Le risque attribuable (RA) mesure la proportion de cas de maladie qui peuvent être attribués à une exposition au niveau de la population. Plusieurs définitions et méthodes d'estimation du RA ont été proposées pour des données de survie. En utilisant des simulations, nous comparons quatre méthodes d'estimation du RA dans le contexte de l'analyse de survie : deux méthodes non paramétriques basées sur l'estimateur de Kaplan-Meier, une méthode semi-paramétrique basée sur le modèle de Cox à risques proportionnels et une méthode paramétrique basée sur un modèle à risques proportionnels avec un risque de base constant par morceaux. Nos travaux suggèrent d'utiliser les approches semi-paramétrique et paramétrique pour l'estimation du RA lorsque l'hypothèse des risques proportionnels est vérifiée. Nous appliquons nos méthodes aux données de la cohorte E3N pour estimer la proportion de cas de cancer du sein invasif attribuables à l'utilisation de traitements hormonaux de la ménopause (THM). Nous estimons qu'environ 9 % des cas de cancer du sein sont attribuables à l'utilisation des THM à l'inclusion. Dans le cas d'une exposition protectrice, une alternative au RA est la fraction préventive (FP) qui mesure la proportion de cas de maladie évités. Cette mesure n'a pas été considérée dans le contexte de l'analyse de survie. Nous proposons une définition de la FP dans ce contexte et des méthodes d'estimation en utilisant des approches semi-paramétrique et paramétrique avec une extension permettant de prendre en compte les risques concurrents. L'application aux données de la cohorte des Trois Cités (3C) estime qu'environ 9 % de cas d'accident vasculaire cérébral peuvent être évités chez les personnes âgées par l'utilisation des hypolipémiants. Notre étude montre que la FP peut être utilisée pour évaluer l'impact des médicaments bénéfiques dans les études de cohorte tout en tenant compte des facteurs de confusion potentiels et des risques concurrents. / The attributable risk (AR) measures the proportion of disease cases that can be attributed to an exposure in the population. Several definitions and estimation methods have been proposed for survival data. Using simulations, we compared four methods for estimating AR defined in terms of survival functions: two nonparametric methods based on Kaplan-Meier's estimator, one semiparametric based on Cox's model, and one parametric based on the piecewise constant hazards model. Our results suggest to use the semiparametric or parametric approaches to estimate AR if the proportional hazards assumption appears appropriate. These methods were applied to the E3N women cohort data to estimate the AR of breast cancer due to menopausal hormone therapy (MHT). We showed that about 9% of cases of breast cancer were attributable to MHT use at baseline. In case of a protective exposure, an alternative to the AR is the prevented fraction (PF) which measures the proportion of disease cases that could be avoided in the presence of a protective exposure in the population. The definition and estimation of PF have never been considered for cohort studies in the survival analysis context. We defined the PF in cohort studies with survival data and proposed two estimation methods: a semiparametric method based on Cox’s proportional hazards model and a parametric method based on a piecewise constant hazards model with an extension to competing risks. Using data of the Three-City (3C) cohort study, we found that approximately 9% of cases of stroke could be avoided using lipid-lowering drugs (statins or fibrates) in the elderly population. Our study shows that the PF can be estimated to evaluate the impact of beneficial drugs in observational cohort studies while taking potential confounding factors and competing risks into account.

<p>Protein malfunction can cause human diseases, which makes the protein a target in the process of drug discovery. In-depth knowledge of how protein functions can widely contribute to the understanding of the mechanism of these diseases. Protein functions are determined by protein structures and their dynamic properties. Protein dynamics refers to the constant physical movement of atoms in a protein, which may result in the transition between different conformational states of the protein. These conformational transitions are critically important for the proteins to function. Understanding protein dynamics can help to understand and interfere with the conformational states and transitions, and thus with the function of the protein. If we can understand the mechanism of conformational transition of protein, we can design molecules to regulate this process and regulate the protein functions for new drug discovery. Protein Dynamics can be simulated by Molecular Dynamics (MD) Simulations.</p> <p>The MD simulation data generated are spatial-temporal and therefore very high dimensional. To analyze the data, distinguishing various atomic interactions within a protein by interpreting their 3D coordinate values plays a significant role. Since the data is humongous, the essential step is to find ways to interpret the data by generating more efficient algorithms to reduce the dimensionality and developing user-friendly visualization tools to find patterns and trends, which are not usually attainable by traditional methods of data process. The typical allosteric long-range nature of the interactions that lead to large conformational transition, pin-pointing the underlying forces and pathways responsible for the global conformational transition at atomic level is very challenging. To address the problems, Various analytical techniques are performed on the simulation data to better understand the mechanism of protein dynamics at atomic level by developing a new program called Probing Long-distance interactions by Tapping into Paired-Distances (PLITIP), which contains a set of new tools based on analysis of paired distances to remove the interference of the translation and rotation of the protein itself and therefore can capture the absolute changes within the protein.</p> <p>Firstly, we developed a tool called Decomposition of Paired Distances (DPD). This tool generates a distance matrix of all paired residues from our simulation data. This paired distance matrix therefore is not subjected to the interference of the translation or rotation of the protein and can capture the absolute changes within the protein. This matrix is then decomposed by DPD</p> <p>using Principal Component Analysis (PCA) to reduce dimensionality and to capture the largest structural variation. To showcase how DPD works, two protein systems, HIV-1 protease and 14-3-3 σ, that both have tremendous structural changes and conformational transitions as displayed by their MD simulation trajectories. The largest structural variation and conformational transition were captured by the first principal component in both cases. In addition, structural clustering and ranking of representative frames by their PC1 values revealed the long-distance nature of the conformational transition and locked the key candidate regions that might be responsible for the large conformational transitions.</p> <p>Secondly, to facilitate further analysis of identification of the long-distance path, a tool called Pearson Coefficient Spiral (PCP) that generates and visualizes Pearson Coefficient to measure the linear correlation between any two sets of residue pairs is developed. PCP allows users to fix one residue pair and examine the correlation of its change with other residue pairs.</p> <p>Thirdly, a set of visualization tools that generate paired atomic distances for the shortlisted candidate residue and captured significant interactions among them were developed. The first tool is the Residue Interaction Network Graph for Paired Atomic Distances (NG-PAD), which not only generates paired atomic distances for the shortlisted candidate residues, but also display significant interactions by a Network Graph for convenient visualization. Second, the Chord Diagram for Interaction Mapping (CD-IP) was developed to map the interactions to protein secondary structural elements and to further narrow down important interactions. Third, a Distance Plotting for Direct Comparison (DP-DC), which plots any two paired distances at user’s choice, either at residue or atomic level, to facilitate identification of similar or opposite pattern change of distances along the simulation time. All the above tools of PLITIP enabled us to identify critical residues contributing to the large conformational transitions in both HIV-1 protease and 14-3-3σ proteins.</p> <p>Beside the above major project, a side project of developing tools to study protein pseudo-symmetry is also reported. It has been proposed that symmetry provides protein stability, opportunities for allosteric regulation, and even functionality. This tool helps us to answer the questions of why there is a deviation from perfect symmetry in protein and how to quantify it.</p>