An important issue of psychological research is how experiments conducted in the laboratory or theories based on such experiments relate to human performance in daily life. Immersive virtual reality (VR) allows control over stimuli and conditions at increased ecological validity. The goal of the present study was to accomplish a transfer of traditional paradigms that assess attention and distraction to immersive VR. To further increase ecological validity we explored attentional effects with daily objects as stimuli instead of simple letters. Participants searched for a target among distractors on the countertop of a virtual kitchen. Target–distractor discriminability was varied and the displays were accompanied by a peripheral flanker that was congruent or incongruent to the target. Reaction time was slower when target–distractor discriminability was low and when flankers were incongruent. The results were replicated in a second experiment in which stimuli were presented on a computer screen in two dimensions. The study demonstrates the successful translation of traditional paradigms and manipulations into immersive VR and lays a foundation for future research on attention and distraction in VR. Further, we provide an outline for future studies that should use features of VR that are not available in traditional laboratory research.
Biosimilars are new drugs, highly similar copies of biological medicines, equally effective and safe but at lower prices. The aim of this brief review is to provide the current status of biosimilars approved in the European Union for dermatological use. We used PubMed for literature search up to June 2018. The keyword 'biosimilars' was searched and 1,691 items were found. From the 1,691 studies, we included 34 articles in our review. Biologics, biosimilars and generics are different types of drugs. Biosimilars are complex molecules produced by a difficult manufacturing process, and changes in product quality may affect its safety and efficacy. Now, there are 9 biosimilar medicines approved by European Medicines Agency (EMA) for plaque psoriasis and hidradenitis suppurativa: Amgevita, Solymbic, Cyltezo, Imraldi, Benepali, Erelzi, Flixabi, Inflectra and Remsima, and the number is increasing. In 2005, EMA issued the first guidelines for approval of biosimilars. Next-generation biologics, called 'biobetters', have the same target or mechanism of action as previously approved biologics, but they have structural changes and an improved formulation. The debate over the future of biosimilars is far from being finished. The explosive development of biological therapy and the emergence of biosimilars represent a significant success in the effort to provide advanced healthcare to patients all over the world. Contents 1. Introduction 2. Literature search 3. Biologics, biosimilars and generics 4. Manufacturing biosimilars 5. Biosimilar medicines used in dermatology approved by EMA 6. The future pathway ahead 7. Conclusions
Considering that most of the patients (>2/3) are diagnosed with psoriasis in the cutaneous form long before the joint damage occurs and, in these conditions, a significant proportion of them is found in the dermatologist's initial records, a question must be asked: when is it necessary to send these patients to a rheumatology consultation? The recognition of psoriatic arthritis in patients with vulgar psoriasis and the dermatologist's ability to differentiate it from other arthritis, offers the opportunity to improve patient prognosis by prompt intervention and close collaboration with the rheumatologist. Diagnosis of early psoriatic arthropathy should be considered when a patient with psoriasis or family history of psoriasis has peripheral inflammatory arthritis (oligoarthritis or distal interphalangeal joints damage), enthesitis, dactylitis, spinal pain of inflammatory type. Given that patients with psoriasis are included in the dermatologists' medical records, it is very important to recognize psoriatic arthritis in patients with cutaneous psoriasis, to differentiate it from other possible arthritis, thus having the possibility to improve patient prognosis by prompt intervention and through collaboration with the rheumatologist.
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