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This article describes an active learning method for the teaching of physical sciences and mathematics to engineers. After defining the challenges involved in the training of engineers, we shall describe the answers provided by our method, "learning by doing" (named "Apprentissage Par l"Action" in French), by introducing four key points: real-life simulation, the management of non-success, the result requirement and the different roles of the teachers. An assessment of this experience is carried out which emphasizes the factors paramount in the success of this pedagogical innovation. Similarities between our experience and other well-known methods such as problem-based learning, problem solving and, more generally, the concept of learning by doing coined by John Dewey in his philosophy of education, are mentioned. (Contains 5 notes.)

During several decades, patients with haemophilia have been treated using FVIII and FIX concentrates by haematologists working in specialized comprehensive haemophilia care centres. In the last fifteen years haemophilia treatments have been tremendously improved and novel treatment options have been developed. Gene therapy is one of these innovative approaches and will soon be available on the market. The European Association for Haemophilia and Allied Disorders and the European Haemophilia Consortium recently described a new healthcare setting for the management of patients who will receive gene therapy. This hub-and-spoke model aims to ensure the safe administration and monitoring of gene therapy by expert comprehensive haemophilia care centres, in close collaboration with the proximity haemophilia treatment centres where the patient is followed up. Any adverse events should be managed by both the expert "hubs" in collaboration with the spoke centre to provide the timeliest state-of-the-art treatment and management options to patients receiving gene therapy. All adverse events and efficacy data should be reported lifelong to a centralised registry. French reference centre for haemophilia and the patient's organization AFH worked together to adapt the European Hub and spoke model to the existing infrastructures and organization for rare bleeding disorders in France. This review describes the haemophilia patient's journey for gene therapy in France. [ABSTRACT FROM AUTHOR]

Purpose: Bioturbation is a major process influencing the functioning of benthic ecosystems. Although controlled experiments with species in monoculture or in artificial combinations have increased the knowledge about the role of biological diversity on geochemical processes, specific interactions have been neglected, making the extrapolation of experimental results to natural systems difficult. In this context, the main objective of this study was to measure the effects of a whole natural macrobenthic community on benthic oxygen uptake. Materials and methods: The relationships between macrofauna and oxygen uptakes were investigated in the estuarine system of the Seine, France, during the winter and fall according to the variability of river discharge. Four undisturbed sediment cores with associated macrofauna and overlying water were sampled at nine subtidal stations in order to perform whole core incubations and measure total oxygen uptake (TOU). Moreover, values of diffusive oxygen uptake (DOU) were obtained using microelectrode profiling and fauna-mediated oxygen uptake (FOU) was calculated as the difference between TOU and DOU. FOUs were thus linked to macrofaunal parameters; both traditional (species richness, abundance and biomass) and functional (trophic guilds and bioturbation modes). Results and discussion: The average FOU (±SD) ranged from 170 ± 36 to 1,324 ± 701 μmol m h, and values represented 33 to 89 % of TOU. Each of the traditional macrofauna parameters had a significant and positive correlation with FOU. In addition, abundance, biomass and species number of some functional groups (e.g. suspension feeders and biodiffusors) were also correlated to FOU, supporting the diversity-stability hypothesis of McArthur (Ecology 36:533-536, ). Nevertheless, the relationship between FOU and other functional groups such as conveyors illustrated the idiosyncratic nature of this hypothesis, underlining the difficulty of clearly identifying the role of a macrofaunal community on oxygen exchanges at the sediment-water interface. Conclusions: Our results confirm the importance of functional biodiversity on mineralization processes as well as the need to take into account the whole community. They also suggest that future studies should focus on the functional consequences of species loss and the potential resilience of the communities as a way to maintain ecosystem processes. [ABSTRACT FROM AUTHOR]

In the Eastern part of the English Channel, high biomasses of the phytoplankton prymnesiophyceae Phaeocystis globosa (reaching biomasses over 20μgChlal−1) are a recurrent spring event (March–June). A significant part of the pelagic Phaeocystis-derived organic matter can be broken down in the sandy permeable sediment that makes up most of the intertidal zone in this part of the Channel. Sediment characteristics, macrofaunal distribution, bacterial biomass, organic carbon content, sediment oxygen demand (SOD), and the sediment–water flux of dissolved inorganic nitrogen and silicates were calculated for an exposed sandy beach (Wimereux, France) over a two-year period (2004–2006). According to the data collected, the SOD remains relatively low throughout the whole survey (64–306μmolm−2 h−1), indicating limited mineralization. However, the same data reveals a temporal variability in the flux, with a sharp increase in the SOD and ammonium released in spring when Phaeocystis-derived phytodetritus was deposited. The organic carbon content and bacterial biomass values indicate similar patterns of increase in response to the phytodetritus deposit. The nitrogen cycle also appears to be modified during the Phaeocystis bloom, with a clear stimulation of nitrification. The influence of various factors (e.g., temperature, nutrient concentrations, and bacterial activity) on the temporal fluctuations of the exchanges is discussed, as are the direct effects of spring bloom. A synthesis of the annual cycle of the mineralization dynamics in this permeable sediment type is also presented. [Copyright &y& Elsevier]

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The Scandinavian countries are often assumed to constitute a coherent and unique social service model characterized by a comparatively high level of universalism and a strong capacity to defamilialize care responsibilities. In examining whether we really can identify such a model when comparing current social service systems, social services in the Scandinavian countries are contrasted with their counterparts in three continental European countries. The resulting data indicate that only Denmark complies with the image of the Scandinavian social service model. Both Norway and Sweden deviate significantly. Norwegian childcare services and Swedish elderly-care services do not stand out as particularly universalistic or defamilializing compared with those of other Western European countries. Given these findings, it may be questioned whether it is reasonable to speak of a 'Scandinavian social service model'. [ABSTRACT FROM AUTHOR]

Supersymmetry with heavy scalars is a model where, at the LHC we have to rely on rate measurements to determine the parameters of the underlying new physics. For this example we show how to combine rate measurements with kinematic endpoints properly, taking into account statistical, systematic and theoretical uncertainties. Provided we observe a sizeable number of events, the LHC should be able to determine many model parameters with small enough error bars to, for example, test unification patterns. [ABSTRACT FROM AUTHOR]

Abstract: Interpretations of Higgs searches critically involve production cross sections and decay probabilities for different analysis channels. Mixing effects can reduce production rates, while invisible decays can reduce decay probabilities. Both effects may transparently be quantified in Higgs systems where a visible Higgs boson is mixed with a hidden sector Higgs boson. Recent experimental exclusion bounds can be re-interpreted in this context as a sign for non-standard Higgs properties. Should a light Higgs boson be discovered, then our analysis will quantify how closely it may coincide with the Standard Model. [Copyright &y& Elsevier]

Abstract: In this Letter we report on a calculation of jet production at next-to-leading order QCD. We include the leptonic decays of the W and take into account all off-shell and finite width effects. This is the first computation which falls into the category of triboson+jet production at next-to-leading order QCD. In total we find sizable corrections with non-trivial phase space dependencies. Therefore, our results are important for phenomenological analyses such as the extraction of anomalous electroweak quartic couplings from inclusive hadron collider data. [Copyright &y& Elsevier]

Abstract: We present a computation of the QCD corrections to production at the Large Hadron Collider. The photon is considered as real, and we include full leptonic decays for the W- and Z-bosons. Based on the structure of the VBFNLO program package, we obtain numerical results via a Monte Carlo program, which allows to implement general cuts and distributions of the final-state particles. The NLO QCD corrections are sizable and strongly exceed the theory error obtained by a scale variation of the leading-order result. Also, the shapes of relevant observables are significantly altered. [ABSTRACT FROM AUTHOR]

Among people living with HIV and hepatitis C virus (HCV), people who inject drugs (PWID) have historically experienced higher mortality rates. Direct-acting antivirals (DAA), which have led to a 90 % HCV cure rate independently of HIV co-infection, have improved mortality rates. However, DAA era mortality trends among PWID with HIV/HCV remain unknown. Using data from the International Collaboration on Hepatitis C Elimination in HIV Cohorts (InCHEHC), we compared pre/post-DAA availability mortality changes in three groups: PWID, men who have sex with men (MSM), and all other participants. We included InCHEHC participants with HIV/HCV followed between 2010 and 2019 in Canada, France, the Netherlands, Spain, and Switzerland. All-cause mortality hazard was compared in the three groups, using Cox proportional hazards regression models adjusted for sex, age, advanced fibrosis/cirrhosis, and pre/post DAA availability. Of the 11,029 participants, 76 % were men, 46 % were PWID, baseline median age was 46 years (interquartile range [IQR] = 40;51), and median CD4 T-cell count was 490 cells/mm3 (IQR = 327;689). Over the study period (median follow-up = 7.2 years (IQR = 3.7;10.0)), 6143 (56 %) participants received HCV treatment, 4880 (44 %) were cured, and 1322 participants died (mortality rate = 1.81/100 person-years (PY) [95 % confidence interval (CI)=1.72–1.91]). Overall, PWID had higher mortality rates than MSM (2.5/100 PY [95 % CI = 2.3–2.6] vs. 0.8/100 PY [95 % CI = 0.7–0.9], respectively). Unlike women with other transmission modes, those who injected drugs had a higher mortality hazard than men who did not inject drugs and men who were not MSM (adjusted Hazard-Ratio (aHR) [95 % CI] = 1.3[1.0–1.6]). Post-DAA availability, mortality decreased among MSM in the Netherlands, Spain, and Switzerland and increased among PWID in Canada (aHR [95 % CI] = 1.73 [1.15–2.61]). Post-DAA availability, all-cause mortality did not decrease in PWID. Determinants of cause-specific deaths (drug-related, HIV-related, or HCV-related) need to be identified to explain persistently high mortality among PWID in the DAA era. [ABSTRACT FROM AUTHOR]

Background: In 2007, the multidisciplinary European Task Force for Advanced Bleeding Care in Trauma published guidelines for the management of the bleeding trauma patient. The present study aimed to assess compliance with the European guidelines during the first 24 h in a level I trauma centre and to determine whether compliance impacts mortality.Methods: This was a retrospective study of consecutive bleeding trauma patients referred to a university hospital in France between 2010 and 2014. A reference document was developed on the basis of the European guidelines to transform the guidelines pragmatically into 22 objectively measurable criteria. We measured per-patient and per-criterion compliance rates and assessed the impact of guideline compliance on mortality.Results: A total of 121 bleeding trauma patients were included. The median (interquartile range) per-patient compliance rate was 75 (65-82)% and the per-criterion compliance rate 64 (57-81)%. Mortality rates were 18 and 32% at 24 h and 30 days, respectively. After adjusting for injury severity, per-patient compliance rates were associated with decreased mortality at 24 h (odds ratio per 10% increase in patient compliance score, 0.43; 95% confidence interval 0.26-0.71; P = 0.0001) and at 30 days (odds ratio per 10% increase in patient compliance score, 0.47; 95% confidence interval 0.31-0.72; P = 0.0004).Conclusions: We found that compliance with protocols based on European guidelines impacts trauma outcome, because patient compliance was associated with survival. Further work is needed to improve adherence to these guidelines, with ongoing monitoring to ensure best practice and optimal patient outcome. [ABSTRACT FROM AUTHOR]

Following recent ATLAS and CMS publications we interpret the results of their Higgs searches in terms of standard model operators. For a Higgs boson mass of 125 GeV we determine several Higgs couplings from published 2011 data and extrapolate the results towards different scenarios of LHC running. Even though our analysis is limited by low statistics we already derive meaningful constraints on modified Higgs sectors. [ABSTRACT FROM AUTHOR]

Abstract: Higgs couplings can be affected by physics beyond the Standard Model. We study modifications through interactions with a hidden sector and in specific composite Higgs models accessible at the LHC. Both scenarios give rise to congruent patterns of universal, or partially universal, shifts. In addition, Higgs decays to the hidden sector may lead to invisible decay modes which we also exploit. Experimental bounds on such potential modifications will measure the concordance of an observed Higgs boson with the Standard Model. [ABSTRACT FROM AUTHOR]

Abstract: In order to provide an accurate annual rate of net benthic community production, community photosynthetic response to incident irradiance and respiration were measured at different times of the year, at mid-tide level on the muddiest part of the Mont Saint-Michel Bay. As the water turbidity prevented any photosynthesis by the microphytobenthos during immersion periods, primary production was measured only during emersion periods. In contrast respiration was expected to vary according to the tidal cycle and was measured during both emersion and immersion periods. Primary production and respiration rates under emersion were assessed using in situ infra-red gas analysis of CO2 exchange measured in a benthic chamber. Respiration rates under immersion were assessed through total CO2 concentration variations in incubated cores. When respiration rate was considered constant over a day and equal to the rate measured under emerged conditions, the community respiration was 54.56gCm−2 yr−1. Taking into account the variations of respiration during the emersion/immersion cycle, community respiration increased to 101.76gCm−2 yr−1 (86% increase). Assuming that community primary production varied as a function of irradiance from the time of exposure until flooding, GCP was 53.22gCm−2 yr−1 when calculated with theoretical irradiance and 45.86gCm−2 yr−1 after correction for cloudiness (14% decrease). Then, by integrating the effect of vertical migration of microphytobenthos, the rate was adjusted to 23.49gCm−2 yr−1 (49% decrease). The net community production budget, calculated as the difference between the GCP and the CR budgets taking into account the corrections described above, was −78.27gCm−2 yr−1. This example of annual budget calculation highlights the need to integrate several processes occurring over various time scales to accurately reflect the metabolic balance of a system. The results also confirmed the heterotrophic status generally suggested for intertidal muddy sediments. [Copyright &y& Elsevier]

Background: Type 2 Normandy von Willebrand disease (VWD2N) is usually perceived as a mild bleeding disorder that can be treated with desmopressin (DDAVP). However, VWD2N patients can be compound heterozygous or homozygous for different variants, with p.Arg854Gln (R854Q) being the most frequent causative one. There are limited data about the impact of 2N variants on VWD2N phenotype and DDAVP response., Objectives: This study aims to describe the phenotype of VWD2N, including DDAVP response, according to genotype., Methods: VWD2N patients with a complete genotype/phenotype characterization by the French reference center for VWD, including MCMDM-1VWD bleeding score, were eligible to be included in the study. Results of the DDAVP trial were also collected., Results: A total of 123 VWD2N patients from the French registry were included in this study. Results were stratified according to the presence (R854QPos, n = 114) or absence (R854QNeg, n = 9) of at least 1 R854Q allele. Three R854QPos subgroups were further individualized: patients homozygous (R854QHmz, n = 55), compound heterozygous for R854Q and a null allele (R854Q/3, n = 48), or compound heterozygous for R854Q and another 2N variant (R854Q/2N, n = 11)., Fviii: C levels were significantly lower in R854QNeg and R854Q/3 patients compared with R854QHmz ones (P < .001 and P < .0001, respectively). R854QNeg patients were diagnosed earlier due to bleeding symptoms and had a higher bleeding score than R854QPos patients (P < .001). In DDAVP trial, FVIII:C survival was lower in VWD type 2N than in type 1 patients. R854QPos patients had a heterogeneous DDAVP response, which was best predicted by baseline FVIII:C level., Conclusion: The heterogeneous genetic background of VWD2N drives different bleeding phenotypes and response patterns to DDAVP, underlining the clinical relevance of DDAVP trial to identify patients potentially eligible to alternative therapeutic options., Competing Interests: Declaration of competing interests F.V. has received honoraria for consultancy, board, or oral presentations from CSL/Behring, LFB, Roche/Chugai, Takeda, Pfizer, and Sobi. Y.R. has received research support outside this work from Stago, Roche-Chugai, CSL Behring, and LFB and received Honoria for lectures or consultancy from Sobi, LFB, Octapharma, Roche-Chugai, CSL Behring, and Shire-Takeda. C.V.D. and P.J.L. are inventors on patents related to VWF. P.J.L. receives research support to institute from BioMarin, Sanofi, Sobi, and Roche. S.S. has received research support outside this work from CSL Behring, Roche-Chugai, Stago, and Siemens Healthineers and received honoraria for lectures or consultancy from BioMarin, Bioverativ, CSL Behring, Hemosonics, LFB, Novo Nordisk, Roche/Chugai, Sanofi, Siemens Healthineers, Shire-Takeda, and Sobi. The other authors have no competing interests to disclose., (Copyright © 2024 International Society on Thrombosis and Haemostasis. Published by Elsevier Inc. All rights reserved.)

Introduction: In the context of severe unexplained haemorrhage (SH), it is usual to seek haematological evaluation and investigate for an inherited rare bleeding disorder (IRBD). In such circumstances, appropriate screen can discriminate between IRBD and suspected child abuse. Yet, little information is available about the frequency of SH in the population of patients with IRBD., Aim: To collect epidemiologic data about SH and IRBD., Method: The database of the FranceCoag network has collected information about IRBD since January 2004. Based on data gathered up to 16 March 2022, a retrospective search was conducted for of SH events having occurred before or at the time of IRBD diagnosis. Demographics and diagnosis circumstances were retrieved, as well as information about SH, defined as any life-threatening bleeding or intracranial haemorrhage., Results: Among the 13,433 patients of the database, 109 (0.8%) fulfilled inclusion criteria including a known date of IRBD diagnosis, haemophilia A or B (HA/HB) being the most frequent (82.5%). IRBD was discovered as a consequence of an SH event in 82.6% of the cases while CNS was involved in 55%. Severe and moderate HA/HB and other severe IRBD presented significantly more intracranial haemorrhage (p < .02) and a lower age at diagnosis (p = .03)., Conclusions: These data support that any unusual SH should raise a suspicion of IRBD. Particularly before 1-year of age, it is suggested to first confirm moderate or severe haemophilia and severe IRBD by standard coagulation tests (APTT, PT and fibrinogen), combined with a clotting FXIII assay as first-line investigation. Subsequent assays of coagulation factors should be performed in the case of abnormal values, in second-line investigation., (© 2024 The Authors. Haemophilia published by John Wiley & Sons Ltd.)

Background: Hypercoagulability seems to contribute to SARS-CoV-2 pneumonia pathogenesis. However, age and metabolic syndrome are potential confounders when assessing the value of coagulation biomarkers' prediction of COVID-19 outcomes. We assessed whether coagulation biomarkers, including factor VIII (FVIII) and von Willebrand factor (VWF) levels, measured at time of admission, were predictive of COVID-19 adverse outcomes irrespective of age and major comorbidities associated with metabolic syndrome., Methods: Blood was sampled at admission in 243 adult COVID-19 patients for analysis of coagulation biomarkers including FVIII and VWF on platelet-poor plasma. The association between baseline C-reactive protein (CRP), activated partial thromboplastin time ratio, prothrombin time ratio, D-dimers, fibrinogen, FVIII, VWF antigen (VWF:Ag), and FVIII/VWF:Ag ratio levels and adverse outcomes (increased oxygen requirements, thrombosis, and death at day 30) was assessed by regression analysis after adjustment on age, sex, body mass index (BMI), diabetes, and hypertension., Results: In univariable regression analysis increased CRP (subdistribution hazard ratio [SHR], 1.68; 95% confidence interval [CI], 1.26-2.23), increased fibrinogen (SHR, 1.32; 95% CI, 1.04-1.68), and decreased FVIII/VWF:Ag ratio (SHR, 0.70; 95% CI, 0.52-0.96) levels at admission were significantly associated with the risk of increased oxygen requirement during follow-up. Leucocytes (SHR, 1.36; 95% CI, 1.04-1.76), platelets (SHR,1.71; 95% CI, 1.11-2.62), D-dimers (SHR, 2.48; 95% CI, 1.66-3.78), and FVIII (SHR, 1.78; 95% CI, 1.17-2.68) were associated with early onset of thrombosis after admission. After adjustment for age, sex, BMI, hypertension, and diabetes, these associations were not modified., Conclusion: Coagulation biomarkers are early and independent predictors of increased oxygen requirement in COVID-19 patients., (© 2020 International Society on Thrombosis and Haemostasis.)

Objectives: To establish national reference levels (RLs) in interventional procedures under CT guidance as required by the 2013/59/Euratom European Directive., Methods: Seventeen categories of interventional procedures in thoracic, abdominopelvic, and osteoarticular specialties (percutaneous infiltration, vertebroplasty, biopsy, drainage, tumor destruction) were analyzed. Total dose length product (DLP), number of helical acquisitions (NH), and total DLP for helical, sequential, or fluoroscopic acquisitions were recorded for 10 to 20 patients per procedure at each center. RLs were calculated as the 3rd quartiles of the distributions and target values for optimization process (TVOs) as the median. RLs and TVOs were compared with previously published studies., Results: Results on 5001 procedures from 49 centers confirmed the great variability in patient dose for the same category of procedures. RLs were proposed for the DLPs and NHs in the seventeen categories. RLs in terms of DLP and NH were 375 mGy.cm and 2 NH for spinal or peri-spinal infiltration, 1630 mGy.cm and 3 NH for vertebroplasty, 845 mGy.cm and 4 NH for biopsy, 1950 mGy.cm and 8 NH for destruction of tumors, and 1090 mGy.cm and 5 NH for drainage. DLP and NH increased with the complexity of procedures., Conclusions: This study was the first nationwide multicentric survey to propose RLs for interventional procedures under CT guidance. Heterogeneity of practice in centers were found with different levels of patient doses for the same procedure. The proposed RLs will allow imaging departments to benchmark their practice with others and optimize their protocols., Key Points: • National reference levels are proposed for 17 categories of interventional procedures under CT guidance. • Reference levels are useful for benchmarking practices and optimizing protocols. • Reference levels are proposed for dose length product and the number of helical acquisitions.

Introduction: Emicizumab (Hemlibra ® ) recently became available and requires an adaptation for managing bleeding, suspected bleeding and emergency or scheduled invasive procedures in haemophilia A patients with inhibitor. This implicates a multidisciplinary approach and redaction of recommendations for care that must be regularly adapted to the available data., Aim: The following text aims to provide a guide for the management of people with haemophilia A with inhibitor treated with emicizumab in case of bleeding or invasives procedures., Methods: The French network on inherited bleeding disorders (MHEMO), the French Reference Centre on Haemophilia (CRH), in collaboration with the French Working Group on Perioperative Haemostasis (GIHP) have been working together to make proposals for the management of these situations., Results: Haemostatic treatment and other medications should be given stepwise, according to the severity and location of the bleeding or the risk of bleeding of the procedure as well as the haemostatic response obtained at each step in order to ensure an optimal benefit/risk ratio., Conclusion: The lack of data means that it is only possible to issue proposals rather than recommendations., (© 2019 John Wiley & Sons Ltd.)

Introduction: Severe haemophilia is a rare disease characterised by spontaneous bleeding from early childhood, which may lead to various complications, especially in joints. It is nowadays possible to avoid these complications thanks to substitutive therapies for which the issue of adherence is major. The transition from adolescence to adulthood in young people with severe haemophilia is a critical period as it is associated with a high risk of lack of adherence to healthcare, which might have serious consequences on daily activities and on quality of life., Methods and Analysis: We present the protocol for a cross-sectional, observational, multicentric study to assess the differences between adolescents and young adults with severe haemophilia in France through the transition process, especially on adherence to healthcare. This study is based on a mixed methods design, with two complementary and consecutive phases, comparing data from a group of adolescents (aged 14-17 years) with those from a group of young adults (aged 20-29 years). The quantitative phase focuses on the determinants (medical, organisational, sociodemographic and social and psychosocial and behavioural factors) of adherence to healthcare (considered as a marker of the success of transition). The qualitative phase explores participants' views in more depth to explain and refine the results from the quantitative phase. Eligible patients are contacted by the various Haemophilia Treatment Centres participating in the French national registry FranceCoag., Ethics and Dissemination: The study was approved by the French Ethics Committee and by the French National Agency for Medicines and Health Products Safety (number: 2016-A01034-47). Study findings will be disseminated to the scientific and medical community in peer-reviewed journals and presented at scientific meetings. Results will be popularised to be communicated via the French association for people with haemophilia to participants and to the general public., Trial Registration Number: NCT02866526; Pre-results., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

The prevalence of habitual snoring and its associations with respiratory symptoms, personal and familial risk factors, ear, nose, and throat (ENT) abnormalities, and its influence on ventilatory function were studied in a sample of 190 children aged 5 to 6 years from nine kindergartens in Nancy (northeastern France). Nineteen (10%; 95% CI 5.7-14.3%) of the children were habitual snorers; the prevalence was the same in boys and girls. In univariate analysis habitual snoring was significantly associated with a personal history of exercise-induced bronchospasm [relative risk (RR) 4.50]; a history of adenotonsillectomy (RR, 2.56); a personal history of allergy (RR, 2.83); a sibling history of atopy (RR, 2.39); and doctor-assessed tonsillar hypertrophy (RR, 2.51). These factors were entered into a logistic regression model that retained as independent determinants exercise-induced asthma, personal history of allergy, sibling history of allergy, and tonsillar hypertrophy. The height-adjusted peak expiratory flow rate was slightly, non-significantly lower in habitual snorers as compared to non-snorers (2.01 +/- 0.32 vs 2.10 +/- 0.38 L/s/m2). Due to the limited numbers in the sample, the increased risk for paternal (RR, 1.8) and maternal (RR, 1.6) smoking at home remained nonsignificant.