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I'm seriously considering trying this game out since the art style looks superb and the story seems like something that's right up my alley.  But before I make any decisions I have to ask, are there any NSFW scenes/content?  When I say that I mean like sexual or explicit content.  Having or not having that kind of stuff isn't going to be my deciding factor but I just want to know exactly what I'm getting myself into.  Can anyone please help clear this up?

There is written NSFW content for some routes but I can't remember there being any explicit CGs, has been a while since I last played, however. Not sure if they were used but I remember there being clothless and barely covered sprites in the files too, so they might make an appearance.

chase has sprites that are only in his boxers, others have shirtless sprites, sex and masturbation is in the writing, but that's about it

Thank you so much to everyone who helped clear this up this question for me.  I have only one more question before I try this game, are their any happy/uplifting endings?  It just seems like this game is going to be pretty heavy and grim at times and I'm curious if their are any paths one can take that lead to a less then horrifying fate for the character(s).

Just one uplifting ending,. Go for the Ram route. if you new to echo I recommend Carl route first then Leo -> TJ -> Flynn -> Jenna, and don't you dare play TJ or Jenna route first since it will reveal a huge plot! 

in my opinion, it depends on who you get attached to.
if you're immediately attached to tj, go for him first because his hurt the most for me.

don't go for flynn first, leave him and jenna for last (and play Route 65 before going through their routes).