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Book Review

Parasitology: An Integrated Approach

Ed. by Alan Gunn and Sarah Jane Pitt, Pub. by Wiley-Blackwell 2012, 456 pp, €41.80
This book provides a concise, student-friendly account of parasites and parasite relationships that is supported by case studies and suggestions for student projects. The book focuses strongly on parasite interactions with other pathogens and in particular parasite-HIV interactions, as well as looking at how host behaviour contributes to the spread of infections. There is a consideration of the positive aspects of parasite infections, how humans have used parasites for their own advantage and also how parasite infections affect the welfare of captive and domestic animals. The emphasis of the book is on recent research throughout and each chapter ends with a brief discussion of future developments. This text is not simply an updated version of typical parastitology books but takes an integrated approach and explains how the study of parasites requires an understanding of a wide range of other topics from molecular biology and immunology to the interactions of parasites with both their hosts and other pathogens

www.wiley.co.uk

Clouds in the lab

Like much in healthcare IT, the development of Laboratory Information Management Systems (LIMS) has been an uneven mix of technology-push and user-pull, coupled with regulatory efforts at streamlining the two. Today, the new vista of cloud computing is rapidly opening up new LIMS opportunities, especially for smaller labs.

The demand for LIMS began in the late 1970s after the proliferation of electronic lab equipment and an explosion in data. The then-emerging technology of ‘minicomputers’ offered LIMS the first realistic alternative to expensive/inaccessible mainframes. Minicomputers, however, were only a brief interlude in computing technology, before the advent of personal computers. Most minicomputer vendors (e.g Data General, Wang, Norsk Data etc.) have since disappeared. By the late 1980s, personal computers enabled LIMS users to leverage relational databases. The arrival of client/server architecture and the Internet in the 1990s expanded the reach of LIMS outside laboratories, providing novelties such as 24×7 analysis from offshore locations. The past decade has expanded the footprint of LIMS further via Wi-Fi, mobile access and standards like XML.

However, much of this has been a mixed blessing. As the LIMS community proliferated, so too did concerns about data security and systems complexity. Competition among LIMS vendors led to a blizzard of new features, ranging from those required to comply with regulations, to a swathe of pureplay ‘business’ applications such as inventory and personnel management, workflow sequencing etc. The result: an escalation in user expectations, and in entry-level costs.

In spite of the recent centralisation of healthcare, most labs are still relatively small. In the US, the largest 50 account for one-third of the industry’s total revenues of about 40 billion dollars; over 7,500 labs share the rest. With commercial LIMS systems beyond their budgets, several labs have sought to develop their own, but almost always ended up with huge cost-overruns, and performance problems. One reason lies in the very essence of information technology, namely the steady fall in unit costs of processing power, with savings harnessed by commercial vendors to bundle additional features. The second reason: any mission-critical IT system needs to handle peak load requirements, often several multiples of the median; healthcare is no exception.
  
Cloud computing technology may answer both the above challenges, and LIMS seems an especially promising area. At its most basic, cloud computing is akin to an electricity grid, pooling computing horsepower across locations to enable scale-up on demand; the parallel is particularly close in terms of load balancing – the ability to adjust database, server and networking capacity to fluctuating demand.
  
In May 2010, a headline feature by the American Chemical Society titled ‘LIMS in the Cloud’ emphasised how cloud computing was opening up LIMS to small labs, which had ‘not been particularly well served’ by vendors. Indeed, cloud-based LIMS pioneers such as LabLynx have acquired over 1,000 customers in less than two years of launch. The recent entry of IT giants such as Microsoft, Oracle and Google into cloud computing promises to galvanise the industry further, with LIMS applications likely to remain at the forefront.

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The fight against blood doping in sport

Blood doping benefits endurance athletes (notoriously, but not only, cyclists) by raising the red blood cell (rbc) count or haematocrit, and so increasing the oxygen supply to the muscles. It is one of the most difficult types of drug abuse to detect. Awareness of blood doping was raised in the popular press recently when comments were made about the impressive nature of China’s Ye Shiwen’s Olympic gold medal wins and with Lance Armstrong’s (cycling’s famous winner of seven Tours de France after surviving advanced testicular cancer) sudden decision to drop his fight against the US Anti-Doping Agency’s drug charges. Hematocrit levels can be raised by a variety of methods ranging from legal altitude training, to the banned use of autologous blood transfusions and erythropoietin (EPO) injections.
Detection of these banned methods is extremely difficult and the fight against them is being waged in a number of ways. The UCI’s (cycling’s governing body) lines of defence include simply demonstrating possession of banned substances and monitoring hematocrit levels, with a limit set at 50% (normal being 41–50% for men).
Some early success was had with testing urine to distinguish pharmaceutical EPO from the nearly identical natural hormone by isolectric focusing, though its accuracy has been questioned with claims that it is not possible to distinguish pharmaceutical EPO from other unrelated proteins that are present in urine after strenuous exercise or as the result of sample degradation and bacterial contamination.
At present, tests that provide indirect evidence of autologous blood transfusion (where the athlete withdraws and then re-injects his own blood) are under development and involve looking at the ratio of immature to mature red blood cells and might also include the measurement of 2,3-bisphophoglycerate (2,3-BPG). As 2,3-BPG degrades over time, stored blood used for autologous transfusions would have less than fresh blood and so levels of 2,3-BPG lower than normal may then indicate blood doping by this method. The presence of plasticizers in the blood (from the IV bags in which blood is stored) has also been used as evidence of blood doping.
While these advances in the detection of blood doping are being made it is tempting to think that we have got there, that the cheats will be caught. However, in the high-stakes world of elite athletes this would be a naive hope: the possibility of athletes subjecting themselves to EPO gene therapy – so called gene doping – has been suggested and methods for the detection of transgenic DNA following in vivo gene transfer are already being developed.

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