Prevention and management of potential adverse events during transapical aortic valve replacement.

BACKGROUND AND AIM OF THE STUDY: Transapical transcatheter aortic valve replacement (TAVR) is a new minimally invasive technique with a known risk of unexpected intra-procedural complications. Nevertheless, the clinical results are good and the limited amount of procedural adverse events confirms the usefulness of a synergistic surgical/anesthesiological management in case of unexpected emergencies. METHODS: A review was made of the authors' four-year database and other available literature to identify major and minor intra-procedural complications occurring during transapical TAVR procedures. All implants were performed under general anesthesia with a balloon-expandable Edwards Sapien stent-valve, and followed international guidelines on indications and techniques. RESULTS: Procedural success rates ranged between 94% and 100%. Life-threatening apical bleeding occurred very rarely (0-5%), and its incidence decreased after the first series of implants. Stent-valve embolization was also rare, with a global incidence ranging from 0-2%, with evidence of improvement after the learning curve. Rates of valve malpositioning ranged from 0% to < 3%, whereas the risk of coronary obstruction ranged from 0% to 3.5%. Aortic root rupture and dissection were dramatic events reported in 0-2% of transapical cases. Stent-valve malfunction was rarely reported (1-2%), whereas the valve-in-valve bailout procedure for malpositioning, malfunctioning or severe paravalvular leak was reported in about 1.0-3.5% of cases. Sudden hemodynamic management and bailout procedures such as valve-in-valve rescue or cannulation for cardiopulmonary bypass were more effective when planned during the preoperative phase. CONCLUSION: Despite attempts to avoid pitfalls, complications during transapical aortic valve procedures still occur. Preoperative strategic planning, including hemodynamic status management, alternative cannulation sites and bailout procedures, are highly recommended, particularly during the learning curve of this technique.

Association of electrocardiogram abnormalities and incident heart failure events.

Unless effective preventive strategies are implemented, aging of the population will result in a significant worsening of the heart failure (HF) epidemic. Few data exist on whether baseline electrocardiographic (ECG) abnormalities can refine risk prediction for HF. METHODS: We examined a prospective cohort of 2,915 participants aged 70 to 79 years without preexisting HF, enrolled between April 1997 and June 1998 in the Health, Aging, and Body Composition (Health ABC) study. Minnesota Code was used to define major and minor ECG abnormalities at baseline and at year 4 follow-up. Using Cox models, we assessed (1) the association between ECG abnormalities and incident HF and (2) the incremental value of adding ECG to the Health ABC HF Risk Score using the net reclassification index. RESULTS: At baseline, 380 participants (13.0%) had minor, and 620 (21.3%) had major ECG abnormalities. During a median follow-up of 11.4 years, 485 participants (16.6%) developed incident HF. After adjusting for the Health ABC HF Risk Score variables, the hazard ratio (HR) was 1.27 (95% CI 0.96-1.68) for minor and 1.99 (95% CI 1.61-2.44) for major ECG abnormalities. At year 4, 263 participants developed new and 549 had persistent abnormalities; both were associated with increased subsequent HF risk (HR 1.94, 95% CI 1.38-2.72 for new and HR 2.35, 95% CI 1.82-3.02 for persistent ECG abnormalities). Baseline ECG correctly reclassified 10.5% of patients with HF events, 0.8% of those without HF events, and 1.4% of the overall population. The net reclassification index across the Health ABC HF risk categories was 0.11 (95% CI 0.03-0.19). CONCLUSIONS: Among older adults, baseline and new ECG abnormalities are independently associated with increased risk of HF. The contribution of ECG screening for targeted prevention of HF should be evaluated in clinical trials.

Lack of support for the association between facial shape and aggression: a reappraisal based on a worldwide population genetics perspective

Antisocial and criminal behaviors are multifactorial traits whose interpretation relies on multiple disciplines. Since these interpretations may have social, moral and legal implications, a constant review of the evidence is necessary before any scientific claim is considered as truth. A recent study proposed that men with wider faces relative to facial height (fWHR) are more likely to develop unethical behaviour mediated by a psychological sense of power. This research was based on reports suggesting that sexual dimorphism and selection would be responsible for a correlation between fWHR and aggression. Here we show that 4,960 individuals from 94 modern human populations belonging to a vast array of genetic and cultural contexts do not display significant amounts of fWHR sexual dimorphism. Further analyses using populations with associated ethnographical records as well as samples of male prisoners of the Mexico City Federal Penitentiary condemned by crimes of variable level of inter-personal aggression (homicide, robbery, and minor faults) did not show significant evidence, suggesting that populations/individuals with higher levels of bellicosity, aggressive behaviour, or power-mediated behaviour display greater fWHR. Finally, a regression analysis of fWHR on individual"s fitness showed no significant correlation between this facial trait and reproductive success. Overall, our results suggest that facial attributes are poor predictors of aggressive behaviour, or at least, that sexual selection was weak enough to leave a signal on patterns of between- and within-sex and population facial variation.

Sherali-Adams Relaxations and Indistinguishability in Counting Logics

Two graphs with adjacency matrices $\mathbf{A}$ and $\mathbf{B}$ are isomorphic if there exists a permutation matrix $\mathbf{P}$ for which the identity $\mathbf{P}^{\mathrm{T}} \mathbf{A} \mathbf{P} = \mathbf{B}$ holds. Multiplying through by $\mathbf{P}$ and relaxing the permutation matrix to a doubly stochastic matrix leads to the linear programming relaxation known as fractional isomorphism. We show that the levels of the Sherali--Adams (SA) hierarchy of linear programming relaxations applied to fractional isomorphism interleave in power with the levels of a well-known color-refinement heuristic for graph isomorphism called the Weisfeiler--Lehman algorithm, or, equivalently, with the levels of indistinguishability in a logic with counting quantifiers and a bounded number of variables. This tight connection has quite striking consequences. For example, it follows immediately from a deep result of Grohe in the context of logics with counting quantifiers that a fixed number of levels of SA suffice to determine isomorphism of planar and minor-free graphs. We also offer applications in both finite model theory and polyhedral combinatorics. First, we show that certain properties of graphs, such as that of having a flow circulation of a prescribed value, are definable in the infinitary logic with counting with a bounded number of variables. Second, we exploit a lower bound construction due to Cai, Fürer, and Immerman in the context of counting logics to give simple explicit instances that show that the SA relaxations of the vertex-cover and cut polytopes do not reach their integer hulls for up to $\Omega(n)$ levels, where $n$ is the number of vertices in the graph.

Chemical profiling: a tool to decipher the structure and organisation of illicit drugs markets: an 8-year study in Western Switzerland

Illicit drug analyses usually focus on the identification and quantitation of questioned material to support the judicial process. In parallel, more and more laboratories develop physical and chemical profiling methods in a forensic intelligence perspective. The analysis of large databases resulting from this approach enables not only to draw tactical and operational intelligence, but may also contribute to the strategic overview of drugs markets. In Western Switzerland, the chemical analysis of illicit drug seizures is centralised in a laboratory hosted by the University of Lausanne. For over 8 years, this laboratory has analysed 5875 cocaine and 2728 heroin specimens, coming from respectively 1138 and 614 seizures operated by police and border guards or customs. Chemical (major and minor alkaloids, purity, cutting agents, chemical class), physical (packaging and appearance) as well as circumstantial (criminal case number, mass of drug seized, date and place of seizure) information are collated in a dedicated database for each specimen. The study capitalises on this extended database and defines several indicators to characterise the structure of drugs markets, to follow-up on their evolution and to compare cocaine and heroin markets. Relational, spatial, temporal and quantitative analyses of data reveal the emergence and importance of distribution networks. They enable to evaluate the cross-jurisdictional character of drug trafficking and the observation time of drug batches, as well as the quantity of drugs entering the market every year. Results highlight the stable nature of drugs markets over the years despite the very dynamic flows of distribution and consumption. This research work illustrates how the systematic analysis of forensic data may elicit knowledge on criminal activities at a strategic level. In combination with information from other sources, such knowledge can help to devise intelligence-based preventive and repressive measures and to discuss the impact of countermeasures.

Characterization of clinical and electrocardiographic findings in a youth population

Resting 12-lead electrocardiogram (ECG) has been employed in the evaluation of young asymptomatic subjects to detect pre-existing heart diseases. Although the incorporation of routine ECG remains controversial, there is increasing evidence that cardiomyopathies and ion channelopathies show ECG changes as the initial manifestation. The causes of sudden cardiac death in young people show a significant geographical variation. We aim to determine the prevalence and spectrum of ECG findings in a youth population. Methodology: From May 2010 to April 2013, a total of 976 young secondary school students (mean age, 14 years; range, 13-15) underwent voluntary medical screening that included a resting 12-lead ECG and structured clinical survey. Subjects with abnormal ECG findings were classified into two groups: major ECG findings group, which fulfilled a pre-specified checklist to screen for principal structural and electrical cardiopathies, and minor ECG findings group showing other ECG changes. The major ECG findings group was referred for secondary diagnostic tests at a tertiary institution. Results: Of the 976 subjects screened, 252 (25.82%; CI95%, 23.17-28.66) had ECG findings. Of note, 17 (1.74%) had major findings and 235 (24.08%) had minor findings on ECG. The prevalence of cardiovascular pathology within the major ECG findings group was 35.29%. The prevalence of ECG abnormalities was significantly higher in males than in females (29% vs 20.9%, P<0.01). Conclusions: The prevalence of ECG findings in a youth population was 25.82%. There were significant gender differences. The inclusion of universal ECG screening, in addition to medical history, may increase the sensitivity of a cardiovascular screening program. Knowledge of the spectrum and prevalence of ECG findings and disease conditions would be pivotal in designing customized screening programs

Computational and Experimental Investigation of the Grooved Roll in Paper Machine Environment

In the paper machine, it is not a desired feature for the boundary layer flows in the fabric and the roll surfaces to travel into the closing nips, creating overpressure. In this thesis, the aerodynamic behavior of the grooved roll and smooth rolls is compared in order to understand the nip flow phenomena, which is the main reason why vacuum and grooved roll constructions are designed. A common method to remove the boundary layer flow from the closing nip is to use the vacuum roll construction. The downside of the use of vacuum rolls is high operational costs due to pressure losses in the vacuum roll shell. The deep grooved roll has the same goal, to create a pressure difference over the paper web and keep the paper attached to the roll or fabric surface in the drying pocket of the paper machine. A literature review revealed that the aerodynamic functionality of the grooved roll is not very well known. In this thesis, the aerodynamic functionality of the grooved roll in interaction with a permeable or impermeable wall is studied by varying the groove properties. Computational fluid dynamics simulations are utilized as the research tool. The simulations have been performed with commercial fluid dynamics software, ANSYS Fluent. Simulation results made with 3- and 2-dimensional fluid dynamics models are compared to laboratory scale measurements. The measurements have been made with a grooved roll simulator designed for the research. The variables in the comparison are the paper or fabric wrap angle, surface velocities, groove geometry and wall permeability. Present-day computational and modeling resources limit grooved roll fluid dynamics simulations in the paper machine scale. Based on the analysis of the aerodynamic functionality of the grooved roll, a grooved roll simulation tool is proposed. The smooth roll simulations show that the closing nip pressure does not depend on the length of boundary layer development. The surface velocity increase affects the pressure distribution in the closing and opening nips. The 3D grooved roll model reveals the aerodynamic functionality of the grooved roll. With the optimal groove size it is possible to avoid closing nip overpressure and keep the web attached to the fabric surface in the area of the wrap angle. The groove flow friction and minor losses play a different role when the wrap angle is changed. The proposed 2D grooved roll simulation tool is able to replicate the grooved aerodynamic behavior with reasonable accuracy. A small wrap angle predicts the pressure distribution correctly with the chosen approach for calculating the groove friction losses. With a large wrap angle, the groove friction loss shows too large pressure gradients, and the way of calculating the air flow friction losses in the groove has to be reconsidered. The aerodynamic functionality of the grooved roll is based on minor and viscous losses in the closing and opening nips as well as in the grooves. The proposed 2D grooved roll model is a simplification in order to reduce computational and modeling efforts. The simulation tool makes it possible to simulate complex paper machine constructions in the paper machine scale. In order to use the grooved roll as a replacement for the vacuum roll, the grooved roll properties have to be considered on the basis of the web handling application.

The Role of Non-Coercive Influence Tactics in Online Marketing

This thesis examines the effectiveness of non-coercive influence tactics in the context of consumer online behaviour. The objective of this study is to develop a comprehensive understanding of consumer online behaviour and the role of information types in affecting the consumer’s cognitive responses and behavioural outcomes. The theoretical part of the study examines the academic literature on consumer online behaviour and influence tactics used both in traditional buyer/seller relationships as well as in relationships mediated by online technologies. The empirical part of the study is carried out with four experiments that utilise non-coercive influence tactics to affect online consumer behaviour. The consumers included in this study are 18-28 year-old structural and civil engineering students in Finland, United Kingdom, United States and India. The findings suggest that non-coercive influence tactics are applicable in the online marketing context and generate cognitive responses of site awareness, site involvement and exploratory behaviour which subsequently results in behavioural outcomes of compliance, eWOM and site abandonment.

Motor behavioral abnormalities and histopathological findings of Wistar rats inoculated with HTLV-1-infected MT2 cells

The objective of the present study was to describe motor behavioral changes in association with histopathological and hematological findings in Wistar rats inoculated intravenously with human T-cell lymphotropic virus type 1 (HTLV-1)-infected MT2 cells. Twenty-five 4-month-old male rats were inoculated with HTLV-1-infected MT2 cells and 13 control rats were inoculated with normal human lymphocytes. The behavior of the rats was observed before and 5, 10, 15, and 20 months after inoculation during a 30-min/rat testing time for 5 consecutive days. During each of 4 periods, a subset of rats was randomly chosen to be sacrificed in order to harvest the spinal cord for histopathological analysis and to obtain blood for serological and molecular studies. Behavioral analyses of the HTLV-1-inoculated rats showed a significant decrease of climbing, walking and freezing, and an increase of scratching, sniffing, biting, licking, and resting/sleeping. Two of the 25 HTLV-1-inoculated rats (8%) developed spastic paraparesis as a major behavioral change. The histopathological changes were few and mild, but in some cases there was diffuse lymphocyte infiltration. The minor and major behavioral changes occurred after 10-20 months of evolution. The long-term observation of Wistar rats inoculated with HTLV-1-infected MT2 cells showed major (spastic paraparesis) and minor motor abnormalities in association with the degree of HTLV-1-induced myelopathy.

A comparison of two computer-assisted remedial reading programs for adolescent unskilled readers : component reading skills and repeated reading

This study compared the relative effectiveness of two computerized remedial reading programs in improving the reading word recognition, rate, and comprehension of adolescent readers demonstrating significant and longstanding reading difficulties. One of the programs involved was Autoskill Component Reading Subskills Program, which provides instruction in isolated letters, syllables, and words, to a point of rapid automatic responding. This program also incorporates reading disability subtypes in its approach. The second program, Read It Again. Sam, delivers a repeated reading strategy. The study also examined the feasibility of using peer tutors in association with these two programs. Grade 9 students at a secondary vocational school who satisfied specific criteria with respect to cognitive and reading ability participated. Eighteen students were randomly assigned to three matched groups, based on prior screening on a battery of reading achievement tests. Two I I groups received training with one of the computer programs; the third group acted as a control and received the remedial reading program offered within the regular classroom. The groups met daily with a trained tutor for approximately 35 minutes, and were required to accumulate twenty hours of instruction. At the conclusion of the program, the pretest battery was repeated. No significant differences were found in the treatment effects of the two computer groups. Each of the two treatment groups was able to effect significantly improved reading word recognition and rate, relative to the control group. Comprehension gains were modest. The treatment groups demonstrated a significant gain, relative to the control group, on one of the three comprehension measures; only trends toward a gain were noted on the remaining two measures. The tutoring partnership appeared to be a viable alternative for the teacher seeking to provide individualized computerized remedial programs for adolescent unskilled readers. Both programs took advantage of computer technology in providing individualized drill and practice, instant feedback, and ongoing recordkeeping. With limited cautions, each of these programs was considered effective and practical for use with adolescent unskilled readers.

Investigation of the composition of linear alkylbenzenes with emphasis on the identification and quantitation of some trace compounds using GS/MS system in both electron impact and chemical ionization modes

Linear alkylbenzenes, LAB, formed by the Alel3 or HF catalyzed alkylation of benzene are common raw materials for surfactant manufacture. Normally they are sulphonated using S03 or oleum to give the corresponding linear alkylbenzene sulphonates In >95 % yield. As concern has grown about the environmental impact of surfactants,' questions have been raised about the trace levels of unreacted raw materials, linear alkylbenzenes and minor impurities present in them. With the advent of modem analytical instruments and techniques, namely GCIMS, the opportunity has arisen to identify the exact nature of these impurities and to determine the actual levels of them present in the commercial linear ,alkylbenzenes. The object of the proposed study was to separate, identify and quantify major and minor components (1-10%) in commercial linear alkylbenzenes. The focus of this study was on the structure elucidation and determination of impurities and on the qualitative determination of them in all analyzed linear alkylbenzene samples. A gas chromatography/mass spectrometry, (GCIMS) study was performed o~ five samples from the same manufacturer (different production dates) and then it was followed by the analyses of ten commercial linear alkylbenzenes from four different suppliers. All the major components, namely linear alkylbenzene isomers, followed the same elution pattern with the 2-phenyl isomer eluting last. The individual isomers were identified by interpretation of their electron impact and chemical ionization mass spectra. The percent isomer distribution was found to be different from sample to sample. Average molecular weights were calculated using two methods, GC and GCIMS, and compared with the results reported on the Certificate of Analyses (C.O.A.) provided by the manufacturers of commercial linear alkylbenzenes. The GC results in most cases agreed with the reported values, whereas GC/MS results were significantly lower, between 0.41 and 3.29 amu. The minor components, impurities such as branched alkylbenzenes and dialkyltetralins eluted according to their molecular weights. Their fragmentation patterns were studied using electron impact ionization mode and their molecular weight ions confirmed by a 'soft ionization technique', chemical ionization. The level of impurities present i~ the analyzed commercial linear alkylbenzenes was expressed as the percent of the total sample weight, as well as, in mg/g. The percent of impurities was observed to vary between 4.5 % and 16.8 % with the highest being in sample "I". Quantitation (mg/g) of impurities such as branched alkylbenzenes and dialkyltetralins was done using cis/trans-l,4,6,7-tetramethyltetralin as an internal standard. Samples were analyzed using .GC/MS system operating under full scan and single ion monitoring data acquisition modes. The latter data acquisition mode, which offers higher sensitivity, was used to analyze all samples under investigation for presence of linear dialkyltetralins. Dialkyltetralins were reported quantitatively, whereas branched alkylbenzenes were reported semi-qualitatively. The GC/MS method that was developed during the course of this study allowed identification of some other trace impurities present in commercial LABs. Compounds such as non-linear dialkyltetralins, dialkylindanes, diphenylalkanes and alkylnaphthalenes were identified but their detailed structure elucidation and the quantitation was beyond the scope of this study. However, further investigation of these compounds will be the subject of a future study.

Deception in Sport: A Conceptual and Ethical Analysis

In 1973, Kathleen Pearson offered a pivotal first step into understanding deception in competitive sport and its many intricacies. However, the analysis falls short of truly deciphering this widespread phenomenon. By creating a taxonomy based on Torres (2000) understanding of various types of skills in an athletic contest, a wider array of deceptive practices are encompassed. Once the taxonomy is put forth, weighing the categories against the three-pronged ethical permissibility test established utilizing elements from formalism, conventionalism and broad internalism sheds lights on what deceptive practices should be deemed ethically permissible for use and which tactics should not be a part of an athlete’s repertoire. By understanding which categories of deception are permissible, the most fair and athletically excellent contest can be created between the opposing players of teams.

The Impact of a Corporate Name Change on Stock Price and Trading Volume of Canadian Companies

This thesis examines the impact of a corporate name change on stock price and trading volume of Canadian companies around the announcement date, the approval date, and the adoption date over the time period from 1997 to 2011. Name changes are classified into six categories: major and minor, structural and pure, diversified and focused, accompanied with a change in ticker symbol and without a change in ticker symbol, “Gold” name addition and deletion, and different reasons for name changes (e.g., merger and acquisition, change of structure, change of strategy, and better image). The thesis uses the standard event study methodology to perform abnormal return and trading volume analyses. In addition, regression analysis is employed to examine which type of a name change has the largest impact on cumulative abnormal returns. Sample stocks exhibit a significant positive abnormal return one-day prior to the approval day and one day after the adoption date. Around the approval date we observe significant abnormal returns for stocks with a structural name change. On the day after the adoption date we document abnormal returns for stocks with major, minor, structural, pure, focused, and ticker symbol name changes. If a merger or acquisition is the reason for a name change, companies tend to experience a significant positive abnormal return one-day before the approval date and on the adoption date. If a change of structure is the reason for a name change, companies exhibit a significant positive abnormal return on the approval date and a significant negative abnormal return on the adoption date. In case of a change of strategy as the reason for a name change, companies show a significant negative abnormal return around the approval date and a significant positive abnormal return around the adoption date.

"Everyone Loves Marineland!" (?): Entertainment Animal Advocacy, Praxis, and Resisting Corporate Repression

Following allegations and graphic evidence of animal cruelty and neglect documented by ex-employee whistleblowers of Marineland Canada to the Toronto Star newspaper in late 2012, the ethics surrounding animal captivity have been increasingly contested in regional public discourse. Animal advocates in the Niagara region and beyond have been compelled to demand change at the infamous local captive animal park— whether it be welfare-oriented reform, or radical animal liberation. With this as a backdrop, this research explores the ideologies, experiences, and strategic tactics of anti-Marineland animal advocates; the sociopolitical issues surrounding the largely unexamined but serious issue of imprisoned animals as entertainers; and the ensuing governmental and corporatist attempts to squash dissent of anti-Marineland critics. Situated within a Critical Animal Studies theoretical paradigm as well as a flourishing global anti-captivity critique inspired by the film Blackfish, this project employs semi-structured interviews and participant observation methodologies to analyze advocates' views on captivity under capitalism and the effectiveness of their praxes. Finally, this research illuminates the nuances of the conventionally-upheld dualistic theoretical debate of animal welfare versus animal rights within zoo and aquaria entertainment contexts through an exploratory examination of advocates' complex ideological views.

Cell lines and animal model in the analysis of pharmacogenomics markers in childhood acute lymphoblastic leukemia

La leucémie aiguë lymphoblastique (LAL) est le cancer pédiatrique le plus fréquent. Elle est la cause principale de mortalité liée au cancer chez les enfants due à un groupe de patient ne répondant pas au traitement. Les patients peuvent aussi souffrir de plusieurs toxicités associées à un traitement intensif de chimiothérapie. Les études en pharmacogénétique de notre groupe ont montré une corrélation tant individuelle que combinée entre les variants génétiques particuliers d’enzymes dépendantes du folate, particulièrement la dihydrofolate réductase (DHFR) ainsi que la thymidylate synthase (TS), principales cibles du méthotrexate (MTX) et le risque élevé de rechute chez les patients atteints de la LAL. En outre, des variations dans le gène ATF5 impliqué dans la régulation de l’asparagine synthetase (ASNS) sont associées à un risque plus élevé de rechute ou à une toxicité ASNase dépendante chez les patients ayant reçu de l’asparaginase d’E.coli (ASNase). Le but principal de mon projet de thèse est de comprendre davantage d’un point de vue fonctionnel, le rôle de variations génétiques dans la réponse thérapeutique chez les patients atteints de la LAL, en se concentrant sur deux composants majeurs du traitement de la LAL soit le MTX ainsi que l’ASNase. Mon objectif spécifique était d’analyser une association trouvée dans des paramètres cliniques par le biais d’essais de prolifération cellulaire de lignées cellulaires lymphoblastoïdes (LCLs, n=93) et d’un modèle murin de xénogreffe de la LAL. Une variation génétique dans le polymorphisme TS (homozygosité de l’allèle de la répétition triple 3R) ainsi que l’haplotype *1b de DHFR (défini par une combinaison particulière d’allèle dérivé de six sites polymorphiques dans le promoteur majeur et mineur de DHFR) et de leurs effets sur la sensibilité au MTX ont été évalués par le biais d’essais de prolifération cellulaire. Des essais in vitro similaires sur la réponse à l’ASNase de E. Coli ont permis d’évaluer l’effet de la variation T1562C de la région 5’UTR de ATF5 ainsi que des haplotypes particuliers du gène ASNS (définis par deux variations génétiques et arbitrairement appelés haplotype *1). Le modèle murin de xénogreffe ont été utilisé pour évaluer l’effet du génotype 3R3R du gène TS. L’analyse de polymorphismes additionnels dans le gène ASNS a révélé une diversification de l’haplotype *1 en 5 sous-types définis par deux polymorphismes (rs10486009 et rs6971012,) et corrélé avec la sensibilité in vitro à l’ASNase et l’un d’eux (rs10486009) semble particulièrement important dans la réduction de la sensibilité in vitro à l’ASNase, pouvant expliquer une sensibilité réduite de l’haplotype *1 dans des paramètres cliniques. Aucune association entre ATF5 T1562C et des essais de prolifération cellulaire en réponse à ASNase de E.Coli n’a été détectée. Nous n’avons pas détecté une association liée au génotype lors d’analyse in vitro de sensibilité au MTX. Par contre, des résultats in vivo issus de modèle murin de xénogreffe ont montré une relation entre le génotype TS 3R/3R et la résistance de manière dose-dépendante au traitement par MTX. Les résultats obtenus ont permis de fournir une explication concernant un haut risque significatif de rechute rencontré chez les patients au génotype TS 3R/3R et suggèrent que ces patients pourraient recevoir une augmentation de leur dose de MTX. À travers ces expériences, nous avons aussi démontré que les modèles murins de xénogreffe peuvent servir comme outil préclinique afin d’explorer l’option d’un traitement individualisé. En conclusion, la connaissance acquise à travers mon projet de thèse a permis de confirmer et/ou d’identifier quelques variants dans la voix d’action du MTX et de l’ASNase qui pourraient faciliter la mise en place de stratégies d’individualisation de la dose, permettant la sélection d’un traitement optimum ou moduler la thérapie basé sur la génétique individuelle.