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Category Archives: Transhuman News

Metabolic Inflammation Contributes to Depression in Psoriatic Disease – Dermatology Times

Posted: May 30, 2023 at 12:10 am

In patients with psoriasis and psoriatic disease, metabolic inflammation is a cause of comorbid depression, according to new research.

A research article1 reported that specific inflammatory patterns within IL-6, IL-8, IL-23, IL-17 family cytokines, and tumor necrosis factor (TNF) can cause neuroinflammation, ultimately leading to anxiety and/or depressive behavior or depression in patients with psoriatic disease. According to authors, prior knowledge of psoriasis and comorbid depression linked burden of disease, psychological stress, and stigmatization to the origins of depression.

Authors noted that non-cutaneous diseases such as diabetes, heart failure, and hypertension were first identified as comorbidities of psoriasis in 1995, with cardio-metabolic consequences related to psoriatic disease being more thoroughly understood over time. Risk of myocardial infarction, for example, was previously found to be significantly higher in patients with psoriasis than in members of the general population.

Other conditions such as dyslipidemia and endothelial dysfunction were also linked to psoriatic disease. Like depression, article authors noted that both comorbid conditions are linked to inflammation.

In western countries, authors note that 1 in 5 people with psoriatic disease, as much as 20%, also experience depression. Previous studies have also demonstrated that rates of depression are higher in patients with psoriatic conditions than in the general population.

Citing recent brain structure research,2 authors described research demonstrating increased right precuneus thickness in people with psoriasis, only in cases where depression was present. Additionally, further research3 demonstrated a positive correlation between psoriasis area and severity index (PASI) and the Zung self-rating depression scale (SDS) in cases of comorbid depression and psoriasis.

Considering that depression is an inflammatory condition with neuroinflammatory events with a similar signature as in the major domains of psoriatic disease, people with psoriasis-associated depression are no longer responsible for their perceived lack of coping with psychological threads, articleauthors wrote. In the practical management of people with psoriatic disease, screening for depression by using simple clinical questions or respective tools needs to be implemented.

References

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Encouraging Diversity and Inclusion for Patients With Psoriatic … – MD Magazine

Posted: at 12:10 am

In an interview with HCPLive Rheumatology, Soumya Chakravarty, MD, PhD, FACP, FACR, Senior Director, Strategic Lead, Janssen Rheumatology, and Daphne Chan, PhD, Head of Dermatology Medical Affairs, Janssen, discussed Janssens commitment to diversity, equity, and inclusion for patients with psoriatic disease.

It has been a fantastic opportunity to emphasize our dedication to advancing care for patients with immune-mediated diseases, especially those with psoriatic disease who belong to communities of color, Chakravarty emphasized. The determination platform we discussed is just one of many ongoing efforts, where we collaborate with various partners to develop specific solutions. It's important to note that this is just the beginning.

Their efforts are accompanied by extensive data generation in patients of color and the creation of a diverse workforce. They strive to deliver culturally competent care and promote progress in this area.

At Janssen, they have undertaken an extensive analysis of the dermatology and rheumatology landscapes to identify unmet needs so they can take meaningful actions as an industry leader and partner. They make an effort to acknowledge the problems the world faces and are realistic about what they can address. Therefore, they focus on the areas where they can make a difference.

Regarding the VISIBLE study, Chan emphasized that simply conducting the study opens doors to demonstrating how it is possible and why it should become the new standard in trial conduct.

Initially, we were apprehensive and doubted whether it could be done, Chan stated. However, I am pleased to report that even taking that first step has yielded tremendous results and rewards. We surprised ourselves by completing the trial's enrollment 7 times faster than projected, concluding 6 months ahead of schedule.

With the trial recruiting so quickly, they expect to have results available sometime next year.

We will be delighted to re-engage in a conversation about the results and what we are learning about people of color living with psoriasis and psoriatic arthritis, Chan emphasized. This experience sets a new chapter for inclusive research and medical practice, defining how it should be in the future.

This transcript was edited for clarity.

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The Weekly Roundup: May 22-26 – Dermatology Times

Posted: at 12:10 am

Expanding Ethnic Hair Care

In this months Cosmetic Conundrums column, Zoe Diana Draelos, MD, discusses solutions for ethnic and Afro-textured hair care.

A recent study supports a degree of correlation between trough serum concentration of infliximab and clinical response to infliximab in patients with the condition.

Researchers analyzed dermatoses associated with obesity and insulin resistance in pediatric patients.

Renata Block, MMS, PA-C, spearheaded a skin cancer screening event for veterans in her hometown.

As many as 1 in 5 patients with psoriasis experience depression as a comorbidity.

Topline results for the topical sodium channel blocker are expected in 2024.

The adalimumab biosimilar will be commercially available in the US starting July 1, 2023.

The first-of-a-kind product uses a topically applied small peptide fluorescent dye and handheld imager to non-invasively detect a biomarker of early tissue changes.

In part 3 of this Frontline Forum series, John M. Strasswimmer, MD, PhD; Andrew H. Weinstein, MD; Neal Bhatia, MD; Laura Ferris, MD; and Aaron S. Farberg, MD, discuss solutions for managing and treating patients with basal cell carcinoma.

New research into the diseases pathogenesis may inform future treatment options.

Cream containing epigallocatechin gallate (EGCG) or EGCG combined with L-carnitine yielded a greater anti-sebum effect.

If you werent able to attend SCALE 2023 or want to review the latest data, our full recap has you covered.

In this weeks Pointers with Portela, the 208SkinDoc gives his best product recommendations for Mother's Day gifts.

The autosomal recessive disorder is primarily caused by mutations in the TGM5 gene and less frequently in the CSTA gene.

While receiving checkpoint inhibitor therapy, patients with advanced melanoma benefitted from a telehealth exercise program.

Click here to answer this week's poll.

The JAK inhibitor demonstrated promising efficacy and safety.

Yuflyma will be available to US patients in July 2023.

The clinical and histologic subtypes encompassed by granulomatous dermatitis include palisaded neutrophilic granulomatous dermatitis and interstitial granulomatous dermatitis. This review compares the features of each cutaneous eruption.

This week's edition of the Mainstream Patient features stories about facial balancing, eyelid surgery 101, dermatologist-recommended sunscreen sticks, and more.

In this months Finance & Practice Management column, we illustrate the importance of developing and maintaining a budget for physicians at all stages of their careers.

Coastal regions require environmentally-protective sun protection measures and best practices.

In patients with high levels of VEGF-A and more severe psoriasis, downregulation of blood vessel area is more abrupt.

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The Weekly Roundup: May 22-26 - Dermatology Times

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Pediatric Psoriasis Market: A Study of the Industry’s Key Applications … – The Navajo Post

Posted: at 12:10 am

[Vancouver, Canada, 16-05-2023] Emergen Research, a leading provider of market research solutions, is thrilled to announce the release of its highly anticipated collection of comprehensive market research content. This innovative offering aims to empower businesses across industries with valuable insights and data-driven strategies to drive growth and success.

In todays competitive marketplace, staying ahead of the curve is essential for businesses of all sizes. Understanding consumer behavior, market trends, and emerging opportunities is crucial for making informed decisions and developing effective strategies. Emergen Research recognizes this need and has invested significant resources in developing a cutting-edge market research content library.

The newly launched Pediatric Psoriasis market research content is meticulously crafted by industry experts, leveraging extensive data analysis, and a deep understanding of various markets. This rich collection includes in-depth reports, whitepapers, case studies, trend analyses, and industry insights covering a wide range of sectors, including but not limited to technology, healthcare, finance, consumer goods, and manufacturing.

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The global pediatric psoriasis market was valued at USD 9.76 billion in 2019 and is expected to reach USD 21.38 billion by the year 2027, at a CAGR of 10.3%. The global Pediatric psoriasis market is growing at a significant pace owing to the growing demand for therapy for diseases such as pediatric psoriasis, favorable government initiatives followed by intensive product development. Considering the factors such as considering the physical development and rate of cutaneous absorption, treating a child with psoriasis has been a huge challenge. With the advent of technology, research has contributed significantly to the various development of treatment for the disease across the globe. Psoriasis is a life-long devitalizing disease that has a significant impact both emotionally and physically including other aspects of life of children. The prolonged sun exposure makes it more demanding while considering phototherapy in children for the rest of their life. Therefore, long-term treatment of psoriasis, with phototherapy or drugs, needs critical evaluation.

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AbbVie Inc.; Amgen Inc.; Johnson & Johnson; Novartis AG; Eli Lilly & Company; AstraZeneca; Celgene Corporation; UCB; and Merck, Boehringer Ingelheim and LEO Pharma

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Market Segmentation:

The report bifurcates the Pediatric Psoriasis market on the basis of different product types, applications, end-user industries, and key regions of the world where the market has already established its presence. The report accurately offers insights into the supply-demand ratio and production and consumption volume of each segment.

Our goal at Emergen Research is to empower businesses with the knowledge and insights necessary to make informed decisions and thrive in todays dynamic business landscape. Our market research content is designed to equip professionals and organizations with comprehensive analyses, actionable recommendations, and a competitive edge to achieve their growth objectives.

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Phototherapy Lamps Market are set to witness a CAGR of 5.8 … – Digital Journal

Posted: at 12:09 am

PRESS RELEASE

Published May 29, 2023

By the end of 2022, the market forPhototherapy Lamps Marketis projected to be worth US$ 3.2 Billion, up from US$ 3.0 Billion in 2021. The overall demand for phototherapy lamps is also anticipated to increase at a CAGR of 5.8% between 2022 and 2032, reaching an estimated value of US$ 5.6 Bn by 2032, due to the growing use of phototherapy lamps for treating a variety of medical disorders, including psoriasis and neonatal jaundice.

Based on product, the LED segment dominated the phototherapy lamps market in 2021, accounting for approximately 37.1% of the market, and it is expected to grow at a higher CAGR during the forecast period.

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According to the reports regional insights, North America will continue to dominate the global phototherapy lamps market in terms of revenue throughout the forecast period.

The adoption of phototherapy as a safer treatment option for skin disorders has increased significantly in the US and Canadas healthcare markets.

Consumer lifestyles in North America will continue to increase the prevalence of common skin diseases, which will primarily be treated with phototherapy lamps.

Furthermore, North Americas dominance in the global market has been supported by a robust infrastructure for the adoption of phototherapy lamps.

According to the report, phototherapy lamps sold in the United States and Canada will generate nearly $700 million in revenue in 2017.

Skin care clinics to emerge as the largest end-user of phototherapy lamps

According to the report, hospitals will initially experience high traction in terms of end-users, but skin care clinics are expected to have the highest revenue share in the global market.

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LED-based phototherapy lamps to register highest sales

According to the study, LED-based phototherapy lamps are the best-selling products on the global market.

The low risk of burns, low cost of production, and ease of installation will continue to drive demand for LED-based phototherapy lamps in the near future.

The LED segment will account for nearly US$ 1.6 billion in revenue in the global phototherapy lamps market by the end of 2026.

According to the study, demand for UV-based phototherapy lamps will be strong, while halogen lamps will lose traction near the end of the forecast period.

Growing effectiveness of phototherapy in psoriasis treatment to drive the sales of phototherapy lamps:

Phototherapy lamps will be primarily used in the treatment of psoriasis due to their applications. Phototherapy lamps sold for the treatment of psoriasis are expected to bring in more than $500 million in 2017.

The use of phototherapy lamps in the treatment of neonatal jaundice is expected to grow at the fastest CAGR of 8.1% during the forecast period.

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Leading manufacturers of phototherapy lamps have been profiled in the report. Koninklijke Philips N.V., General Electric Company, Drgerwerk AG & Co. KGaA, Bistos Co. Ltd., TSE SPOL. S. R. O., The Daavlin Company, Fanem Ltda., Herbert Waldmann GmbH & Co. KG, Natus Medical Incorporated, and Schulze & Bohm GmbH are expected to actively partake in the expansion of the global phototherapy lamps market through 2026.

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Celltrion seeks approval for Stelara biosimilar in EU – The Investor

Posted: at 12:09 am

Celltrion's corporate logo (Celltrion)

Celltrion said Friday that the company has submitted a marketing authorization application for CT-P43, the company's ustekinumab biosimilar referencing Stelara, to the European Medicines Agency.

Stelara is one of Janssen's top-selling drugs. In 2022, Stelara generated $9.7 billion in revenue, according to a report released by Statista.

The global market for ustekinumab last year was estimated at $17.7 billion, Celltrion added.

Celltrion said its CT-P43, like the reference drug Stelara, can be used to treat patients with psoriasis, psoriatic arthritis, Crohns disease and ulcerative colitis.

Celltrion added it is seeking EMA approval for the same indications that have been labeled for Stelara.

Previously, Celltrion conducted a global phase 3 clinical trial to compare the efficacy and safety of CT-P43 to Stelara in patients with moderate to severe plaque psoriasis.

If it wins approval, Celltrion will look to boost its sales.

"If CT-P43 wins the EMA approval, the company will be able to increase competitiveness in the autoimmune disease therapeutics market, where the company has previously launched treatments such as Remsima, Remsima SC and Yuflyma," Celltrion said.

By Shim Woo-hyun (ws@heraldcorp.com)

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Peter Marinkovich, MD: FDA Approval of B-VEC Gene Therapy for … – MD Magazine

Posted: at 12:09 am

In this HCPLive interview, Peter Marinkovich, MD, associate professor of dermatology at Stanford University School of Medicine, spoke about the US Food and Drug Administration (FDA) approval of beremagene geperpavec (B-VEC) (VYJUVEK) for patients with dystrophic epidermolysis bullosa (DEB).1

Marinkovich had been a primary investigator in the multi-center, randomized, double-blind, placebo-controlled GEM-3 trial sponsored by Krystal Biotech.

The phase 3 trial had met both its primary and secondary endpoints, with B-BEC-treated patients having a substantially greater rate of achieving complete wound healing from DEB than placebo at 3 and 6 months (P <.005).2

Before the PDUFA dates announcement, trial data on 31 DEB patients indicated that around 70% of wounds had closed within 6 months of treatment, including the patient that had the dominant form of DEB.

It's just the the culmination of a number of multi-year effort to develop this topical gene therapy drug, and it's so exciting to actually be able to be in this position to be able to offer something back to the very deserving patient population who does not currently have any approved therapies and who are very much in need, Marinkovich explained.

The treatments PDUFA data had been extended to May 2023 resulting from a regulatory update that the FDA deemed important. Krystal Biotech then submitted its manufacturing information update related to a replaced hardware unit in B-VECs manufacturing process.

This is a vector that's based on the HSV-1 backbone, he said. HSV-1 over its many thousands of years of cohabitation with humans has evolved a way to be able to evade the immune systemAs a gene therapy vector, to have a vector that can evade the immune system, it really makes it much easier to use.

Marinkovich explained the function of the treatment and how it addresses wound healing for DEB patients. He then went into related research in which he had been involved.

Some of the things that we're currently studying are the effects of feedback on mucosal surfaces in addition to the skin, he said. And that was a very promising report of a single patient who's had their eyes treated, and was able to show some improvement in the vision as well as very good safety over multiple applications.

Marinkovich noted that these are all areas that EB patients suffer from and that they could benefit from B-VEC therapy. He concluded with his thoughts on the future for DEB patient options.

I'm super happy about the FDA decision, they also seem to recognize the important need of the EB patients to get a corrective therapy like this one, Marinkovich said. And I feel so happy for the EB patients to be able to have corrective therapy and be able to finally, after all these years, be able to actually start to get some benefit.

The quotes contained here were edited for clarity. For further information about Marinkovichs take on the FDAs approval of B-VEC therapy, view the video above.

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Nick Stucky, MD, Phd: Implications for Media Influence on Minoxidil … – MD Magazine

Posted: at 12:09 am

Nick Stucky, MD, PhD, continued his discussion of his teams findings on rates of prescription of oral minoxidil following the publication of an article by The New York Times, noting the biggest implications of the findings.1

Stucky is vice president of research at Truveta, working also as a physician-scientist and bioengineer. Additionally, he is known for being a start-up founder, faculty teaching, and having been research director.

After having described the findings, Stucky in this interview segment first described the studys limitations in general.

One thing is that we get data from our member healthcare systems, so they provide care to a certain population, he explained. We have 17% of the US healthcare daily delivered care within our dataset, so it's quite large. But there are always potential biases if you're not actually surveying the whole US population.

Stucky also added that there may be a skew toward insured patients, for example. He added that there were certain questions by reviewers regarding whether the article led to increased prescribing for all hair loss medications.

And so we added kind of a control armwhich was another hair loss medication that wasn't mentioned in that article, Stucky explained, adding that this group had no changes in prescribing.

He then highlighted some of the biggest implications from his teams findings, noting that they did not know for sure whether the article had a direct impact on the providers or the patients who read the single media publication.

But yes, I mean, I think it definitely says that we're all human, and we all are sort of influenced by our environment, Stucky said. And certainly, this indicates that either practitioners or patients can be profoundly impacted in terms of how they interact with the healthcare system, by a single article.

Additionally, Stucky mentioned that he believes there are other important implications for his teams findings.

I think many providers probably had concerns about whether it was safe, whether there'd be any adverse effects, but those had mostly been put to rest by these handful of studies that have come out, he said. But nobody was aware of them and so by, in this case, a New York Times article, but really any other media that we're consuming, we can learn really valuable (insights).

The interview segments quotes were edited for clarity. For more information on the research described here, view the full video above.

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Top 5 Technologies That Will Make Mars Habitable – Jumpstart Media

Posted: May 28, 2023 at 11:56 am

From silica aerogel to MOXIE, these revolutionary technologies are bringing us a step closer to making Mars home!

Mars, the fourth planet from the Sun, has long captivated the curiosity of scientists. Some of the most intelligent mindsBuzz Aldrin, Neil Degras Tyson and Stephen Hawkingagree that humankind should work towards occupying Mars. And there is a good reason for that. When life on Earth was evolving, Mars was going through significant climate change. Studying the red planet, both its past and present, can help us understand the details of the evolution of Earth and other planets in the solar system.

Besides, scientists have found evidence of water on Mars that could be harvested for human consumption. Consequently, we are seeing the emergence of projects like Artemis 1, which intends to establish a human presence on Mars by 2028. But the million-dollar question is: How will this plan, or any other plan to colonize Mars come to fruition? Here are some of the technologies that have been developed or are currently being developed, that will help make life on Mars possible.

Silica aerogel is a porous, lightweight translucent material used for high-temperature insulation. Its insulating properties are so potent that, in 2019, researchers from Harvard University and NASAs Jet Propulsion Lab found that silica aerogel could mimic the greenhouse effect on Mars. What makes Mars uninhabitable right now is the low temperatures and high levels of ultraviolet radiation. The researchers believe that a 2-3 cm thick silica aerogel layer would transmit sufficient life for photosynthesis, help block out the radiation and raise temperatures above the melting point of water.

Mars atmosphere is made up of 95% carbon dioxide (CO2). In 2021, the National Renewable Energy Laboratory (NREL) in the U.S. and its partner biotechnology company Nzyme2HC came up with the idea of harnessing this CO2 supply to make ethylene. To do so, it is using ethylene-emitting cyanobacteria (bacteria that obtain energy from photosynthesis) created by NREL scientists in 2012. Creating ethylene (an integral component of plastics) from the CO2 supply on Mars could help astronauts readily produce the building materials needed for a Mars colony.

While the red planet has a lot of CO2, its atmosphere only consists of 0.6% molecular oxygen. This means, to make life possible on the planet, scientists need to find a way for us to breathe. To help solve this problem, the Massachusetts Institute of Technology (MIT) has created the Mars Oxygen In-Situ Resource Utilization Experiment (MOXIE). MOXIE is a lunchbox-sized device that collects atmospheric CO2 and heats it to 1500 degrees Fahrenheit, splitting it into oxygen and carbon monoxide. The device is still in the experimental stages but has been successful in producing oxygen seven different times.

Another major barrier is traveling back and forth between Earth and Mars. There is a distance of 33.9 million miles between the two planets, and it takes seven months to travel from one to the other, kicking off at a speed of about 39,600 km per hour. To tackle this issue, the National Aeronautics and Space Administration (NASA) has partnered with the Defense Advanced Research Projects Agency (DARPA) to work on nuclear thermal propulsion technology for rockets. This technology provides a high thrust and propels the rocket much faster than chemical rockets. Reducing the travel time will help cut down the supplies needed for inter-planet travel. While the technology isnt ready yet, NASA says it intends to make it possible by 2027.

Given how far the two planets are from each other, it would be greatly beneficial to have a source of fuel on Mars as well. In 2021, the Georgia Institute of Technology suggested that microbes could be carried to Mars to produce fuel on the red planet. These microbes are cyanobacteria (which converts carbon dioxide into sugar and oxygen) and an engineered variety of E.colii (which converts the extracted sugar into a fuel called 2,3-butanediol).

To give these microbes the environment to be functional, plastic materials would have to be carried to Mars which would then be assembled into photobioreactors for the microbes. Besides creating fuel, the process also generates 44 tons of excess clean oxygen. This process of producing fuel on Mars would reduce power consumption by 32% as compared to the current method (carrying methane and liquid oxygen reserves to the planet).

From creating oxygen to reducing fuel costs and eliminating radiation, evolving technologies solve the many problems associated with Mars colonization. It opens up possibilities for sustained human habitation on the planet. As we continue to push the boundaries of scientific and technological innovation, we can look forward to a future where humans are not only Earthbound but also interplanetary, with Mars being the first step in our journey to the stars.

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10 Best Paradox Interactive Games – TheGamer

Posted: at 11:56 am

Paradox Interactive has released many great titles and series over the years after becoming an independent company in 2004. When you think of games that Paradox has published, titles like the Cities Skylines series, Surviving Mars, and many other strategy games come to mind.

Related: The Best Ubisoft Games

Grand strategy games are not the only ones it has under its belt, however. Action adventure, role-playing, and simulation and management are some of the other genres that the company has published, which have been some of the most successful releases. With a wide variety of games, these are some of the best titles to check out from Paradox Interactive.

Fantasy games always bring forth a very interesting world no matter how they are received on release. Magicka brought a new world based on Norse mythology, creating a fun and rich experience.

In this game, you are a wizard who is trying to stop an evil sorcerer who has caused chaos in the world. There are many spells you can cast and combine for a magic system unlike any other, and many items to find. You can also play solo or in co-op with up to four friends in a dozen campaigns.

Victoria 2 is the second installment in the grand strategy Victoria series. Taking place during the 19th-century colonial era you guide your country to expand and industrialize. This includes expanding through political power, military conquest, and colonization.

This political simulation game gives you many options in terms of gameplay. You have dozens of different governments, production for your country, and a very detailed economy. There are over 200 countries to play as along with many historical missions. All of these features really help make Victoria 2 a very intriguing strategy game, and one of the best.

The Age of Wonders series has captivated fans with its unique gameplay and story. Age of Wonders 4 continues to bring together roleplaying and strategy along with turn-based combat. All of those elements put together in a fantasy realm are what make this game really popular.

Related: Age Of Wonders 4: Beginner Tips

The fantasy realm is created by you, in which you create your followers, build up armies, get magical tomes to evolve your followers, and create powerful beings. There are endless possibilities for your creations and realms to explore. You can be a fearful ruler that dominates other realms or one that creates alliances to squash the evil in the world.

There are many games that are part of the grand strategy war games genre. One of the most well-known series is Hearts of Iron. The fourth installment transports you into World War 2 and offers both historical and alternative events.

This military simulation game gives players the opportunity to command any nation while managing politics, economy, production and supply lines, and military units. There is also a complex research tree and multiplayer in which you can take control of different aspects of a nation's strategy.

Europa Universalis is one of Paradoxs biggest series and for good reason. A grand strategy game with the ability to dominate, explore, and expand your world. Starting before the Renaissance, this game lets you build your own empire and change history.

You can choose any date you want with historical figures and nations and experience history throughout your time. Choosing marriage candidates, building alliances, and trading with others help your nation thrive. Even whoever is on the throne really influences your nation's progression for both good and bad.

Out of all the grand strategy games in Paradoxs catalog, Stellaris is the one that took a different approach to its setting. Most of the games are based on history, but Stellaris decided to take the genre to space.

Related: Stellaris: Guide For Absolute Beginners

Your journey takes you into space exploration and building a galactic empire. You can discover many new species out in the galaxy by sending research ships out, building space stations, and discovering new planets. There is an infinite number of races to discover, characteristics for your race and others, as well as diplomacy and galactic warfare. If the gameplay doesn't capture your attention, then maybe the stunning visuals created will.

There are many big-name developers that partner up with publishers for their next big game. So when Obsidian Entertainment, developer of games like Fallout: New Vegas and South Park: The Stick of Truth, decided to make a new RPG, the decision was to partner with Paradox.

Pillars of Eternity is an adventure game that aims to recapture the nostalgia of classic RPGs. This game delivers a very expansive and deep character development system that adds to the six races you can play. Each has its own core skills that add to the characters' uniqueness. Not to mention a rich world with many classes, missions, and a reputation system that has an effect on your character.

Prison Architect became a hit management and simulation game due to its fun and chaotic nature. This game brings top-down gameplay with building and managing a prison. As warden of the prison, it is your job to create an environment for the world's most vile prisoners.

Related: Prison Architect: Tips For Building And Running A Successful Prison

What really made this game a hit and stand apart from others is the sporadic nature of the prisoners. While your main job is to optimize the prison, the prisoners can cause riots, start fights, or even start a fire. There are various things that can go on within the prison walls, like gang activity and even disease, so it's wise to make sure you have hired the best staff such as guards, doctors, and others. These are just a few of the features that make this a fun game.

Combing roleplaying and grand strategy in the Medieval Ages is exactly what makes Crusader Kings 3 an outstanding game. Part of the original Paradox Development Studio, this game continues to expand on the Crusader Kings series.

You start by taking control of your house and expanding your dynasty on a vast map. There is a very in-depth customer characterization that has effects on your journey. This game is all about lineage and keeping your heir and bloodline in charge through the years. You can make choices about who you marry or who your heirs marry. You can be as graceful as a ruler as you want, or be devious by sending spies to other houses, plotting against houses, and murdering those you want for your own advantage.

Perhaps one of the biggest and most well-known management games is Cities: Skylines. You get to build up your own city however you want and from there make sure the residents of your city are happy. There are plenty of obstacles that you will face when you plan out your city.

Everything from education, street flow, food, businesses, healthcare, entertainment, and commute all have an effect on your citizens. Those are only a few of the factors you need to think about when constructing your city. There are various DLCs that add different things like airports, stadiums, and weather events that add some extra fun and difficulty to the game. Cities: Skylines also has one of the most active modding communities where you can find a plethora of items to add to your world.

Next: The Best Story-Driven Games

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10 Best Paradox Interactive Games - TheGamer

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