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Teaching of veterinary parasitology: the Italian perspective.

The curriculum in veterinary medicine in Italy is undergoing important changes, as in the rest of Europe. The 2001 fall semester will mark the beginning of a new format for the degree in veterinary medicine and these changes will obviously affect the teaching of veterinary parasitology. In Italy, veterinary parasitology is usually taught in the third year with a disciplinary approach, similar to that described by Euzéby [Vet. Parasitol. 64 (1996) 21] and Eckert [Vet. Parasitol. 88 (2000) 117]. Approximately 90 h of lectures and 40 h of laboratory are offered and are usually divided into parasitology, followed by parasitic diseases. A more problem-oriented approach to parasitology is offered to fifth-year students within several professional routes (large animal medicine, small animal medicine, hygiene and food safety, etc.), amounting to approximately 15-60 h per student. Indeed, in the last year of study, there are less students and it is possible to present clinical cases and orient the students towards team work and critical discussion. This new curriculum guarantees a reduction in the number of lecture hours and an increase in both laboratory work and personal study, as suggested by the guidelines of the European association of establishment for veterinary education (EAEVE).

Animals↗

A prospective, randomized controlled study of computer-assisted learning in parasitology.

PURPOSE: To compare, using a prospective, randomized controlled study, three methods of teaching a medical school parasitology course: computer-based instruction, traditional lecture-based instruction, and a combination of computer-based and lecture-based instruction. METHOD: A single class of the University of Utah School of Medicine was randomized into three study groups for the second-year parasitology course. The computer group (n = 29) used a locally developed interactive parasitology computer program; the lecture group (n = 32) had traditional lectures, and the combined group (n = 33) used both the computer program and lectures. Students' knowledge was assessed using a pretest, a final examination, and a posttest administered four months after the course. Students also used logs to track the amounts of time they spent studying. Their impressions and course evaluations were collected using a standardized course-evaluation form. RESULTS: The groups' scores on the pretest, final examination, and posttest were not statistically significantly different. Students in the computer group averaged 26.8 hours of studying over the two-week course compared with 32.1 hours in the lecture group and 32.7 hours in the combined group. The difference in study times between the computer and combined groups yielded a significant p value of 0.036. Students were generally positive about the course and the computer program. CONCLUSION: Students can learn parasitology from computer-based instruction as effectively as from traditional lecture-based instruction, and they can do so in less time.

Adult↗

Parasitology: United Kingdom National Quality Assessment Scheme.

AIMS: To assess the results from parasitology laboratories taking part in a quality assessment scheme between 1986 and 1991; and to compare performance with repeat specimens. METHODS: Quality assessment of blood parasitology, including tissue parasites (n = 444; 358 UK, 86 overseas), and faecal parasitology, including extra-intestinal parasites (n = 205; 141 UK, 64 overseas), was performed. RESULTS: Overall, the standard of performance was poor. A questionnaire distributed to participants showed that a wide range of methods was used, some of which were considered inadequate to achieve reliable results. Teaching material was distributed to participants from time to time in an attempt to improve standards. CONCLUSIONS: Since the closure of the IMLS fellowship course in 1972, fewer opportunities for specialised training in parasitology are available: more training is needed. Poor performance in the detection of malarial parasites is mainly attributable to incorrect speciation, misidentification, and lack of equipment such as an eyepiece graticule.

Animals↗

[Cost and workload in the parasitology laboratory derived from attention to the immigrant].

INTRODUCTION: To determine the cost and volume of work implied in providing a parasitological diagnosis when attending immigrants in a referral Tropical Medicine Unit. METHODS: The total number and type of samples, requests processed and parasitology laboratory costs were quantified after attending 1258 immigrants during the period January 1989 to December 2001. Estimation of laboratory workload for the total was made on the basis of results from 748 of these patients. A reference to relative value units (RVU) was established for each of the tests used in the parasitological diagnosis. The evaluation included costs related to disposable material and time spent by technicians and medical staff, but did not include costs related to sample extraction or processing of the test request. Modified indicators from the Catalogue of Microbiology studies of the Valencian Community for the year 2000 were used, establishing the equivalence of 1 RVU as the value of one urine culture 5 2.39 3 (398 pesetas). RESULTS: The overall cost was 99,680.99 3 (16,585,522 pesetas) or 45,934.94 RVU, and the cost per patient was 79.24 3 (13.185 pesetas) or 36.51 URV. The volume of work dedicated to attending immigrants was 9.7% of the total of samples received in the laboratory. CONCLUSIONS: The cost and volume of work involved in attending this group of patients in the parasitology laboratory was not high.

Adolescent↗

[Impact of a new parasitologic laboratory for malaria diagnosis on diagnosis and cost of malaria in a company setting: experience from Angola].

In malaria endemic areas treating every fever episode as a malaria onset would result in overdiagnosis with a margin of the error varying in function of epidemiological factors. When further compounded by overestimation related to errors in parasitologic diagnosis, clinical misdiagnosis leads to unwarranted hospitalization and inappropriate treatment. In a company setting this would mean unnecessary loss of employee work time. False positive diagnosis causes overestimation of chemoresistance, overconsumption of antimalarial drugs and underestimation of other infectious diseases. Judging from these high costs, it can be assumed that improving the reliability of parasitologic diagnosis would have a positive impact on the quality of clinical management, efficiency of antimalarial use and accuracy of epidemiological surveys. This assumption was confirmed by analysis of data following start-up of a parasitologic laboratory for malaria diagnosis in the health care clinic at Sonamet's fabrication yard in Lobito, Angola. Laboratory personnel receives expert training and audit findings demonstrate consistently reliable diagnosis. This experience underscores the need for reliable parasitologic diagnosis as a prerequisite for any large-scale malaria control program.

Absenteeism↗

A clinical-parasitological monotherapy cure in the treatment of experimental infection by a highly virulent strain of Toxoplasma gondii.

Toxoplasmic encephalitis in patients with the acquired immunodeficiency syndrome (AIDS) is treated classically with pyrimethamine plus sulfadiazine. Unfortunately, up to 40% of these patients are unable to complete the course of therapy because of adverse reactions to sulfonamides. This study considers the possible usefulness of monotherapies in the treatment of acute toxoplasmosis, producing parasitological cures 2-3 months after the date of infection. With this therapy, the main adverse effects are suppressed. Groups of mice infected with the RH strain of Toxoplasma gondii were treated with pyrimethamine alone, sulfadiazine alone, and pyrimethamine plus sulfadiazine for 7 d. Treatment with pyrimethamine plus sulfadiazine produced clinical cures in 100% of the infected mice 1 month after infection. Treatment with pyrimethamine gave a 60% survival rate (clinical cure) at 1 month postinfection. Finally, treatment with sulfadiazine produced a 60% survival rate at 1 month postinfection. Although the antitoxoplasmic regimen with pyrimethamine plus sulfadiazine has proven to be effective in intensive treatment of toxoplasmic encephalitis, relapses occur in more than 80% of cases after cessation of antitoxoplasmic therapy, making secondary prophylaxis mandatory. In this study the efficacy of treatment was also evaluated in terms of parasitological cure. None of the three therapies showed parasitological cure after 1 month of treatment. When the intervals were extended to a 3-month observation, monotherapy with pyrimethamine and sulfadiazine alone produced a parasitological cure.

Animals↗

Evaluation of a simple PCR technique for the diagnosis of Trypanosoma vivax infection in the serum of cattle in comparison to parasitological techniques and antigen-enzyme-linked immuno sorbent assay.

Polymerase chain reaction (PCR) with specific oligonucleotides for the amplification of Trypanosoma vivax DNA has been developed by Masiga et al. (1992) to detect the presence of T. vivax DNA in biting flies. The aim of this experiment was to evaluate the efficacy of this technique when applied directly on cattle serum, without DNA purification, to detect infection. The sensitivity of this PCR technique was compared with parasitological techniques, namely haematocrit centrifuge technique (HCT) and buffy coat method (BCM), and with the antigen-enzyme-linked immunosorbent assay (Ag-ELISA) for T. vivax developed by Nantulya and Lindqvist (1989). Blood and serum samples were collected from four calves experimentally infected with a stock of T. vivax from French Guyana (IL4007). During the first 51 days of infection, a total of 164 samples were collected and processed using the four tests. Mean percentages of positive results were 68% with HCT, 59% with BCM, 4% with Ag-ELISA and 64% with PCR. Parasitological and PCR techniques yielded approximately the same sensitivities. PCR was able to detect active infection in serum samples when parasitaemia was over 10(3) trypanosomes/ml. With this isolate of T. vivax the Ag-ELISA was not found to be sensitive enough to be used as a diagnostic tool. The sensitivity of this PCR technique is not greater than parasitological techniques but it allows delayed processing of the samples and gives a highly species-specific diagnosis. This simple PCR technique should be evaluated for field diagnosis because it makes retrospective epidemiological survey using serum banks possible. Moreover, it can be substituted to parasitological techniques when immediate examination is not feasible.

Animals↗

Parasitological detection of Trypanosoma brucei gambiense in serologically negative sleeping-sickness suspects from north-western Uganda.

Forty-five parasitologically confirmed cases of sleeping sickness were diagnosed in north-western Uganda using a combination of two or three techniques. Forty of the cases were positive by the card agglutination test for trypanosomiasis (CATT), four were negative and one was not screened by the CATT. Trypanosomes isolated from the four CATT-negative but parasitologically positive cases were propagated for detailed biochemical genetic analysis. The aim was to demonstrate whether these four stocks lacked the LiTat 1.3 gene which encodes the antigen on which the CATT is based. All the DNA extracts isolated from these CATT-negative stocks and from six CATT-positive stocks of Trypanosoma brucei gambiense were targeted for amplification by the three variable-surface-glycoprotein genes thought to be ubiquitous in T. b. gambiense. The LiTat 1.3 gene was shown to be present in all 10 stocks. Trypanosome carriers may be CATT-negative because the CATT is not sensitive enough, because their parasites lack the LiTat 1.3 gene, or because their parasites have this gene but do not express it. The four sleeping-sickness cases who gave negative CATT results in the present study have very important implications in the diagnosis of T. b. gambiense infections using the CATT. Following treatment of the CATT-positive cases, the CATT-negative carriers of the trypanosomes remain as human reservoir hosts for continuous infection of the population. Because CATT-negative individuals are rarely examined further, the general prevalence of parasitologically positive but CATT-negative cases is unclear. This study demonstrates the value of co-ordinated use of serological and parasitological techniques in the diagnosis of Gambian sleeping sickness.

Agglutination Tests↗

Itraconazole or allopurinol in the treatment of chronic American trypanosomiasis: the results of clinical and parasitological examinations 11 years post-treatment.

Eleven years after they had been given itraconazole or allopurinol for the treatment of chronic American trypanosomiasis, 109 adult patients were checked for electrocardiographic abnormalities and evidence of Trypanosoma cruzi infection. The parasitological investigations included xenodiagnosis, in which the faeces of Triatoma infestans that had fed on the patients were checked under the microscope for flagellates. In addition, a PCR-based assay and a hybridization assay were used to test blood samples from the patients, and faeces from the Tri. infestans that had fed on the patients, for Try. cruzi DNA. For the data analysis, the patients were divided into four groups known as normal/normal, abnormal/normal, normal/abnormal and abnormal/abnormal, according to whether the patients had been found to have normal or abnormal electrocardiograms (ECG) shortly before the first treatment and to have normal or abnormal ECG when checked at the 11-year follow-up. The 51 normal/normal and 24 normal/abnormal patients were assumed to have been in the 'indeterminate' phase of the disease when they were treated, whereas the 16 abnormal/normal and 18 abnormal/abnormal patients all had evidence of chagasic cardiopathy at that time. When checked 11 years post-treatment, 40 (78.4%), 17 (70.8%), 14 (87.5%) and 17 (94.4%) of these patients, respectively, were each found positive for Try. cruzi in at least one of the parasitological tests. The hybridization assay, whether applied to human blood or bug faeces, appeared a significantly more sensitive test than the PCR-based assays or microscopically assessed xenodiagnosis (P<0.05). Only the 21 patients who appeared to be negative for Try. cruzi could be considered parasitologically cured (although all still appeared to have anti-Try. cruzi antibodies in their blood). Only 13 of these parasitologically cured patients (seven of those treated with itraconazole and six of those given allopurinol) had normal ECG at the 11-year follow-up. In Chile at least, itraconazole, which caused fewer adverse effects than the allopurinol while being no less effective at preventing cardiopathy, appears to be the drug of choice to treat chronic American trypanosomiasis in adults.

Adult↗

A retrospective examination of sporozoite-induced and trophozoite-induced infections with Plasmodium ovale: development of parasitologic and clinical immunity during primary infection.

A retrospective analysis was made of clinical and parasitologic parameters in patients with induced Plasmodium ovale infection to document the initial clinical and parasitologic response and their subsequent development of clinical and parasitologic immunity, and to determine the effect of previous homologous and heterologous malaria on subsequent infection with this parasite. The prepatent periods were relatively uniform. Eight patients injected with sporozoites that had been stored frozen had a median prepatent period of 14 days (range = 14-20 days). Thirty-five patients infected via the bites of infected mosquitoes had a median prepatent period of 15 days (range = 12-18 days). In eight patients previously infected with P. vivax, the median prepatent period was 16 days. High-intensity fever (> or = 104 degrees F) was frequently seen, with instances of fever > or = 106 degrees F recorded on many occasions. Fever > 101 degrees F and > 104 degrees F occurred for much shorter periods of time than had been observed in patients infected with P. falciparum. Parasite counts > 10,000/microL were infrequent; in most patients, such parasite counts rarely lasted more than two or three days. Gametocytemia was generally of low density and lasted only a few days. The overall length of the clinical and parasitologic period was much shorter compared with that seen in patients infected with P. falciparum. Previous infection with P. ovale did not prevent reinfection, but resulted in reduced levels of parasitemia and fever. Previous infection with heterologous species of Plasmodium did not prevent infection; some reduction in the frequency and intensity of fever and parasite counts was evident. Previous infection with homologous or heterologous parasites failed to eliminate the production of infective gametocytes. A total of 462 lots of mosquitoes were fed on 67 patients with no previous history of infection. Of these feedings, 168 (36.4%) resulted in infection as determined by the presence of oocysts on the midguts of dissected mosquitoes. As shown, the infection rate increased with the density of gametocytes even though 48 (23.4%) of 205 lots of mosquitoes fed when no gametocytes were detected were infected.

Animals↗

A retrospective examination of sporozoite- and trophozoite-induced infections with Plasmodium falciparum: development of parasitologic and clinical immunity during primary infection.

A retrospective analysis was made of the parasitologic and fever records of 318 patients who had been infected with the El Limon, Santee Cooper, or McLendon strains of Plasmodium falciparum for treatment of neurosyphilis between 1940 and 1963 to determine the development of parasitologic and clinical immunity during primary infection. The presence of fever > or = 101 degrees F and > or = 104 degrees F, asexual parasite counts > or = 1,000 and > or = 10,000/microl, and gametocyte counts > or = 100/microl and > or = 1,000/microl are presented. The frequency of fever (number of patients with fever/number of patients remaining in study) for the first 100 days of patent parasitemia, the frequency of parasite counts > or = 1,000 and > or = 10,000/microl during the first 100 days of patent parasitemia, and the frequency of gametocyte counts > or = 100 and > or = 1,000/microl during the first 100 days of patent parasitemia are presented for 4 groups of patients: 1) sporozoite-induced and 2) trophozoite-induced infections requiring treatment during their primary attack, and 3) sporozoite-induced and 4) trophozoite-induced infections not requiring treatment during the primary attack. For each sporozoite-induced infection, the route of inoculation (bites or syringe), the species of mosquito used, the number of mosquito glands or bites, the intensity of salivary gland infection, and the length of the prepatent period are recorded. Prepatent periods for 109 sporozoite-induced infections ranged from 6 to 28 days. Patients with parasitologic or clinical findings that required suppressive, but non-curative treatment, during the primary attack had higher frequency of fever, parasitemia, and gametocytemia than patients not so treated. Fever was concentrated in the first 2 weeks of patent parasitemia although instances of fever were reported >100 days after infection. High-density parasitemia was also concentrated early in the infection; instances of parasite counts > or = 10,000/microl occurred > 75 days after infection. In conclusion, immunity to infection with P. falciparum was shown to develop rapidly. Following primary infection, clinical and parasitologic immunity was evident within 2-3 weeks following the detection of parasites in the peripheral circulation.

Animals↗

The parasitological and serological prevalence of tsetse-transmitted bovine trypanosomosis in the Eastern Caprivi (Caprivi District, Namibia).

Between August 1995 and June 1997 a survey to determine the distribution of tsetse-transmitted trypanosomosis was conducted in the Eastern Caprivi (Caprivi District, Namibia). A total of 1,481 adult cattle was examined at 33 sampling sites. Direct parasitological diagnostic tests were used and eluted blood spots were screened for the presence of anti-trypanosomal antibodies. Tsetse-transmitted trypanosomal infections were detected in 66 animals (4.5%) from 14 different locations. The parasitological and serological prevalence of trypanosomosis was highest in the Mamili area. Trypanosomosis was virtually absent in the Linyanti/Chobe area and the target barrier along the Kwando River had significantly reduced the prevalence of trypanosomosis in cattle grazing to the east of it. This suggests that anti-trypanosomal antibody prevalence data can be used to evaluate and monitor the effectiveness of tsetse control measures. Survey results suggest that in the Katima Mulilo area, trypanosomal infections were being acquired when cattle grazed along the Zambezi River. Moreover, survey results indicate that tsetse have not been able to establish themselves in the Katima Mulilo area. The parasitological prevalence in a herd and the respective prevalence of anti-trypanosomal antibodies was significantly correlated to the percentage of anaemic animals in that herd. Furthermore, the parasitological prevalence in a herd was positively correlated with the prevalence of anti-trypanosomal antibodies of that herd. It is concluded that the prevalence of anti-trypanosomal antibodies in a herd can be used as an additional indicator of the extent of infection in that particular herd.

Animals↗

[Profuse scabies: kinetic curves of parasitologic cure with an association of benzyl benzoate and sulfiram].

BACKGROUND: In vitro exposure to benzyl benzoate (25 p. 100) kills Sarcoptes scabiei within three hours. The aim of our study was to determine in vivo elimination of Sarcopte scabiei with a benzyl benzoate-sulfiram association. METHODS: Medical charts of patients hospitalized for disseminated scabies from 1993 to 1999 were reviewed retrospectively. The diagnosis of scabies was confirmed by microscopic determination. Parasitological examinations were conducted every day or every two days until negative results. Patients were treated by successive applications of benzyl benzoate until parasitological cure. RESULTS: Twenty patients were included in the study. The median delay of parasitological cure was seven days. After 15 days, 95 p. 100 of patients were cured. Two cutaneous side-effects were reported. DISCUSSION: Despite immediate in vitro efficacy, benzyl benzoate action is delayed in vivo. The time of parasitological negativation after one application of benzyl benzoate is unknown. Therefore, it is not currently possible to determine whether our therapeutic regimen was excessive or not.

Aged↗

[The significance of the incidence of coccidia of the Cryptosporidium species in the etiopathogenesis of neonatal diarrhea syndrome and enteritis in calves on the basis of simultaneous histopathologic and parasitologic studies].

In 1985, a histopathological examination was conducted in the ileum and a parasitological examination in the ileum and rectum of 345 emergency slaughtered calves. The pathogenic role of cryptosporidia was compared in two groups of calves: group A contained 184 calves (53.3%) with scours and enteritis, group B contained 161 calves (46.7%) with other types of disease. In both groups the calves were divided into four age categories: 7 to 10 days (7.8%), 11 to 14 days (29.3%), 15 to 21 days (53.0%), 22 days and older (9.9%). During the parallel examination by both methods, cryptosporidia were detected in 124 cases, i.e. at the total invasion extensity of 35.93%; in group A the cryptosporidia were found in 76 cases (22.02%) and in the group B in 48 cases (13.91%). As indicated by the results, cryptosporidiosis is a disease of polyfactorial origin and cryptosporidia must be taken into account as one of the enteropathogenic factors in the etiology of scours. It is confirmed by the positive findings of cryptosporidia in the calves of group B (29.81%) and the negative finding in group A (31.3%) that no clear relationship was demonstrated to exist between the positive findings of these protozoans and the clinical symptoms of the diseases and enteritis. The pathogenesis of cryptosporidiosis includes significant regressive changes in the microvillous layer and enterocytes, which were a common finding at heavy invasions. The total positivity of the findings of cryptosporidia in the ileum was significantly higher (by 14.8%) during the histopathological examination, as compared with the parasitological examination. Out of the total positive findings, 39 cases (31.5%) were demonstrated histopathologically. During the parasitological examination, the positivity of the findings of cryptosporidia was higher by 4.3% in the rectum than in the ileum. When there was conducted a parallel parasitological examination of the ileum and rectum, the total positivity was higher by 7.5% than at the histopathological examination in the ileum. The highest invasion extensity was found at the age of 7 to 10 days in both groups of calves. The highest invasion intensity was found at the age of 11 to 21 days in both groups. The age until the 21st day when the parasitosis is intensively spread is considered as the most dangerous age of the calves from the epizootological point of view. Cryptosporidia occurred all the year round, no characteristic seasonal patterns were observed. The total average invasion extensity of the 24 farms from where the calves came was 42.3%, its range being from 0 to 85.7%.

Animals↗

Kala-azar: a comparative study of parasitological methods and the direct agglutination test in diagnosis.

In a comparative study 88 patients were diagnosed as suffering from kala-azar (visceral leishmaniasis) using 3 parasitological methods simultaneously. Splenomegaly was absent in 4 cases. In 84 patients with splenomegaly, splenic aspiration appeared to be the most sensitive method (96.4%), followed by bone marrow aspiration (70.2%) and lymph node aspiration (58.3%). There was no relation between titres in the direct agglutination test and parasite load as determined by the number of parasitological methods which were positive or parasite density in splenic aspirates. Splenic aspiration and bone marrow aspiration were compared as an assessment of cure in kala-azar. In 6 (13%) of 46 patients tested, parasites were found, all by splenic aspiration. Bone marrow showed parasites in one of these. The literature with regard to parasitological investigations before and after treatment is reviewed.

Agglutination Tests↗

Parasitology tutoring system: a hypermedia computer-based application.

The teaching of parasitology is a basic course in all life sciences curricula, and up to now no computer-assisted tutoring system has been developed for this purpose. By using Knowledge Pro, an object-oriented software development tool, a hypermedia tutoring system for teaching parasitology to college students was developed. Generally, a tutoring system contains a domain expert, a student model, a pedagogical expert and the user interface. In this project, particular emphasis was given to the user interface design and the expert knowledge representation. The system allows access to the educational material through hypermedia and indexing at the pace of the student. The hypermedia access is facilitated through key words defined as hypertext and objects in pictures defined as hyper-areas. The indexing access is based on a list of parameters that refers to various characteristics of the parasites, e.g. taxonomy, host, organ, etc. In addition, this indexing access can be used for testing the student's level of understanding. The advantages of this system are its user-friendliness, graphical interface and ability to incorporate new educational material in the area of parasitology.

Artificial Intelligence↗

Parasites, flies and men--21st Meeting of the German Society of Parasitology in Würzburg.

The German Society of Parasitology (Deutsche Gesellschaft für Parasitologie) was founded in 1960 and its 21st biannual meeting took place in Würzburg, Germany, from March 17 to 20, 2004. Whereas interim meetings that are being held every other year focus on specific topics of parasitology, such as the symposia on "Life in Vacuoles" in 2003 and on "Immunomodulation by Parasites" in 2001, the general biannual meetings cover a wide range of topics. This year's meeting at the University of Würzburg was organised by Klaus Brehm and Matthias Frosch (both at the Institute of Hygiene) and Heidrun Moll (Institute for Molecular Biology of Infectious Diseases). It was attended by more than 500 scientists from 16 countries who presented 181 research projects dealing with the topics defence mechanisms and immunology, genomics and proteomics, epidemiology, cell biology and biochemistry, chemotherapy and vaccines, parasite classification and morphology, vectors, intermediate hosts, and veterinary parasitology. In addition, six plenary lectures highlighted the subjects of comparative nematode genomics, cell biology, immunology, and parasite eradication programmes.

Animals↗

Parasitology yesterday--following the trends.

The 1980s were a period of great activity in the field of parasitology that generated a vast amount of research published in approximately 20 specialist and several other learned journals. There was, however, no vehicle for disseminating the exciting discoveries that were being made in an immediate, easily readable and accessible form suitable for teachers, students and others interested in aspects of the subject that were broader than their own particular specialty. To fill this perceived gap, Elsevier decided in 1985 that it would be worthwhile publishing Parasitology Today to complement its other successful Trends journals. In this article, I review the breadth of coverage of topics published during the first year of Parasitology Today, most of which continue to be of interest today.

Animals↗