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Erschienen in: Journal of Parasitic Diseases 2/2016

31.08.2014 | Original Article

Geohelminths distribution as affected by soil properties, physicochemical factors and climate in Sharkyia governorate Egypt

verfasst von: Samia E. Etewa, Sara A. Abdel-Rahman, Naglaa F. Abd El-Aal, Ghada M. Fathy, Mahmoud A. El-Shafey, A. M. G. Ewis

Erschienen in: Journal of Parasitic Diseases | Ausgabe 2/2016

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Abstract

Soil-transmitted helminths are mainly a group of parasitic nematodes causing human infection through contact with parasite eggs or larvae; they survive in the warm and moist soil of the tropical and subtropical countries. This study was carried out in Sharkyia governorate from October, 2011 to October, 2013, to correlate between the prevalence and distribution of these parasites in the soil and the physicochemical factors affecting the examined samples of the soil. One hundred and twenty samples of different types of soil (clay, silt, sand) from different localities were collected and examined. Diagnosis of geohelminths was confirmed by the recovery of their eggs and larvae with other protozoa by different parasitological methods. The modified baermann method was found to be more efficient in detection of geohelminths larvae than charcoal culture method. Among the examined sites geohelminths were much more numerous in the soil of rural areas especially in the spring and summer seasons, while the contamination of canal banks by geohelminths was the worst (80 %). An insignificant correlation was reported between the soil texture and the number of positive samples in the examined areas while the relationship was directly proportional among (moisture, PH, organic). It appeared that the most common geohelminthic stage was Toxocara spp. eggs besides other types of protozoa especially Balantidium coli cysts. This suggests that factors other than soil texture are important in the prevalence of geohelminths in the soil e.g. temperature, moisture, PH and organic matter. So, to change some of these factors in a trial to control geoparasites transmission but with keeping the environment should be tried. These results also open the way to further studies to highlight the mutual affection between inhabitants of these sites and the prevalence of these geoparasites.
Literatur
Zurück zum Zitat Akl OA, Abdel-Aziz H (2008) Environmental characters of Sharkyia governorate. Sharkyia governorate, Cairo Akl OA, Abdel-Aziz H (2008) Environmental characters of Sharkyia governorate. Sharkyia governorate, Cairo
Zurück zum Zitat Amadi EC, Uttahe C (2010) Bionomics of Geohelminth Nematodes in Contaminated Foci in Parts of Abua Communities, Niger Delta, Nigeria. J Appl Sci Environ Manag 14(2):61–64 Amadi EC, Uttahe C (2010) Bionomics of Geohelminth Nematodes in Contaminated Foci in Parts of Abua Communities, Niger Delta, Nigeria. J Appl Sci Environ Manag 14(2):61–64
Zurück zum Zitat Avcioglu H, Burgu A (2008) Seasonal prevalence of Toxocara ova in soil samples from public parks in Ankara, Turkey. Vector Borne Zoonotic Dis 8:345–350CrossRefPubMed Avcioglu H, Burgu A (2008) Seasonal prevalence of Toxocara ova in soil samples from public parks in Ankara, Turkey. Vector Borne Zoonotic Dis 8:345–350CrossRefPubMed
Zurück zum Zitat Beaver PC (1952) The detection and identification of some common nematode parasites of man. Am J Clin Pathol 22:481–494 Beaver PC (1952) The detection and identification of some common nematode parasites of man. Am J Clin Pathol 22:481–494
Zurück zum Zitat Beaver PC, Jung RC, Cupp EW (1984) Clinical parasitology, 9th edn. Lea & Febiger, Philadelphia Beaver PC, Jung RC, Cupp EW (1984) Clinical parasitology, 9th edn. Lea & Febiger, Philadelphia
Zurück zum Zitat Bethony J, Brooker S, Albonico M, Geiger SM, Loukas AL, Diemert D, Hotez PJ (2003) Soil transmitted helminthic infections: ascariasis, trichuriasis and hookworm. Lancet 367:1521–1532CrossRef Bethony J, Brooker S, Albonico M, Geiger SM, Loukas AL, Diemert D, Hotez PJ (2003) Soil transmitted helminthic infections: ascariasis, trichuriasis and hookworm. Lancet 367:1521–1532CrossRef
Zurück zum Zitat Blaszkowska J, Kumatowski P, Damiecka P (2011) Contamination of the soil by eggs of geohelminths in rural areas of Lodz district (Poland). Helminthologia 48:67–76CrossRef Blaszkowska J, Kumatowski P, Damiecka P (2011) Contamination of the soil by eggs of geohelminths in rural areas of Lodz district (Poland). Helminthologia 48:67–76CrossRef
Zurück zum Zitat Blaszkowska J, Wojcik A, Kurnatowski P, Szwabe K (2013) Geohelminth egg contamination of children′s play areas in the city of Lodz (Poland). Vet Parasitol 192:228–233CrossRefPubMed Blaszkowska J, Wojcik A, Kurnatowski P, Szwabe K (2013) Geohelminth egg contamination of children′s play areas in the city of Lodz (Poland). Vet Parasitol 192:228–233CrossRefPubMed
Zurück zum Zitat Blatt J, Cantos GA (2003) Evaluation of techniques for the diagnosis of Strongyloides stercoralis in human immunodeficiency virus (HIV) positive and HIV negative individuals in the city of Itajaí, Brazil. Braz J Infect Dis 7(6):402–408CrossRef Blatt J, Cantos GA (2003) Evaluation of techniques for the diagnosis of Strongyloides stercoralis in human immunodeficiency virus (HIV) positive and HIV negative individuals in the city of Itajaí, Brazil. Braz J Infect Dis 7(6):402–408CrossRef
Zurück zum Zitat Bouyoucos GS (1962) Hydrometer method improved for making particle size analysis of soils. Agron J 54:464–465CrossRef Bouyoucos GS (1962) Hydrometer method improved for making particle size analysis of soils. Agron J 54:464–465CrossRef
Zurück zum Zitat Brooker S, Michael E (2000) The potential of geographical information systems and remote sensing in the epidemiology and control of human helminth infections. Adv Parasitol 47:245–287CrossRefPubMed Brooker S, Michael E (2000) The potential of geographical information systems and remote sensing in the epidemiology and control of human helminth infections. Adv Parasitol 47:245–287CrossRefPubMed
Zurück zum Zitat Burns R (1978) Soil enzymes, 3rd edn. Academic Press, London Burns R (1978) Soil enzymes, 3rd edn. Academic Press, London
Zurück zum Zitat Christensen BT (2001) Physical fractionation of soil and structural and functional complexity in organic matter turnover. Eur J Soil Sci 52:345–353CrossRef Christensen BT (2001) Physical fractionation of soil and structural and functional complexity in organic matter turnover. Eur J Soil Sci 52:345–353CrossRef
Zurück zum Zitat Conkling BL, Blanchar RW (1988) A comparison of pH measurements using the antimony microelectrode and glass electrode. Agron J 80:275–278CrossRef Conkling BL, Blanchar RW (1988) A comparison of pH measurements using the antimony microelectrode and glass electrode. Agron J 80:275–278CrossRef
Zurück zum Zitat Dada BJ (1979) A new technique for recovery of Toxocara eggs from soil. J Helminthol 53:141–143CrossRefPubMed Dada BJ (1979) A new technique for recovery of Toxocara eggs from soil. J Helminthol 53:141–143CrossRefPubMed
Zurück zum Zitat El-Beshbishi SN, Abdel-Magied AA, El-Nahas HA, Azab MS, El-Shazly AM, Morsy ATA, Gamal-Edin MK, El Kadi MA (2005) Geoparasites in rural Dakahlia Governorate, a preliminary based study for development of the community-based intervention programs. J Egypt Soc Parasitol 35(3):1051–1070PubMed El-Beshbishi SN, Abdel-Magied AA, El-Nahas HA, Azab MS, El-Shazly AM, Morsy ATA, Gamal-Edin MK, El Kadi MA (2005) Geoparasites in rural Dakahlia Governorate, a preliminary based study for development of the community-based intervention programs. J Egypt Soc Parasitol 35(3):1051–1070PubMed
Zurück zum Zitat El-Shazly AM, Mohammed RM, El-Beshbishi SN, Azab MS, El-Ghareeb AS, Abdel-Tawab AH, Zalook KH (2009) Soil-transmitted parasites particularly Toxocara eggs in Egypt. J Egypt Soc Parasitol 39(1):151–162PubMed El-Shazly AM, Mohammed RM, El-Beshbishi SN, Azab MS, El-Ghareeb AS, Abdel-Tawab AH, Zalook KH (2009) Soil-transmitted parasites particularly Toxocara eggs in Egypt. J Egypt Soc Parasitol 39(1):151–162PubMed
Zurück zum Zitat FIFA (2006) A survey for parasitic Nematodes, 3rd edn. CSIRO, Collingwood FIFA (2006) A survey for parasitic Nematodes, 3rd edn. CSIRO, Collingwood
Zurück zum Zitat Gardner WH (1986) Water content. In: Klute A (ed) Methods of soil analysis, Part 1, American Society of Agronomy, Soil Science Society of American Journal, pp 493–544 Gardner WH (1986) Water content. In: Klute A (ed) Methods of soil analysis, Part 1, American Society of Agronomy, Soil Science Society of American Journal, pp 493–544
Zurück zum Zitat Graeff-Teixeira C, Medeiros E, Zanini GM, Brasil CA, Cardozo BL, Dalpiaz MG, Bisol LW (1997) Inexpensive alternative material for the isolation of the larvae with Baermann method. Mem Inst Oswaldo Cruz 92(3):399–400CrossRefPubMed Graeff-Teixeira C, Medeiros E, Zanini GM, Brasil CA, Cardozo BL, Dalpiaz MG, Bisol LW (1997) Inexpensive alternative material for the isolation of the larvae with Baermann method. Mem Inst Oswaldo Cruz 92(3):399–400CrossRefPubMed
Zurück zum Zitat Hanafi FZ, Yousseff ME, Abdel-Wahab FM (1987) Soil as vehicle of parasitic infection to inhabitans of Talkha, Dakahlia Governorate. J Egypt Soc Parasitol 17(1):135–145PubMed Hanafi FZ, Yousseff ME, Abdel-Wahab FM (1987) Soil as vehicle of parasitic infection to inhabitans of Talkha, Dakahlia Governorate. J Egypt Soc Parasitol 17(1):135–145PubMed
Zurück zum Zitat Harada U, Mori O (1995) A new method for culturing hookworm. Yonago Acta Med 1:177–179 Harada U, Mori O (1995) A new method for culturing hookworm. Yonago Acta Med 1:177–179
Zurück zum Zitat Hong ST, Chai JY, Choi MH, Huh S, Rim HJ, Lee SH (2006) A successful experience of soil transmitted helminths control in republic of Korea. Kor J Parasitol 44(3):177–185CrossRef Hong ST, Chai JY, Choi MH, Huh S, Rim HJ, Lee SH (2006) A successful experience of soil transmitted helminths control in republic of Korea. Kor J Parasitol 44(3):177–185CrossRef
Zurück zum Zitat Hotez PJ, Bundy DAP, Kathleen-Beegle K (2006) Helminth infections: soil transmitted helminth infections and schistosomiasis. In: Jamison DT, Breman JG, Measham AR (eds) Disease control priorities in developing countries. Oxford University Press, New York, pp 467–482 Hotez PJ, Bundy DAP, Kathleen-Beegle K (2006) Helminth infections: soil transmitted helminth infections and schistosomiasis. In: Jamison DT, Breman JG, Measham AR (eds) Disease control priorities in developing countries. Oxford University Press, New York, pp 467–482
Zurück zum Zitat Khalil HM, Khaled ML, Farag OA, Hifny N, Bebars M (1978) Examination of soil for Toxocara canis eggs in different Governorates of Egypt. J Egypt Pub Health Assoc 53(5–6):295–302 Khalil HM, Khaled ML, Farag OA, Hifny N, Bebars M (1978) Examination of soil for Toxocara canis eggs in different Governorates of Egypt. J Egypt Pub Health Assoc 53(5–6):295–302
Zurück zum Zitat Komiya Y, Yasuraoka Y (1966) The biology of hookworms. Prog Med Parasitol Jpn 3:4–114 Komiya Y, Yasuraoka Y (1966) The biology of hookworms. Prog Med Parasitol Jpn 3:4–114
Zurück zum Zitat Kozakiewicz B (1980) Analiza inwazjologiczna realizacji programu zwalczania robaczyc swin w gospodarstwatch wielkostadnych (in polish). Med Weter 39:83–86 Kozakiewicz B (1980) Analiza inwazjologiczna realizacji programu zwalczania robaczyc swin w gospodarstwatch wielkostadnych (in polish). Med Weter 39:83–86
Zurück zum Zitat Kunwar CB, Chapagain RH, Subba B, Shrestha M, Jha B, Subedi J, Blangero J, Williams-Blangero S, Towne B (2006) Occurrence of soil transmitted helminths in women at Himalayan region of Nepal. Kathmandu Univ Med J 4(4):444–447 Kunwar CB, Chapagain RH, Subba B, Shrestha M, Jha B, Subedi J, Blangero J, Williams-Blangero S, Towne B (2006) Occurrence of soil transmitted helminths in women at Himalayan region of Nepal. Kathmandu Univ Med J 4(4):444–447
Zurück zum Zitat Lilley B, Lammie P, Dickerson J, Eberhard M (1997) An increase in hookworm infection temporally associated with ecologic change. Emerg Infect Dis 3:391–393CrossRefPubMedPubMedCentral Lilley B, Lammie P, Dickerson J, Eberhard M (1997) An increase in hookworm infection temporally associated with ecologic change. Emerg Infect Dis 3:391–393CrossRefPubMedPubMedCentral
Zurück zum Zitat Lonc E (1980) The possible role of the soil funa in the epizootiology of cysticercosis in castle. I. Earthworms: a biotic factor in the transmission of Taenia saginata eggs. Parasitology 21:133 Lonc E (1980) The possible role of the soil funa in the epizootiology of cysticercosis in castle. I. Earthworms: a biotic factor in the transmission of Taenia saginata eggs. Parasitology 21:133
Zurück zum Zitat Mandarino-Pereira A, Silva de Souza F, Carlos WGL, Maria JSP (2010) Prevalence of parasites in soil and dog feces according to diagnostic tests. Vet Parasitol 170:176CrossRefPubMed Mandarino-Pereira A, Silva de Souza F, Carlos WGL, Maria JSP (2010) Prevalence of parasites in soil and dog feces according to diagnostic tests. Vet Parasitol 170:176CrossRefPubMed
Zurück zum Zitat Matsuo K, Kamiya H (2005) Modified sugar centrifugal flotation technique for recovering Echino-coccus multilocularis eggs from soil. J Parasitol 91(1):208–209CrossRefPubMed Matsuo K, Kamiya H (2005) Modified sugar centrifugal flotation technique for recovering Echino-coccus multilocularis eggs from soil. J Parasitol 91(1):208–209CrossRefPubMed
Zurück zum Zitat Maxwell N (2005) A survey for parasitic Nematodes. Blackwell Scientific Books Ltd., Oxford Maxwell N (2005) A survey for parasitic Nematodes. Blackwell Scientific Books Ltd., Oxford
Zurück zum Zitat Mizgajska H (1993) The distribution and survival of eggs of Ascaris suum in six different natural soil profiles. Acta Parasitol 38:170–174 Mizgajska H (1993) The distribution and survival of eggs of Ascaris suum in six different natural soil profiles. Acta Parasitol 38:170–174
Zurück zum Zitat Mizgajska H (1997) The role of some environmental factors in the contamination of soil with Toxocara spp. and other geohelminths eggs. Parasitol Int 46:67–72CrossRef Mizgajska H (1997) The role of some environmental factors in the contamination of soil with Toxocara spp. and other geohelminths eggs. Parasitol Int 46:67–72CrossRef
Zurück zum Zitat Mizgajska H (2001) Eggs of Toxocara spp. in the enviroment and their public health implications. J Helminthol 75:147–151PubMed Mizgajska H (2001) Eggs of Toxocara spp. in the enviroment and their public health implications. J Helminthol 75:147–151PubMed
Zurück zum Zitat Moyo C, Kissel D, Cabrera M (1989) Temperature effects on soil urease activity. Soil Biol Biochem 7:935–938CrossRef Moyo C, Kissel D, Cabrera M (1989) Temperature effects on soil urease activity. Soil Biol Biochem 7:935–938CrossRef
Zurück zum Zitat Nordin A, Nyberg K, Vinneras B (2009) Inactivation of Ascaris eggs in source-separated urine and feces by ammonia at ambient temperatures. Appl Environ Microbiol 75:662–667CrossRefPubMed Nordin A, Nyberg K, Vinneras B (2009) Inactivation of Ascaris eggs in source-separated urine and feces by ammonia at ambient temperatures. Appl Environ Microbiol 75:662–667CrossRefPubMed
Zurück zum Zitat Nwosu ABC, Anya AO (1980) Seasonality in Hookworm infection in an endemic area of Nigerian and its relationship to rainfall. Tropeumed Parasitol 31:201–208 Nwosu ABC, Anya AO (1980) Seasonality in Hookworm infection in an endemic area of Nigerian and its relationship to rainfall. Tropeumed Parasitol 31:201–208
Zurück zum Zitat Owen WB (1930) Factors that influence the development of the ova of an Ascaris, round worm; Toxocara canis under field conditions. Tech Bull 71:24–27 Owen WB (1930) Factors that influence the development of the ova of an Ascaris, round worm; Toxocara canis under field conditions. Tech Bull 71:24–27
Zurück zum Zitat Pecson B, Barrios J, Jimenez JA (2007) The effects of temperature, pH and ammonia concentration on the inactivation of Ascaris eggs in sewage sludge. Water Res 41:2893–2902CrossRefPubMed Pecson B, Barrios J, Jimenez JA (2007) The effects of temperature, pH and ammonia concentration on the inactivation of Ascaris eggs in sewage sludge. Water Res 41:2893–2902CrossRefPubMed
Zurück zum Zitat Phiri K, Whitty CJ, Graham SM, Ssembatya-Lule G (2000) Urban/rural differences in prevalence and risk factors for intestinal helminths infection in southern Malawi. Ann Trop Med Parasitol 94:381–387PubMed Phiri K, Whitty CJ, Graham SM, Ssembatya-Lule G (2000) Urban/rural differences in prevalence and risk factors for intestinal helminths infection in southern Malawi. Ann Trop Med Parasitol 94:381–387PubMed
Zurück zum Zitat Schad GA, Chowdhury AF, Dean CG et al (1973) Arrested development in human hookworm infections: an adaption to a seasonally unfavorable external environment. Science 180:502–504CrossRefPubMed Schad GA, Chowdhury AF, Dean CG et al (1973) Arrested development in human hookworm infections: an adaption to a seasonally unfavorable external environment. Science 180:502–504CrossRefPubMed
Zurück zum Zitat Sharad SM, Ligia Maria CE, Ricardo I (2012) A novel strategy for environmental control of soil transmitted helminthes. Health Environ J 3(3):28 Sharad SM, Ligia Maria CE, Ricardo I (2012) A novel strategy for environmental control of soil transmitted helminthes. Health Environ J 3(3):28
Zurück zum Zitat Shimizu T (1993) Prevalence of Toxocara eggs in sandpits in Tokushima outskirts. J Vet Med Sci 55:807–811CrossRefPubMed Shimizu T (1993) Prevalence of Toxocara eggs in sandpits in Tokushima outskirts. J Vet Med Sci 55:807–811CrossRefPubMed
Zurück zum Zitat Steinmann P, Zhou XN, Du ZW, Jiang JY et al (2007) Occurrence of Strongyloides stercoralis in Yunnan Province, China, and comparison of diagnostic methods. PLoS Negl Trop Dis 31(1):75CrossRef Steinmann P, Zhou XN, Du ZW, Jiang JY et al (2007) Occurrence of Strongyloides stercoralis in Yunnan Province, China, and comparison of diagnostic methods. PLoS Negl Trop Dis 31(1):75CrossRef
Zurück zum Zitat Stephensom LS, Holland CV, Cooper ES (2000) The public health significance of Trichuris trichiura. Parasitology 121:73–95CrossRef Stephensom LS, Holland CV, Cooper ES (2000) The public health significance of Trichuris trichiura. Parasitology 121:73–95CrossRef
Zurück zum Zitat Stojcevic D, Susic V, Lucinger S (2010). Contamination of soil and sand with parasite elements as a risk factor for human health in public parts and playgrounds in Pula, Croatia. Vet Arhiv 80:733–742 Stojcevic D, Susic V, Lucinger S (2010). Contamination of soil and sand with parasite elements as a risk factor for human health in public parts and playgrounds in Pula, Croatia. Vet Arhiv 80:733–742
Zurück zum Zitat Sudhakar NR, Samanta S, Sahu S, Raina OK, Gupta SC, Madhu DN, Kumar A (2013) Prevalence of Toxocara species eggs in soil samples of public health importance in and around Bareilly, Uttar Pradesh, India. Vet World 6(2):87–90CrossRef Sudhakar NR, Samanta S, Sahu S, Raina OK, Gupta SC, Madhu DN, Kumar A (2013) Prevalence of Toxocara species eggs in soil samples of public health importance in and around Bareilly, Uttar Pradesh, India. Vet World 6(2):87–90CrossRef
Zurück zum Zitat Troeh F, Thompson L (1993) Soils and Soil Fertility, 3rd edn. Oxford, New York Troeh F, Thompson L (1993) Soils and Soil Fertility, 3rd edn. Oxford, New York
Zurück zum Zitat Udonsi JK, Anya AO (1981) Necator americanus: studies on the bionomics in relation to moisture suction. Niger J Parasitol 2:4–14 Udonsi JK, Anya AO (1981) Necator americanus: studies on the bionomics in relation to moisture suction. Niger J Parasitol 2:4–14
Zurück zum Zitat Umar AA, Bassey SE (2010) Incidence of Strongyloides stercoralis infection in Ungogo, Nassarawa, Dala and Fagge local government areas of Kano state, Nigeria. Bayero J Pure Appl Sci 3(2):76–80 Umar AA, Bassey SE (2010) Incidence of Strongyloides stercoralis infection in Ungogo, Nassarawa, Dala and Fagge local government areas of Kano state, Nigeria. Bayero J Pure Appl Sci 3(2):76–80
Zurück zum Zitat van Doorn HR, Koelewijn R, Hofwegen H et al (2007) Use of enzyme-linked immunosorbent assay and dipstick assay for detection of Strongyloides stercoralis infection in humans. J Clin Microbiol 45(2):438–442CrossRefPubMed van Doorn HR, Koelewijn R, Hofwegen H et al (2007) Use of enzyme-linked immunosorbent assay and dipstick assay for detection of Strongyloides stercoralis infection in humans. J Clin Microbiol 45(2):438–442CrossRefPubMed
Zurück zum Zitat WHO (1964) Environmental factors that contribute to the high rate of infection: a review of disease control 6 WHO (1964) Environmental factors that contribute to the high rate of infection: a review of disease control 6
Zurück zum Zitat Woodruff A, Salih S, Designy D, Baya E, Shah A (1981) Toxocariasis in the Sudan. Ann Trop Med Parasitol 75(5):559–561CrossRefPubMed Woodruff A, Salih S, Designy D, Baya E, Shah A (1981) Toxocariasis in the Sudan. Ann Trop Med Parasitol 75(5):559–561CrossRefPubMed
Zurück zum Zitat World Health Organization WHO (1983) Diagnostic techniques in Schistosomiasis control. Report of the Schistosomiasis unit of the WHO parasitic disease programme (PDP). WHO Technical Report Series 386 World Health Organization WHO (1983) Diagnostic techniques in Schistosomiasis control. Report of the Schistosomiasis unit of the WHO parasitic disease programme (PDP). WHO Technical Report Series 386
Zurück zum Zitat Xavier RIG, Ramos BC, Santare’m VA (2010) Recovery threshold of Toxocara canis eggs from soil. Vet Parasitol 167:77–80CrossRef Xavier RIG, Ramos BC, Santare’m VA (2010) Recovery threshold of Toxocara canis eggs from soil. Vet Parasitol 167:77–80CrossRef
Metadaten
Titel
Geohelminths distribution as affected by soil properties, physicochemical factors and climate in Sharkyia governorate Egypt
verfasst von
Samia E. Etewa
Sara A. Abdel-Rahman
Naglaa F. Abd El-Aal
Ghada M. Fathy
Mahmoud A. El-Shafey
A. M. G. Ewis
Publikationsdatum
31.08.2014
Verlag
Springer India
Erschienen in
Journal of Parasitic Diseases / Ausgabe 2/2016
Print ISSN: 0971-7196
Elektronische ISSN: 0975-0703
DOI
https://doi.org/10.1007/s12639-014-0532-5

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