{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T02:30:34Z","timestamp":1789871434383,"version":"4.0.1"},"reference-count":63,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2013,2,1]],"date-time":"2013-02-01T00:00:00Z","timestamp":1359676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,2,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Sexual health issues for women who have cancer are an important and under-diagnosed and under-treated survivorship issue. Survivorship begins at the time a cancer is detected and addresses health-care issues beyond diagnosis and acute treatment. This includes improving access to care and quality-of-life considerations, as well as dealing with the late effects of treatment. Difficulties with sexual function are one of the more common late effects in women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This article attempted to characterize the etiology, prevalence, and treatment for sexual health concerns for women with gynecological cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic survey of currently available relevant literature published in English was conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The issue of sexual health for women with cancer is a prevalent medical concern that is rarely addressed in clinical practice. The development of sexual morbidity in the female cancer survivor is a multifactorial problem incorporating psychological, physiologic, and sociological elements. Treatments such as chemotherapy, radiation therapy, surgery, and hormonal manipulation appear to have the greatest influence on the development of sexual consequences. Sexual complaints include but are not limited to changes in sexual desire, arousal, and orgasmic intensity and latency. Many women suffer from debilitating vaginal dryness and painful intercourse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Many of the sexual health issues experienced by cancer survivors can be addressed in clinical practice. A multimodal treatment paradigm is necessary to effectively treat these sexual complaints in this special patient population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jsm.12034","type":"journal-article","created":{"date-parts":[[2013,2,6]],"date-time":"2013-02-06T11:47:29Z","timestamp":1360151249000},"page":"5-15","source":"Crossref","is-referenced-by-count":75,"title":["Sexual Health Issues in Women with Cancer"],"prefix":"10.1093","volume":"10","author":[{"given":"Michael","family":"Krychman","sequence":"first","affiliation":[{"name":"Southern California Center for Sexual Health and Survivorship Medicine , Newport Beach, CA , USA"},{"name":"VCF University of California Irvine , Irvine, CA , USA"},{"name":"USC , Los Angeles, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah S.","family":"Millheiser","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Stanford University School of Medicine , Stanford, CA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2013,2,1]]},"reference":[{"key":"2023012308002317500_bb0010","volume-title":"Cancer Facts and Figures","author":"American Cancer Society","year":"2012"},{"key":"2023012308002317500_bb0015","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1200\/JCO.1998.16.2.501","article-title":"Life after breast cancer: Understanding women\u2019s health-related quality of life and sexual functioning","volume":"16","author":"Ganz","year":"1998","journal-title":"J Clin Oncol"},{"key":"2023012308002317500_bb0020","first-page":"2857","article-title":"Sexual problems","volume-title":"Cancer: Principles and practice of oncology","author":"Schover","year":"1997","edition":"5th edition"},{"key":"2023012308002317500_bb0025","first-page":"2371","article-title":"Predictors of sexual health in women after a breast cancer diagnosis","volume":"17","author":"Ganz","year":"1999","journal-title":"J Clin Orthod"},{"key":"2023012308002317500_bb0030","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1016\/j.ygyno.2011.11.030","article-title":"A systematic review of sexual concerns reported by gynecological cancer survivors","volume":"124","author":"Abbott-Anderson","year":"2012","journal-title":"Gynecol Oncol"},{"key":"2023012308002317500_bb0035","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1093\/jnci\/djr541","article-title":"Quality of life, fertility concerns, and behavioral health outcomes in younger breast cancer survivors: A systematic review","volume":"104","author":"Howard-Anderson","year":"2012","journal-title":"J Natl Cancer Inst"},{"key":"2023012308002317500_bb0040","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1002\/pon.744","article-title":"Psychosocial problems among younger women with breast cancer","volume":"13","author":"Avis","year":"2004","journal-title":"Psychooncology"},{"key":"2023012308002317500_bb0045","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1002\/pon.991","article-title":"Body image and sexual problems in young women with breast cancer","volume":"15","author":"Fobair","year":"2006","journal-title":"Psychooncology"},{"key":"2023012308002317500_bb0050","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1097\/NCC.0b013e31819b5a93","article-title":"Changes in sexuality and intimacy after the diagnosis and treatment of cancer: The experience of partners in a sexual relationship with a person with cancer","volume":"32","author":"Hawkins","year":"2009","journal-title":"Cancer Nurs"},{"key":"2023012308002317500_bb0055","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1200\/JCO.1996.14.5.1718","article-title":"Ovarian function in premenopausal women treated with adjuvant chemotherapy for breast cancer","volume":"14","author":"Bines","year":"1996","journal-title":"J Clin Oncol"},{"key":"2023012308002317500_bb0060","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/j.1743-6109.2008.01151.x","article-title":"HPV infection in women: Psychosexual impact of genital warts and intraepithelial lesions","volume":"6","author":"Graziottin","year":"2009","journal-title":"J Sex Med"},{"key":"2023012308002317500_bb0065","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1002\/pon.1245","article-title":"Chemotherapy-induced alopecia and effects on quality of life among women with breast cancer: A literature review","volume":"17","author":"Lemieux","year":"2008","journal-title":"Psychooncology"},{"key":"2023012308002317500_bb0070","first-page":"177","article-title":"Sexuality and body image in younger women with breast cancer","volume":"16","author":"Schover","year":"1994","journal-title":"J Natl Cancer Inst Monogr"},{"key":"2023012308002317500_bb0075","first-page":"2815","article-title":"Sexual problems in younger women after breast cancer surgery","volume":"24","author":"Burwell","year":"2006","journal-title":"J Clin Orthod"},{"key":"2023012308002317500_bb0080","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1002\/cncr.11877","article-title":"Early stage cervical carcinoma, radical hysterectomy and sexual function. A longitudinal study","volume":"100","author":"Jensen","year":"2004","journal-title":"Cancer"},{"key":"2023012308002317500_bb0085","first-page":"581","article-title":"Pelvic dysfunctions and quality of life after nerve-sparing radical hysterectomy: A multicenter comparative study","volume":"32","author":"Ceccaroni","year":"2012","journal-title":"Anticancer Res"},{"key":"2023012308002317500_bb0090","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1111\/j.1743-6109.2012.02723.x","article-title":"Sexual function after surgery for early-stage cervical cancer: Is there a difference in it according to the extent of surgical radicality?","volume":"9","author":"Song","year":"2012","journal-title":"J Sex Med"},{"key":"2023012308002317500_bb0095","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1743-6109.2011.02520.x","article-title":"Sexual, psychological, and relational functioning in women after surgical treatment for vulvar malignancy: A literature review","volume":"9","author":"Aerts","year":"2012","journal-title":"J Sex Med"},{"key":"2023012308002317500_bb0100","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.ygyno.2012.04.015","article-title":"Long-term sexual function in survivors of vulvar cancer: A cross-sectional study","volume":"126","author":"Hazewinkel","year":"2012","journal-title":"Gynecol Oncol"},{"key":"2023012308002317500_bb0105","doi-asserted-by":"crossref","first-page":"332","DOI":"10.3109\/00365599.2011.585621","article-title":"Radical cystectomy and urinary diversion in women: Impact on sexual function","volume":"45","author":"El-Bahnasawy","year":"2011","journal-title":"Scand J Urol Nephrol"},{"key":"2023012308002317500_bb0110","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1111\/j.1743-6109.2006.00257.x","article-title":"Female sexual function and activity following cystectomy and continent urinary tract diversion for benign indications: A clinical pilot study and review of literature","volume":"4","author":"Elzevier","year":"2007","journal-title":"J Sex Med"},{"key":"2023012308002317500_bb0115","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1093\/annonc\/mdr133","article-title":"Sexual (dys)function and the quality of sexual life in patients with colorectal cancer: A systemic review","volume":"23","author":"Traa","year":"2012","journal-title":"Ann Oncol"},{"key":"2023012308002317500_bb0120","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1097\/DCR.0b013e3182444fd1","article-title":"Comparative quality of life in patients following abdominoperineal excision and low anterior resection for low rectal cancer","volume":"55","author":"How","year":"2012","journal-title":"Dis Colon Rectum"},{"key":"2023012308002317500_bb0125","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1007\/s00404-011-1988-5","article-title":"Impact of pelvic radiotherapy on female sexuality","volume":"285","author":"Rodrigues","year":"2012","journal-title":"Arch Gynecol Obstet"},{"key":"2023012308002317500_bb0130","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1016\/j.ejca.2008.12.014","article-title":"Risk factors for sexual dysfunction after rectal cancer treatment","volume":"45","author":"Lange","year":"2009","journal-title":"Eur J Cancer"},{"key":"2023012308002317500_bb0135","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1111\/j.1525-1438.2006.00348.x","article-title":"Vaginal stenosis in patients treated with radiotherapy for carcinoma of the cervix","volume":"16","author":"Brand","year":"2006","journal-title":"Int J Gynecol Cancer"},{"key":"2023012308002317500_bb0140","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1016\/S0360-3016(03)00362-6","article-title":"Longitudinal study of sexual function and vaginal changes after radiotherapy for cervical cancer","volume":"56","author":"Jensen","year":"2003","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2023012308002317500_bb0145","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1002\/(SICI)1097-0142(19991001)86:7<1231::AID-CNCR18>3.0.CO;2-Y","article-title":"Severe adverse impact on sexual functioning and fertility of bone marrow transplantation, either allogenic or autologous, compared with consolidation chemotherapy alone: Analysis of the MRC AML 10 trial","volume":"86","author":"Watson","year":"1999","journal-title":"Cancer"},{"issue":"1","key":"2023012308002317500_bb0150","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.3747\/co.2007.151","article-title":"Management of sexual dysfunction in postmenopausal breast cancer patients taking adjuvant aromatase inhibitor therapy","volume":"14","author":"Derzko","year":"2007","journal-title":"Curr Oncol"},{"key":"2023012308002317500_bb0155","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1111\/j.1743-6109.2010.02034.x","article-title":"Sexual function after breast cancer","volume":"8","author":"Panjari","year":"2011","journal-title":"J Sex Med"},{"key":"2023012308002317500_bb0160","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1080\/00926239208404354","article-title":"A neglected issue: The sexual side effects of current treatments for breast cancer","volume":"18","author":"Kaplan","year":"1992","journal-title":"J Sex Marital Ther"},{"key":"2023012308002317500_bb0165","first-page":"4261","article-title":"Quality of life of postmenopausal women in the Arimidex, Tamoxifen, Alone or in Combination (ATAC) adjuvant breast cancer trial","volume":"22","author":"Fallowfield","year":"2004","journal-title":"J Clin Orthod"},{"key":"2023012308002317500_bb0170","first-page":"1488","article-title":"Effect of tamoxifen on sexual functioning in patients with breast cancer","volume":"17","author":"Mortimer","year":"1999","journal-title":"J Clin Orthod"},{"key":"2023012308002317500_bb0175","first-page":"359","article-title":"Gynecologic cancer","volume-title":"Psychoncology","author":"Auchincloss","year":"1998"},{"key":"2023012308002317500_bb0180","first-page":"200","article-title":"Psychosexual morbidity following gynecological malignancy","volume":"89","author":"Casey","year":"1996","journal-title":"Ir Med J"},{"key":"2023012308002317500_bb0185","first-page":"314","article-title":"Chapter 11: Sexuality and illness","volume-title":"Practices and principles of sex therapy","author":"Elliot","year":"2007"},{"key":"2023012308002317500_bb0190","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1016\/S0015-0282(02)02969-2","article-title":"Female androgen insufficiency: The Princeton consensus statement on definition, classification and assessment","volume":"77","author":"Bachman","year":"2002","journal-title":"Fertil Steril"},{"key":"2023012308002317500_bb0195","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1159\/000398268","article-title":"Definitive symptoms of post menopause-incorporating use of vaginal parabasal cell index","volume":"3","author":"Utian","year":"1975","journal-title":"Front Horm Res"},{"key":"2023012308002317500_bb0200","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1097\/00006250-199004001-00006","article-title":"Sexuality and menopause","volume":"75","author":"Sarrel","year":"1990","journal-title":"Obstet Gynecol"},{"key":"2023012308002317500_bb0205","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/S0015-0282(98)80034-4","article-title":"Vasodilator effects of estrogen are not diminished by androgen in postmenopausal women","volume":"68","author":"Sarrel","year":"1997","journal-title":"Fertil Steril"},{"key":"2023012308002317500_bb0210","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1097\/gme.0b013e31819e8e2d","article-title":"Intravaginal dehydroepiandrosterone (Prasterone), a physiological and highly efficient treatment of vaginal atrophy","volume":"16","author":"Labrie","year":"2009","journal-title":"Menopause"},{"key":"2023012308002317500_bb0215","first-page":"448","article-title":"Ospemifene hormos","volume":"5","author":"Gennari","year":"2004","journal-title":"Curr Opin Investig Drugs"},{"key":"2023012308002317500_bb0220","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1097\/gme.0b013e3181c1ac01","article-title":"Ospemifene effectively treats vulvovaginal atrophy in postmenopausal women: Results from a pivotal phase 3 study","volume":"17","author":"Bachmann","year":"2010","journal-title":"Menopause"},{"key":"2023012308002317500_bb0225","author":"Vagifem\u00ae[package insert]","year":"2003"},{"key":"2023012308002317500_bb0230","author":"Memorial Sloan-Kettering Cancer Center Clinical Trial","year":"2009","journal-title":"Serum estradiol levels in post menopausal women with breast cancer receiving adjuvant aromatase inhibitors and vaginal estrogen"},{"key":"2023012308002317500_bb0235","first-page":"1","article-title":"Treating dyspareunia caused by vaginal atrophy: A review of treatment options using vaginal estrogen therapy","volume":"2","author":"Kingsberg","year":"2009","journal-title":"Int J Womens Health"},{"key":"2023012308002317500_bb0240","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1097\/00042192-200007030-00005","article-title":"17 beta estradiol vaginal tablet versus conjugated equine estrogen vaginal cream to relieve menopausal atrophic vaginitis","volume":"7","author":"Rioux","year":"2000","journal-title":"Menopause"},{"key":"2023012308002317500_bb0245","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1200\/JCO.1997.15.3.969","article-title":"Phase III randomized double-blind study to evaluate the efficacy of a polycarbophil-based vaginal moisturizer in women with breast cancer","volume":"15","author":"Loprinzi","year":"1997","journal-title":"J Clin Oncol"},{"key":"2023012308002317500_bb0250","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s00404-010-1382-8","article-title":"The comparison of hyaluronic acid vaginal tablets with estradiol vaginal tablets in the treatment of atrophic vaginitis: A randomized controlled trial","volume":"283","author":"Ekin","year":"2011","journal-title":"Arch Gynecol Obstet"},{"key":"2023012308002317500_bb0255","first-page":"411","article-title":"Effectiveness and safety of vaginal suppositories for the treatment of the vaginal atrophy in postmenopausal women: An open, non-controlled clinical trial","volume":"12","author":"Costantino","year":"2008","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"2023012308002317500_bb0260","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1097\/AOG.0b013e3182118790","article-title":"Vaginal pH-balanced gel for the control of atrophic vaginitis among breast cancer survivors: A randomized controlled trial","volume":"117","author":"Lee","year":"2011","journal-title":"Obstet Gynecol"},{"key":"2023012308002317500_bb0265","first-page":"S1","article-title":"A positive approach to female sexual health: A summary report","volume":"34","author":"Hutchison","year":"2009","journal-title":"Female Patient"},{"key":"2023012308002317500_bb0270","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1111\/j.1743-6109.2010.01988.x","article-title":"Simple strategies for vaginal health promotion in cancer survivors","volume":"8","author":"Carter","year":"2011","journal-title":"J Sex Med"},{"key":"2023012308002317500_bb0275","first-page":"85S","article-title":"Sexual dysfunction","volume":"104","author":"American College of Obstetricians and Gynecologists Task Force on Hormone Therapy","year":"2004","journal-title":"Obstet Gynecol"},{"key":"2023012308002317500_bb0280","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1016\/S1470-2045(11)70364-3","article-title":"Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): A randomised controlled trial","volume":"13","author":"Mann","year":"2012","journal-title":"Lancet Oncol"},{"key":"2023012308002317500_bb0285","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/01.jcp.0000125686.20338.c1","article-title":"Bupropion sustained release for the treatment of hypoactive desire disorder","volume":"24","author":"Seagraves","year":"2004","journal-title":"J Clin Psychopharmacol"},{"key":"2023012308002317500_bb0290","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1089\/152460902317586001","article-title":"Efficacy and safety of sildenafil citrate in women with sexual dysfunction associated with female sexual arousal disorder","volume":"4","author":"Basson","year":"2002","journal-title":"J Womens Health Gend Based Med"},{"key":"2023012308002317500_bb0295","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1097\/01.gme.0000177709.65944.b0","article-title":"Position statement: The role of testosterone therapy in post menopausal women: A position statement of the North American Menopause Society","volume":"12","author":"Shifren","year":"2005","journal-title":"Menopause"},{"key":"2023012308002317500_bb0300","author":"Biosante website libigel data summary","year":"2012"},{"key":"2023012308002317500_bb0305","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1080\/713846828","article-title":"A double-blind placebo-controlled study of ArginMax, a nutritional supplement for enhancement of female sexual function","volume":"27","author":"Ito","year":"2001","journal-title":"J Sex Marital Ther"},{"key":"2023012308002317500_bb0310","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1080\/00926230903375701","article-title":"Randomized, placebo-controlled, double-blind, parallel design trial of the efficacy and safety of Zestra\u00ae in women with mixed desire\/interest\/arousal\/orgasm disorders","volume":"36","author":"Ferguson","year":"2010","journal-title":"J Sex Marital Ther"},{"key":"2023012308002317500_bb0315","article-title":"A case series of female orgasmic complaints in cancer survivors treated with a topical applied blend of botanical oils and extracts","volume-title":"ISSM\/SMSNA Cancer Survivorship and Sexuality Annual Meeting. Unmoderated Poster. Annual Meeting","author":"Krychman","year":"2011"},{"key":"2023012308002317500_bb0320","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1177\/104990910402100109","article-title":"Sexuality at the end of life","volume":"21","author":"Stausmire","year":"2004","journal-title":"Am J Hosp Palliat Care"}],"container-title":["The Journal of Sexual Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609515304938?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1743609515304938?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/10\/Supplement_1\/5\/48805920\/jsm_10_supplement_1_5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jsm\/article-pdf\/10\/Supplement_1\/5\/48805920\/jsm_10_supplement_1_5.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,23]],"date-time":"2023-01-23T03:02:14Z","timestamp":1674442934000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jsm\/article\/10\/Supplement_1\/5\/6994575"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,2,1]]},"references-count":63,"journal-issue":{"issue":"Supplement_1","published-online":{"date-parts":[[2013,2,1]]},"published-print":{"date-parts":[[2013,2,1]]}},"URL":"https:\/\/doi.org\/10.1111\/jsm.12034","relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.718001242.793475148","asserted-by":"object"}]},"ISSN":["1743-6109","1743-6095"],"issn-type":[{"value":"1743-6109","type":"electronic"},{"value":"1743-6095","type":"print"}],"subject":[],"published-other":{"date-parts":[[2013,2]]},"published":{"date-parts":[[2013,2,1]]}}}