The New York Times: U.S. Health Workers Recalled From Shutdown Furlough For Medicare, A.C.A. Enrollments
The Centers for Medicare and Medicaid Services said it would temporarily call back all of its furloughed employees on Monday to handle open enrollment for both Medicare and health plans available under the Affordable Care Act. The decision was made “to best serve the American people amid the Medicare and marketplace open enrollment seasons,” according to an agency spokeswoman. The employees have been furloughed for three weeks since the government shutdown began. (Abelson, 10/23)

The New York Times: Federal Workers Have Started Missing Paychecks During The Shutdown 
Thousands of federal workers missed their first paycheck this week as the government shutdown persisted with no end in sight. Among those working without pay is Pamela Ward, a telephone service representative for the Social Security Administration in Birmingham, Ala. Ms. Ward said that she knew she would not be paid this week, but seeing a $0 paycheck was still a shock. “It was a rough day today,” Ms. Ward, 52, said on Wednesday. “I think the roughest part is I’ve worked all my life. I’ve worked 27 years, and this is my first time ever receiving a paycheck when there was nothing on it.” (Sullivan, 10/24)

Bloomberg: Democrats Block Senate Bill To Pay Some Workers During Shutdown
Senate Democrats blocked a Republican measure aimed at paying military troops and some federal workers during the US government shutdown in the latest sign the spending deadlock shows no sign of ending. The vote on Thursday to advance the bill failed on a 54 to 45 vote, with 60 votes needed. Democrats have blocked a temporary spending measure 12 times in the Senate since, arguing that they cannot support it without new healthcare spending attached. (Wasson, 10/23)

On SNAP funding —

NBC News: SNAP Recipients Told To Buy Shelf-Stable Food As Funding Deadline Looms
Recipients of SNAP food assistance benefits across the country face a looming deadline: Come Nov. 1, their cards may not get refilled because of the government shutdown in Washington. The Supplemental Nutrition Assistance Program, which serves nearly 42 million people each month, allocates money to states on a monthly basis. Benefits were largely uninterrupted over the past three weeks because funding for October was allocated to states before the shutdown began on Oct. 1. (Bendix, 10/23)

KFF Health News: KFF Health News’ ‘What The Health?’: Nutrition Programs Face Their Own Shutdown
Health programs are feeling the pinch of the ongoing government shutdown. Funding for the Supplemental Nutrition Assistance Program, or SNAP, and the food program for women, infants, and children, WIC, is likely to run out in November, and cuts at the Centers for Disease Control and Prevention are keeping the agency from carrying out some of its primary public health functions. (Rovner, 10/23)

KFF Health News: Listen: Amid Shutdown Stalemate, Families Brace For SNAP Cuts And Paycheck Limbo
Affordable Care Act tax credits are at the heart of one of the longest government shutdowns in U.S. history. The impact is starting to be felt by families and federal employees. Food assistance programs could run out of money at the end of the month. And federal health agencies such as the Centers for Disease Control and Prevention have faced layoffs. (Rovner, 10/24)

On Obamacare —

KFF Health News: GOP Talking Point Holds ACA Is Haunted By ‘Phantom’ Enrollees, But The Devil’s In The Data
The idea that Affordable Care Act marketplaces are riddled with fraud has become a major talking point among Republicans, as lawmakers in Congress argue about whether to extend the enhanced tax credits that are helping offset the cost of health care marketplace coverage for low- and middle-income people. Those ACA subsidies expire at the end of the year and have become a flash point in the government funding showdown. “The tax credits go to some people deservedly. And we think the tax credits actually go to a lot of waste and fraud within the insurance industry,” said Vice President JD Vance during a recent interview on CBS News. (Knight, 10/24)

Modern Healthcare: Molina Healthcare To Exit Some ACA Markets In 2026
Molina Healthcare is pulling out of one-fifth of the counties where it sells health insurance exchange plans, the company announced Thursday. While the exchanges represent a substantial share of Molina Healthcare’s business, the segment is pressured by costs that exceeded projections, Chief Financial Officer Mark Keim said during a call with investor analysts on the company’s third-quarter financial report. (Tepper, 10/23)

Modern Healthcare: Where Centene, Oscar, Cigna Are Expanding ACA Plans For 2026
Major health insurance companies are expanding where they sell exchange plans for 2026 despite uncertainty over rising costs and federal policy. The biggest unknown is how Congress will deal with the enhanced exchange subsides that drove record enrollment in recent years but are scheduled to expire at the end of 2025. The issue is at the center of the showdown between the Republican congressional majority and the Democratic minority that led to the government shutdown that began Oct. 1. (Tepper, 10/23)

In other news from Capitol Hill —

The Hill: Casey Means, Trump's Surgeon General Pick, Set For Virtual Confirmation Hearing
The Senate Committee on Health, Education, Labor, and Pensions (HELP) will hold a virtual confirmation hearing over the nomination of Casey Means to be U.S. surgeon general next week, five months after she was nominated. The HELP Committee said in an announcement that Means would appear before the panel virtually, calling in from Kilauea, Hawaii. (Choi, 10/23)

The Hill: Judge Strikes Down Rule Extending Health Protections To Transgender Care
A federal judge on Wednesday struck down a former President Biden-era rule that extended federal health antidiscrimination protections to transgender health care. Judge Louis Guirola Jr. of the U.S. District Court for the Southern District of Mississippi ruled in favor of a coalition of 15 GOP-led states that sued over the rule, which broadened sex discrimination by adding sexual orientation and gender identity to the list of protected characteristics in certain health programs and activities. (Weixel, 10/23)

The 19th: Intersex Awareness Day Highlights A Fight For Rights That’s Far From Over
On October 26, 1996, two intersex people and 26 self-proclaimed transsexuals changed history around the world. (Sosin, 10/23)

On IVF —

Stat: Trump IVF Proposal Prompts Market Moves From Fertility Benefit Firms 
The Trump administration’s push to make in vitro fertilization more affordable is changing the outlook and offerings in the fertility sector, even as some details of its policies remain confidential and others have yet to be released. The administration’s changes have been followed by hope for increased demand for IVF and fertility coverage, lowered prices for patients, and even some new offerings, leaders in the space told STAT. (Payne, 10/23)

Boston Globe: Massachusetts' IVF Insurance Law Leaves Many Out
It was midday when the nurse pulled her car into the Market Basket parking lot in Hanover and sidled up to a black SUV. She said hello to the SUV driver, a suburban mom she’d connected with in a private Facebook group. The driver got out and handed the nurse a plastic bag. Inside, nestled in ice, were drugs worth thousands of dollars. “Good luck,” the woman said, then vanished into the grocery store to buy food for her family. The nurse sighed with relief — she had enough hormone shots for today. (Bartlett, 10/23)

On pregnancy and breastfeeding —

The Washington Post: Michigan Women Sue Over Law Voiding End-Of-Life Choices During Pregnancy 
Nine Michigan residents are suing Gov. Gretchen Whitmer (D) and other state officials over a law that voids a pregnant patient’s health care advance directive. (Somasundaram, 10/23)

AP: Extreme Heat Brings Extra Risks For Pregnant People
Doctors have long known that heat puts a strain on the heart, kidneys and other organs. Those risks are exacerbated for pregnant people, as the body’s processes for staying cool are altered. It’s a problem that climate change, caused by the burning of fuels like gasoline and coal, is worsening. Intensifying extreme heat events, high temperatures well into the night and shattering weather records means more exposure for pregnant people, particularly in developing countries. (Walling, 10/23)

The 19th: Doulas Are Crafting A Climate Disaster Blueprint For Pregnant People
In the days leading up to Hurricane Irma’s landfall in September 2017, Esther Louis made preparations to flee Florida with her husband and four children. The Category 4 Hurricane was expected to hit the Florida Keys and make it’s way up the state, posing a risk to millions of residents. One of those residents was a client of Louis’ who was nine months pregnant and living in a home that the Miami-based doula feared was in too poor of condition to withstand the storm. (Kutz, 10/23)

The New York Times: Ruth A. Lawrence, Doctor Who Championed Breastfeeding, Is Dead At 101 
Ruth A. Lawrence, a pediatrician who almost single-handedly elevated breastfeeding from a medical afterthought to a distinct specialty, igniting a revolution in the education of physicians and support for nursing mothers, died on Oct. 12 in Rochester, N.Y. She was 101.Her death, in a care home, was announced by the University of Rochester Medical Center, where she founded the Breastfeeding and Human Lactation Study Center. It was among the first organizations in the country to offer feeding guidance and resources to caregivers of newborn mothers. (Rosenwald, 10/23)

In UTI research —

CBS News: Nearly 1 In 5 Urinary Tract Infections Linked To Contaminated Meat, Study Finds 
Nearly one in five urinary tract infections in a group of patients in Southern California were linked to E. coli from contaminated meat, a four-year study found. And researchers say the problem could be occurring across the United States. The researchers found 18% of the more than 2,300 urinary tract infections, or UTIs, in the study — published in the mBio journal on Thursday — were linked to E. coli strains found in meat samples from grocery stores in the same area. The meats most commonly found to test positive for E. coli were turkey and chicken, followed by pork and beef, the study found. (Moniuszko, 10/23)

The Wall Street Journal: D.C.’s Howard University Hospital Could Be Brought To Its Knees By Looming Medicaid, ACA Cuts
For more than a century, Howard University Hospital has been a lifeline for Washington’s low-income communities, treating patients who often have nowhere else to turn. But with a patient population heavily reliant on Medicare and Medicaid—nearly 85%, according to administrators—the hospital has little financial cushion to absorb major reductions in federal funding. President Trump’s One Big Beautiful Bill Act enacted the largest federal healthcare spending cuts in U.S. history, totaling over $1 trillion over the next decade, primarily targeting Medicaid. (Siddiqui, 10/23)

In other Medicaid news —

AP: California Union Floats Idea Of Taxing Billionaires To Offset Medicaid Cuts
A major union announced a proposal Thursday to impose a one-time 5% tax on billionaires in California to address federal funding cuts to health care for low-income people. Proponents, including the Service Employees International Union, hope to place the statewide measure before voters next year. The tax would be on the net worth of California’s richest residents. A small portion of the money would also help fund K-12 education since the federal government has threatened to withhold grant money from public schools. (Austin, 10/23)

Axios: Scoop: Planned Parenthood Fights Proposed Termination Of Medicaid Agreements In Ohio
Two Planned Parenthood affiliates in Ohio are fighting a recent state proposal to terminate their Medicaid provider agreements. (King, 10/24)

Stat: Advocacy Group Probes Algorithms For Medicaid Home-Based Care 
The massive tax cut bill President Trump signed in July is forcing states to grapple with a pivotal question: With federal Medicaid spending projected to drop drastically, which patients should get care at home, and how much care should they get? (Broderick, 10/24)

The Atlantic: No Appointments, No Nurses, No Private Insurance Needed
Many health facilities try to avoid Medicaid. A Colorado clinic prefers it. (Ouyang, 10/21)

In Medicare updates —

Becker's Hospital Review: AHA Pushes CMS Delay On Medicare Prior Authorization Pilot
The American Hospital Association is urging CMS to delay its Medicare prior authorization pilot — the Wasteful and Inappropriate Service Reduction initiative — by at least six months. “This timeframe is impractical for providers and jeopardizes the administration’s goal of easing provider administrative burden associated with prior authorization,” the organization said in an Oct. 23 letter to CMS. The model is currently slated to launch in Arizona, Washington, New Jersey, Texas, Ohio and Oklahoma Jan. 1, 2026. (Casolo, 10/23)

Modern Healthcare: Medicare Advantage Market Exits Worry Post-Acute Providers
Discharges to post-acute care could get dicier next year in regions where insurers are offering fewer Medicare Advantage plans or exiting markets entirely, unless patients move to traditional Medicare. Medicare-eligible consumers in states such as Vermont, New Hampshire, North Dakota, South Dakota and Indiana will see the number of the private plans available in 2026 shrink by one-third to one-half compared to this year. (Eastabrook, 10/23)

Modern Healthcare: Centene Cuts More Medicare Advantage Commissions For Brokers
Centene is cutting commissions for more Medicare Advantage plans and further limiting marketers’ ability to sign up new members.Starting Friday, the health insurer won’t compensate agents and brokers for new enrollments into 13 plans in Arizona, Connecticut, Kentucky, Michigan, Ohio, Oregon and Washington, the company informed agents and brokers in a notice Wednesday. Centene also will remove 36 plans from the portals brokers and agents use to sign up beneficiaries. The annual enrollment period began Oct. 15 and ends Dec. 7. (Tepper, 10/23)

Stat: Launch Prices For New Drugs 'Significantly' Exceed Inflation, Analysis Says 
Amid intensifying angst over prescription drug prices, a new analysis found that the median net price for 154 newly launched medicines, when adjusted for inflation and manufacturer discounts, rose by 51% between 2022 and 2024. (Silverman, 10/23)

Stat: Buyer's Club Will Obtain Generic Of Pricey Vertex Cystic Fibrosis Drug 
Frustrated by the price of a lifesaving cystic fibrosis treatment sold by Vertex Pharmaceuticals, a group of families is working with a generic manufacturer to revive a buyer’s club and distribute the medication in countries where the cost is out of a reach. (Silverman, 10/23)

The New York Times: Drug With A 30-Year Monopoly Is Target Of State-Level Push To Curb Prices
With a sticker price that has risen nearly tenfold since 1998, Enbrel, the blockbuster arthritis drug sold by Amgen, has become emblematic of pharmaceutical industry tactics that keep prices high. Cheaper versions offered by competitors began arriving in Europe in 2016, but they are not expected to reach the United States until 2029. Those dynamics have recently made Enbrel a target of federal and state efforts to lower drug prices. (Robbins, 10/23)

More pharma and tech news —

MedPage Today: Cancer Drug Pulled From Market Regains FDA Approval
The FDA has once again approved belantamab mafodotin (Blenrep) for multiple myeloma, 3 years after the drug left the market over questions about its efficacy. A B-cell maturation antigen (BCMA)-targeted agent, belantamab mafodotin is now indicated in combination with bortezomib (Velcade) and dexamethasone (BVd) for the treatment of adults with relapsed or refractory multiple myeloma who have received at least two prior lines of therapy, including a proteasome inhibitor and an immunomodulatory drug. (Bassett, 10/23)

NBC News: A Liver Transplant Might Save Him — If He Can Get The Drug He Needs To Stay Alive Long Enough
The prognosis for John Middleton isn’t good. The 43-year-old engineer from Asheville, North Carolina, has a type of bile duct cancer hidden inside his liver called cholangiocarcinoma. It’s rare, diagnosed in about 8,000 people each year in the U.S., according to the American Cancer Society. And it’s deadly. The National Cancer Institute says that just 22% of patients live five years after their diagnoses. (Edwards, McLaughlin and Herzberg, 10/23)

The Baltimore Sun: AI-Powered App Speaks For Persons With Disabilities
Getting a quick zinger into a fast-paced conversation takes timing, wit and speed. For people who have difficulty putting their thoughts into words, a new app developed at the University of Maryland, College Park, could reopen opportunities to share in the humor. (Hille, 10/23)

Newsweek: New York City Mayor Adams Eliminates $135 Million In Medical Debt
New York City has canceled nearly $135 million in medical debt for more than 75,000 residents, Mayor Eric Adams said Wednesday. Eliminating medical debt was one of the key commitments Adams laid out in his State of the City address last year. (Giella, 10/23)

The Hill: Maryland Gov. Wes Moore Criticizes FEMA's Denial Of Disaster Aid
Maryland Gov. Wes Moore (D) said the Federal Emergency Management Agency (FEMA) denied his state’s appeal for federal disaster relief for flooding in May. Moore, in a Thursday release, called the move “deeply frustrating” and said it “leaves Marylanders on their own.” (Rego, 10/23)

WUSF: Six Times The Recommended Limit Of PFAS Were Found In USF Tampa's Drinking Water
A study by a national news organization has found that levels of so-called "forever chemicals" in area public water supplies are several times over the recommended limits. The report by USA Today shows levels of PFAS in most regional municipal water systems are several times the limits that have been recommended by the Environmental Protection Agency. (Newborn, 10/24)

WUSF: Florida Hospital Association CEO Mary Mayhew Details Struggles Of Rural Hospitals 
Florida’s rural hospitals are navigating an increasingly uncertain financial landscape, and DeSoto Memorial Hospital in Arcadia is a clear example, according to Florida Hospital Association CEO and president Mary Mayhew. (Mayer, 10/23)

Chicago Tribune: Federal Judge Postpones Ruling On Detained Father Of Sick Teen
Attorneys for Ruben Torres Maldonado, a 40-year-old Portage Park man detained by federal immigration agents last Saturday while his 16-year-old daughter, Ofelia, is undergoing cancer treatment, petitioned the court for him to be freed as his deportation case works its way through the system. (Pratt, 10/23)

Aurora Beacon-News: Kane Health Department In Illinois Launches Respiratory Illness Campaign
The Kane County Health Department has launched an education campaign meant to help residents access “clear, trustworthy information” about respiratory illnesses and vaccines, according to a news release from the county. (10/23)

ProPublica: Idaho Banned Vaccine Mandates. Activists Want To Make It A Model For The Country 
Three women become choked up as they deliver news in a video posted to social media. “We did it, everybody,” says Leslie Manookian, the woman in the middle. She is a driving force in a campaign that has chipped away at the foundations of modern public health in Idaho. The group had just gotten lawmakers to pass what she called the first true “medical freedom” bill in the nation. “It’s literally landmark,” Manookian said. “It is changing everything.” (Dutton, 10/23)

The Baltimore Sun: Wawa Drinks Recalled In Maryland For “Foreign Object Contamination”
Wawa has issued a recall for its strawberry lemonade, strawberry lowfat milk and whole milk pints from Maryland and other states due to “potential foreign object contamination,” according to the Food and Drug Administration. The drinks being recalled were sold in Delaware, Maryland, New Jersey and Pennsylvania. (Pryce, 10/23)

AP: Girl Shot In The Head In Minneapolis Church Attack Celebrates Return Home From The Hospital
A 12-year-old girl who was shot in the head during a deadly attack at a Minneapolis Catholic church in August was released from the hospital Thursday and greeted with cheers as the police chief paraded her around town in a stretch limousine, according to the Minneapolis Star Tribune. Sophia Forchas was the most seriously wounded child among those who survived the shooting at the Church of the Annunciation. A shooter opened fire with a rifle through the windows of the church on Aug. 27 and struck some of the nearly 200 children celebrating Mass during the first week of school, killing two and wounding 17 people. The children who died were 8 and 10 years old. (10/24)

In other mental health news —

Military.com: From Combat To Community: Penn State Unpacks What Shapes Veterans’ Mental Health 
There’s a stigma that veterans, especially those who were in combat, are defined by what they did on the battlefields. However, a new study from Pennsylvania State University, centering around post-9/11 veterans, found that for most, aspects of their mental health are shaped by other factors too, including traumatic moments from their youth, gender roles, and other deployment experiences. (Damask, 10/23)

North Carolina Health News: NC Youth Forge Their Own Path To Mental Wellness
At first, meditation and deep breathing were things Diya Patel used to help herself when she felt anxious or stressed. Then she saw a close friend struggle with a mental health crisis. Patel realized she could help other young people going through similar circumstances. (Fernandez, 10/24)

Katie Couric Media: Why Life After Breast Cancer Is Harder Than We Think
Remission from breast cancer is often framed as a happy ending: Cue the music, roll the credits, and voilà, life resumes. But for millions of women with breast cancer, survivorship is not a finale. Instead, it’s a messy sequel starring anxiety, grief, and the lurking fear that cancer could come back at any time. Even when the chemo chairs are gone and the radiation schedule has been completed, emotional aftershocks remain. Nearly half of breast cancer survivors face depression, anxiety, or both within five years of treatment — about twice the rate as what’s seen in the general female population. Then there’s “scanxiety,” the survivor-coined term for the dread that’s often set off by something as routine as an annual mammogram or as small as an unexplained ache. (Mancini, 10/23)

The New York Times: Kim Kardashian Announces Brain Aneurysm Diagnosis. Here’s What To Know.
Kim Kardashian, the reality television star and entrepreneur, says that she has been diagnosed with a brain aneurysm. Ms. Kardashian, 45, disclosed the diagnosis during a teaser for the seventh season of her reality show, “The Kardashians,” which premiered on Thursday on Hulu. (Petri and Blum, 10/24)

Also —

The Washington Post: ‘Scream Clubs’ Are The Latest Way People Are Blowing Off Steam 
The first rule of Scream Club is that you have to sign something indemnifying Scream Club in case you hurt yourself screaming. “I acknowledge that participation in Scream Clubᵀᴹ may carry certain risks, including but not limited to emotional distress, vocal strain, or accidental injury,” reads the liability waiver. The second rule of Scream Club is that you don’t talk about what brought you to Scream Club. Well, you can if you really want to. But feel free to set an intention in your heart and keep it there. (Judkis, 10/22)

The New York Times: When Joy Feels Out Of Reach
Struggling to feel pleasure is a key marker of depression. But this distressing symptom can also occur on its own. (Caron, 10/16)

The Washington Post: Want To Feel Better? Stop Trying To Be Happy And Do This Instead.
We are living through highly uncertain times. But a study out of Cornell has identified a happiness hack that can lead you toward a life of purpose. (Milbank, 10/24)

If you need help —

Dial 988 for 24/7 support from the Suicide & Crisis Lifeline. It's free and confidential.

The New York Times: Some N.F.L. Players Are Finding Second Careers As Nurses 
A handful of pro players are choosing scrubs after leaving the football field. (Dunn, 10/19)

AP: Women Are Embracing A Bald Head As The Ultimate Style And Power Move
More women are defying traditional beauty standards and finding empowerment by going without hair on their heads. (Bussewitz, 10/20)

AP: How Listening To Music May Help Ease Pain From Surgery Or Illness 
Hospitals and doctors' offices are inviting singers and musicians to help patients manage their pain, as music's ability to reduce pain is gaining attention. (Larson, 10/18)

Undark: A Struggle To Find Adequate Care For PMDD
Millions of women have pre-menstrual dysphoric disorder, or PMDD. But diagnoses and treatments vary considerably. (Klotz, 10/22)

The Washington Post: How A Joe Rogan-Mel Gibson Podcast Inspired Florida’s Cancer Research Focus
Following a Joe Rogan, Mel Gibson podcast, Florida wants to study whether ivermectin could work against cancer. There is not yet evidence it would. (Weber, 10/21)

The 19th: Her Refusal To Approve A Dangerous Drug Changed Medical History
As federal workers face mass layoffs and a government shutdown, Dr. Frances Oldham Kelsey's story is a reminder of what public servants can do when they stand their ground. (Rodriguez, 10/22)

Stat: I’m Stuck In The Gray Market For GLP-1s 
On Oct. 16, President Trump promised to slash the price of brand-name GLP-1 drugs like Ozempic and Wegovy to $150 a month. Even after a top health official suggested price negotiations between drugmakers and the administration were ongoing, the announcement sent Novo Nordisk and Eli Lilly stocks tumbling. For patients who’ve been priced out, that number sounded like relief. (Nick Dothee, 10/24)

Stat: TrumpRx And A Most Favored Nation Policy Won’t Lower Prices For Patients
Recently, President Trump signed a “most-favored nation” executive order on drug prices with a claim that it would force pharmaceutical companies to lower U.S. prescription costs to match those abroad. As a result, the White House announced a deal with Pfizer to lower drug prices and a new direct-to-consumer website dubbed “TrumpRx.” (Tahir Amin, 10/24)

The Washington Post: Can You Pick A Good Health Plan This Open Enrollment When It’s All Pricey?
My 27-year-old son, who works part-time, just received notice of his health insurance premium for next year. Under his Affordable Care Act plan through the Maryland marketplace, his monthly premium will increase by 17.1 percent. He’s also facing a 10.3 percent jump to his deductible, to just over $10,000, in 2026. (Michelle Singletary, 10/24)

The Washington Post: How To Engage With AI Chatbots To Answer Medical Questions
Many readers shared how AI helped them make sense of their diagnoses and treatment options. Sharon from Rhode Island wrote that when her 2-year-old daughter was diagnosed with a rare brain cancer, she was terrified. The wait to see a specialist felt endless, so she turned to ChatGPT every day with the questions that she wanted to ask a doctor. (Leana S. Wen, 10/23)

Chicago Tribune: Stop Letting Chicago’s Hospital Aid Flow To Wealthy Suburbs
Many of my constituents live in communities where hospitals have closed, clinics are underfunded and patients are forced to travel miles just to see a doctor. That’s exactly why Congress created the federal 340B Drug Pricing Program in 1992. The idea was to give hospitals that serve large numbers of low-income patients drugs at significant discounts, often 25% to 50% below market price, while still getting each drugs’ full reimbursement rate from insurance. They were supposed to invest the difference in price into free clinics, charity care and community health programs in the underserved areas they serve. (La Shawn K. Ford, 10/24)