Neue Studien: Europe PMChttps://www.psoriasis-news.de/articles.html/1_articles/page/20/?d=1Neue Studien: Europe PMCdeFamily planning and pregnancy among patients with psoriasis: incorporating the patients' voice in healthcare practice and information provision.https://www.psoriasis-news.de/articles.html/1_articles/family-planning-and-pregnancy-among-patients-with-psoriasis-incorporating-the-patients-voice-in-healthcare-practice-and-information-provision-r167/Aim: Having psoriasis and being treated with medication could raise concerns regarding family planning and pregnancy (FPP), and no guidelines are available on healthcare practice and information provision regarding FPP for these patients. This study aims to gain insight in the perspectives of patients with psoriasis on this important subject.Methods: A cross-sectional questionnaire study including adult female and male patients with psoriasis, independent of their treatment type.Results: A total of 102 patients responded to the questionnaire (70% females, 30% males), of whom 47.1% have ever used biologic therapy. Respondents preferred dermatologists or general practitioners (GPs) as information provider. Patients would like to receive FPP information on fertility, heredity of psoriasis, use of psoriasis medication, and - specifically for females- the course of psoriasis during and after pregnancy and breastfeeding. Timing of FPP information provision was preferable at moment of diagnosis and medication changes or upon explicit request.Conclusion: Dermatologists and GPs have a crucial role in providing FPP information. The findings of this study have provided hands-on guidance for healthcare professionals to improve healthcare for both female and male patients with psoriasis in the reproductive age.

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]]>167Mon, 04 Aug 2025 07:43:04 +0000Greater topical corticosteroid quantity applied reduces severity of psoriasis: Results from two randomized controlled trials.https://www.psoriasis-news.de/articles.html/1_articles/greater-topical-corticosteroid-quantity-applied-reduces-severity-of-psoriasis-results-from-two-randomized-controlled-trials-r166/BackgroundTopical drugs containing corticosteroids are recommended first-line treatment for patients with mild-moderate psoriasis. However, the optimal recommended dosage of topical drugs has not been well established.

Objectives

To investigate the effect of topical drug application quantity and treatment duration on psoriasis treatment outcome.

Methods

We conducted a post-hoc analysis of two randomized controlled trials investigating 214 patients with psoriasis using topical drugs containing corticosteroids and/or calcipotriol for up to 48 weeks. We measured the amount of topical drugs used during the study period and calculated the mean amount of applied drugs per 1% affected body surface area (BSA) divided by number of days in the study period. Improvement in severity of psoriasis was measured by Lattice-System Physician's Global Assessment (LS-PGA) (where affected BSA was divided into seven categories) from baseline to last study visit. Descriptive results were reported as counts with proportions, and as means with normality-based confidence intervals (CI). Associations were analyzed using linear regressions.

Results

Most study participants had a duration of psoriasis greater than 20 years, moderate psoriasis, and no history of using systemic psoriasis treatment. They had applied a mean of 1.0 g per 1% BSA per day (95% CI 0.9; 1.2). Daily use of topical drugs for four-weeks reduced severity of psoriasis. However, extended daily use for up to 48 weeks provided further reduction in disease severity (coefficient --0.30 (95% CI -0.51, -0.09)) and -0.73 (95% CI -1.09; -0.38) (P= 0.028). Greater amount of applied topical drugs reduced severity of psoriasis in a linear manner. Every increase of 1 g of topical drugs applied per 1% BSA per day reduced LS-PGA by 0.43 (95% CI 0.24; 0.61). Finally, patients who had never used systemic drugs experienced a greater reduction in psoriasis when applying the same mean amount of topical drugs (coefficient -0.7 (95% CI -1.1, -0.4) compared to those who had a history of taking systemic treatment (-0.3 (95% CI -0.5; -0.1), P=0.026).

Conclusions

A mean application amount of at least 1.0 g of topical drugs per 1% BSA per day seems safe and effective and can be used daily until clearance.

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]]>166Mon, 04 Aug 2025 07:43:04 +0000Apremilast in Psoriasis: Current Landscape and Perspectives.https://www.psoriasis-news.de/articles.html/1_articles/apremilast-in-psoriasis-current-landscape-and-perspectives-r165/Weiterlesen

]]>165Mon, 04 Aug 2025 07:43:04 +0000Therapeutic Potential of Mesenchymal Stem Cells in Psoriasis.https://www.psoriasis-news.de/articles.html/1_articles/therapeutic-potential-of-mesenchymal-stem-cells-in-psoriasis-r164/Weiterlesen

]]>164Mon, 04 Aug 2025 07:43:04 +0000Copay Accumulators: A Legislative Issue in Dermatology.https://www.psoriasis-news.de/articles.html/1_articles/copay-accumulators-a-legislative-issue-in-dermatology-r163/No abstract supplied.

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]]>163Mon, 04 Aug 2025 07:43:04 +0000Real-World Effectiveness and Safety of Risankizumab in Psoriasis: A Comprehensive Analysis from the Saudi Arabia Psoriasis Registry (PSORSA).https://www.psoriasis-news.de/articles.html/1_articles/real-world-effectiveness-and-safety-of-risankizumab-in-psoriasis-a-comprehensive-analysis-from-the-saudi-arabia-psoriasis-registry-psorsa-r154/IntroductionPsoriasis is a chronic immune-mediated skin condition that has a substantial impact on patients' quality of life. The Saudi Arabia Psoriasis Registry (PSORSA) was established to address long-term real-world data (RWD) on systemic and biologic therapies in the region. This observational cohort study provides a comprehensive analysis of baseline disease characteristics, comorbidities, and treatment efficacy among patients enrolled in PSORSA, with an emphasis on risankizumab.

Methods

Data were sourced from a governmental online database covering multiple healthcare centers. Patients eligible for biologics were followed at baseline and at weeks 16, 28, 40, and 52 to evaluate disease severity, quality of life, and adherence. Statistical analyses were conducted using Jamovi and R. Descriptive statistics were performed for categorical and continuous variables. p-Values < 0.05 were considered significant.

Results

The study cohort included 313 patients. Plaque psoriasis was the most prevalent clinical type (93.9%). An analysis of treatment history revealed that 39.6% of patients had prior therapy exposure, and all patients received risankizumab as a biologic therapy. At baseline, the mean Psoriasis Area and Severity Index (PASI) score was 25.49. By week 52, it had decreased to 0.358, indicating complete clearance. PASI scores showed a steady and substantial reduction over time, with an 88% reduction at week 16, 96% at week 28, 97.5% at week 40, and 98.5% by week 52, demonstrating a strong and sustained treatment effect (p < 0.001). Additionally, risankizumab exhibited a favorable drug survival profile, with many patients maintaining treatment beyond 122 weeks.

Conclusion

This study represents the first real-world assessment of risankizumab for moderate-to-severe psoriasis in Saudi Arabia. The findings demonstrate that risankizumab is an effective and well-tolerated treatment for moderate-to-severe psoriasis in this Saudi Arabian cohort. However, future studies should explore long-term safety outcomes and the comparative effectiveness of risankizumab and emerging biologics in diverse patient populations.

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]]>154Thu, 31 Jul 2025 12:43:37 +0000Biologic and small molecule therapies for psoriasis in individuals with Down syndrome: Two cases and a systematic review.https://www.psoriasis-news.de/articles.html/1_articles/biologic-and-small-molecule-therapies-for-psoriasis-in-individuals-with-down-syndrome-two-cases-and-a-systematic-review-r153/Weiterlesen

]]>153Thu, 31 Jul 2025 12:43:37 +0000Correction to "Impact of Delay of Treatment With Disease-Modifying Antirheumatic Drugs in Psoriatic Arthritis: The CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry".https://www.psoriasis-news.de/articles.html/1_articles/correction-to-impact-of-delay-of-treatment-with-disease-modifying-antirheumatic-drugs-in-psoriatic-arthritis-the-corevitas-psoriatic-arthritisspondyloarthritis-registry-r152/No abstract supplied.

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]]>152Thu, 31 Jul 2025 12:43:37 +0000A Validated Quantitative LC-MS/MS Method for Determination of Deucravacitinib in Rat Plasma and Its Application to a Pharmacokinetic Study.https://www.psoriasis-news.de/articles.html/1_articles/a-validated-quantitative-lc-msms-method-for-determination-of-deucravacitinib-in-rat-plasma-and-its-application-to-a-pharmacokinetic-study-r151/2 = 0.9976). The intraday and interday precisions were less than 6.62% and 5.95%, respectively, with accuracies ranging from 90.68% to 103.80%. The recovery of deucravacitinib ranged from 95.34% to 103.80% and remained stable under different conditions. After successful validation, the method was used for pharmacokinetic profiling of deucravacitinib in rats following oral administration.

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]]>151Thu, 31 Jul 2025 12:43:37 +0000Greater topical corticosteroid quantity applied reduces severity of psoriasis: Results from two randomized controlled trials.https://www.psoriasis-news.de/articles.html/1_articles/greater-topical-corticosteroid-quantity-applied-reduces-severity-of-psoriasis-results-from-two-randomized-controlled-trials-r150/Weiterlesen

]]>150Thu, 31 Jul 2025 12:43:37 +0000IL-17A inhibitors modulate skin microbiome in psoriasis: implications for microbial homeostasis.https://www.psoriasis-news.de/articles.html/1_articles/il-17a-inhibitors-modulate-skin-microbiome-in-psoriasis-implications-for-microbial-homeostasis-r149/BackgroundThe IL-17A inhibitors target aberrant immune responses in psoriasis but also impacts the host's defense against infections. The effects of this treatment on skin microorganisms and microbiome-encoded metabolic pathways remain unclear.

Objectives

This was an exploratory clinical study designed to investigate whether Psoriasis is associated with skin microbiota, as well as a longitudinal cohort study aimed at revealing the effects of IL-17A inhibitor treatment on skin microbiota in Psoriasis.

Methods

In this study, we recruited 26 patients with moderate to severe psoriasis and 15 healthy controls. We collected skin microbiome samples from both greasy and dry skin regions. All samples were analyzed using 16S rDNA gene sequencing to determine the microbial profiles.

Results

Compared with healthy controls, the composition and function of skin microbiome in psoriasis patients are heterogeneous. Treatment with IL-17A inhibitors significantly increases the alpha diversity of the skin microbiota in psoriasis patients, indicating potential restoration of microbial community richness and evenness. However, this treatment does not entirely alter the taxonomic composition of the skin microbiota; rather, it shifts the relative abundance of specific microbial species, indicating that certain core microbial features remain relatively stable. Moreover, IL-17A inhibitors help adjust the functional profile of the skin microbiome in psoriasis patients, bringing it closer to that of healthy individuals.

Conclusions

Psoriasis patients exhibit significant heterogeneity in both the composition and functionality of their skin microbiota. Although IL-17A inhibitor treatment fails to fundamentally alter its taxonomic composition, this therapy effectively enhances microbial community stability by increasing alpha diversity and modulating the relative abundance of various taxa. Additionally, it adjusts the functional profile of the skin microbiota towards a healthier state, thereby contributing to the restoration of microecological balance.

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]]>149Thu, 31 Jul 2025 12:43:37 +0000Successful Treatment with Secukinumab in a Psoriasis Patient on Hemodialysis.https://www.psoriasis-news.de/articles.html/1_articles/successful-treatment-with-secukinumab-in-a-psoriasis-patient-on-hemodialysis-r148/Weiterlesen

]]>148Thu, 31 Jul 2025 12:43:37 +0000Copay Accumulators: A Legislative Issue in Dermatologyhttps://www.psoriasis-news.de/articles.html/1_articles/copay-accumulators-a-legislative-issue-in-dermatology-r147/No abstract supplied.

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]]>147Thu, 31 Jul 2025 12:43:37 +0000Treatment of severe psoriasis in a hospice care patient using secukinumab, an inhibitor of interleukin-17A expression: Treatment response and changes in quality of life.https://www.psoriasis-news.de/articles.html/1_articles/treatment-of-severe-psoriasis-in-a-hospice-care-patient-using-secukinumab-an-inhibitor-of-interleukin-17a-expression-treatment-response-and-changes-in-quality-of-life-r146/Weiterlesen

]]>146Thu, 31 Jul 2025 12:43:37 +0000Correction to “Impact of Delay of Treatment With Disease‐Modifying Antirheumatic Drugs in Psoriatic Arthritis: The CorEvitas Psoriatic Arthritis/Spondyloarthritis Registry”https://www.psoriasis-news.de/articles.html/1_articles/correction-to-impact-of-delay-of-treatment-with-disease%E2%80%90modifying-antirheumatic-drugs-in-psoriatic-arthritis-the-corevitas-psoriatic-arthritisspondyloarthritis-registry-r145/No abstract supplied.

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]]>145Thu, 31 Jul 2025 12:43:37 +0000Recent advancement of fisetin-based nanoformulations in the management of psoriasis.https://www.psoriasis-news.de/articles.html/1_articles/recent-advancement-of-fisetin-based-nanoformulations-in-the-management-of-psoriasis-r143/Weiterlesen

]]>143Sat, 12 Jul 2025 18:34:11 +0000Neutrophil Extracellular Trap (NET) Markers in Psoriasis: Linking with Disease Severity and Comorbidities.https://www.psoriasis-news.de/articles.html/1_articles/neutrophil-extracellular-trap-net-markers-in-psoriasis-linking-with-disease-severity-and-comorbidities-r142/Weiterlesen

]]>142Sat, 12 Jul 2025 18:34:11 +0000Diagnosis of psoriasis and lichen planus in real-time using neural networks based on skin Biomechanical properties obtained from numerical simulation.https://www.psoriasis-news.de/articles.html/1_articles/diagnosis-of-psoriasis-and-lichen-planus-in-real-time-using-neural-networks-based-on-skin-biomechanical-properties-obtained-from-numerical-simulation-r141/Weiterlesen

]]>141Sat, 12 Jul 2025 18:34:11 +0000Moving beyond the Janus kinase signaling kinases in the pathogenesis and treatment of psoriasis and psoriatic arthritis.https://www.psoriasis-news.de/articles.html/1_articles/moving-beyond-the-janus-kinase-signaling-kinases-in-the-pathogenesis-and-treatment-of-psoriasis-and-psoriatic-arthritis-r140/Weiterlesen

]]>140Sat, 12 Jul 2025 18:34:11 +0000Exploring the relationship between novel measurements of abdominal obesity and psoriasis: a cross-sectional study from the NHANES database.https://www.psoriasis-news.de/articles.html/1_articles/exploring-the-relationship-between-novel-measurements-of-abdominal-obesity-and-psoriasis-a-cross-sectional-study-from-the-nhanes-database-r139/BackgroundPsoriasis is a chronic skin disease affecting millions of people, with obesity being a common comorbidity. Many studies suggest that obesity may influence the onset and treatment efficacy of psoriasis. Currently, increasing evidence indicates that abdominal obesity is associated with various metabolic diseases, but research on the relationship between abdominal obesity and psoriasis remains limited. This study uses advanced obesity indicators such as the conicity index and body roundness index to explore the association between abdominal obesity and psoriasis.

Methods

This study is a cross-sectional analysis that uses univariate regression analysis and weighted multivariable logistic regression to investigate the relationship between conicity index, android percent fat, body roundness index, and psoriasis. Additionally, restricted cubic spline analysis was performed to explore the nonlinear association between these indicators and psoriasis. Subgroup analysis and interaction tests were also conducted.

Results

A total of 4873 participants were included in this study. After adjusting for confounding variables, the results showed a positive correlation between conicity index, android percent fat, body roundness index, and the risk of psoriasis. When conicity index, android percent fat, and body roundness index were converted into quartiles (Q1-Q4), the risk of psoriasis in the Q4 group was significantly higher compared to the Q1 group (conicity index: p = 0.032, android percent fat: p = 0.020, body roundness index: p = 0.003). In the subgroup analysis and interaction tests, no significant interaction between the conicity index, body roundness index, and the association with psoriasis was found (p > 0.05). The results only suggest that the poverty income ratio (PIR), marital status, and alcohol consumption may influence the relationship between android percent fat and psoriasis. In addition, subgroup analysis based on age shows that the association between abdominal obesity and psoriasis is more significant in the population over 40 years old.

Conclusions

After adjusting for covariates, the study found that three abdominal obesity indicators-conicity index, android percentage fat, and body roundness index-are positively correlated with psoriasis risk, suggesting that the association between abdominal obesity and psoriasis as a comorbidity is more likely to occur, emphasizing the clinical significance of this link.

Level of evidence

Level III, Evidence obtained from well-designed cohort or case-control analytic studies.

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]]>139Sat, 12 Jul 2025 18:34:11 +0000Trace Elements and Risk of Immune-Mediated Skin Disease: A Systematic Review and Meta-analysis.https://www.psoriasis-news.de/articles.html/1_articles/trace-elements-and-risk-of-immune-mediated-skin-disease-a-systematic-review-and-meta-analysis-r138/ContextEvidence regarding the relationship between serum trace element levels and immune-mediated inflammatory skin diseases (IMSDs) is inconsistent.

Objective

In this systematic review and meta-analysis we aimed to evaluate the association between selected serum trace element levels (zinc [Zn], copper [Cu], iron [Fe], selenium [Se], and calcium [Ca]) and IMSDs (psoriasis, vitiligo, atopic dermatitis [AD], alopecia areata [AA], hidradenitis suppurativa, and bullous diseases).

Data sources

We conducted a comprehensive search on the PubMed, EMBASE, Scopus, China National Knowledge Infrastructure, and Web of Science databases from the database inception date to May 2, 2024. Studies measuring serum, plasma, or whole-blood levels of Zn, Cu, Fe, Se, or Ca in patients with IMSD compared to those in healthy controls were included.

Data extraction

This study followed the guidelines of the Meta-analysis of Observational Studies in Epidemiology and the Preferred Reporting Items for Systematic Review and Meta-analyses guidelines. Two authors (X.Y.S. and Y.O.) independently reviewed the titles and abstracts of the identified studies using a standardized collection form.

Data analysis

The primary outcome was the standardized mean difference with a 95% CI in serum trace element levels (Zn, Cu, Fe, Se, and Ca) between patients with IMSDs and healthy controls. Overall, 113 studies involving 7014 patients with IMSD were included in the meta-analysis. Compared with those in the healthy control group, serum Zn levels decreased in patients with vitiligo, psoriasis, and AA; serum Cu levels increased in patients with psoriasis, AD, and AA; serum Se and Fe levels decreased in patients with psoriasis and AD.

Conclusion

Serum trace element levels showed more significant changes in patients with IMSDs than in healthy controls. These findings suggest that alterations in trace element levels may be associated with the occurrence, development, and prognosis of IMSDs.

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]]>138Sat, 12 Jul 2025 18:34:11 +0000Association between Polycyclic Aromatic Hydrocarbon Metabolites and Psoriasis in US Adults: Evidence from the National Health and Nutrition Examination Survey.https://www.psoriasis-news.de/articles.html/1_articles/association-between-polycyclic-aromatic-hydrocarbon-metabolites-and-psoriasis-in-us-adults-evidence-from-the-national-health-and-nutrition-examination-survey-r137/BackgroundPolycyclic aromatic hydrocarbons (PAHs) are environmental pollutants with widespread human exposure and have been associated with adverse health outcomes. However, their potential relationship with psoriasis remains insufficiently explored.

Objective

The aim of this study is to investigate the association between PAH exposure and psoriasis.

Methods

Data were obtained from the National Health and Nutrition Examination Survey (NHANES) for the periods 2005-2006, 2009-2010, and 2011-2012. Weighted multivariate logistic regression analysis was performed to assess the association between individual PAH metabolites and psoriasis. Bayesian kernel machine regression (BKMR), quantile g-computation (qgcomp), and weighted quantile sum (WQS) regression were used to evaluate the relationship between mixed PAH exposure and psoriasis, as well as to determine the relative contributions of specific PAH metabolites. Stratified and sensitivity analyses were conducted to assess result stability.

Results

A total of 4,912 participants (mean age, 43.52 years; 95% CI, 42.65-44.39 years) were included, of whom 2,514 (51.18%) were female, and 141 (2.87%) were diagnosed with psoriasis. Multivariate logistic regression analysis identified significant positive associations between psoriasis and seven urinary PAH metabolites: 2-hydroxynaphthalene, 3-hydroxyfluorene, 2-hydroxyfluorene, 3-hydroxyphenanthrene, 1-hydroxyphenanthrene, 2-hydroxyphenanthrene, and 1-hydroxypyrene. Analysis of mixed exposure PAH across all three models demonstrated significant positive associations between urinary PAH metabolites and psoriasis, with 2-hydroxyphenanthrene and 2-hydroxynaphthalene identified as primary contributors. Stratified and sensitivity analyses confirmed the robustness of these results, and the observed associations persisted among non-smokers.

Conclusion

Both single and mixed exposure analyses demonstrated a positive association between PAH exposure and psoriasis. These findings suggest that reducing PAH exposure may help mitigate psoriasis risk.

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]]>137Sat, 12 Jul 2025 18:34:11 +0000Global Guidelines for Psoriatic Arthritis Management: A Comparative Analysis.https://www.psoriasis-news.de/articles.html/1_articles/global-guidelines-for-psoriatic-arthritis-management-a-comparative-analysis-r136/BackgroundPsoriatic arthritis (PsA) is a complex immune-mediated heterogeneous inflammatory disease. Treatment decisions are challenging given the multisystem involvement. To further guide management strategies, we conducted a comparative analysis of the latest global guidelines highlighting the contrast in their approach to treat different PsA domains.

Methods

Major global guidelines for PsA management were reviewed, including American College of Rheumatology 2018 update, European Alliance of Associations for Rheumatology 2023 update, British Society of Rheumatology 2022, Group for Research and Assessment of Psoriasis and Psoriatic Arthritis 2021, and Pan American League of Associations for Rheumatology 2024.

Results

The guidelines unanimously recommend a treat-to-target strategy with a focus on active PsA. Divergence existed in treatment sequencing regarding the use of biologic and targeted disease-modifying antirheumatic drugs (DMARDs). Variations were also noted in the management of enthesitis and dactylitis. Addressing comorbidities and associated conditions is regarded to be a cornerstone for optimizing disease control and preventing flares.

Conclusion

This review highlights the different management strategies among the global guidelines. Furthermore, we pointed at promising new therapeutic targets that are likely to be incorporated into future recommendations.

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]]>136Sat, 12 Jul 2025 18:34:11 +0000Validation of patient-reported outcome measures for dactylitis, psoriatic skin and nail disease, and uveitis in patients with psoriatic arthritis in routine care.https://www.psoriasis-news.de/articles.html/1_articles/validation-of-patient-reported-outcome-measures-for-dactylitis-psoriatic-skin-and-nail-disease-and-uveitis-in-patients-with-psoriatic-arthritis-in-routine-care-r135/BackgroundIn routine care, Danish patients with psoriatic arthritis are monitored in the DANBIO registry. In March 2022, patient-reported outcome measures (PROMs) on selected non-musculoskeletal manifestations (NMM) were implemented.

Aim

To validate PROMs for current dactylitis, skin and nail psoriasis, and recent uveitis in patients with psoriatic arthritis.

Methods

Adaptive cross-sectional study. Patients in the rheumatologic clinic answered PROMs with 'yes'/'no'/'do not know' and assessed the extent of skin psoriasis and number of dactylitis-affected digits in DANBIO. PROM entries were compared with the physician's assessments (physical examination, review of patient file), with the physician being the gold standard. With 134 patients included, 20% had incorrectly reported dactylitis; therefore, a dactylitis photo was added to the PROM. Sensitivity, specificity, positive and negative predictive values, accuracy and Cohen's kappa were calculated. Level of agreement for dactylitis count was explored by Bland-Altman plot. From patient 200, the physician was blinded to PROs.

Results

We included 300 patients (51% female, median age=55 years), with a median disease duration of 8 years, where 43% received biologic treatment. According to the physician's assessment, 41 (14%) patients had current dactylitis, 164 (55%) psoriasis, 163 (54%) nail psoriasis and 3 (1%) recent uveitis. For the dactylitis PROM, the sensitivity/specificity/Cohen's kappa was 0.89/0.81/0.57, psoriasis 1.0/0.94/0.95, nail psoriasis 0.76/0.94/0.66 and uveitis 1.00/0.99/0.59. Agreement on psoriasis extent was 90%. Patient-reported dactylitis count was on average 1.0 unit higher than physician-reported but decreased to 0.7 after adding the dactylitis photo. Results were similar irrespective of blinding.

Conclusion

Patients reliably self-report dactylitis, psoriasis, and uveitis and the PROMs are valuable for monitoring NMMs in routine care.

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]]>135Sat, 12 Jul 2025 18:34:11 +0000A case report of genital psoriasis following transgender vaginoplastyhttps://www.psoriasis-news.de/articles.html/1_articles/a-case-report-of-genital-psoriasis-following-transgender-vaginoplasty-r134/No abstract supplied.

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]]>134Sat, 12 Jul 2025 18:34:11 +0000