The agonal phase of 173 potential DCD donors was characterized according to the presence or absence of: acidemia; lactic acidosis; prolonged (> 30 min) hypotension, hypoxia or oliguria, and the impact of these characteristics on 3- and 12-month transplant outcome evaluated by multivariable regression analysis. Of the 117 referrals who became donors, 27 (23.1%) arrested more than 1 h after WLST. Longer

agonal-phase times were associated with greater donor instability, but surprisingly neither agonal-phase instability nor its duration influenced transplant outcome. In contrast, 3- and 12-month eGFR in the 190 transplanted kidneys was influenced independently by donor age, and 3-month eGFR by cold ischemic time. DCD kidney numbers are increased by 30%, without compromising transplant outcome, by lengthening the minimum waiting time after WLST from 1 to 4 h.”
“The role of endothelin-1 (ET-1) and nitric Epigenetics inhibitor oxide (NO) as two important mediators in the development of cerebral vasospasm (CVS) after subarachnoid haemorrhage (SAH) is controversial. The objective of this study was to determine whether local levels of ET-1 and NO in cerebral arterial plasma and/or in cerebrospinal fluid (CSF) are associated with the occurrence of CVS Buparlisib nmr after SAH.

CVS was induced using the one-haemorrhage rabbit model and confirmed by digital subtraction angiography of the rabbits’ basilar artery on day

5. Prior to sacrifice, local CSF and basilar arterial plasma samples were obtained by a transclival approach to the basilar artery. Systemic arterial plasma samples were obtained. ET-1 levels were determined by immunometric technique (pg/ml +/- SEM) and total nitrate/nitrite level spectrophotometrically (A mu mol/l +/- SEM).

Angiographic CVS was documented after SAH induction (n = 12, P < 0.05). The ET-1 level in CSF was significantly elevated by 27.3% to 0.84 +/- 0.08 pg/ml in SAH animals (n = 7) in comparison to controls (0.66 +/- 0.04 pg/ml, n = 7, P < 0.05). There was no significant LY3023414 clinical trial difference in ET-1 levels in systemic

and basilar arterial plasma samples of SAH animals compared to controls. A significant lack of local NO metabolites was documented in basilar arterial plasma after SAH (36.8 +/- 3.1 A mu mol/l, n = 6) compared to controls (61.8 A +/- 6.2 A mu mol/l, n = 6, P < 0.01).

This study demonstrates that an elevated ET-1 level in CSF and local lack of NO in the basilar arterial plasma samples are associated with CVS after experimental SAH.”
“Catecholaminergic polymorphic ventricular tachycardia (CPVT) is an inherited condition associated with ventricular tachycardia (VT) triggered by exercise or sympathetic stress. Incessant VT may develop due to defibrillator-induced storminga condition where implantable cardioverter-defibrillator discharges result in a hyperadrenergic state, provoking further VT and defibrillator discharge.

In contrast to what is known, it is observed that nanobubbles are formed on an ultrathin dewetted layer of 0.5 nm thickness and exhibit unusual stability at ultrahigh vacuum conditions. Further, nanobubble rings are observed at atmospheric selleck products pressure. The results provide direct experimental evidence of the interaction between MWCNTs and nanobubbles at air-liquid-solid triple contact line and at lower step edge

of the FLG, which together lead to the alignment of MWCNTs. Due to the balance between the surface tension forces and the strain forces arising from tube bending, MWCNTs attained straight rod-like shape. This enabled us to evaluate the elastic modulus of the MWCNT as E = 0.9 TPa. (C) 2011 American Institute of Physics. [doi:10.1063/1.3626456]“
“In

1997, Taiwan made highly active antiretroviral therapy (HAART) available without cost to HIV-infected persons; in 2001, a national web-based surveillance system was implemented. Healthcare workers use the system selleck inhibitor to monitor patients’ conditions and can intervene when necessary. Free HAART, coupled with the surveillance system, appears to have increased survival rates of HIV-infected persons with tuberculosis in Taiwan.”
“The aim of this work is to compare disabilities of the upper limb before and after hand allograft transplantation (HAT), and to describe the side effects of immunosuppressive (IS) agents given to recipients of hand allografts. Clinical cases of HAT published between 1999 and 2011 in English, French, or German were reviewed systematically, with emphasis on comparing disabilities of the arm, shoulder and hand (DASH) scores before and after transplantation. MLN8237 manufacturer Duration of ischemia, extent of amputation, and time since amputation were evaluated for their effect on intrinsic

musculature function. Infectious, metabolic, and oncological complications because of IS therapy were recorded. Twenty-eight patients were reported in 56 clinical manuscripts. Among these patients, disabilities of the upper limb dropped by a mean of 27.6 (+/- 19.04) points on the DASH score after HAT (P = 0.005). Lower DASH scores (P = 0.036) were recorded after secondary surgery on hand allografts. The presence of intrinsic muscle function was observed in 57% of the recipients. Duration of ischemia, extent of transplantation, and time since amputation were not associated statistically with the return of intrinsic musculature function. Three grafts were lost to follow-up because of noncompliance with immunosuppression, rejection, and arterial thrombosis, respectively. Fifty-two complications caused by IS agents were reported, and they were successfully managed medically or surgically. HAT recipients showed notable functional gains, but most complications resulted from the IS protocols.

Seventeen (56.6%) were women. Age, BMI, and duration of diabetes were 48 +/- 9 years, 33.7 +/- 1.2 kg/m(2), 4 +/- 2.9 years, respectively. No mortality IPI-145 in vivo was observed. No conversion/reoperation was needed. Average length of stay was 3.2 +/- 0.9 days. Early and late postoperative complications were observed in five (16.6%) and five (16.6%) patients, respectively. Twelve months after surgery, remission was observed in 25 of 30 patients (83.3%). After 2 years, remission was achieved in 13 of 20 patients (65%), and hemoglobin A1c decreased from 8.1 +/- 1.8% to 5.9 +/- 1.1% and

homeostasis model assessment of insulin resistance from 5.7 +/- 3.2 to 1.9 +/- 0.8 after 12 months. RYGB is a safe and effective procedure to induce T2DM remission in otherwise ACY-738 not eligible patients for bariatric surgery. Evidence from prospective studies is needed to validate this approach.”
“Objective. The aim of this study was to determine the function of newborn nurses given at newborn feeding in the newborn units of public hospitals in Konya, Turkey, besides it was also to determine the effect of nurses which had short-term training, aka education, in practice and in theory.

Methods. This was an experimental study conducted with a total of 50 newborn nurses between 15 September 2004 and 30 February 2005. In collecting the data, a survey sheet including the demographic characteristics

of newborn nurses and their knowledge on newborn feeding was applied, along with another remark form that shows clinical practices about newborn feeding.

Results. Considering the nurses, their knowledge mean score ‘after education (AE)’ was calculated to be 72.4 +/- 10.4, which

was significantly higher than that of ‘before education (BE)’, which was 58.0 +/- 9.3, (p < 0.05). Likewise, the implementation mean score of these nurses AE (57.2 +/- 4.9) was also found higher than the mean score BE (54.4 +/- 5.0) (p < 0.05). There were statistically significant differences in the posteducation mean scores of nurses for the number of children they had, and for the hospital they work.

Conclusion. In this study, it was determined that the nurses had knowledge deficits about newborn feeding both in theory and practice, but after a short educational program on newborn feeding their theoretical GM6001 and practical knowledge had shown increases.”
“The influence of creatine (Cr) supplementation on cortical and trabecular bone from ovariectomized rats was studied using FT-Raman spectroscopy. The intensity of organic-phase Raman bands was compared to mineral phase ones. Twenty-one female Wistar rats aged 3 months were divided into three groups (n = 7 per group): ovariectomized (OVX), ovariectomized treated with creatine (CRE) and sham-operated (SHAM) groups. Creatine supplementation (300 mg kg(-1) day(-1)) was provided for 8 weeks, starting 12 weeks after ovariectomy.

9) in comparison to the first and third trimesters (22.4 +/- 4.1 and 18.6 +/- 3.8, respectively). Total FSFI score was found to be positively correlated to pre-conception total FSFI score. However, age, parity and duration of marriage were negatively correlated.

ConclusionFSD is a prevalent problem during pregnancy among Egyptian women. The magnitude of the problem is highest during the third trimester while the

second trimester represents the peak of sexual function during pregnancy.”
“Objective. The objective of this study BTSA1 ic50 was to quantify the network complexity, information flow, and effect of critical-node failures on a prototypical regional anesthesia and perioperative pain medicine (RAPPM) service using social network analysis. Design. Pilot cross-sectional investigation. Setting. This study was conducted at a prototypical single-center, multi-location academic anesthesiology department with an active selleck inhibitor RAPPM service. Interventions. We constructed an empirically derived prototypical social network representative of a large academic RAPPM service. Outcome Measures. The primary objective was measurement of network complexity via network size, structure, and information flow metrics. The secondary objective identified, via network simulation, those nodes whose deletion via single, two-level, or three-level node failures would result

in the greatest network fragmentation. Exploratory analyses measured the impact of nodal failures on the resulting network complexity. Results. The baseline network consisted Quisinostat mw of 84 nodes and 208 edges with a low density of 0.03 and high Krackhardt hierarchy of

0.787. Nodes exhibited low average total degree centrality (mean +/- standard deviation [SD]) of 0.03 +/- 0.034 and mean eigenvector centrality of 0.164 +/- 0.182. The RAPPM resident-on-call was identified as the critical node in a single-node failure, with the resulting network fragmentation increasing from 0 to 0.52 upon node failure. A two-level failure involved both the RAPPM resident-on-call as well as the RAPPM attending-on-call, with the resulting fragmentation expanding to 0.772. A three-level node failure included the RAPPM resident-on-call, the main block-room attending, and block room fellow with fragmentation increasing to 0.814. Conclusions. The RAPPM service entails considerable network complexity and increased hierarchy, but low centrality. The network is at considerable fragmentation risk from even single-node failure.”
“Osteochondral lesions (OCLs) are rare joint disorders, typically found in the larger joints of the body and less so in smaller joints (J Bone Joint Surg Am 41-A: 988-1020, 1959; Arthroscopy 6(3): 190-197, 1990; Clin Orthop Relat Res 148: 245-253, 1980). Although their specific cause is subject to frequent debate, they are often caused by trauma with subsequent compromise of the articular cartilage (Arthroscopy 6(3): 190-197, 1990; J Bone Joint Surg Am 78(3): 439-456, 1996).

Methods. A 50-year-old woman with treatment history of spinal NCC presented with back pain and radicular pain. The lumbar magnetic resonance imaging showed a cystic lesion with septation and slight rim enhancement after gadolinium administration at the L4-S1 area. We performed surgical removal of this lesion and postoperative medical therapy for complete eradication of the parasite.

Results. The histopathology was diagnostic GSK690693 in vivo for a cysticercal cyst. Adjuvant medical therapy with albendazole was administered for 30 days after surgery. The patient remained symptom-free for 1 year after surgery without any evidence of recurrence.

Conclusion. We report a rare case of recurrent primary spinal subarachnoid NCC at L4-S1 area. In cases

of primary spinal subarachnoid NCC can be treated by adequate combined approach with surgery and medical therapy. Spinal subarachnoid NCC should be added to the differential diagnosis of primary spinal intradural cysts, because this lesion can occur primarily.”
“The National Cancer Strategy heralded a major reorganisation of the delivery of cancer services in Ireland. As a result of this policy, cancer care was centralised to

eight centres. The impact of this strategy on hospitals no longer providing cancer services has not been analysed to date.

The aim of this study was to examine the impact of centralisation of cancer services on surgical workload at Mayo General Hospital.

Data pertaining to all surgical procedures performed in 2007 (prior to the introduction of the National Cancer Strategy) and 2011 were obtained using the Hospital Inpatient Enquiry system. Histopathology Selleckchem Z-VAD-FMK reports and theatre registers were also analysed https://www.selleckchem.com/products/OSI-906.html to ensure accuracy of the data.

The numbers of elective and emergency surgical admissions during 2007 and 2011 were broadly similar (2,581 vs. 2,662). One hundred and thirty-five oncological procedures (colorectal and breast) were carried out in 2007 compared with 50 (colorectal) in 2011. This represents a 63 % reduction in cancer surgery workload following the

implementation of the National Cancer Strategy. There was a concomitant increase in surgery performed for benign conditions (laparoscopic cholecystectomy and hernia repair), which coincided with the innovative introduction of 43 ring-fenced surgical in-patient beds in June 2010.

This study demonstrates the impact of the centralisation of cancer services on surgical workload in a non-cancer centre. Our results show that there continues to be a role for general hospitals in the provision of elective surgical services. Hospital network arrangements have the potential to facilitate such developments.”
“To assess the association between severity and extent of maternal periodontal disease and preterm birth/low birth weight (PLBW) among women in the north of Jordan.

A total of 148 woman who gave preterm birth/low birth weight birth and 438 women with uncomplicated full term vaginal delivery were included in this study.

The aim of this study was to investigate the feasibility of detecting promoter hypermethylation as a diagnostic tool with using liquid-based cytology samples for differentiating between malignant and benign effusions. Methods : A multiplex, nested,

methylation-specific polymerase chain reaction analysis was used to examine promoter methylation of 4 genes (retinoic acid receptor-beta, [RAR-beta], adenomatous polyposis coli [APC], Twist and high in normal-1 [HIN-1]) in malignant (n = 85) and benign (n = 31) liquid-based cytology samples. Results : The frequencies of hypermethylation of RAR-beta, APC, Twist and HIN-1 were significantly higher in the malignant effusions than in the benign effusions (p < 0.001 for each). On the receiver-operating characteristic analysis, the area under the curve (AUC) for APC was the greatest. The AUC for the best two-gene combination NU7441 chemical structure (APC/HIN-1) was not statistically different from the AUC for the best individual tumor suppressor gene (APC). Conclusions : This study suggests

that promoter methylation analysis on residual liquid-based effusion samples may be a feasible approach to detect malignant effusions, and that APC is the best marker for differentiating between malignant and benign effusions.”
“Fragment-based drug discovery using NMR and x-ray crystallographic methods has proven utility Salubrinal nmr but also non-trivial time, materials, and labor costs. Current computational fragment-based approaches circumvent these issues but suffer from limited representations of protein flexibility and solvation

effects, leading to difficulties with rigorous ranking of fragment affinities. To overcome these limitations we describe an explicit solvent all-atom molecular dynamics methodology (SILCS: Site Identification by Ligand Competitive Saturation) that uses small aliphatic and aromatic molecules plus water molecules to map the affinity pattern of a protein for hydrophobic groups, aromatic groups, hydrogen bond donors, and hydrogen GSK2879552 purchase bond acceptors. By simultaneously incorporating ligands representative of all these functionalities, the method is an in silico free energy-based competition assay that generates three-dimensional probability maps of fragment binding (FragMaps) indicating favorable fragment: protein interactions. Applied to the two-fold symmetric oncoprotein BCL-6, the SILCS method yields two-fold symmetric FragMaps that recapitulate the crystallographic binding modes of the SMRT and BCOR peptides. These FragMaps account both for important sequence and structure differences in the C-terminal halves of the two peptides and also the high mobility of the BCL-6 His116 sidechain in the peptide-binding groove. Such SILCS FragMaps can be used to qualitatively inform the design of small-molecule inhibitors or as scoring grids for high-throughput in silico docking that incorporate both an atomic-level description of solvation and protein flexibility.

Accordingly, short-term variability, basal heart rate, accelerations and decelerations were quantified at 20-24 find more weeks gestation among women with uncomplicated pregnancies.

Methods: This study was conducted in a subset of participants enrolled in a large prospective pregnancy cohort study.

Our final data set consisted of 281 recordings of women with good perinatal outcomes who had undergone fetal electrocardiographic assessment as part of the Safe Passage Study.

Results: The success rate of the recordings was 95.4%. The mean frequency of small and large accelerations was 0.5 and 0.1 per 10 min, respectively and that of small and large decelerations 0.3 and 0.008 per 10 min, respectively. The mean and basal heart rates were both equal to 148.0 bpm at a median gestation of 161 days. The mean short term variation was 6.2 (SD 1.4) ms and mean minute

range 35.1 (SD 7.1) ms.

Conclusion: The 20-24-week fetus demonstrates FHR patterns with more accelerations and decelerations, as well as higher baseline variability than was anticipated. Information from this study provides an important foundation for further, more detailed, studies of early FHR patterns.”
“Signaling peptides produced in peripheral tissues such as gut, adipose tissue, and pancreas communicate with brain centers, such as hypothalamus and hindbrain to manage energy homeostasis. BMS-345541 These regulatory mechanisms of energy intake and storage have evolved during long periods of hunger in the evolution of man to protect the species from extinction. It is now clear that these circuitries are influenced by prenatal and postnatal environmental factors including endocrine disruptive chemicals. Hypothalamic appetite regulatory Duvelisib price systems develop and mature in utero and early

infancy, and involve signaling pathways that are important also for the regulation of puberty onset. Recent studies in humans and animals have shown that metabolic pathways involved in regulation of growth, body weight gain and sexual maturation are largely affected by epigenetic programming that can impact both current and future generations. In particular, intrauterine and early infantile developmental phases of high plasticity are susceptible to factors that affect metabolic programming that therefore, affect metabolic function throughout life. In children born small for gestational age, poor nutritional conditions during gestation can modify metabolic systems to adapt to expectations of chronic undernutrition. These children are potentially poorly equipped to cope with energy-dense diets and are possibly programmed to store as much energy as possible, leading to later obesity, metabolic syndrome, disturbed regulation of normal puberty and early onset of cardiovascular disease. Most cases of disturbed energy balance are likely a result of a combination of genetics, epigenetics and environment.

44 and 77.16 +/- 17.61 in 10,000 IU uhCG, 250 mu g rhCG and 500 mu g rhCG, respectively which was significantly higher with 500 mu g rhCG than the lower dose(P = .04). Other cycles and clinical outcomes were comparable between groups.

Recombinant hCG shows equivalent efficacy to urinary hCG in terms of the number of oocytes per aspirated follicles in selected patients undergoing ICSI; however, 500 mu g rhCG seems to be more advantageous than the lower dose in this indication. Larger randomized trials are needed to generalize this strategy.

ClinicalTrials.gov identifier: NCT01507376.”
“Neonatal sepsis is common and is a major cause of morbidity

and mortality. Vancomycin is the preferred treatment of several neonatal staphylococcal infections. The aim of this study was to review published data on

vancomycin pharmacokinetics in neonates and to provide a critical analysis of the literature. A bibliographic search was performed using PubMed and XMU-MP-1 datasheet Embase, and articles with a publication date of August 2011 or earlier were included in the analysis. Vancomycin pharmacokinetic estimates, which are different in neonates compared with adults, also exhibit extensive inter-neonatal variability. In neonates, several vancomycin dosing schedules have been proposed, mainly based on age (i.e., postmenstrual buy Alvocidib and postnatal), body weight or serum creatinine level. Other covariates [e. g., extracorporeal membrane oxygenation (ECMO), indomethacin or ibuprofen, and growth restriction] of vancomycin pharmacokinetics have been reported in neonates. Finally, vancomycin penetrates cerebrospinal fluid (range = 7-42%). Renal function drives vancomycin pharmacokinetics. Because either age or weight is the most relevant covariate of renal maturation, https://www.selleckchem.com/products/pf-03084014-pf-3084014.html these covariates should be considered first in neonatal vancomycin dosing guidelines and further adjusted by renal dysfunction indicators (e. g., ECMO and ibuprofen/indomethacin).

In addition to the prospective validation of available dosing guidelines, future studies should focus on the relevance of therapeutic drug monitoring and on the value of continuous vancomycin administration in neonates.”
“Background: The success of US Air Force Critical Care Air Transport Teams (CCATT) in transporting critically ill and injured patients enabled changes in military medical force deployment and casualty care practice. Even so, a subset of casualties remains who exceed even CCATT capabilities for movement. These patients led to the creation of the Landstuhl Acute Lung Rescue Team (ALeRT) to close the “”care in the air”" capability gap.

Methods: The ALeRT Registry was queried for the period between November 1, 2005, and June 30, 2010. Additionally, Landstuhl Regional Medical Center critical care patient transfers to host nation medical centers were reviewed for cases using extracorporeal lung support systems.

Results: For the review period, US Central Command activated the ALeRT on 40 occasions.

“
“The polyphenolic natural product resveratrol (RV), best known for its occurrence in grape skin and red wine, is considered a candidate drug for prevention

and treatment of cardiovascular diseases. This review aims to summarize the molecular effects of RV on endothelial cells, which line the inner walls of blood vessels and play a key role in the development of those diseases. We describe how RV enhances endothelial nitric oxide production, improves endothelial redox balance and inhibits endothelial activation in response to pro-inflammatory and metabolic insults. Furthermore, we summarize effects of RV on endothelial senescence, apoptosis, endothelin-1 release, and endothelial progenitor cell function. As many of RV’s actions seem to be mediated by R406 cell line SIRT1, different mechanistic possibilities how RV may lead to SIRT1 activation are discussed. (C) 2010 International Union of Biochemistry and Molecular Biology, Inc. Volume

36, Number 5, September/October 2010, Pages 342-349. E-mail: THZ1 [email protected]”
“Recently in this journal, David Ropeik argued for imposing additional burdens upon individuals who refused vaccines for themselves or for their children. Specifically, Ropeik advocated for policies that would decrease the ease of claiming vaccine exemptions and restricting unvaccinated children participation in social activities. We argue that, in order to derive the optimal societal benefit from modern vaccinology in an era of vaccine hesitancy, we need to consider doing more than conventional remodeling of current policies. We may need to fundamentally redesign and rebuild.”
“Purpose of review

Obesity is commonly associated with multiple conditions imparting adverse cardiovascular risk, including hypertension, dyslipidemia, and insulin resistance or diabetes. In addition, sleep disordered breathing, inflammation, left ventricular hypertrophy, left atrial enlargement, and subclinical

left ventricular systolic and diastolic dysfunction may collectively contribute to increased cardiovascular morbidity and mortality. Navitoclax datasheet This review will describe improvements in cardiovascular risk factors after bariatric surgery.

Recent findings

All of the cardiovascular risk factors listed above are improved or even resolved after bariatric surgery. Cardiac structure and function also have shown consistent improvement after surgically induced weight loss. The amount of improvement in cardiac risk factors is generally proportional to the amount of weight lost. The degree of weight loss varies with different bariatric procedures. On the basis of the improvement in risk profiles, it has been predicted that progression of atherosclerosis could be slowed and the 10-year risk of cardiac events would decline by similar to 50% in patients undergoing weight loss surgery.

Our study provides no strong evidence of spatial displacement of wild grazers

by cattle. We suggest that pastoralist decisions on cattle distribution do not need to negatively affect wildlife distribution and that coexistence can be possible through spatial partitioning. our results show that pastoralist decisions play an important role in the interactions between livestock and wildlife in African savannas and that herd mobility is a key component in supporting sustainable use of resources for both wildlife and livestock. (C) 2008 Elsevier Ltd. All rights reserved.”
“Development of bakery products containing milled flaxseed, could have check details potential health benefits due to its high antioxidant, lignan and omega-3 fatty acid alpha linolenic acid content. However the effect of adding flaxseed, especially in the high amounts required for use as the food supplement in clinical trials, may affect the flavor characteristics. The objective of this study was to evaluate the flavor profile of different muffin and snack bar formulations with and without

milled flaxseed. Three snack bar formulations and two muffin formulations with and without flaxseed were evaluated by ten and eleven trained assessors respectively. The intensity of seven aroma and eight flavor attributes for snack bars, and nine aroma and ten flavor attributes for muffins were measured on 15-cm line TPCA-1 mw scales. Both the orange cranberry and apple spice muffin formulations with flaxseed had significantly lower sweetness and vanilla aroma and flavor intensities, and significantly higher grain/flax aroma and flavor, and bitter taste compared to the non-flax muffin. Of the two flavorings apple spice appeared to have the best potential, since the apple aroma and flavor were significantly higher for the flax muffin compared to the non-flax muffin. The orange cranberry, gingerbread raisin and cappuccino chocolate chip snack bar formulations with and without flaxseed showed no significant differences in intensities for the grain/flax aroma and flavor. The gingerbread raisin snack find more bar formulations showed no significant differences

for any other attributes except for higher spice aroma in the flax sample, which makes it a promising flavoring option. (C) 2011 Elsevier Ltd. All rights reserved.”
“We integrated satellite-tracking data from black-footed albatrosses (Phoebastria nigripes; n = 7) and Laysan albatrosses captured in Alaska (Phoebastria immutabilis; n = 18) with data on fishing effort and distribution from commercial fisheries in the North Pacific in order to assess potential risk from bycatch. Albatrosses were satellite-tagged at-sea in the Central Aleutian Islands, Alaska, and tracked during the post-breeding season, July-October 2005 and 2006. In Alaskan waters, fishing effort occurred almost exclusively within continental shelf and slope waters.