The intersection of gynecology and mental health: addressing the psychological dimensions of women's health
Palabras clave:
Gynecology, holistic care, mental health, psychological well-being, reproductive health, women healthResumen
Introduction: the intersection between gynecology and mental health is a crucial, yet often underappreciated, aspect of women's healthcare. Various gynecologic conditions and treatments have significant psychological implications, highlighting the need to integrate mental health into gynecologic care.
Objective: to explore the psychological dimensions of gynecologic health.
Methods: a systematic review of relevant literature was conducted using databases including PubMed, Google Scholar, Scopus, and Web of Science. Specific keywords, including “Gynecology,” “Mental Health,” and “Holistic Approach,” were used to identify studies on the psychological dimensions of women's health. After a rigorous screening process, 38 articles that met the inclusion criteria were included, providing a comprehensive analysis of the psychological aspects of gynecologic health.
Conclusions: the review highlights the profound impact of hormonal influences, reproductive challenges, and gynecologic cancers on mental well-being, demonstrating the need for holistic care in gynecology. Cultural and socioeconomic factors also influence access to mental health support, reinforcing the need to integrate mental health into gynecologic care. Recommendations include expanding mental health screening and promoting a multidisciplinary approach to improve outcomes and address the unique health care needs of women.
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2. Carlini SV, Deligiannidis KM. Evidence-Based Treatment of Premenstrual Dysphoric Disorder: A Concise Review. J Clin Psychiatry [Internet]. 2020 [cited 21/03/2024]; 81(2):19ac13071. Available in: https://doi.org/10.4088/JCP.19ac13071
3. Till SR, As-Sanie S, Schrepf A. Psychology of Chronic Pelvic Pain: Prevalence, Neurobiological Vulnerabilities, and Treatment. Clin Obstet Gynecol [Internet]. 2019 [cited 29/03/2024]; 62(1):22-36. Available in: https://doi.org/10.1097/GRF.0000000000000412
4. La Rosa VL, De Franciscis P, Barra F, Schiattarella A, Török P, Shah M, et al. Quality of life in women with endometriosis: a narrative overview. Minerva Medica [Internet]. 2020 [cited 25/03/2024]; 111(1):68–78. Available in: https://doi.org/10.23736/S0026-4806.19.06298-0
5. Yang K, Wu J, Chen X. Risk factors of perinatal depression in women: a systematic review and meta-analysis. BMC Psychiatry [Internet]. 2022 [cited 05/03/2024]; 22(1):63. Available in: https://doi.org/10.1186/s12888-021-03684-3
6. Patel A, Sharma PSVN, Kumar P. "In Cycles of Dreams, Despair, and Desperation:" Research Perspectives on Infertility Specific Distress in Patients Undergoing Fertility Treatments. Journal of Human Reproductive Sciences [Internet]. 2018 [cited 13/04/2024]; 11(4):320–328. Available in: https://doi.org/10.4103/jhrs.JHRS_42_18
7. Nasution LA, Afiyanti Y, Ma’rifah AR. The most unmet needs on Gynecological and Breast Cancer Survivors, A Systematic Review. Enfermería Global [Internet]. 2023 [cited 04/03/2024]; 22(2):497–521. Available in: https://doi.org/10.6018/eglobal.530511
8. Ma'rifah AR, Afiyanti Y, Huda MH, Chipojola R, Putri YR, Nasution MAT. Effectiveness of psychoeducation intervention among women with gynecological cancer: a systematic review and meta-analysis of randomized controlled trials. Supportive Care in Cancer [Internet]. 2022 [cited 19/03/2024]; 30(10):8271–8285. Available in: https://doi.org/10.1007/s00520-022-07277-y
9. Adebisi OY, Carlson K. Hypoactive Sexual Desire Disorder in Women. StatPearls Publishing [Internet]. 2024 [cited 24/03/2024]. Available in: https://www.ncbi.nlm.nih.gov/books/NBK603746/
10. Miller ES, Jensen R, Hoffman MC, Osborne LM, McEvoy K, Grote N, et al. Implementation of perinatal collaborative care: a health services approach to perinatal depression care. Primary Health Care Research & Development [Internet]. 2020 [cited 17/03/2024]; 21. Available in: https://doi.org/10.1017/S1463423620000110
11. Brindis CD, Laitner MH, Clayton EW, Scrimshaw SC, Grosz BJ, Simpson LA, et al. Health-care workforce implications of the Dobbs v Jackson Women's Health Organization decision. Lancet [Internet]. 2024 [cited 30/03/2024]; 403(10445):2747–2750. Available in: https://doi.org/10.1016/S0140-6736(24)00581-6
12. Geraghty L. Homelessness facts and statistics: The numbers you need to know in 2024. Big Issue [Internet]. 2024 [cited 03/02/2024]. Available in: https://www.bigissue.com/news/housing/britains-homelessness-shame-cold-hard-facts/#:~:text=A%20total%20of%204%2C118%20people,statistics%20have%20taken%20its%20place
13. Raney JH, Weinstein S, Ganson KT, Testa A, Jackson DB, Pantell M, et al. Mental Well-Being Among Adversity-Exposed Adolescents During the COVID-19 Pandemic. JAMA Network Open [Internet]. 2024 [cited 13/04/2024]; 7(3). Available in: https://doi.org/10.1001/jamanetworkopen.2024.2076
14. Raney JH, Weinstein S, Ganson KT, Testa A, Jackson DB, Pantell M, et al. In the Face of Adversity: Pandemic Mental Health Protective Factors for Adolescents Who Have Experienced Adverse Childhood Experiences. Journal of Adolescent Health [Internet]. 2024 [cited 11/04/2024]; 74(3). Available in: https://doi.org/10.1016/j.jadohealth.2023.11.305
15. Ma S, Song SJ. Oral contraceptives containing drospirenone for premenstrual syndrome. Cochrane Database Syst Rev [Internet]. 2023 [cited 26/02/2024]; 6(6):CD006586. Available in: https://doi.org/10.1002/14651858.CD006586.pub5
16. Zethraeus N, Kocoska-Maras L, Ellingsen T, von Schoultz B, Hirschberg AL, Johannesson MA. A randomized trial of the effect of estrogen and testosterone on economic behavior. Proceedings of the National Academy of Sciences of the United States of America [Internet]. 2009 [cited 23/04/2024]; 106(16):6535–6538. Available in: https://doi.org/10.1073/pnas.0812757106
17. Mu E, Kulkarni J. Hormonal contraception and mood disorders. Australian Prescriber [Internet]. 2022 [cited 01/03/2024]; 45(3):75-79. Available in: https://doi.org/10.18773/austprescr.2022.025
18. Maki PM, Kornstein SG, Joffe H, Bromberger JT, Freeman EW, Athappilly G, et al. Guidelines for the Evaluation and Treatment of Perimenopausal Depression: Summary and Recommendations. Journal of Women's Health [Internet]. 2019 [cited 22/02/2024]; 28(2):117-134. Available in: https://doi.org/10.1089/jwh.2018.27099.mensocrec
19. Namazi M, Behboodi Moghadam Z, Zareiyan A, Jafarabadi M. Exploring the impact of endometriosis on women's lives: A qualitative study in Iran. Nurs Open [Internet]. 2021 [cited 15/03/2024]; 8(3):1275-1282. Available in: https://doi.org/10.1002/nop2.744
20. Yin X, Ji Y, Chan CLW, Chan CHY. The mental health of women with polycystic ovary syndrome: a systematic review and meta-analysis. Arch Womens Ment Health [Internet]. 2021 [cited 02/02/2024]; 24(1):11-27. Available in: https://doi.org/10.1007/s00737-020-01043-x
21. Chiuve SE, Huisingh C, Petruski-Ivleva N, Owens C, Kuohung W, Wise LA. Uterine fibroids and incidence of depression, anxiety and self-directed violence: a cohort study. Journal of Epidemiology and Community Health [Internet]. 2022 [cited 04/03/2024]; 76(1):92–99. Available in: https://doi.org/10.1136/jech-2020-214565
22. South & West. 7.4.2 Drugs for urinary frequency, enuresis, and incontinence. South & West [Internet].2024 [cited 30/03/2024]. Available in: https://southwest.devonformularyguidance.nhs.uk/formulary/chapters/7-obstetrics-gynaecology-and-urinary-tract-disorders/7-4-genito-urinary-disorders/7-4-2-drugs-for-urinary-frequency-enuresis-and-incontinence
23. Rooney KL, Domar AD. The relationship between stress and infertility. Dialogues in Clinical Neuroscience [Internet]. 2018 [cited 22/02/2024]; 20(1):41–47. Available in: https://doi.org/10.31887/DCNS.2018.20.1/klrooney
24. Lewkowitz AK, Whelan AR, Ayala NK, Hardi A, Stoll C, Battle CL, et al. The effect of digital health interventions on postpartum depression or anxiety: a systematic review and meta-analysis of randomized controlled trials. American Journal of Obstetrics and Gynecology [Internet]. 2024 [cited 23/03/2024];230(1):12–43. Available in: https://doi.org/10.1016/j.ajog.2023.06.028
25. Mughal S, Azhar Y, Siddiqui W. Postpartum Depression. StatPearls [Internet]. 2022 [cited 26/02/2024]. Available in: https://www.ncbi.nlm.nih.gov/books/NBK519070/
26. Global Cancer Observatory [Internet]. 2024 [cited 04/03/2024]. Available in: https://gco.iarc.fr/en
27. Zhao J, Kong Y, Xiang Y, Yang J. The research landscape of the quality of life or psychological impact on gynecological cancer patients: A bibliometric analysis. Frontiers in Oncology [Internet]. 2023 [cited 16/02/2024]; 13. Available from: https://doi.org/10.3389/fonc.2023.1115852
28. Hack C, Hüttner N, Paepke D, Voiß P, Dobos G, Kümmel S, et al. Integrative Medizin in der Gynäkologischen Onkologie – Möglichkeiten und Grenzen Teil 1. Tumordiagnostik & Therapie [Internet]. 2014 [cited 28/03/2024]; 35(06):337–344. Available in: https://doi.org/10.1055/s-0034-1385131
29. de Rooij BH, Thomas TH, Post KE, Flanagan J, Ezendam NPM, Peppercorn J, et al. Survivorship care planning in gynecologic oncology-perspectives from patients, caregivers, and health care providers. Journal of Cancer Survivorship [Internet]. 2018 [cited 06/02/2024]; 12(6):762–774. Available in: https://doi.org/10.1007/s11764-018-0713-9
30. ACOG Committee Opinion No. 757: Screening for Perinatal Depression. Obstet Gynecol [Internet]. 2018 [cited 30/03/2024]; 132(5)–e212. Available in: https://doi.org/10.1097/AOG.0000000000002927
31. World Health Organization. Integrating the social determinants of health into health workforce education and training [Internet]. 2023 [cited 06/02/2024]. Available in: https://www.who.int/news-room/events/detail/2023/11/08/default-calendar/integrating-the-social-determinants-of-health-into-health-workforce-education-and-training
32. Chen W, Peng W, Zhang Y, Zhou H, Zhang M. Anxiety and depression among perinatal women during the long-term normal prevention of COVID-19 pandemic period in China: a cross-sectional study. BMC Psychiatry [Internet]. 2023 [cited 29/02/2024]; 23(1):451. Available in: https://doi.org/10.1186/s12888-023-04930-6
33. American Medical Association. Integrating mental health care into the OB practice [Internet]. 2022 Mar [cited 05/03/2024]. Available in: https://www.ama-assn.org/about/events/integrating-mental-health-care-ob-practice
34. Selix N, Henshaw E, Barrera A, Botcheva L, Huie E, Kaufman G. Interdisciplinary Collaboration in Maternal Mental Health. MCN the American Journal of Maternal/Child Nursing [Internet]. 2017 [cited 12/03/2024]; 42(4):226–231. Available in: https://doi.org/10.1097/nmc.0000000000000343
35. World Health Organization. WHO unveils a digital health promoter harnessing generative AI for public health [Internet]. 2024 [cited 28/02/2024]. Available in: https://www.who.int/news/item/02-04-2024-who-unveils-a-digital-health-promoter-harnessing-generative-ai-for-public-health
36. GOV.UK. Keeping children safe in education [Internet]. 2024 [cited 05/03/2024]. Available in: https://www.gov.uk/government/publications/keeping-children-safe-in-education--2
37. World Health Organization. World health statistics 2024: monitoring health for the SDGs, sustainable development goals [Internet]. 2024 May 21 [cited 29/02/2024]. Available in: https://www.who.int/publications/i/item/9789240094703
38. U.S. Agency for International Development. Digital Strategy 2020-2024 [Internet]. 2024 [cited 01/03/2024]. Available in: https://www.usaid.gov/digital-development/digital-strategy#:~:text=USAID's%20first%20Digital%20Strategy%20charts,development%20and%20humanitarian%20assistance%20outcomes
2. Carlini SV, Deligiannidis KM. Evidence-Based Treatment of Premenstrual Dysphoric Disorder: A Concise Review. J Clin Psychiatry [Internet]. 2020 [cited 21/03/2024]; 81(2):19ac13071. Available in: https://doi.org/10.4088/JCP.19ac13071
3. Till SR, As-Sanie S, Schrepf A. Psychology of Chronic Pelvic Pain: Prevalence, Neurobiological Vulnerabilities, and Treatment. Clin Obstet Gynecol [Internet]. 2019 [cited 29/03/2024]; 62(1):22-36. Available in: https://doi.org/10.1097/GRF.0000000000000412
4. La Rosa VL, De Franciscis P, Barra F, Schiattarella A, Török P, Shah M, et al. Quality of life in women with endometriosis: a narrative overview. Minerva Medica [Internet]. 2020 [cited 25/03/2024]; 111(1):68–78. Available in: https://doi.org/10.23736/S0026-4806.19.06298-0
5. Yang K, Wu J, Chen X. Risk factors of perinatal depression in women: a systematic review and meta-analysis. BMC Psychiatry [Internet]. 2022 [cited 05/03/2024]; 22(1):63. Available in: https://doi.org/10.1186/s12888-021-03684-3
6. Patel A, Sharma PSVN, Kumar P. "In Cycles of Dreams, Despair, and Desperation:" Research Perspectives on Infertility Specific Distress in Patients Undergoing Fertility Treatments. Journal of Human Reproductive Sciences [Internet]. 2018 [cited 13/04/2024]; 11(4):320–328. Available in: https://doi.org/10.4103/jhrs.JHRS_42_18
7. Nasution LA, Afiyanti Y, Ma’rifah AR. The most unmet needs on Gynecological and Breast Cancer Survivors, A Systematic Review. Enfermería Global [Internet]. 2023 [cited 04/03/2024]; 22(2):497–521. Available in: https://doi.org/10.6018/eglobal.530511
8. Ma'rifah AR, Afiyanti Y, Huda MH, Chipojola R, Putri YR, Nasution MAT. Effectiveness of psychoeducation intervention among women with gynecological cancer: a systematic review and meta-analysis of randomized controlled trials. Supportive Care in Cancer [Internet]. 2022 [cited 19/03/2024]; 30(10):8271–8285. Available in: https://doi.org/10.1007/s00520-022-07277-y
9. Adebisi OY, Carlson K. Hypoactive Sexual Desire Disorder in Women. StatPearls Publishing [Internet]. 2024 [cited 24/03/2024]. Available in: https://www.ncbi.nlm.nih.gov/books/NBK603746/
10. Miller ES, Jensen R, Hoffman MC, Osborne LM, McEvoy K, Grote N, et al. Implementation of perinatal collaborative care: a health services approach to perinatal depression care. Primary Health Care Research & Development [Internet]. 2020 [cited 17/03/2024]; 21. Available in: https://doi.org/10.1017/S1463423620000110
11. Brindis CD, Laitner MH, Clayton EW, Scrimshaw SC, Grosz BJ, Simpson LA, et al. Health-care workforce implications of the Dobbs v Jackson Women's Health Organization decision. Lancet [Internet]. 2024 [cited 30/03/2024]; 403(10445):2747–2750. Available in: https://doi.org/10.1016/S0140-6736(24)00581-6
12. Geraghty L. Homelessness facts and statistics: The numbers you need to know in 2024. Big Issue [Internet]. 2024 [cited 03/02/2024]. Available in: https://www.bigissue.com/news/housing/britains-homelessness-shame-cold-hard-facts/#:~:text=A%20total%20of%204%2C118%20people,statistics%20have%20taken%20its%20place
13. Raney JH, Weinstein S, Ganson KT, Testa A, Jackson DB, Pantell M, et al. Mental Well-Being Among Adversity-Exposed Adolescents During the COVID-19 Pandemic. JAMA Network Open [Internet]. 2024 [cited 13/04/2024]; 7(3). Available in: https://doi.org/10.1001/jamanetworkopen.2024.2076
14. Raney JH, Weinstein S, Ganson KT, Testa A, Jackson DB, Pantell M, et al. In the Face of Adversity: Pandemic Mental Health Protective Factors for Adolescents Who Have Experienced Adverse Childhood Experiences. Journal of Adolescent Health [Internet]. 2024 [cited 11/04/2024]; 74(3). Available in: https://doi.org/10.1016/j.jadohealth.2023.11.305
15. Ma S, Song SJ. Oral contraceptives containing drospirenone for premenstrual syndrome. Cochrane Database Syst Rev [Internet]. 2023 [cited 26/02/2024]; 6(6):CD006586. Available in: https://doi.org/10.1002/14651858.CD006586.pub5
16. Zethraeus N, Kocoska-Maras L, Ellingsen T, von Schoultz B, Hirschberg AL, Johannesson MA. A randomized trial of the effect of estrogen and testosterone on economic behavior. Proceedings of the National Academy of Sciences of the United States of America [Internet]. 2009 [cited 23/04/2024]; 106(16):6535–6538. Available in: https://doi.org/10.1073/pnas.0812757106
17. Mu E, Kulkarni J. Hormonal contraception and mood disorders. Australian Prescriber [Internet]. 2022 [cited 01/03/2024]; 45(3):75-79. Available in: https://doi.org/10.18773/austprescr.2022.025
18. Maki PM, Kornstein SG, Joffe H, Bromberger JT, Freeman EW, Athappilly G, et al. Guidelines for the Evaluation and Treatment of Perimenopausal Depression: Summary and Recommendations. Journal of Women's Health [Internet]. 2019 [cited 22/02/2024]; 28(2):117-134. Available in: https://doi.org/10.1089/jwh.2018.27099.mensocrec
19. Namazi M, Behboodi Moghadam Z, Zareiyan A, Jafarabadi M. Exploring the impact of endometriosis on women's lives: A qualitative study in Iran. Nurs Open [Internet]. 2021 [cited 15/03/2024]; 8(3):1275-1282. Available in: https://doi.org/10.1002/nop2.744
20. Yin X, Ji Y, Chan CLW, Chan CHY. The mental health of women with polycystic ovary syndrome: a systematic review and meta-analysis. Arch Womens Ment Health [Internet]. 2021 [cited 02/02/2024]; 24(1):11-27. Available in: https://doi.org/10.1007/s00737-020-01043-x
21. Chiuve SE, Huisingh C, Petruski-Ivleva N, Owens C, Kuohung W, Wise LA. Uterine fibroids and incidence of depression, anxiety and self-directed violence: a cohort study. Journal of Epidemiology and Community Health [Internet]. 2022 [cited 04/03/2024]; 76(1):92–99. Available in: https://doi.org/10.1136/jech-2020-214565
22. South & West. 7.4.2 Drugs for urinary frequency, enuresis, and incontinence. South & West [Internet].2024 [cited 30/03/2024]. Available in: https://southwest.devonformularyguidance.nhs.uk/formulary/chapters/7-obstetrics-gynaecology-and-urinary-tract-disorders/7-4-genito-urinary-disorders/7-4-2-drugs-for-urinary-frequency-enuresis-and-incontinence
23. Rooney KL, Domar AD. The relationship between stress and infertility. Dialogues in Clinical Neuroscience [Internet]. 2018 [cited 22/02/2024]; 20(1):41–47. Available in: https://doi.org/10.31887/DCNS.2018.20.1/klrooney
24. Lewkowitz AK, Whelan AR, Ayala NK, Hardi A, Stoll C, Battle CL, et al. The effect of digital health interventions on postpartum depression or anxiety: a systematic review and meta-analysis of randomized controlled trials. American Journal of Obstetrics and Gynecology [Internet]. 2024 [cited 23/03/2024];230(1):12–43. Available in: https://doi.org/10.1016/j.ajog.2023.06.028
25. Mughal S, Azhar Y, Siddiqui W. Postpartum Depression. StatPearls [Internet]. 2022 [cited 26/02/2024]. Available in: https://www.ncbi.nlm.nih.gov/books/NBK519070/
26. Global Cancer Observatory [Internet]. 2024 [cited 04/03/2024]. Available in: https://gco.iarc.fr/en
27. Zhao J, Kong Y, Xiang Y, Yang J. The research landscape of the quality of life or psychological impact on gynecological cancer patients: A bibliometric analysis. Frontiers in Oncology [Internet]. 2023 [cited 16/02/2024]; 13. Available from: https://doi.org/10.3389/fonc.2023.1115852
28. Hack C, Hüttner N, Paepke D, Voiß P, Dobos G, Kümmel S, et al. Integrative Medizin in der Gynäkologischen Onkologie – Möglichkeiten und Grenzen Teil 1. Tumordiagnostik & Therapie [Internet]. 2014 [cited 28/03/2024]; 35(06):337–344. Available in: https://doi.org/10.1055/s-0034-1385131
29. de Rooij BH, Thomas TH, Post KE, Flanagan J, Ezendam NPM, Peppercorn J, et al. Survivorship care planning in gynecologic oncology-perspectives from patients, caregivers, and health care providers. Journal of Cancer Survivorship [Internet]. 2018 [cited 06/02/2024]; 12(6):762–774. Available in: https://doi.org/10.1007/s11764-018-0713-9
30. ACOG Committee Opinion No. 757: Screening for Perinatal Depression. Obstet Gynecol [Internet]. 2018 [cited 30/03/2024]; 132(5)–e212. Available in: https://doi.org/10.1097/AOG.0000000000002927
31. World Health Organization. Integrating the social determinants of health into health workforce education and training [Internet]. 2023 [cited 06/02/2024]. Available in: https://www.who.int/news-room/events/detail/2023/11/08/default-calendar/integrating-the-social-determinants-of-health-into-health-workforce-education-and-training
32. Chen W, Peng W, Zhang Y, Zhou H, Zhang M. Anxiety and depression among perinatal women during the long-term normal prevention of COVID-19 pandemic period in China: a cross-sectional study. BMC Psychiatry [Internet]. 2023 [cited 29/02/2024]; 23(1):451. Available in: https://doi.org/10.1186/s12888-023-04930-6
33. American Medical Association. Integrating mental health care into the OB practice [Internet]. 2022 Mar [cited 05/03/2024]. Available in: https://www.ama-assn.org/about/events/integrating-mental-health-care-ob-practice
34. Selix N, Henshaw E, Barrera A, Botcheva L, Huie E, Kaufman G. Interdisciplinary Collaboration in Maternal Mental Health. MCN the American Journal of Maternal/Child Nursing [Internet]. 2017 [cited 12/03/2024]; 42(4):226–231. Available in: https://doi.org/10.1097/nmc.0000000000000343
35. World Health Organization. WHO unveils a digital health promoter harnessing generative AI for public health [Internet]. 2024 [cited 28/02/2024]. Available in: https://www.who.int/news/item/02-04-2024-who-unveils-a-digital-health-promoter-harnessing-generative-ai-for-public-health
36. GOV.UK. Keeping children safe in education [Internet]. 2024 [cited 05/03/2024]. Available in: https://www.gov.uk/government/publications/keeping-children-safe-in-education--2
37. World Health Organization. World health statistics 2024: monitoring health for the SDGs, sustainable development goals [Internet]. 2024 May 21 [cited 29/02/2024]. Available in: https://www.who.int/publications/i/item/9789240094703
38. U.S. Agency for International Development. Digital Strategy 2020-2024 [Internet]. 2024 [cited 01/03/2024]. Available in: https://www.usaid.gov/digital-development/digital-strategy#:~:text=USAID's%20first%20Digital%20Strategy%20charts,development%20and%20humanitarian%20assistance%20outcomes
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01-01-2025
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Eskandar K. The intersection of gynecology and mental health: addressing the psychological dimensions of women’s health. MedEst [Internet]. 1 de enero de 2025 [citado 18 de enero de 2025];5(1):e278. Disponible en: https://revmedest.sld.cu/index.php/medest/article/view/278
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