Understanding sexuality during your testicular cancer journey

Hi Readers! 

This week’s topic is testicular cancer. Specifically, how testicular cancer can affect your sexuality. For all other information about testicular cancer, please visit the Orchid Cancer Appeal’s website. You will be able to download all the information you may want or need. If you or someone you know is affected by testicular cancer, call the Orchid Free National Helpline on 0808 802 0010 to speak to a specialist nurse. You can also email helpline@orchid-cancer.org.uk The helpline is open on Mondays, Wednesdays and Fridays from 9:00am to 5:30pm.

A lot of the information in today’s article is from Orchid Cancer Appeal.

Individuals who are affected by testicular cancer often have questions about their sexuality post treatment. Usually, removing a testicle will not affect the sexual performance of an individual or their ability to conceive children as the remaining testicle will produce enough testosterone and sperm to compensate, as long as it is healthy. 

If both testicles need to be removed, a testosterone replacement therapy will be needed. Testosterone replacement therapy is usually given in the form of injections or gels and should enable an individual with male anatomy to have sexual intercourse. Chemotherapy can cause temporary infertility that tends to persist for a (short) period of time after the treatment has finished. If you or a loved one is going through testicular cancer and its associated treatment, speak to the healthcare professional about options such as sperm storage or sperm banking. 

This is a great option for individuals who know they want a family as well as for those who are unsure. You will feel more at ease knowing that this is still an option.

Sexuality

A low libido is also a side effect of cancer and cancer treatment but the good news is a stable libido will return once treatment is over. Remember that intimacy is an important part of a couple’s sexuality. You can read more about intimacy here. If this is something you would like to explore, please see the self-help or the couple’s intimacy workbooks here

Talking about your concerns and fears of post treatment sexuality with your partner can feel uncomfortable, scary or timid. Communication within a couple is necessary. You cannot know what your partner is thinking if they do not tell you or you do not ask. Couples may find a new closeness after communicating. I invite you to read last week’s article about communication, if you haven’t already done so, by clicking here.

“One common fear is that cancer cells can be passed on to a partner during sex. This is not true. Cancer is not infectious and it is perfectly safe to have sexual intercourse” – Orchid Cancer Appeal.

For more information please visit www.orchid-cancer.org.uk and yourprivates.org.uk 

Be kind to one another!

Julia, Sexologist

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This is Why Communication is so Famous!

Hi Readers! 

This week’s topic is communication but more specifically, communication within your couple. It is imperative that you do not lose sight of the fact that the role of communication is to make the relationship stronger, not to break it. 

A few tips to consider before starting a healthy and calm conversation with your partner:

  • Let your partner know that you want to talk about topic X. Set a time and a place that is comfortable and possible for both of you. 
  • When you are stressed about something, it is easy to get defensive. Try some breathing exercises prior to the conversation to help calm yourself.
  • As they say… honesty is the best policy! Be open about your fears, concerns and desires with your partner.
  • Give your partner a chance to express themselves and use active listening skills like repeating what your partner said to ensure you understand. Do your best to validate your partner’s feelings with words of understanding. Listening to another person is about them, not you. Put aside your point of view, thoughts, opinions and reactions while they are speaking. They need to be heard as much as you do. 
  • The conversation should have open-ended questions. An interaction consisting of yes / no questions would not be a conversation. 
  • Know when you need to stop talking. If the conversation starts to get heated, it is probably time to wrap it up and conclude. Remember why you started the conversation. It wasn’t to start an argument. If things are constantly difficult, it may be a good idea to get in touch with a couple’s counsellor. 

Unfortunately, the reality of most conversations within a couple is one party gets blamed /victimised more than the other. Avoid lapsing into attacking, accusing, criticising or blaming your partner. Talk about yourself. Beginning a statement with “I feel that… I think we should……” instead of “You are doing….”

There is a difference between listening and hearing. Hearing is the act of perceiving sound by the ear. Hearing simply happens. Listening however is something that one consciously chooses to do. Listening requires concentration so that the brain processes meaning from words and sentences. Listening leads to learning. This isn’t always easy. The normal adult rate of speech is 100-150 words per minute but the brain can think at a rate of 400-500 words a minute, leaving extra time for day dreaming or anticipation. 

Listening skills can be learned and refined. Active listening allows you to be sensitive to the multiple dimensions of communication:

  • The occasion of the message: what is the reason why the person is communicating with me now?
  • The length of the message: What can the length of the message tell me about its importance?
  • The words chosen: Is the message being delivered formally? Or with slang?
  • The volume & pace: What clues do the loudness and speed give me?
  • The pauses & hesitations: How do these enhance or detract from the message?
  • The non-verbal clues: What do eye contact, posture or facial expressions tell me about the message?

Please remember to stay respectful, open, honest, calm and have compassion.

You can also purchase our Couple’s Intimacy Workbook here to help you and your partner improve, maintain or restore the intimacy in your couple. 

Be kind to one another, 

Julia, Sexologist

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How Stress is Affecting your Sex Life

Hi Readers!

April is Stress Awareness Month. Started in 1992, this is a national campaign to inform people about the dangers of stress, successful coping strategies and harmful misconceptions about stress that are prevalent in our society. 

Dealing with stress can affect your sex life and relationships. When a stress is applied, the body must react and change in order to cope. It does this through a release of hormones, like cortisol and epinephrine, which can cause a decrease in you libido. There are also psychological effects, being stressed about a multitude of things can impact your mood and a busy mind can distract you from wanting sex and lower your libido. Stress can also affect your lifestyle; some people deal with stress by smoking, drinking, overeating, forgetting about self-care and exercise. These choices will influence how you feel about yourself and interfere with your sex life. 

If you suspect that life stress is putting a damper on your libido, the first thing you should consider  is stress management. Changing the way you perceive and digest the stress can help you manage it better. There are many known strategies for dealing with stress and anxiety to ensure they won’t have an impact on your sexuality: meditation, high intensity exercise, yoga, journaling, and aromatherapy are just a few examples.

It is also recommended that you look at the health of your relationships. If there are stress and conflicts within those relationships, it may have an impact on your libido. It is important that you are communicating with the other person in your relationship. Try to understand the challenges you face together rather than being against each other. Spoil alert! Blaming one another doesn’t get you anywhere and you won’t find a solution that way. Be conscious of how you are getting your argument/point of view across. Using “ I feel….” or “I would like…” rather than “you did this…” and “you are so…”  * stay tuned for next week’s article about communication to learn more. 

Pick up a hobby together. Exercising together can be a fun way of spending time together. Make time for each other during the week. Practice just being together, with no pressure to have sex. A lot of couples tend to put pressure on sexual intercourse, but sexuality and intimacy are so much more than that. Focus on sensations and experiences rather than focusing on sex. For example: hugging, mutual massages, taking a bath/shower together.

Practice self-care and self-esteem, they make a difference in your sex life. If you don’t feel good about yourself, it will transpire in your sexuality and you won’t feel like having sex and being intimate with your partner.  

Our Intimacy Self-Help workbook and our Couple’s Intimacy workbook are available to purchase. 

Our Guide to Self-Love workbook is available to purchase here

Be kind to one another!

Julia, Sexologist

Julia, Sexologist Blog

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Vaginismus

Hi Readers!

This week’s topic is Vaginismus. This is when the vagina suddenly tightens up just as you try to insert something into it. It can be painful and cause distress. Good news is that this can be treated.

Vaginismus is an automatic reaction to the fear of some or all types of vaginal penetration. Whenever penetration is attempted, the vaginal muscles tighten up on their own. The person has no control over this. Vaginismus does not necessarily affect the ability to get aroused and enjoy other types of sexual contact. 

If you are experiencing vaginismus, remember it is not your fault and there is nothing to be ashamed of. 

NHS recommends that you see a GP or go to a sexual health clinic if:

  • You find it hard inserting a tampon into your vagina 
  • You struggle with vaginal penetration during sex
  • You feel burning or stinging pain during sex 

Treatment for vaginismus usually focuses on managing feelings around penetration and exercises to gradually get used to penetration. Possible treatments are psychosexual therapy, relaxation techniques, pelvic floor exercises, sensate focus and vaginal trainers. 

There are no obvious explanations for vaginismus, but there are some things thought to cause it; such as fear that the vagina is too small, a bad first sexual experience, an unpleasant medical examination, a belief that sex is shameful or wrong or a painful medical condition.

Be kind to one another!

Julia, Sexologist

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World Tuberculosis Day

Hi Readers! 

Today is World Tuberculosis Day. This day is to raise awareness about the health, social and economic consequences of Tuberculosis (TB). In 1882, Dr Robert Koch announced that he discovered the bacterium that causes TB, which paved the way to diagnosing and curing the disease. 

Each year, close to 28,000 people become ill with TB and nearly four thousand of them lose their lives, which makes this the deadliest infection! TB is preventable and curable. Since the year 2000, global efforts have saved approximately 63 million lives. 

The clock is ticking! A World TB Day campaign for action!

On World TB Day, WHO calls on everyone to keep the promise to:

  • Accelerate the End TB Response to reach the targets set in Sustainable Development Goals, WHO End TB Strategy, the Moscow Declaration to End TB and the political declaration of the UN High-Level Meeting on TB.
  • Diagnose and treat 40 million people with TB by 2022 including 3.5 million children and 1.5 million people with drug-resistant TB. This is in line with WHO’s overall drive towards Universal Health Coverage and the WHO Director General’s flagship initiative “Find. Treat. All. #EndTB” jointly with the Global Fund and Stop TB Partnership.
  • Reach 30 million people with TB preventive treatment by 2022 so that those people most at risk receive TB preventive treatment, including 24 million household contacts of TB patients – 4 million of whom are children under 5 – and 6 million people living with HIV.
  • Mobilize sufficient and sustainable financing to reach USD 13 billion a year to support efforts to end TB; for every USD 1 invested to end TB, USD 43 is returned as the benefits of a healthy functioning society (Economist/ Copenhagen Consensus).
  • Invest in TB research to reach at least USD 2 billion a year for better science, better tools and better delivery.

THE CLOCK IS TICKING. IT’S TIME TO KEEP OUR PROMISES. IT’S TIME TO #END TB.

You can find the campaign tool kit here

Share the information

Be Kind to one another!

Julia, Sexologist

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Let’s talk about the birds and the bees…

Hi Readers!

Great News!!!

In 3 days it will be spring!!! March 20th is the first day of spring! More people are out, it is beginning to warm up, a new beginning, days are longer! More people will be going out on dates, forming couples, etc. This is a great time to take a deep dive into the human reproductive anatomy! Let’s go!

There is one common part in both male and female genital anatomy and that is the anus. It is the opening of the rectum. The anus has a lot of sensitive nerve endings, so some people enjoy sexual pleasure from stimulating this body part.

We will begin with what is typically called ‘male genitalia’. 

The external anatomy is:

  • The penis: It is made of 3 layers of spongy tissue. When a person is aroused, blood fills these tissues. This causes the penis to become hard and stand up erect and is called an erection. The average size of an adult erect penis is between 5 to 7 inches long. All penises look different. For example: some curve, some are circumsized, others not, etc. (This is normal!!) They may look different, but they all have the same parts.
  • Glans: This is also commonly called the head or tip of the penis and contains the opening for the urethera. This is also where the pre-ejaculate and semen come out of as well as urine. For many, this is the most sensitive part of the penis. 
  • Shaft: The shaft of the penis extends from the tip to where it connects to the lower belly. The urethra is inside the shaft.
  • Foreskin: This is a patch of skin that covers and protects the glans. When the penis is erect, the foreskin pulls back and the tip is exposed. For some, foreskin is circumcised (surgically removed by a doctor soon after birth). 
  • Frenulum: This is where the foreskin meets the underside of the penis. It looks like a V just below the glans. This is very sensitive for many.
  • The Scrotum: This is the sac of skin that hangs below the penis. The scrotum holds the testicles and keeps them at the right temperature. If it’s too cold, the scrotum pulls the testicles closer to the body and vice-a-versa if it’s too warm. This part of the genitalia is covered by hair, which varies in colour. The scrotum can be big or small and may differ between the right side and the left side. The scrotum is very sensitive.

The internal anatomy is:

  • Testicles: They are the 2 ball-like glands inside the scrotum. They make sperm and hormones like testosterone.
  • Epididymis: This is the tube where the sperm matures. It connects each testicle to each vas deferens. It holds the sperm before ejaculation.
  • Vas Deferens: This is a long, narrow tube that carries sperm from the epididymis to the seminal vesicles during ejaculation. There is is one vas deferens for each epididymis.
  • Seminal Vesicles: These are 2 small organs that produce semen, the fluid that the sperm moves in. This is located below the bladder.
  • Prostate gland: Makes the fluid that helps your sperm move. It is approximately the size of a walnut of golf ball. The prostate gland is sensitive to the touch that can be pleasurable for many.
  • Cowper’s Glands: This produces fluid called pre-ejaculate. It prepares the urethra for ejaculation. It reduces friction so the semen can move easily. These glands are under the prostate and attached to the urethra. 
  • Urethra: This tube carries urine, pre-ejaculate and semen out of the body.
  • Cremaster: This is a muscle that moves the scrotum and testicles closer to the body. It happens  when it is too cold, when the individual is aroused or when the inner thigh is touched.   
PHOTO CREDIT: webmd
PHOTO CREDIT: webmd

Now let’s learn about what is typically “female genitalia”.

  • Vulva: part of the genitals on the outside of the body. The vulva has a lot more parts than just the vagina. Lots of people tend to say vagina when they really mean vulva although vagina is part of the vulva. Just like penises, there are no 2 vulvas that look the same, but they are made up of the same parts.
  • Labia: These are commonly called the lips, which are folds of skin around the vaginal opening. The labia majora, the outer lips, are usually covered with pubic hair. The labia minora, the inner lips, are inside the outer lips. These begin at the clitoris and end under the opening of the vagina. The labias vary in colour, some are pink, some are brown. The colour can change as individuals get older. Labias are sensitive and swell when aroused. 
  • Clitoris: The tip of the clitoris is located at the top of the vulva, where the inner lips meet. It is also covered by the clitoral hood. The size of the clitoris varies. The part that is visible is only the beginning of the clitoris as it extends inside the body and down on both sides of the vagina and is approximately 5 inches long. The clitoris is made of spongy tissues that become swollen when aroused. It has thousands of nerve endings – more than any other part of the human body, so you can imagine that it brings lots of pleasure!
  • Opening of the Urethra: This is a tiny hole that the urine comes out of, located just below the clitoris.
  • Opening of the vagina: It is located right below the urethral opening. It is where menstrual blood leaves the body, and through which babies are usually born. 
  • Mons Pubis: The mons is a mound above the vulva. After puberty, it is covered with pubic hair. The mons pubis cushions the pubic bone. 

The internal parts female sexual anatomy:

  • Vagina: A tube that connects the vulva with the cervix and uterus. It’s what babies and menstrual blood leave the body through. The vagina is really stretchy, and expands when a person is aroused. 
  • Cervix: The cervix is located and divides the vagina and uterus. It is round and has a hole in the middle which connects the uterus and the vagina. It let’s menstrual blood out and sperm in. It dilates during childbirth. The cervix separates the vagina from the rest of the body. 
  • Uterus: This is a pear-shaped muscular organ. This is where the foetus grows during pregnancy, some refer to it as the womb. During sexual arousal, the lower part of the uterus lifts toward the belly button, which is why the vagina gets longer when aroused.  
  • Fallopian tubes: These are 2 narrow tubes that carry eggs from the ovaries to the uterus. These are also used by the sperm to travel to fertilise an egg.
  • Fimbriae: Look like tiny fingers at the end of each fallopian tube. When the ovary releases an egg, they sweep it into the fallopian tube.
  • Ovaries: The ovaries store the eggs. They produce hormones, including oestrogen, progesterone and testosterone. These hormones control things like your period and pregnancy. 
  • Bartholin’s glands: These glands are near the vaginal opening. They release fluid that lubricates the vagina when aroused. 
  • Skene’s glands: They are on either side of the urethral opening. They release fluid during female ejaculation. 
  • Hymen: This is a thin tissue that stretches across part of the opening to the vagina. Hymens can sometimes, but not always, tear and cause some bleeding the first time vaginal penetration occurs. 
  • G spot: The famous Gräfenberg spot! It is located on the front or belly-button side of the vagina. It is a few inches inside the vagina and swells when aroused. Some like the feeling of their G-spot being touched. 
Photo credit: WebMD 
Photo credit: PlannedParenthood
Photo credit: PlannedParenthood

You should explore your body and get to know what your genitalia look and feel like. Yes, that means grab a mirror and check yourself out!! It is important to know what ‘YOUR normal’ looks and feels like so if something doesn’t seem right you are able to better identify it and seek out medical assistance.

Happy Spring Equinox!!

Be kind to one another

Julia, Sexologist

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UK SAYS NO MORE

Hi Readers! 

March 7th to 13th is UK SAYS NO MORE. This campaign’s aim is to unite and strengthen a diverse community of the public and organisations nationwide to actively take a stand against domestic abuse and sexual violence. 

Domestic abuse and sexual violence can impact anyone, at any point in their life, regardless of their background, age, gender, ethnicity, socio-economic status or sexuality. 

What is domestic abuse?

Domestic abuse can happen anytime and in any type of partner relationship. At times family members and extended family members can take part in the abuse. These include “honour” based violence, female genital mutilation and forced marriage. The abuse an individual will experience will differ from circumstance to circumstance. The types of violence can include, but is  not limited to, physical, economic, financial, online, psychological and emotional abuse, coercive control and sexual abuse.

It is important that we believe all victims of abuse, we respond by listening without judgement and offer support by referring to specialist support services. 

What is sexual violence?

Sexual violence is a term used to encompass any type of unwanted sexual act or activity, including rape, sexual assault, sexual abuse and many others. Sexual violence can happen to anyone, at any age. 

It is important to remember that it is never the survivor’s fault. The responsibility lies solely with the perpetrator.

It is also important to remember that the survivor has the choice and control over what they want to do next. 

Impacts on the victims

  • Over time, the survivor’s self-esteem may be worn down. They may believe their abuser’s insults. 
  • The survivor may blame themselves for the abuse. It is not their fault.
  • The survivor may feel a sense of shame, sadness and powerlessness.
  • Low self-esteem, feeling unworthy
  • Low self-image
  • Anxiety
  • Depression
  • Post-traumatic stress disorder (PTSD); including flashbacks, nightmares, uncontrollable thoughts
  • Alcohol and drug abuse
  • Suicidal thoughts or attempts
    • If someone you know if feeling suicidal, please give them the phone number of a local or national charity / helpline that they can call for help
  • Hopelessness
  • Inability to trust

If you are worried about someone you know, reach out to them. Before you do that, make sure you have the information you need, such as domestic violence resources in your country, so you know where to signpost the person. You can also help them through their next steps. Remember that it is difficult and may take time for an individual to want to talk and divulge information about abuse. Be patient with them. 

It will also take some time for the survivor to get back to being “themselves”. It takes work to undo what has been done to them. These survivors are courageous, respectful, powerful and resilient. 

You can click here for resources.

Be kind to one another!

Julia, Sexologist

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#ChooseToChallenge

Hi Readers!

Monday 8 March 2021 is International Women’s Day! 

The 2021 campaign is focused on challenge and change, #ChooseToChallenge.

The premise is that a challenged world, is an alert world. 

As individuals, of all gender identities, we are responsible for our actions and thoughts. You have the power and the choice to challenge and speak up. It is when things are challenged, that there is a change. There is still a lot of work to be done to create a gender-equal world, but collectively we can make a change. 

So, I challenge you to take a photo of yourself in the #ChooseToChallenge pose.

#choosetochallenge

Will you actively call out gender bias, discrimination and stereotyping each time you see it? Will you choose to challenge? 

You can submit your #ChooseToChallenge pose on the IWD website and they will be sharing them on their platforms in the lead up to International Women’s Day on March 8th. 

All gender identities are welcome and encouraged. 

For teachers, tutors and educators the International Women’s Day downloadable resources can be found here.

Remember that when you #ChooseToChallenge it is not just on International Women’s Day or during the month of March. You #ChooseToChallenge for the year! 

Be kind to one another!

Julia, Sexologist

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Puberty – boys

Hi Readers!

As promised, this week’s topic is about puberty in boys.

Puberty is when a child’s body begins to develop and change as they become an adult. Boys develop a deeper voice and facial hair will start to appear. The average age for boys to begin puberty is 12. But it varies from boy to boy. Do not worry if the child reaches puberty before or after their friends. It is normal for puberty to begin at any point from the ages 8 to 14 and the process takes up to 4 years.

What are the first signs of puberty?

The first sign of puberty for boys is usually that their testicles get bigger and the scrotum begins to thin and redden, pubic hair also starts to appear at the base of the penis. 

Beginning one year after the start of puberty and continuing for the next three years:

  • The penis and testicles grow and the scrotum gradually becomes darker
  • Pubic hair becomes thicker and curlier
  • Underarm hair starts to grow
  • More sweat
  • Breasts can slightly swell temporarily (no, this is not the same as “man-boobs”)
  • Boys may have “wet dreams”. These are involuntary ejaculations of semen as they sleep
  • The voice starts to get permanently deeper
  • Acne starts to develop
  • Growth spurt (around 3 inches a year)

After approximately 4 years, genitals are adult-like and pubic hair has spread to the inner thighs, facial hair begins to grow and boys generally start to shave. While boys continue to grow until age 16, growth is at a slower rate than during the first four years and, by age 18, they will have reached adult maturity. 

How does it affect children?

This period in life can be very difficult. There are a lot of changes happening in the body and the appearance of acne and body odours can lead children / teens to feel self-conscious. Puberty can also be an exciting time as they develop new emotions and feelings. That being said, many go through an emotional “rollercoaster” which can have psychological and emotional effects. For example, unexplained mood swings, low self-esteem, low self-image as they become more and more self-conscious, aggression or depression. 

Although is may seem like no one understands, everyone has and will go through these changes. 

If you are going through puberty, it is important to talk and let these feelings out; talk to a friend, a teacher, a counsellor, your parents, a family member.

As for parents, it can seem difficult talking to your child if they do not seem like themselves psychologically. Let them know you are there for them. You can bring up the subject. The NHS has a few pages for parents for coping with their children and talking to your teen.

Be kind to one another 

Julia, Sexologist

Puberty – Girls

Hi Readers!

This week’s subject is about puberty in girls. I will cover puberty in boys next week!

Puberty is when a child’s body begins to develop and change as they become an adult.

Girls develop breasts and start their periods. The average age for girls to begin puberty is 11. Do not worry if a child reaches puberty before or after their friends, is it different for everyone. It is normal for puberty to begin at any point from the ages 8 to 14 and the process takes up to 4 years.

What are the first signs of puberty?

During the first couple of years of puberty, girls undergo many changes:

  • Breasts grow and become fuller
  • First menstruation
  • Pubic hair becomes coarser and curlier
  • Underarm hair begins to grow along with hair on other parts of the body
  • Girls start to sweat more
  • Appearance of acne 
  • Vaginal discharge
  • Growth spurts until adult height is reached at the end of puberty
  • Most girls gain weight as their body shape changes

After approximately 4 years of puberty, breasts are fully developed, pubic hair has spread to the inner thigh, genitals are fully developed and the teenager stops growing. 

How does puberty affect children?

This period can be very difficult. There are a lot of changes happening in the body and the appearance of acne and body odours can lead children / teens to feel self-conscious. Puberty can also be an exciting time as they develop new emotions and feelings. That being said, many go through an emotional “rollercoaster” which can have psychological and emotional effects. For example, unexplained mood swings, low self-esteem, low self-image as they become more and more self-conscious, aggression or depression. 

Although it may seem like no one understands, everyone has and will go through these changes. If you are going through puberty, it is important to let these feelings out; talk to a friend, a teacher, a counsellor, your parents, a family member.

And for all you parents out there, it might feel difficult to talk to your child when they do not seem like themselves psychologically but it is important to let them know you are there for them. In fact, the NHS has some resources that can help you start the conversation with your teenager. Parents for coping with their children and talking to your teen.  

Be kind to one another,

Julia, Sexologist

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