Ukulutha komuntu ongcolile: Ingabe kuyinto ehlukile? (I-2017)

Adnan Kadiani, U-Ekram Goyal, Spandana Devabhaktuni, UBrig Daniel Saldanha, Bhushan Chaudhari
UMnyango Wezifo Zengqondo, UDkt DY Patil Medical College, Isibhedlela Nesikhungo Sokucwaninga, Pune, Maharashtra, India

Ikheli Lokuxhumana:
UBrig Daniel Saldanha
UMnyango Wezengqondo, uDkt DY Patil Medical College, iPimpri, iPune - 411 018, Maharashtra
India

Umthombo Wokusekela: Akunjalo, Ukungqubuzana kwezintshisekelo: None

I-DOI: I-10.4103 / MJDRDYPU.MJDRDYPU_303_16

Kuzo zonke izinhlobo ezahlukahlukene zokuluthwa umkhuba, lowo ohlobene nomsebenzi wezocansi kungenzeka ukuthi kunzima kakhulu ukuwaphatha njengoba simanqikanqika ukuxoxa ngezinkinga ezihlobene nezocansi. Ukusuka ekubukeni okungenacala kokuqukethwe kocansi ebusheni, owesilisa oneminyaka engu-34 oshadile oneminyaka engu-6 uba umlutha wakho. Leli cala libonisa ukubaluleka kokubona umlutha wobulili ezingcolile njengokuphazamiseka nobunzima obukhona ekuphathweni kwabo.

Amagama angukhiye: Ukwelapha kokuziphatha okuqondayo, ukuziphatha okubuka ezocansi, umlutha wobulili ezingcolile

Ukukhula okucacile kwe-intanethi ezikhathini zamuva kukhombisa ubukhulu babantu, ababuka izithombe zocansi, okungukuthi, kunamawebhusayithi angaphezu kwezigidi eziyi-4.2 wezithombe zocansi anezicelo eziyizinkulungwane ezingama-68 zenjini yokusesha yezithombe zocansi. Cishe ababukeli be-inthanethi abacishe babe ngu-42.7% babuka izithombe zocansi kuthi izigidi ezingama-72 zibuke amasayithi abantu abadala emhlabeni wonke ngenyanga. Cishe i-28% yemali engenayo ye-porn yaseChina neyaseNingizimu Korea ifinyelela ngaphezulu kwama- $ 27.40 billion ngamunye eyanele ukondla ama-62% wabantu abalambile emhlabeni unyaka wonke.^[1] Njengoba kunikezwe amaqiniso angenhla, umlutha we-inthanethi yize ungafakwanga ohlwini lokuphazamiseka kwengqondo ku-International Classization of Disease 10 noma i-Diagnostic and Statistical Manual of Mental Disorder-5 (DSM-5), ukuba khona kwayo kuyindaba yokuphikisana yize abaningi bethi bayimilutha. ezithombeni ezingcolile futhi ufune usizo.^[2] Abanye abacwaningi bazamile ukukuqhathanisa nezindlela zokunye umlutha osunguliwe njengokuhlukumeza izidakamizwa.^[3] Umlutha osondele kakhulu wokuziphatha ongaqhathaniswa nawo mhlawumbe “ukugembula” obizwa ngokuthi umlutha ngaphandle kwesidakamizwa. Isizathu sokubandakanya ukugembula njengesisetshenziswa somlutha kanye nokuphazamiseka kokusebenzisa izidakamizwa kususelwa ebufakazini obuvela ocwaningweni obukhona obukhombisa ukuthi abagembuli bahlanganyela ukuhlukunyezwa kwengqondo nokuhlukumezeka kokuziphatha kuvame ukubonwa kubantu abanokuphazamiseka kokusebenzisa izidakamizwa.^[3],[4]

Ukutadisha kokuluthwa kokuziphatha okusho ukugembula, ukusebenzisa i-inthanethi, ukudlala imidlalo, ukuthenga, ukudla, umsebenzi, ezocansi, njll., Sekuthole ukuthandwa okwandayo eminyakeni yamuva.^[4] Umlutha wokuya ocansini yisimo sokuziphatha okuphikelelayo esenziwa naphezu kwemiphumela emibi eqhubekayo ekuzicabangeni nasekucindezelekeni kwabanye. Umlutha wokuya ocansini unezindlela eziningi ezihlukene: ukushaya indlwabu okuphoqayo, ubulili nezifebe, ubulili obungaziwa nabalingani abaningi, izindaba eziningi ngaphandle kobudlelwano obuzinzile, ukubukisa ngemikhuba yakho, ukuthambekela kokuziphatha okuhle, ukuthinta ngokungafanele ucansi, ukuhlukunyezwa kwezingane njalo ngocansi neziqephu zokudlwengulwa. Kwesinye isikhathi, umlutha ungahilela ukwenza isenzo sobulili esidlangalaleni, esikhundleni salokho, kungahle kufake amahora wokufunda nokubuka izithombe zocansi.^[5] Abesilisa be-20% –60% abesilisa abasekolishi ababike ukubuka izithombe zocansi kuyinkinga ngokuya ngesizinda sabo. Kube namacala ambalwa esayensi abika umlutha wobulili ezingcolile nemiphumela yako emibi.^[2],[6] Siveza icala elilodwa elinjalo elafika laqashelwa.

Owesilisa oneminyaka engama-34 oshadile kusukela eminyakeni eyisi-6 weza emnyangweni wezokwelapha kanye nomkakhe ngenhloso yokuxazulula izingqinamba zomshado ikakhulukazi ezithinta ukungathandi komyeni ocansini nokukhathazeka kwakhe okuhlobene nezithombe zocansi kule minyaka engu-3 eyedlule. Inkinga yamanje yayikhuphuke eminyakeni emithathu eyedlule ngenkathi umkakhe ekhulelwe, futhi bebengakwazi ukuzibandakanya ocansini kaningi ababejwayele ngenxa yemikhawulo ebangelwa ukukhulelwa.

Umyeni unikeze umlando wokubuka izithombe zocansi kusukela eneminyaka engu-16. Yize ngokungajwayelekile ngalesosikhathi, manje useguqile ekubukeni kaningi kulandelwa ukushaya indlwabu. Uvumile ukuthi waqala ukuchitha isikhathi esithe xaxa ebuka izithombe zocansi ukuze afinyelele ezingeni lakhe lentokozo ayithandayo. Ngesikhathi sokubika, wasebenzisa i-4-5 h / usuku noma ngaphezulu kwesinye isikhathi ekubukeni okubuka ezocansi. Wayewabuka amafilimu yize eseqedile ukushaya indlwabu futhi wabika nokuthola ukwaneliseka kuphela ekubukeni lawo mafilimu. Uma isikhathi sakhe sincishisiwe noma waphazanyiswa othile, waba nosizi futhi wacasuka. Emsebenzini, waxwayiswa ngokuziphatha okungafanele ngemuva kokuthi igciwane le-inthanethi liholele ekuhlulekeni kohlelo futhi walandelwa kumawebhusayithi ezithombe zocansi ayezivakashele. Kamuva, ngemuva kokuba engasakwazi ukubuka izingosi ezibonisa ubulili emsebenzini, isiguli sasihamba naye omagazini bezithombe zobulili ezingcolile futhi sachitha isikhathi sakhe esiningi sizifunda. Le mikhuba inciphise kakhulu ikhono lakhe lokuhlushwa nokusebenza kahle emsebenzini. Waqala ukuchitha isikhathi esincane nendodakazi yakhe nenkosikazi yakhe futhi waba nesikhathi esithe xaxa phambi kwekhompyutha noma iselula yakhe. Unkosikazi wakhe wabona ushintsho ekuziphatheni kwakhe futhi wasebenzisa isikhathi esithe xaxa kwi-intanethi. Ekutholeni izimpendulo ezingagculisi emibuzweni yakhe nokungakhathaleli kuyena nendodakazi yakhe, wahlangana naye futhi waqonda ngenkinga yakhe yokubuka izithombe zocansi ze-inthanethi ukwanelisa i-libido yakhe. Ukwamukele ukuthi wehluleka ukulawula izifiso zakhe kanye nesifiso sokubuka izinto ezingcolile yize emthanda umkakhe futhi azi ukuthi lokhu kubeke umshado wakhe engcupheni. Ubuye wamtshela ukuthi ngeke alufune usizo lochwepheshe njengoba enomuzwa wokuthi angaluyeka. Umkakhe, nokho, akazange akholwe, futhi wamlethela ukuba azobonisana.

Ukuhlolwa kwesimo sengqondo kwembula imizwa ephansi kanye nokuthinteka komoya. Inqubo yakhe yokucabanga ikhombise umuzwa wokungakwazi ukusiza nokungabi nathemba mayelana nokuhluleka kwakhe ukulawula isimilo sakhe. Ku-Hamilton Depression Rating Scale (HAM-D) ushaye i-9. Kwakungekho okukhohlisayo noma ukuqagelwa. Ukwahlulela nokuqonda kwakhe kwakungaqondile. Sinqume ukuthi, i-Obsessive Compulsive Disorder (OCD), ukudangala kanye nokuphazamiseka kobuntu ngokuxoxisana isiguli nonkosikazi ngokuhlukile. Lokhu kwenziwa ngokuzimela yizazi zengqondo ezimbili, futhi kwaxilongwa okokugcina umlutha we-Intanethi kwenziwa ngemuva kokukhumbula intshiseko yezimpawu ezitholakalayo njengokusebenza kokuphazamiseka kokusebenzisa izidakamizwa. Kwakungekho mlando wama-paraphilias wanoma yiluphi uhlobo. Sazakhela ikhambi lokwelapha ukubhekana nenkinga yakhe futhi sabhekana nezindawo ezintathu eziyinkinga empilweni yakhe, okungukuthi, (a) umuntu, (b) umndeni, kanye (c) nomsebenzi.

Personal

Isiguli sahlolwa ezinye izici zokuhlangana ezaziphathelene nokuthuthukiswa komlutha. Isiguli sicabange ngamanga ukuthi ukuthuthuka okulingene kwanele ukuthi, "Nginamandla okulawula izifiso zami." Ukuphikwa kwenkinga bekufanele kube nakho. Wachazwa ukuthi ukululama ngokuphelele kusho ukuphenya ngezinto eziyisisekelo eziholele ekuziphatheni nasekuxazululeni lezo zinkinga ngendlela enempilo; ngaphandle kwalokho, ukubuyela emuva bekungumphumela ongahle ube khona.

Wafundiswa ngokuthi lezi zindlela zokuziphatha zingavela kanjani kwezinye izinkinga ezingokomzwelo noma zesimo ezifana nokudangala, ukukhathazeka, ukucindezelwa, izinkinga zobudlelwano, izinkinga zomshado kanye / noma ubunzima emsebenzini. Wacabanga ngokuziphatha kwakhe ngokuthi, "Angilimazi muntu ngokubuka i-porn," "futhi angikhohlisi umkami ngokuvakashela abantu abathengisa ngocansi." Ngokuzibandakanya kwakhe nezithombe zocansi, wayengekho nje kuphela izinsuku zokugcina ezibalulekile emsebenzini kodwa. uchithe isikhathi esincane nomndeni wakhe.

Isigaba sokuqala sokwelashwa sasinokuziphatha, sigxila ekuziphatheni okuqondile nasezimweni lapho ukuphazamiseka kokulawula ukungathandeki kubangele khona ubunzima obukhulu. Ukwelapha ngokuziphatha kubhekwe kuzo zonke izingosi lapho isiguli singena kuzo okuqukethwe ezocansi kubandakanya namagajethi kanye nemifanekiso efana neyomagazini. Wabuye wachazelwa ukuthi izingcingo zeselula namanye amagajethi asephenduke ingxenye ebalulekile yezimpilo zethu futhi lokho bekungasho ukuthi kumele sibe ngumlutha wazo, kepha singakhulisa ukusebenziseka kwazo ngezindlela ezingcono. Enye yezinhloso zokuqala zokwelashwa kokuziphatha kwakuwukuqala ukuphatha isikhathi esichithwa kokuqukethwe kwezithombe zobulili ezingcolile nokwakha uhlelo olucacile nolwehlelekile lokuhlenga kabusha.

Kulokhu, kusetshenziselwa ukwelashwa kokucabanga kokuqonda (i-CBT) ukwehlisa izimpawu, ukuthuthukisa ukulawulwa kokuthakathwa, inselelo yokuhlanekezelwa kwengqondo, nokubhekana nezici zomuntu nezesimo ezihlobene ngokuqondile nokusetshenziswa okuphoqelekile kwe-Intanethi nokubhekana nemicabango engalunganga evame ukuhlotshaniswa nayo.

Ukwelashwa kokunciphisa okulimazayo nokugcina ilogi yosuku lokubuka okuqukethwe

Isayithi elithile lezithombe zocansi, isikhathi esithile sosuku noma imizwa yesiguli ngaphambi nje kokubuka kusebenza njengezimbangela ezingaholela ekuziphatheni nasekuhlukumezeni okungafanele. Ukusiza ukukhomba nokuthola lezi zimbangela, wacelwa ukuthi alondoloze ilog yokuqukethwe yansuku zonke ukugcina ithrekhi yokuthi ubukele nini futhi kanjani futhi aqophe usuku nesikhathi sokwenziwa komsebenzi ngamunye, imicimbi eyandulelayo eholela ekubukeni i-porn, nezindlela ukufinyelela okuqukethwe. Ngokulandelayo, wacelwa ukuba alandelele ukuthi isikhathi ngasinye sithathe isikhathi esingakanani, ikakhulukazi ukurekhoda inani lemizuzu noma amahora ngayinye se ision. Ubuye wachaza imiphumela yesikhathi ngasinye ngokuya ngokuthi yiziphi izinto eseziqediwe, iziphi izinto eziphazamisekile ngenkathi ebuka ezocansi, noma imizwa abe nayo ngemuva kweseshini ngasinye. Ukugcina ilogi elinemininingwane enjalo kwakusebenza njengesisekelo ukukhomba izimo ezinobungozi obukhulu eziholela ekusebenziseni ngokweqile. Lokhu kwasisiza ukuthi sizibekele imigomo ekuhleleni kokwelashwa.

Esinyatsheni esilandelayo, iklayenti lalulekwa ukuba lisuse amabhukumaka noma amafayela ayithandayo ekhompyutheni futhi alahle izinto eziyimfihlo azisebenzisa ngenkathi ebuka noma efunda okuqukethwe ezocansi.

Zimbalwa izikhathi ezigxile ekuhlelweni kabusha kwengqondo kweklayenti. Ukulungiswa kabusha kwengqondo kuhilela ukukhomba okuhleliwe kwamaphethini wokucabanga okuyinkinga okunikele ekuqalisweni nasekugcinweni kokubukelwa kwakhe kobulili okuyinkinga. Lokhu kusize ekuhlaziyeni kabusha umlando wokuziphatha kwakhe kumkakhe nengane.

Ngokuhamba kwesikhathi, ukuphonsela inselelo lolu hlobo lokuchazwa okungalungile futhi okuyiphutha ngokuziphatha kwakhe kanye nokubambisana okusebenzayo komkakhe kwasiza lowo muntu ukuba anqobe kancane kancane ukubukwa okuphoqayo kwezithombe zocansi ze-intanethi. Iklayenti likhuthazwe ukuba linikeze uhlu lwezinkinga ezinkulu ezibangelwa umlutha futhi luze nezinzuzo ezinkulu zokunciphisa noma zokuyeka ukusetshenziswa kobulili ezingcolile. Isiguli sanikezwa izikhathi ze-12 ze-CBT ngaphezulu kwezinyanga ze-3 ze-45-60 min ngayinye. Futhi ukuze uqukethe ukukhathazeka kwakhe, usizi, kanye nokuthinteka okucindezelekile kuthathe isikhathi saqala kwithebhulethi efanelekile ye-serotonin reuptake inhibitor (SSRI) sertraline ku-umthamo we-50 mg ekuqaleni kanye ngosuku futhi kancane kancane wakhuphukela kwi-150 mg ngosuku.

Umndeni nomsebenzi

Njengoba isiguli besinenkinga yobudlelwano nonkosikazi waso, kwaphakanyiswa ukwelulekwa ngemibhangqwana esikhundleni sokuphendukela ocansini lwe-inthanethi ukubhekana nalezi zinkinga zokusondelana. Futhi njengoba ebanjwa ebuka izithombe zobulili ezingcolile esemsebenzini, wafundiswa izindlela zokuphumula zemisipha eziqhubekayo nezindlela zokuphazamisa ukuphatha ukucindezela okusebenzayo ukumsiza ukuba aphumule esikhundleni sokuncika ku-porn. Ukhuthazwe ukuthi aziphazamise noma nini lapho enesifiso sokubuka izithombe zocansi ngokuhambahamba ehhovisi noma ngokuyobheka ukuthi yiliphi ilungu lomndeni elenza egumbini elilandelayo. Lezi zindlela zamsiza ukuthi azikhiphe ekusetshenzisweni okuyinkinga futhi agxile ezindleleni zokuphazamisa amaphethini amadala wokuziphatha okuluthayo. Ukufakwa kancane kancane kukankosikazi wakhe ngezikhathi, inqubo ephumelelayo yokuxhumana nezokuziphatha yaqinisa ubuhlobo babo. Ngemuva kokubuyekezwa kweziguli ezilandelanayo ngemuva kokutholakala ukuthi uxazulule izingqinamba zakhe zomshado ngezinga elikhulu sathola ithebhulethi ye-SSRI sertraline esikhathini esiyizinyanga ezi-3. Isiguli sabika ukwehla okuphawulekayo kwimvamisa yokuziphatha kwe-porn kanye nobudlelwano obusondelene nonkosikazi wakhe. Ngesikhathi sokubuyekezwa kokugcina, unkosikazi wabika ukuthuthuka ekuziphatheni komyeni wakhe nasezibophweni zomshado ezazikhona phakathi kwabo engxenyeni yabo yokuqala yempilo yomshado.

Kunamathuba angenakubalwa wokuthi noma ngubani ahlole okuqukethwe kocansi kwi-intanethi ukuzanelisa izifiso zakho zangaphakathi. Ucwaningo lwesikhathi eside sonyaka we-1 wezinhlelo zokusebenza ze-Intanethi nguMeerkerk et al. iveze ukuthi izithombe ezingcolile ze-Intanethi zinamandla amakhulu okulutha.^[7] I-DSM kwi-5 yayo^th I-edition ifake ukungahambisani nokugembula njengesifo sokulutha esihlobene nokunganakekeli. Izindlela zokubona umlutha wokugembula zachazwa kanye nezimpawu ezijwayelekile zokuluthwa yizidakamizwa, okungukuthi ukusetshenziswa okuphoqayo, ukuhoxa, ukubekezelela, ukungakwazi ukuncipha ngisho nangemva kokulimazeka emsebenzini. Kodwa-ke, yenqabile ukwengeza ukungaziphathi kahle ngokobulili ngoba zazingekho izincwadi ezanele zokusungula izindlela zokuxilongwa kwe-hypersexuality nokubuka kwayo okungcolile ngokweqile kwe-porn.^[8],[9] Ucwaningo olusebenzayo lokuhlaziya i-magnetic resonance imaging lwamadoda afuna ukwelashwa kokusebenzisa inkinga yezithombe zocansi (PPU) eziyinkinga et al.^[10] kutholwe ukwenziwa okwengeziwe kwesifunda somvuzo wobuchopho (i-ventral striatum) ezithombeni ezixakile kunokwenzelwa imali. Lokhu kusebenze kobuchopho kuhambisane nesisusa esengeziwe sokuziphatha sokubuka izithombe ezivusa inkanuko (“ukufuna” okuphezulu). Ukuhlangana kabusha kwe-Ventral striatal kuhlobene nobukhulu be-PPU, inani lokusetshenziswa kwezithombe zocansi ngesonto nenombolo yokushaya indlwabu masonto onke. Lokhu kufana nokusetshenziswa kwezidakamizwa kanye nokuphazamiseka kokugembula. Lokhu okutholakele kusikisela ukuthi i-PPU ingahle imele umlutha wokuziphatha ophakamisa ukuthi ukungenelela ekubhekiseni ukulutha kokuziphatha nezidakamizwa kungasiza amadoda ane-PPU.^[11],[12] Ucwaningo luphakamisa nokuthi isimilo sokubeka engcupheni abagembuli sinesizathu esiyimbangela yezinzwa, okungukuthi, ukugxila okungakajwayelekile kwe-3 methoxy-4 hydroxyphenylglycol (MHPG) e-plasma nokukhuphuka kokuhlushwa kwe-MHPG ku-cerebrospinal fluid. Kukhona nobufakazi obusikisela ukungasebenzi kahle kwe-serotonergic kubagembuli be-pathological.^[13] Ngakho-ke, ukuba usizo kwe-SSRI ezimweni ezinjengokulutha kwe-inthanethi okufana nokuphazamiseka kokugembula kubalulekile, futhi sikuthole kuwusizo kithi ukwephula ukwenqaba kwakhe kokuqala ukwamukela usizo lochwepheshe.

Ukungathandi kwesiguli ekwamukeleni usizo lochwepheshe ekuqaleni nasekuzimiseleni kamuva, ukungenelela komkakhe ngesikhathi esifanele nokubambisana kulo lonke kusize leli cala ekuthuthukiseni izimpawu zokubuyisa impilo yomndeni wakhe.

Izindlela zokubiza amacala ethu njengomlutha wobulili ezingcolile zibonakala zihlangabezana nezindlela ezijwayelekile zokulutha kokuziphatha. Kulokho, wayenokubekezelela, ukuhoxa, ukuqwashisa, kanye nokulimazeka kwezenhlalo okuhlobene nokuziphatha kwakhe kokubuka ezocansi.

Imilutha yezocansi kunzima ukuyiphatha ngaphandle kokubambisana okugcwele kwesiguli kanye nalabo abathintekile. Njengoba isibalo esithe xaxa sokuvela kokunye nokuqhubeka komsebenzi singayiqinisa njengendlela yokufakwa njengenkinga yokulutha.

Isimemezelo semvume yesiguli

Ababhali baqinisekisa ukuthi bazitholile zonke izindlela ezifanele zokuvuma iziguli. Ngendlela isiguli / iziguli ezinikeze ngayo / imvume yazo / yezithombe zayo kanye neminye imininingwane yezokwelapha okufanele ibikwe ephephandabeni. Iziguli ziyaqonda ukuthi amagama azo kanye nezinsizakusebenza ngeke zishicilelwe kanti nemizamo efanele izokwenziwa yokufihla ubunikazi bayo, kepha ukungaziwa kungaziwa.

Ukwesekwa kwezezimali nokuxhaswa

Nil.

Izingxabano zesithakazelo

Azikho izingxabano zentshisekelo.

1.	Itholakala kusuka: http://www.internet-filter-review.toptenreviews.com/internet-pornography-statistics.html. [Kugcine ukutholakala ku-2017 Jan 25].
2.	UDarshan MS, uSathyanarayana Rao TS, Manickam S, Tandon A, uRam D. Umbiko wamacala wokulutha ngezithombe zobulili ezingcolile une-Dhat syndrome. I-Indian J Psychiatry 2014; 56: 385-7. Kuyatholakala kusuka: http://www.indianjpsychiatry.org/text.asp?2014/56/4/385/146536. [Kugcine ukukhuluma ku-2017 Jan 23].
3.	Leeman RF, Potenza MN. Ukufana nomehluko phakathi kokugembula kwe-pathological kanye nokuphazamiseka kokusetshenziswa kwezidakamizwa: Ukugxila ekuxhashazweni nasekucindezelweni. I-Psychopharmacology (Berl) 2012; 219: 469-90.   [I-PUBMED]
4.	I-Alavi SS, i-Ferdosi M, i-Jannatifard F, i-Eslami M, i-Alaghemandan H, i-Setare M. Behavioural umlutha wokuqhathaniswa nokuluthwa kwezidakamizwa: Ukuxhumana kokubukwa kwengqondo nokusebenza kwengqondo. I-Int J Prev Med 2012; 3: 290-4.   [I-PUBMED]
5.	I-Bancroft J, i-Vukadinovic Z. Umlutha wezocansi, ukunyanzelwa kwezocansi, ukuziphoqelela ngokocansi, noma yini? Ngokubhekisisa Imodeli Yasethiyethi. Ijenali yocwaningo lwezocansi 2004; 41: 225-34.   [I-PUBMED]
6.	ILungu LamaPedihig, uCrosby JM, uCox JM. Ukubuka izithombe zocansi ze-Intanethi: Kubani okuyinkinga, kubani, futhi ngani? I-XAUMX yokulutha ngokwezemizwa ngokocansi: 2009-16.
7.	UMeerkerk GJ, uVan Den Eijnden RJ, uGarretsen HF. Ukubikezela ukusetshenziswa kwe-Intanethi okuphoqelela: kumayelana nezocansi! ICyberpsychol Behav 2006; 9: 95-103.
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