Honeywell (France)

A memory hierarchy has coherence problems as soon as one of its levels is split in several independent units which are not equally accessible from faster levels or processors. The classical solution to these problems, as found for instance in multiprocessor, multicache systems, is to restore a degree of interdependence between such units through a set of high speed interconnecting buses. This solution is not entirely satisfactory, as it tends to reduce the throughput of the memory hierarchy and to increase its cost.

The elimination of redundant computations and the moving of invariant computations out of loops are often done separately, with invariants moved outward loop by loop. We propose to do both at once and to move each expression directly to the entrance of the outermost loop in which it is invariant. This is done by solving a more general problem, i.e. the elimination of computations performed twice on a given execution path. Such computations are termed partially redundant. Moreover, the algorithm does not require any graphical information or restrictions on the shape of the program graph. Testing this algorithm has shown that its execution cost is nearly linear with the size of the program, and that it leads to a smaller optimizer that requires less execution time.

Objectives/Hypothesis Establish treatment patterns and economic burden in US patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) versus without chronic rhinosinusitis (CRS). Determine comparative costs of subgroups with high clinical burden. Study Design Observational, retrospective, case‐control study. Methods This study matched patients with CRSwNP to patients without CRS (1:1) using the Truven Health MarketScan US claims database. Categorical and continuous variables were compared using McNemar test and paired t test (normal distribution) or Wilcoxon signed rank tests (non‐normal distribution). Within subgroups, χ 2 and Wilcoxon or t tests were used (normal distribution). Results There were 10,841 patients with CRSwNP and 10,841 patients without CRS included. Mean age in the CRSwNP cohort was 45.8 years; 56.2% were male. During follow‐up, patients with CRSwNP had an increased diagnosis of asthma versus patients without CRS (20.8% vs. 8.1%, respectively; P < .001). Annual incremental costs were $11,507 higher for patients with CRSwNP versus those without CRS. Costs were higher in subgroups of patients with CRSwNP undergoing functional endoscopy sinus surgery (FESS), with a comorbid diagnosis of asthma, receiving oral corticosteroids, or macrolides versus the overall CRSwNP group. Patients with CRSwNP undergoing FESS had the highest costs of the four subgroups ($26,724, $22,456, $20,695, and $20,990, respectively). Conclusions Annual incremental costs were higher among patients with CRSwNP versus without CRS. Patients with CRSwNP with high clinical burden had higher overall costs than CRSwNP patients without. Level of Evidence NA Laryngoscope , 129:1969–1975, 2019

AIMS: To investigate the efficacy and safety of alirocumab in participants with type 2 (T2D) or type 1 diabetes (T1D) treated with insulin who have elevated LDL cholesterol levels despite maximally tolerated statin therapy. METHODS: Participants at high cardiovascular risk with T2D (n = 441) or T1D (n = 76) and LDL cholesterol levels ≥1.8 mmol/L (≥70 mg/dL) were randomized 2:1 to alirocumab:placebo administered subcutaneously every 2 weeks, for 24 weeks' double-blind treatment. Alirocumab-treated participants received 75 mg every 2 weeks, with blinded dose increase to 150 mg every 2 weeks at week 12 if week 8 LDL cholesterol levels were ≥1.8 mmol/L. Primary endpoints were percentage change in calculated LDL cholesterol from baseline to week 24, and safety assessments. RESULTS: Alirocumab reduced LDL cholesterol from baseline to week 24 by a mean ± standard error of 49.0% ± 2.7% and 47.8% ± 6.5% vs placebo (both P < .0001) in participants with T2D and T1D, respectively. Significant reductions were observed in non-HDL cholesterol (P < .0001), apolipoprotein B (P < .0001) and lipoprotein (a) (P ≤ .0039). At week 24, 76.4% and 70.2% of the alirocumab group achieved LDL cholesterol <1.8 mmol/L in the T2D and T1D populations (P < .0001), respectively. Glycated haemoglobin and fasting plasma glucose levels remained stable for the study duration. Treatment-emergent adverse events were observed in 64.5% of alirocumab- vs 64.1% of placebo-treated individuals (overall population). CONCLUSIONS: Alirocumab produced significant LDL cholesterol reductions in participants with insulin-treated diabetes regardless of diabetes type, and was generally well tolerated. Concomitant administration of alirocumab and insulin did not raise any safety concerns (NCT02585778).

AIMS: To compare the efficacy and safety of new insulin glargine 300 U/ml (Gla-300) with insulin glargine 100 U/ml (Gla-100) over 12 months of treatment in people with type 2 diabetes using basal insulin and oral antihyperglycaemic drugs (OADs). METHODS: EDITION 2 (NCT01499095) was a randomized, 6-month, multicentre, open-label, two-arm, phase IIIa study investigating once-daily Gla-300 versus Gla-100, plus OADs (excluding sulphonylureas), with a 6-month safety extension. RESULTS: Similar numbers of participants in each group completed 12 months of treatment [Gla-300, 315 participants (78%); Gla-100, 314 participants (77%)]. The reduction in glycated haemoglobin was maintained for 12 months with both treatments: least squares (LS) mean (standard error) change from baseline -0.55 (0.06)% for Gla-300 and -0.50 (0.06)% for Gla-100; LS mean difference -0.06 [95% confidence interval (CI) -0.22 to 0.10)%]. A significant relative reduction of 37% in the annualized rate of nocturnal confirmed [≤3.9 mmol/l (≤70 mg/dl)] or severe hypoglycaemia was observed with Gla-300 compared with Gla-100: rate ratio 0.63 [(95% CI 0.42-0.96); p = 0.031], and fewer participants experienced ≥1 event [relative risk 0.84 (95% CI 0.71-0.99)]. Severe hypoglycaemia was infrequent. Weight gain was significantly lower with Gla-300 than Gla-100 [LS mean difference -0.7 (95% CI -1.3 to -0.2) kg; p = 0.009]. Both treatments were well tolerated with a similar pattern of adverse events (incidence of 69 and 60% in the Gla-300 and Gla-100 groups). CONCLUSIONS: In people with type 2 diabetes treated with Gla-300 or Gla-100, and non-sulphonylurea OADs, glycaemic control was sustained over 12 months, with less nocturnal hypoglycaemia in the Gla-300 group.

We measured the effect of the direct addition to the rumen of Saccharomyces cerevisiae (SC 50 mg/day) and Aspergillus oryzae (AO 3 g/day) on the fermentation processes in fistulated sheep. The measurements were carried out on animals whose rumens were first defaunated and then refaunated. The animals received a ration composed of hay (600 g/day), barley (600 g/day) and soybean meal (150 g/day), fed twice daily in two equal meals. The number of fungi and total, viable or cellulolytic bacteria were lower after the inoculation of protozoa in defaunated rumens. The probiotics stimulated the development of total bacteria but reduced the population of cellulolytic bacteria. The addition of the probiotics and the presence of protozoa each incurred a decrease in the redox potential values. The association of both treatments had an additive effect on this parameter. The two probiotics and the protozoa stabilized the rumen pH after the meal, maintaining it above the value of 6 for a longer period of time. The positive effects on pH were accumulated in the refaunated animals receiving probiotics. The ammonia nitrogen concentration was considerably increased by the presence of the protozoa; the probiotics increased the ammonia concentration only in the refaunated sheep. The methane and hydrogen proportions in the fermentation gases were invariably higher in the refaunated animals. The probiotics had no clear effect either on the gas composition or the concentration and the composition of the mixture of volatile fatty acids; only the concentration of isovalerate was significantly increased by probiotics and only in refaunated animals. The protozoa did, however, considerably increase the concentrations of acetate, butyrate and isoacids and decreased the concentration of caproate.

The organization of liquid crystalline fluorinated acrylate polymers has been generally described so far in the literature in terms of phase segregation between hydrogenated and fluorinated moieties within the polymer and preferential orientation induced by the backbone. However, little is known on the effects of the chemical composition on the properties of such fluorine-containing polymers. Our study was then focused on the role played by the spacer group located in the side chain between the backbone and the fluorinated segment and, in particular, on the properties of poly[2-[[[[2-(perfluoroalkyl)ethyl]sulfonyl]methyl]amino]ethyl]acrylates (pASn). Surface and bulk organization of fluorinated side chains of those polymers were investigated by surface tension, X-ray scattering, and differential scanning calorimetry measurements. Results were compared with those obtained with poly[(perfluoroalkyl)ethyl] acrylates (pAFn) of the same perfluoroalkyl chain lengths. A strong correlation between bulk organization and surface properties of our polymers could be established. Surprisingly, in the perfluorohexyl series, pAS6 with a N-methylsulfonamide spacer group was found to be organized in a crystalline lamellar structure whereas pAF6 was found to be amorphous. This indicates that the introduction of a N-methylsulfonamide spacer group in the side-chain allows the system to crystallize with a shorter -C6F13 fluorinated segment, whereas in the presence of methylene groups, an organization is only present with a -C8F17 segment (pAF8). This was mainly attributed to the strong dipole−dipole interaction between N-methylsulfonamide groups that tends to align the fluorinated segments in a lamellar structure that eventually crystallizes as long as the section of the N-alkylsulfonamide group does not induce steric hindrance.

AIMS: To evaluate the maintenance of efficacy and safety of insulin glargine 300 U/ml (Gla-300) versus glargine 100 U/ml (Gla-100) in people with type 2 diabetes mellitus (T2DM) using basal plus meal-time insulin for 12 months in the EDITION 1 trial. METHODS: EDITION 1 was a multicentre, randomized, open-label, two-arm, phase IIIa study. Participants completing the initial 6-month treatment period continued to receive Gla-300 or Gla-100, as previously randomized, once daily for a further 6-month open-label extension phase. Changes in glycated haemoglobin (HbA1c) and fasting plasma glucose concentrations, insulin dose, hypoglycaemic events and body weight were assessed. RESULTS: Of 807 participants enrolled in the initial phase, 89% (359/404) assigned to Gla-300 and 88% (355/403) assigned to Gla-100 completed 12 months. Glycaemic control was sustained in both groups (mean HbA1c: Gla-300, 7.24%; Gla-100, 7.42%), with more sustained HbA1c reduction for Gla-300 at 12 months: least squares mean difference Gla-300 vs Gla-100: HbA1c -0.17 [95% confidence interval (CI) -0.30 to -0.05]%. The mean daily basal insulin dose at 12 months was 1.03 U/kg for Gla-300 and 0.90 U/kg for Gla-100. Lower percentages of participants had ≥1 confirmed [≤3.9 mmol/l (≤70 mg/dl)] or severe hypoglycaemic event with Gla-300 than Gla-100 at any time of day [24 h; 86 vs 92%; relative risk 0.94 (95% CI 0.89-0.99)] and during the night [54 vs 65%; relative risk 0.84 (95% CI 0.75-0.94)], while the annualized rates of such hypoglycaemic events were similar. No between-treatment differences in adverse events were apparent. CONCLUSION: During 12 months of treatment of T2DM requiring basal and meal-time insulin, glycaemic control was better sustained and fewer individuals reported hypoglycaemia with Gla-300 than with Gla-100. The mean basal insulin dose was higher with Gla-300 compared with Gla-100, but total numbers of hypoglycaemic events and overall tolerability did not differ between treatments.

In this paper, two active fault-tolerant control (AFTC) schemes dedicated to induction-motor drives in electric or hybrid vehicle powertrains are presented and compared. Fault detection and mitigation are merged to propose a robust algorithm against speed-sensor faults (fault is modeled as significant additional noise or an exponential type emulating a bias) leading to uncertainties in the measurement. The first architecture is a hybrid fault tolerant-control (FTC) with proportional-integral and H <sub xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">∞</sub> controllers; the second architecture is the generalized internal model control (GIMC) with a natural reconfiguration. Both are built to ensure resilience while keeping good dynamic performances. For each architecture, the speed-sensor fault detection is based on an extended Kalman filter (EKF) that generates a residual vector. The correction method is calculated differently for the two schemes specifically in the switching transition phase between the nominal and robust controllers. A comparative study is carried out between the two FTC schemes.

Together with proteins and fats, carbohydrates are one of the macronutrients in the human diet. Digestible carbohydrates, such as starch, starch-based products, sucrose, lactose, glucose and some sugar alcohols and unusual (and fairly rare) α-linked glucans, directly provide us with energy while other carbohydrates including high molecular weight polysaccharides, mainly from plant cell walls, provide us with dietary fibre. Carbohydrates which are efficiently digested in the small intestine are not available in appreciable quantities to act as substrates for gut bacteria. Some oligo- and polysaccharides, many of which are also dietary fibres, are resistant to digestion in the small intestines and enter the colon where they provide substrates for the complex bacterial ecosystem that resides there. This review will focus on these non-digestible carbohydrates (NDC) and examine their impact on the gut microbiota and their physiological impact. Of particular focus will be the potential of non-digestible carbohydrates to act as prebiotics, but the review will also evaluate direct effects of NDC on human cells and systems.

Turbochargers (TCs) improve performance in internal combustion engines. Due to low production costs, TC assemblies are supported on floating ring bearings (FRBs). TCs show subsynchronous motions of significant amplitudes over a wide speed range. However, the subsynchronous whirl motions generally reach a limit cycle enabling continuous operation. The paper advances progress on the validation against measurements of linear and nonlinear rotordynamic models for predicting shaft motions of automotive TCs. A comprehensive thermohydrodynamic model predicts the floating ring speeds, inner and outer film temperatures and lubricant viscosity changes, clearances thermal growth, operating eccentricities for the floating ring and journal, and linearized force coefficients. A nonlinear rotordynamics program integrates the FRB lubrication model for prediction of system time responses under actual operating conditions. Measurements of shaft motion in a TC unit driven by pressurized air demonstrate typical oil-whirl induced instabilities and, due to poor lubricant conditions, locking of the floating rings at high shaft speeds. Nonlinear predictions are in good agreement with the measured total amplitude and subsynchronous frequencies when implementing the measured ring speeds into the computational model. The computational tools aid to accelerate TC prototype development and product troubleshooting.

BACKGROUND: Previous studies suggested that genetic status affects the clinical course of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) patients. The aim of this study was to compare the outcome of desmoglein-2 (DSG2) mutation carriers to those who carry the plakophilin-2 (PKP2) mutation, the most common ARVC/D-associated gene. METHODS AND RESULTS: Consecutive ARVC/D patients carrying a pathogenic mutation in PKP2 or DSG2 were selected from a national ARVC/D registry. The cumulative freedom from sustained ventricular arrhythmia and cardiac transplantation/death from heart failure (HF) during follow-up was assessed, compared between PKP2 and DSG2, and predictors for ventricular arrhythmia and HF events determined. Overall, 118 patients from 78 families were included: 27 (23%) carried a DSG2 mutation and 91 (77%) a PKP2 mutation. There were no significant differences between DSG2 and PKP2 mutation carriers concerning gender, proband status, age at diagnosis, T-wave inversion, or right ventricular dysfunction at baseline. DSG2 patients displayed more frequent epsilon wave (37% vs. 17%, P = 0.048) and left ventricular dysfunction at diagnosis (54% vs. 10%, P < 0.001). During a median follow-up of 5.6 years (2.5-16), DSG2 and PKP2 mutation carriers displayed a similar risk of sustained ventricular arrhythmia (log-rank P = 0.20), but DSG2 mutation carriers were at higher risk of transplantation/HF-related death (log-rank P < 0.001). The presence of a DSG2 mutation vs. PKP2 mutation was a predictor of transplantation/HF-related death in univariate Cox analysis (P = 0.0005). CONCLUSIONS: In this multicentre cohort, DSG2 mutation carriers were found to be at high risk of end-stage HF compared to PKP2 mutation carriers, supporting careful haemodynamic monitoring of these patients. The benefit of early HF treatment needs to be assessed in DSG2 carriers.

Abstract The photooxidation of poly(tetramethylene glycol) (PTMG), poly(propylene glycol) (PPG) and poly(ethylene glycol) (PEG) was studied at 60°C applying wavelengths longer than 300 nm. Hydroperoxy groups were found to accumulate in high photostationary concentration in PTMG and were decomposed essentially into formate groups. Hydroperoxides were observed in low photostationary concentration in PEG and PPG. Decomposition of the PPG hydroperoxides into formate groups showed that hydroperoxidation occurs, surprisingly, at the secondary carbon atom of the propylene glycol monomeric unit, rather than at the tertiary carbon. These results account for the large variation in the properties of hydroperoxides observed throughout the photooxidation of polyether‐ block ‐polyamides of various composition.

BACKGROUND: Injury to the spinal accessory nerve in the posterior cervical triangle leads to paralysis of the trapezius muscle. The aim of this study was to determine the indications for nerve repair or reconstructive surgery according to the etiology, the duration of the preoperative delay, and specific patient characteristics. METHODS: Of twenty-seven patients with a trapezius palsy, twenty were treated with neurolysis or surgical repair (direct or with a graft) of the spinal accessory nerve and seven were treated with the Eden-Lange muscle transfer procedure. Lymph node biopsy was the main cause of the nerve injury. The nerve repairs were performed at an average of seven months after the injury, and the reconstructive procedures were done at an average of twenty-eight months. Nerve repair was performed for iatrogenic injuries of the spinal accessory nerve, within twenty months after the onset of symptoms, and in one patient with spontaneous palsy. Reconstructive surgery was performed for cases of trapezius palsy secondary to radical neck dissection, for spontaneous palsies, and after failure of nerve repair or neurolysis. The mean follow-up period was thirty-five months. The functional outcome was assessed clinically on the basis of active shoulder abduction, pain, strength of the trapezius on manual muscle-testing, and level of subjective patient satisfaction. RESULTS: The results were good or excellent in sixteen of the twenty patients treated with nerve repair and in four of the seven patients treated with the Eden-Lange procedure. Poor results were seen in older patients and in patients with a previous radical neck dissection. CONCLUSIONS: Good results can be expected from a repair of the spinal accessory nerve if it is performed within twenty months after the injury, as the nerve is basically a purely motor nerve and the distance from the injury to the motor end plates is short. Muscle transfer should be performed in patients with spontaneous trapezius palsy, when previous nerve surgery has failed, or when the time from the injury to treatment is over twenty months. Treatment is less likely to succeed when the patient is older than fifty years of age or the palsy was due to a radical neck dissection, penetrating injury, or spontaneous palsy.

Twenty-four patients with histologically proven metastatic malignant melanoma were included in a Phase II trial of human DNA recombinant interferon (rDNA IFN alpha 2). They were given 10 X 10(6) IU of IFN alpha 2 subcutaneously three times a week until progression of disease or major intolerance developed. Twenty-two patients were evaluable for toxicity and response. General manifestations of intolerance were seen in all the patients. Hematologic toxicity was seen in six patients and therapy had to be interrupted in one patient. Mild liver toxicity was seen in most patients after 2 weeks of treatment. These manifestations disappeared within 2 weeks after treatment was discontinued. A partial response was seen in four cases lasting 2, 4, 4, and 5 months, respectively. There were two complete responses (one skin, one lymph node metastasis) lasting 20 and 6 weeks, respectively. These results indicate a potential role for rDNA IFN alpha 2 in treating patients with metastatic malignant melanoma. However, further trials are required to determine the optimal dose and schedule of administration and modalities of combination.

A series of five fluorinated dithioesters PhC(S)SRCH2CnF2n+1 (where R represents an activating spacer and n = 6 or 8) was obtained in fair to high yields (57–88%). These transfer agents were successfully used in reversible addition-fragmentation transfer (RAFT) of styrene (S), methyl methacrylate (MMA), ethyl acrylate (EA) and 1,3-butadiene. Well-chosen fluorinated dithioesters were able to lead to a good control of the radical polymerization of these monomers (i.e., molar masses of the produced polymers increased linearly with the monomer conversion and the polydispersity indexes ranging between 1.1 and 1.6 remained low). The relationship between the structures of the dithioesters and the living behavior of the radical polymerization of these above monomers is discussed and it is shown that the nature of the R group influences the living behavior from different contributions to radical stabilization. Furthermore, the RAFT process also yielded PMMA-b-PS and PEA-b-PS block copolymers bearing a fluorinated moiety.

Abstract Passenger vehicle turbochargers (TCs) offer increased engine power and efficiency in an ever-competitive marketplace. Turbochargers operate at high rotational speeds and use engine oil to lubricate fluid-film-bearing supports (radial and axial). However, TCs are prone to large amplitudes of subsynchronous shaft motion over wide ranges of their operating speed. Linear rotordynamic tools cannot predict the amplitudes and multiple frequency shaft motions. A comprehensive nonlinear rotordynamics model coupled to a complete fluid-film-bearing model solves in real time the dynamics of automotive turbochargers. The computational design tool predicts the limit cycle response for several inner and outer film clearances and operating conditions including rotor speed and lubricant feed pressure. Substantial savings in product development and prototype testing are the benefits of the present development. The paper presents predictions of the linear and nonlinear shaft motion of an automotive turbocharger supported on a semi-floating ring bearing. The shaft motion predictions are compared to measurements of shaft motion at the compressor nose for speeds up to 240krpm, and for lubricant inlet pressure of 4bar at 150°C. Linear and nonlinear rotordynamic models reproduce very well the test data for synchronous response to imbalance. The nonlinear results show two subsynchronous whirl frequencies whose large magnitudes agree well with the measurements. A large side load predicted for this turbocharger must be considered for accurate prediction of the rotordynamic response.

BACKGROUND: Calcineurin inhibitor-induced renal dysfunction is a major problem in liver transplantation. Interleukin-2 receptor antagonist induction followed by delayed tacrolimus (Tac) administration may minimize the renal insult without compromising immunoprotection. METHODS: This open, randomized, multicenter trial evaluated the benefit of daclizumab induction with delayed Tac on renal function at 6 months; an observational study was continued for 18 months. Liver transplant patients with a 12-hr serum creatinine (SrC) level less than 180 micromol/L received either delayed Tac with daclizumab induction (n=98) or standard Tac (n=101) both combined with mycophenolate mofetil and steroids. The primary endpoint was the incidence of SrC level more than 130 micrommol/L at 6 months. RESULTS: The incidence was 22.4% with delayed Tac and 29.7% with standard Tac (P=ns), which remained unchanged at 12 months (21.6% and 23.9%) but increasing slightly at 24 months (29.0% and 32.9%), respectively. A post hoc analysis of renal function was done based on patients stratification by SrC at 12 hr (<or=100micromol/L or >100 micromol/L) showing no difference in SrC values at 6 months regardless of the 12-hr values despite a trend toward better estimated glomerular filtration rate for patients with 12-hr value less than 100 micromol/L in the delayed Tac group. Biopsy-proven acute rejection was similar at 6 months (17.5% and 18.75%), 12 months (23.5% and 23.8%), and 24 months (24.5% and 25.7%), respectively. Patient and graft survival in both groups were comparable and good. Similar types and incidences of adverse events were reported in both groups at all time. CONCLUSIONS: Delay of Tac does not benefit renal function in liver transplant recipients with a good renal function at baseline.

BACKGROUND: Consumers often do not understand nutrition labels or do not perceive their usefulness. In addition, price can be a barrier to healthy food choices, especially for socio-economically disadvantaged individuals. METHOD: A 6-month intervention combined shelf labeling and marketing strategies (signage, prime placement, taste testing) to draw attention to inexpensive foods with good nutritional quality in two stores located in a disadvantaged neighborhood in Marseille (France). The inexpensive foods with good nutritional quality were identified based on their nutrient profile and their price. Their contribution to customers' spending on food was assessed in the two intervention stores and in two control stores during the intervention, as well as in the year preceding the intervention (n = 6625). Exit survey (n = 259) and in-depth survey (n = 116) were used to assess customers' awareness of and perceived usefulness of the program, knowledge of nutrition, understanding of the labeling system, as well as placement-, taste- and preparation-related attractiveness of promoted products. Matched purchasing data were used to assess the contribution of promoted products to total food spending for each customer who participated in the in-depth survey. RESULTS: The contribution of inexpensive foods with good nutritional quality to customers' total food spending increased between 2013 and 2014 for both the control stores and the intervention stores. This increase was significantly higher in the intervention stores than in the control stores for fruits and vegetables (p = 0.001) and for starches (p = 0.011). The exit survey revealed that 31 % of customers had seen the intervention materials; this percentage increased significantly at the end of the intervention (p < 0.001). The in-depth survey showed that customers who had seen the intervention materials scored significantly higher on quizzes assessing nutrition knowledge (p < 0.001) and understanding of the labeling system (p = 0.024). CONCLUSION: A social marketing intervention aimed at increasing the visibility and attractiveness of inexpensive foods with good nutritional quality may improve food purchasing behaviors in disadvantaged neighborhoods.

BACKGROUND: The effect of certolizumab pegol on employment status and work productivity has not been previously assessed. AIM: To assess the impact of treatment with certolizumab pegol, the only PEGylated, Fab' TNF antagonist, on work productivity in patients with active Crohn's disease (CD) from the PRECiSE 2 study. METHODS: Patients (n = 668) with active disease [CD activity index (CDAI) score of 220-450] were treated with open-label subcutaneous certolizumab pegol 400 mg (week 0, 2, 4). Responders (n = 425) (> or = 100-point decrease in CDAI from baseline) were randomized to receive certolizumab pegol 400 mg or placebo every 4 weeks until week 24, with final evaluation at week 26. Patients completed the Work Productivity and Activity Impairment for CD questionnaire (WPAI:CD) and the Inflammatory Bowel Disease Questionnaire (IBDQ) at weeks 0, 6, 16 and 26 and at the withdrawal visit. RESULTS: Work productivity improved following induction with certolizumab pegol. Between week 6 and 26, certolizumab pegol-treated patients experienced significant improvement in work productivity compared with placebo recipients (11% and 10% overall improvement in work and activity impairment, respectively). During the maintenance phase, impairments in productivity and activities due to CD were significantly less in the certolizumab pegol group than in the placebo group. CONCLUSION: Induction and maintenance therapy with certolizumab pegol significantly improved the work productivity of patients with active CD compared with those in the placebo group.