & numerical data ; Child, Preschool ; Critical Pathways ; Croatia ; Drug Resistance, Microbial ; Humans ; Infant ; Practice Guidelines as Topic ; Urinary Tract Infections/drug therapy ; Urinary Tract Infections/epidemiology
Chemical Substances	Anti-Bacterial Agents ; Anti-Infective Agents, Urinary
Language	English
Publishing date	2016
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	1478635-7
ISSN	0353-9466
ISSN	0353-9466
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Article: Antibiotic prescription rate for upper respiratory tract infections and risks for unnecessary prescription in Croatia.

Botica, Marija Vrca / Botica, Iva / Stamenić, Valerija / Andrasević, Arjana Tambić / Kern, Josipa / Spehar, Stanislava Stojanović

Collegium antropologicum

2013 Volume 37, Issue 2, Page(s) 449–454

Abstract: Overprescribing of antibiotics in primary care has been recognized as public health problem. We investigated visits prescription rate of antibiotics to patients with upper respiratory tract infections (URTI) and unnecessary prescription for ... ...

Abstract	Overprescribing of antibiotics in primary care has been recognized as public health problem. We investigated visits prescription rate of antibiotics to patients with upper respiratory tract infections (URTI) and unnecessary prescription for tonsillopharyngitis, in Croatia. In prospective observational study in November 2007. 25 GPs in Croatia recorded all patients' visits with URTI episode according ICPC-2. Clinical status of patients with tonsillopharyngitis were categorized according to Centor Criteria. 689 visits were analysed, 82% of visits were initial. Antibiotics were prescribed in 44.7% visits with URTI. There were no significant differences in antibiotic prescription rates regarding non-clinical factors. Antibiotics were prescribed to patients with tonsillopharyngitis in 62.2% visits. Unnecessary antibiotics were prescribed (Centor 1,2) in 49.6% visits with tonsillopharyngitis. Logistic regression analysis showed significant differences in unnecessary antibiotic prescription rates only with respect to the workday--Wednesday, CI (1.117-2.671), p = 0.0139. Leading antibiotic was amoxicillin + clavulonic acid, second was amoxicillin, the third were macrolides, the fourth was narrow spectrum penicillin and fifth were cephalosporins. This study shows over prescription for URTI. Unnecessary prescription for tonsillopharyngitis depend on non clinical factor--day of the week. This should be further explored and help to improved prescribe antibiotics.
MeSH term(s)	Adolescent ; Adult ; Aged ; Anti-Bacterial Agents/therapeutic use ; Child ; Croatia/epidemiology ; Drug Prescriptions/statistics & numerical data ; Female ; General Practice/statistics & numerical data ; Humans ; Male ; Middle Aged ; Practice Patterns, Physicians'/statistics & numerical data ; Respiratory Tract Infections/drug therapy ; Respiratory Tract Infections/epidemiology ; Risk Factors ; Unnecessary Procedures/statistics & numerical data ; Young Adult
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2013-06
Publishing country	Croatia
Document type	Journal Article
ZDB-ID	233430-6
ISSN	0350-6134 ; 0353-3735
ISSN	0350-6134 ; 0353-3735
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