Experts who are adept at handling massive scientific data sets are examining ways that the revolution sweeping their field can address one of medicine’s biggest challenges: the spread of drug-resistant microbes.Maha Farhat, assistant professor of biomedical informatics and one of the organizers of a symposium on the topic, said antibiotic resistance has reached “epidemic proportions” but, with more data available than ever, there’s hope that medical science will discover ways to combat it. What’s needed, however, are better tools to analyze that data, she said. Related Heading off the post-antibiotic age “It really threatens one of the most core therapies that define modern medicine,” Farhat said. “We do think the problem of antibiotic resistance is at such scale that we should come at it from many different angles.”The symposium, “Data-Powered Strategies to Counteract Antibiotic Resistance,” held Wednesday at Harvard Medical School’s New Research Building on the Longwood campus, featured speakers who focused on three major areas: detecting and diagnosing drug-resistant microbes, applying big data to the problem, and developing new drugs to fight resistance.Speakers came from both academia and industry and represented Harvard, Massachusetts Institute of Technology, Imperial College London, McMaster University, Boston Children’s Hospital, Entasis Therapeutics, and Accelerate Diagnostics.Harvard Medical School Dean George Daley introduced the session, calling the years after penicillin first became widely used in the 1940s a time of relative innocence. Penicillin was so effective in fighting infections that previously would have been fatal that it transformed not just the hospital, but the battlefield.The rise of drug resistance in the decades since, however, has resulted in some 2 million drug-resistant infections that kill 23,000 people in the U.S. each year. The resistance also costs the medical industry billions a year in higher medical costs.,Daley, who, before becoming dean directed the pediatric bone marrow program at Boston Children’s Hospital and the Dana-Farber Cancer Institute, said physicians there — concerned about infection because bone marrow transplants weaken the immune system — could see that the tools they had at their disposal were weakening.“The fact is that the diminishing potency of our prophylactic armamentarium really was quite frightening. There were lots of diseases and infections that, once they set in, despite our efforts at prophylaxis, it became very, very challenging,” Daley said. “In virtually every medical context, the physicians’ arsenal of antimicrobial therapies has become a rapidly dwindling set. New therapies are just not being developed fast enough.”The problem is alarming enough, Daley said, that in 2016 the World Health Organization declared it one of the greatest threats to global health and made it a top priority.Though improper use of drugs — for the wrong microbes, or in regimens that don’t completely eradicate the infection, leaving the hardiest surviving microbes alive to multiply — can increase resistance, it’s also a natural process, part of an ongoing arms race between microbe and host, Daley said. Research has found mechanisms of drug resistance in 30,000-year-old microbes frozen in permafrost, indicating that it is a natural phenomenon and not a result of poor prescribing practices and patient adherence.“What it says is that the constant battle between pathogen and host … has been an ancient battle. It’s now playing out in the human body,” Daley said.While Daley said that new antibiotic drugs are needed, progress in fighting resistance will come from other sources as well, including leveraging insights about bacteria gleaned by analyzing the large data sets newly available. One potentially fruitful area, Daley said, is the vast amount of genomic data now available that can provide a better understanding of a microbe’s weaknesses.Thousands of tuberculosis genomes have been analyzed, for example, as researchers look to better understand patterns of drug resistance in a bacterium that ranks high on a global list of the most worrisome drug-resistant infections.,One important area where progress is being made is in rapid diagnostics. A severely ill patient suffering from an infection is usually treated right away, without waiting for lab results to provide information about a particular strain and its susceptibility to antibiotics, which can take days. James Collins of MIT, the Broad Institute of MIT and Harvard, and Harvard’s Wyss Institute for Biologically Inspired Engineering, and Romney Humphries of Accelerate Diagnostics presented two early talks about rapid diagnostics.Humphries described her company’s phenotype-based test, which cuts diagnosis time from several days to about seven hours. That’s still too late to inform the first application of antibiotics, Humphries said, but could allow physicians to shift medication strategies for second and subsequent doses should a strain be determined to be resistant to particular drugs. What’s needed, she said, are diagnostics available within 30 minutes, so physicians can avoid prescribing inappropriate or ineffective medicines from the start, which not only do the patients no good, but risk enhancing resistance.Collins, the Termeer Professor of Medical Engineering and Science at MIT and a founding core faculty member at the Wyss, described the development of engineered bacteria that function as living diagnostics, and of inexpensive, paper-based diagnostics that can be used in remote locations.He also described a new approach to fighting infection by harnessing the microbiome. Researchers in his lab seeded the intestines of mice with a microbe found in dairy products, one that they’d engineered to detect cholera and that in its natural form makes the gut more acidic. That makes the gut a more hostile environment for the cholera bacterium, staving off its potentially deadly symptoms.“This opens up a broad range of possibilities,” Collins said. “This is something you can have in a simple pill or literally spike in yogurt or fermented dairy products” when a pandemic threatens. Big data, massive potential Across Harvard, programs and researchers are mining vast quantities of computerized information, sometimes revolutionizing their fields in the process Symposium explores the science and business of limiting resistance to drugs
Oscar’s second-half winner handed Chelsea a Capital One Cup fourth-round tie against League Two side Shrewsbury at the expense of Bolton Wanderers.French centre-back Kurt Zouma put Chelsea ahead on his debut when he fired high into the net after Bolton had failed to clear a corner.The Trotters were level six minutes later when Matt Mills headed home.But Chelsea, who had 28 shots to Bolton’s three, deservedly won when Oscar hit a low drive into the corner.German midfielder Andre Schurrle also had several chances for the Blues, while Bolton goalkeeper Andrew Lonergan was in excellent form to restrict the Premier League side.Chelsea wasted opportunities to take the lead against the Championship club in the first quarter of the match. Schurrle’s inswinging free-kick was saved by Lonergan, before the World Cup-winner made a mess of his header from Mohamed Salah’s cross.The Bolton keeper then prevented Oscar from scoring, before Salah and striker Loic Remy missed from close range.Schurrle went close, twice more, before the Premier League leaders finally went ahead, from a corner.After Gary Cahill’s header from the delivery was blocked, Remy nodded the ball back into the six-yard area where Zouma was on hand to convert.But the Trotters hit back soon after the restart. Liam Feeney’s deep free-kick from the right found Mills on the edge of the hosts’ box. The defender leapt highest to direct his header in from 16 yards.Chelsea picked up the pace again. Schurrle fired off target, Nathan Ake was denied from 25 yards by Lonergan, who then saved a header from Oscar.The Brazil midfielder did, however, find the net when he drilled in the loose ball from Remy’s blocked shot.Chelsea keeper Petr Cech saved from Bolton substitute Lee Chung-yong five minutes from time.Chelsea assistant Steve Holland: “It’s nice not to have extra-time. We don’t have any new injuries, we’ve progressed to the next round of the competition.”Several of our players who probably needed a game now have 90 minutes under their belts heading into two or three important fixtures. It’s a good situation to be in.”Bolton manager Dougie Freedman: “When I saw the team-sheet that I knew their manager treated this competition with respect and the opposition with respect. They were taking it very seriously.”We were going to have to ride our luck a little bit and our goalkeeper was fantastic. They hit the bar but in the last 10, 15 minutes we gave it a right good go, played a bit more expansive. “A little bit more quality would have taken it to extra-time.”
MORE: Fantasy Alarm 2020 Fantasy Baseball Draft GuideJustin Verlander Injury: Effects on fantasy baseball draft ADPJustin Verlander’s lat strain has caused his ADP to fall significantly, as he is expected to miss six-to-eight weeks. This timetable would have him make his debut in late April or early May. He has gone from a late-first/early-second-round pick to a third- to fourth-round pick. Now that the start of the season will be delayed, Verlander might move back up to the early second round.What is expected to be seen, but which hasn’t really panned out yet, is that there will be some movement in the top pitchers moving up a little bit on people’s draft boards. With some more data, we may see Walker Buehler, Jack Flaherty, Stephen Strasburg, and if he isn’t hurt, Max Scherzer, get taken earlier. As they move up, you may see a ripple effect that moves the second- and third-tier pitchers move up also. Verlander’s injury also brought his teammates into light, as we saw some significant ADP movement by Jose Urquidy and Josh James. James was in a battle for the fifth starter, but it seems clear now that he will break camp as a starter. Both saw little movement in their MDA ADP, but the drafters in the NFBC gave them both significant boosts with James rising 110 slots. He is someone you can miss out on if you don’t use a short time period on whatever ADP you may follow during your draft.2020 Fantasy Baseball Rankings:Catcher | First | Second | Third | Short | Outfield | Starter | Reliever | Top 300Giancarlo Stanton, Aaron Judge Injuries: Sleeper Mike Tauchman benefitsThe Yankees injury bug was never eradicated from 2019 and has continued into this year. With Judge out with a stress fracture of his rib indefinitely, there has been a big drop in his ADP over the past week as his status is up in the air. Stanton’s ADP has dropped, but it had already been taking a hit because of his calf injury.The beneficiary of their drops is Mike Tauchman. He has had a 165-ADP rise over the last week. The Army has even moved him higher this week to 264 (up from 292). Clint Frazier still hasn’t come up on the radar, but if it’s announced that he will break camp with the Yankees, which most assume he will, you should see a bounce in his stock. Now, with the potential delayed opening of the season, do Judge and Stanton become less of a risk and move back up into the earlier rounds?2020 Fantasy Baseball Sleepers:Catcher | First | Second | Third | Short | Outfielder | Starter | Each teamFantasy Baseball Sleeper: Jordan Montgomery seeing ADP riseMontgomery was a long shot to make the Yankees rotation when spring training started. The injuries to James Paxton (back) and Luis Severino (elbow) put him in the mix. Now that he’s having a very good spring with 16 Ks in 11 innings, he’s jumping up everyone’s draft rankings. His only flaw has been he’s given up four homers over 11 innings. His WHIP is 0.73, and despite the four home runs, he’s given up just five runs. He’s a buy now, but will he remain in the rotation once Paxton and Domingo German (suspension) return? If the season gets delayed, will his stock go down as Paxton will be much closer to returning?2020 Fantasy Baseball Tiers, Draft Strategy:Catcher | First | Second | Third | Short | Outfield | Starter | RelieverWillie Calhoun Injury: Door open for sleeper Nick SolakCalhoun started his breakout in 2019, and there are some who believe it would continue into ’20. Then along came a Julio Urias fastball to the jaw and all bets are off. His injury wasn’t too severe and he is expected to make a full recovery, but there has been no word on long he’ll be sidelined. His MDA stock has plummeted like Wall Street’s recent decline, going from 175 to 256 in its small sample size. In the NFBC he’s seen a 25-slot drop.Nick Solak is one of the players who could receive a boost in ADP with Calhoun’s injury, and the Army drafted him about three rounds earlier. There was little change in his NFBC ADP. Is this a wait-and-see for the NFBC owners, or do they not value Solak enough to bump him up?DOMINATE YOUR DRAFT: Ultimate 2020 Fantasy Baseball Cheat SheetTrey Mancini Illness: Orioles sleepers Austin Hays, Anthony Santander to move up in drafts?Mancini underwent surgery to have a malignant tumor removed from his colon on Thursday, and will miss an extended period of the season. With so much uncertainty surrounding the situation, it’s likely Mancini will fall off draft boards until at least the final couple rounds.Orioles outfielders, such as Austin Hays and Anthony Santander, should eventually see a big boost in their ADPs, but it’s too early speculate just how much. A flurry of MLB injuries has affected the average draft position (ADP) of not only the afflicted players but those potential sleepers who may benefit from more playing time. With Tout Wars, the NFBC NY Main Event, and many home fantasy baseball leagues drafting this weekend, we need to stay updated on who the risers and fallers are on your draft boards. However, now that the Coronavirus outbreak will delay the start of the season, those risers and fallers that are caused by injuries may reverse course, so there’s a lot to balance here. The ADP data referenced below is based on this week’s Fantasy Alarm’s Mock Draft Army (MDA) mock drafts, as well as overall MDA ADP and the NFBC ADP from March 1-6 and March 7-11. More 2020 Fantasy Baseball: Auction Values | Mock Draft SimulatorMichael Conforto Injury: Effects on mock draft ADPConforto was diagnosed with a Grade-1 oblique strain on March 11, and we know those injuries can linger for an extended period of time. It’s probably a four-week injury, putting his return in mid-April. Some have said that it would be JD Davis getting the boost in value, but I see it being Dominic Smith, who was going to be a bench player. The other possibility is that Jeff McNeil gets moved to right field, Davis to left field, and either Luis Guillorme or Eduardo Nunez takes over at third. This is not expected to be a long-term injury, and Conforto isn’t being discounted much in drafts (and will be even less with the opening day delay). None of the other Mets appear to be worth moving up your draft boards.Depending upon what decisions are made, drafts over the weekend may be very different than they would be even today. Follow the news and make sure you factor in all the available information before you have to make those critical choices on draft day. Check the Fantasy Alarm Ultimate Cheat Sheet as it is updated daily for the latest information and rankings.