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We performed steered molecular dynamics (SMD) and umbrella sampling simulations of Cl− ion migration through the transmembrane domain of a prototypical E. coli CLC Cl−/H+ antiporter by employing combined quantum-mechanical (QM) and molecular-mechanical (MM) calculations. The SMD simulations revealed interesting conformational changes of the protein. While no large-amplitude motions of the protein were observed during pore opening, the side chain rotation of the protonated external gating residue Glu148 was found to be critical for full access of the channel entrance by Cl−. Moving the anion into the external binding site (Sext) induced small-amplitude shifting of the protein backbone at the N-terminal end of helix F. As Cl− traveled through the pore, rigid-body swinging motions of helix R separated it from helix D. Helix R returned to its original position once Cl− exited the channel. Population analysis based on polarized wavefunction from QM/MM calculations discovered significant (up to 20%) charge loss for Cl− along the ion translocation pathway inside the pore. The delocalized charge was redistributed onto the pore residues, especially the functional groups containing π bonds (e.g., the Tyr445 side chain), while the charges of the H atoms coordinating Cl− changed almost negligibly. Potentials of mean force computed from umbrella sampling at the QM/MM and MM levels both displayed barriers at the same locations near the pore entrance and exit. However, the QM/MM PMF showed higher barriers (~10 kcal/mol) than the MM PMF (~2 kcal/mol). Binding energy calculations indicated that the interactions between Cl− and certain pore residues were overestimated by the semi-empirical PM3 Hamiltonian and underestimated by the CHARMM36 force fields, both of which were employed in the umbrella sampling simulations. In particular, CHARMM36 underestimated binding interactions for the functional groups containing π bonds, missing the stabilizations of the Cl− ion due to electron delocalization. The results suggested that it is important to explore these quantum effects for accurate descriptions of the Cl− transport.

Background/Aim: Galectins affect diverse physiological and pathophysiological processes such as development, inflammation, and tumor growth. We aimed to compare serum galectin-3 levels in three patient groups with chronic hepatitis B and C virus (HBV, HCV), cirrhosis secondary to HBV or HCV, and hepatocellular carcinoma (HCC) secondary to HBV or HCV and evaluate the role of galectin-3 during HCC progression. Patients and Methods: Nineteen patients with hepatocellular cancer, 22 patients with cirrhosis, and 24 patients with chronic hepatitis B and C were included in this study. Serum galectin-3 levels in different liver diseases were assessed by enzyme-linked immunosorbent assay. Results: The mean galectin-3 levels were 4.61 ng/mL (±2.32) in HCC patients, 5.68 ng/mL (±2,2) in cirrhotic patients, 1.98 ng/mL (±1.50) in chronic viral hepatitis group. There were no statistical differences between HCC and cirrhotic patients (P = 0.5), but lower in chronic hepatitis group statistically compared with cirrhosis and HCC (P < 0.001, P = 0.002, respectively). In case of cirrhotic patients, galectin-3 levels were significantly higher in patients with cirrhosis secondary to HCV compared with HBV (P = 0.03). When we evaluated galectin-3 levels in HCC patients, it was found to be 3.92 ng/mL in HCC secondary to hepatitis B and 5.37 ng/mL in HCC secondary to hepatitis C. Conclusion: Serum galectin-3 levels in patients with chronic HBV or HCV may guide us about progression to cirrhosis or HCC and prognosis of the disease. Especially, galectin-3 levels may be more pronounced in case of HCV.

Background: Emerging carbapenem-resistant Klebsiella pneumoniae (K. pneumoniae) (CRKP) bacteremias are presenting significant public health risks due to limited treatment options and increased mortality. K. pneumoniae isolates exhibit carbapenem resistance rates that vary from 25% to 50% throughout the European continent, including our country. Aims: To assess the characteristics of CRKP bacteremia, a condition that has recently demonstrated an increasing prevalence in our center. We sought to ascertain the resistance rates of isolated strains to antibiotics other than carbapenems, identify the responsible carbapenemase genes, evaluate the efficacy of antibiotics, determine mortality rates, explore clonality among strains, and investigate the influence of the COVID-19 pandemic on all these factors. Study Design: Retrospective observational study. Methods: This study included patients aged 18 and older who had experienced meropenem-resistant K. pneumoniae bacteremia. Meropenem resistance was confirmed by employing the Kirby-Bauer disk diffusion method. Meropenem minimum inhibitory concentration (MIC) levels were determined using the gradient test, while colistin MIC levels were ascertained using the disk elution technique. Carbapenemase genes were evaluated via colony polymerase chain reaction (PCR), and clonality analysis was performed using the arbitrarily primed PCR technique. Results: The study comprised 230 patients, with a mean age of 63.1 ± 15.9 years, of whom 58.7% were male. Oxacillinase-48 (OXA-48) was detected in 74.8% of the patients, New Delhi metallo-beta-lactamase (NDM) in 12.6%, OXA-48 + NDM in 7.8%, and KPC in 4.8%. The 14-day and 30-day mortality rates were 57% and 69.6%, respectively. Multivariate analysis of the 30-day mortality revealed several crucial factors, including bacteremia development in the intensive care unit, the occurrence of bacteremia during the COVID-19 pandemic, polymicrobial bacteremia, the use of indwelling intravenous catheters, a platelet count of ≤ 140,000/µl, procalcitonin levels of ≥ 6 µg/l, and a Charlson comorbidity score ≥ 3. Notably, the OXA-48 and KPC genes were upregulated significantly during the COVID-19 pandemic, while the NDM gene groups were downregulated. Additionally, both 14-day and 30-day mortality rates increased significantly. Conclusion: In this study, the most prevalent carbapenemase gene was OXA-48; however, there has been a recent increase in KPC genes. No dominant epidemic strain was identified through clonality analysis. The clustering rate was 68% before the pandemic, increasing to 85.7% during the pandemic. The significance of infection control measures is underscored by the rise in both clustering and mortality rates during the COVID-19 pandemic.

This paper presents an image clustering algorithm that classifies parts to be fabricated using traditional and additive manufacturing (AM) technologies. The proposed algorithm is a MATLAB-based software tool that clusters 3D CAD models of parts considering their geometry only. The algorithm can classify image datasets, CAD datasets, and combined datasets that contain both images and CAD models. The software tool reduces the time and effort spent during process selection by offering a preselected set of parts that are more suitable for AM. The software tool is aimed at supporting decision-making for traditional manufacturing companies that consider expanding their production capability by introducing AM processes in their production facilities. The HICA software tool expands the scope of scientific applications in manufacturing process selection by providing an unsupervised approach that does not require data labelling. The tool is made available as a MATLAB function through a permanent link.

ABSTRACTThe evolution of manufacturing systems toward Industry 4.0 and 5.0 paradigms has pushed the diffusion of Machine Learning (ML) in this field. As the number of articles using ML to support manufacturing functions is expanding tremendously, the main objective of this review article is to provide a comprehensive and updated overview of these applications. 114 journal articles have been collected, analysed, and classified in terms of supervision approaches, function, ML algorithm, data inputs and outputs, and application domain. The findings show the fragmentation of the field and that most of the ML-based systems address limited objectives. Some inputs and outputs of the analysed support tools are shared across the reviewed contributions, and their possible combinations have been outlined. The advantages, limitations, and research opportunities of ML support in manufacturing are discussed. The paper outlines that the excessive specialization of the reviewed applications could be overcome by increasing the diffusion of transfer learning in the manufacturing domain.

Mobility-as-a-Service (MaaS) has emerged as a promising concept in the mobility landscape. Researchers are increasingly interested in understanding this digital service's potential acceptance and uptake. Despite this interest, the extant literature lacks a comprehensive overview of various factors that play a role in its acceptance by target users. In this study, we aim to establish a current state of the art of MaaS user acceptance to inform practice in the effective design of related services, and to support the scientific community by offering future directions for their research. To achieve this, we performed a Systematic Literature Review (SLR) of relevant empirical studies and analyzed the factors considered significant in MaaS acceptance by target users. Our in-depth analyses of these works resulted in several factors, which we grouped into three categories: traveler and trip characteristics, service and technology characteristics, and urban environment characteristics. Certain factors, such as age, trip frequency, MaaS bundle price, and transportation facility, were found to be consistent in their influence on MaaS acceptance. However, empirical works conflict regarding the influence of a number of factors, such as income and public transport card ownership. This study serves as a comprehensive source of the factors investigated in the literature to the moment and a basis for future research to improve our understanding of factors that require further investigation.

Artificial intelligence (AI) encompasses a broad spectrum of techniques that have been utilized by pharmaceutical companies for decades, including machine learning, deep learning, and other advanced computational methods. These innovations have unlocked unprecedented opportunities for the acceleration of drug discovery and delivery, the optimization of treatment regimens, and the improvement of patient outcomes. AI is swiftly transforming the pharmaceutical industry, revolutionizing everything from drug development and discovery to personalized medicine, including target identification and validation, selection of excipients, prediction of the synthetic route, supply chain optimization, monitoring during continuous manufacturing processes, or predictive maintenance, among others. While the integration of AI promises to enhance efficiency, reduce costs, and improve both medicines and patient health, it also raises important questions from a regulatory point of view. In this review article, we will present a comprehensive overview of AI’s applications in the pharmaceutical industry, covering areas such as drug discovery, target optimization, personalized medicine, drug safety, and more. By analyzing current research trends and case studies, we aim to shed light on AI’s transformative impact on the pharmaceutical industry and its broader implications for healthcare.

Melatonin’s antioxidant properties make it a valuable component in anti-aging semisolid topical products. This study explores the role of Pemulen®, an acrylic-based viscosifying agent, in stabilizing cream-gel formulations. Remarkably, even at low concentrations (0.4%), Pemulen® successfully produced physicochemical stable topical formulations. In this work, the impact of the ratio of the oily phase—comprising olive oil and isopropyl myristate from 0 to 20%—was investigated to understand the internal microstructure effect on skin permeability, rheological properties, and stability. The formulations exhibited pseudoplastic behavior, with a significant positive correlation (p-value < 0.1) between the oily phase ratio, viscosity, spreadability, skin adhesiveness, and permeability. Formulations without the oil phase exhibited greater skin permeability. However, higher oily phase content enhanced viscosity, spreadability, and skin adhesion. Given that melatonin primarily degrades through oxidation, incorporating antioxidant excipients in semisolid formulations is crucial for maintaining its chemical stability. A quality by design (QbD) approach was used to assess the impact of four excipients—(a) DL-α-tocopheryl acetate (0.05%), (b) ascorbic acid (0.1%), (c) ethylene diamine tetraacetic acid (0.1%), and (d) sodium metabisulphite (0.5%)—on melatonin’s stability. Our findings indicate that maintaining the physical stability of the formulation with a 20% oil phase is more critical for protecting melatonin from oxidation than merely adding antioxidant excipients.

Hard candies are sugar confections comprising mainly water and sucrose. Corn syrup, colorants and flavors are also usually added to hard candy formulations. The production of hard candy requires heating of the ingredients to very high temperatures to reduce moisture content and subsequent cooling to obtain a solid matrix. Cooling of the mixtures achieves the final, well known glassy state of the products. In this glassy state, the system is kinetically stable and molecular mobility is restricted, providing longer shelf life to hard candies. There are, however, several factors affecting the final quality and consumer acceptance of hard candies. Production methods and parameters, initial formulations as well as storage conditions all play a crucial role in the physicochemical, textural and sensory properties of hard candies. Addition of colorants and flavors also plays a vital role in the final quality. Although hard candy production is a simple process with few production stages, even small changes in the method of production and process parameters may induce substantial changes in the final product characteristics. Additionally, storage conditions such as temperature and humidity can change the product properties leading to graining and stickiness which are the two major problems for hard candies during storage. Both production and storage conditions should therefore be carefully chosen and controlled for desirable hard candy properties. This review addresses the general production methods and considers process parameters and quality parameters of hard candy products. Moreover, a comprehensive review of the related hard candy literature is also presented. The majority of hard candy reviews focus on specific methods and processes, but this review will present a more general frame on the subject.

Hard candies produced from sucrose and doctoring agents such as glucose syrup (GS) and high fructose corn syrup (FS) have been investigated in terms of their final composition, glass transition temperature (Tg), degree of crystallinity, total soluble solids (TSS) content and water activity (aw). Time domain (TD) 1H NMR longitudinal relaxation time (T1) and second moment (M2) measurements have been used to understand the glassy state and crystallization characteristics for different hard candy formulations. The investigated candies include sucrose as the main sugar component. Different levels of doctoring agents have been mixed with sucrose to obtain products with different characteristics. It has been shown that addition of any doctoring agent to sucrose formulations decreases the Tg of the system significantly (p≤ 0.05). Furthermore, GS or FS addition also induce significant changes in TSS and aw. T1 and M2 results are almost parallel to each other, both reaching the highest values for the highest sucrose concentration (p≤ 0.05). The results demonstrate that the glass transition and crystallization characteristics of hard candy formulations can be monitored and analyzed by TD NMR relaxometry, alternative to other frequently used conventional methods including differential scanning calorimetry (DSC) and X-ray diffraction.

Osteocytes play an important role as regulators of both osteoclasts and osteoblasts, and some proteins that are secreted from them play a role in bone remodeling and modeling. LPS affects bone structure because it is an inflammatory factor, despite verbascoside’s potential for bone preservation and healing. Osteocytes may also be involved in the control of the bone’s response to immunological changes in inflammatory situations. MLO-Y4 cells were cultured in either supplemented -MEM alone with a low serum to inhibit cell growth or media with LPS (10 ng/mL) and/or verbascoside (50 g/mL) to show the LPS effect. In our research, LPS treatment increased RANKL levels while decreasing OPG and RUNX2 expression. Treatment with verbascoside reduced RANKL expression. In our work, verbascoside increased the expression of OPG and RUNX2. In MLO-Y4 cells exposed to verbascoside, SOD, CAT, and GSH activities as well as the expression levels of bone mineralization proteins like PHEX, RUNX2, and OPG were all elevated.

OBJECTIVES/GOALS: In this study, we implemented deformable medial modeling as a morphometric approach in first trimester placentas to characterize morphometric differences between fully automated and manual segmentations. METHODS/STUDY POPULATION: Twenty placentas from singleton pregnancies between 11-14 weeks’ gestation were manually and automatically segmented from 3D ultrasound volumes. Automated segmentations were produced by a trained convolutional neural network pipeline. Dice overlap scores and volumes were computed between manual and automated segmentations. Deformable medial modeling was applied to both manual and automated segmentations to produce the following metrics: maternal and chorionic surface areas (SA), thickness, circumference, and diameter along the generated medial surface. Placental non-planarity was also determined as the greatest medial surface height difference. A paired t-test and simple linear regression was performed between manual and automated segmentations for each shape metric. RESULTS/ANTICIPATED RESULTS: Mean placental volume measurements between manual and automated segmentations were similar, with a percent difference of 3.28% and a mean Dice overlap score of 0.85 ± 0.07. There were strong, statistically significant (p

Kosovo has historically been the scene of ethnic-driven regional conflicts among the communities. After the disengagement of the Socialist Federal Republic of Yugoslavia (SFRY) in 1992, the conflicts that had begun with the independence declarations of the Republics of SFRY eventually evolved into ethnic disputes between Serbs and Albanians. As the United Nations (UN) failed to resolve the conflict by diplomatic means, the North Atlantic Treaty Organization (NATO) initiated an air campaign to stop armed attacks by Serbian Military Forces on the Albanian civil communities. The UN Interim Administration Mission in Kosovo (UNMIK) was established in 1999 to restore peace and stability in Kosovo. One of the mandated tasks of the UNMIK was to establish the local police known as Kosovo Police Service (KPS) and to build its capacity. The objectives of this research are to determine whether the UNMIK was effective and successful in building the KPS’s capacity. A set of new success criteria is developed and applied to evaluate the success of UNMIK in this mandated task. Data for this study were collected using official reports of the UN and the crime statistics of the KPS. As a result of the analysis, it was determined that UNMIK was successful in establishing a local police force.

In this study, we assessed the interactions of mothers and fathers with their children diagnosed with autism spectrum disorder (ASD) in terms of emotional availability (EA) and compared them with the interactions of healthy controls. Children, aged 13–60 months and applied to the Infant Mental Health Unit between January 2019 and March 2021 and their parents without any clinical diagnosis, were included. The EA levels of mothers and fathers of the autistic group, which included 30 boys and 13 girls, and those of the control group, which included 10 boys and 10 girls, were compared. According to the results obtained, it was determined that the EA levels of mothers and fathers of healthy controls were not different; however, the mothers were more sensitive and better in structuring the content of play compared with the fathers in the ASD group. It was noted that the fathers of children with ASD were more hostile than the mothers. EA should be taken as a criterion to determine the intensity and content of treatment, particularly in ASD. Additionally, increased awareness of fathers in EA may provide better results in the intervention process.

The aim of this study is to examine the fluctuation in atmospheric pressure caused by the volcanic eruption of Hunga Tonga - Hunga Ha’apai volcano on January 15, 2022, at 04:14 UTC. In the study, it was predicted that the wave created by the explosion would move at a constant speed of sound and it was calculated that it would arrive in Türkiye in 13 hours and 22 minutes. According to this situation, it was calculated that the first lamb wave could come to Türkiye as of 15 January 2022 17:36 UTC. In the second stage, 1 minute pressure data of 12 Meteorological Station (Automated Weather Observation System, AWOS) in Türkiye was analyzed. In the analyzes and evaluations made, a sharp upward movement was observed in the pressure measured at 18:38 on January 15, 2022, at the Van Meteorology Station, which is the easternmost station. It was calculated that the lamb wave arrived at this station at an average speed of 303.2 m/s in 15.1 hours.

The purpose of the present study was to investigate the antimicrobial effect of propolis ethanol extract collected from the Tarsus district of Mersin province, Kilis province, Yayladagi district of Hatay province in southern Türkiye and Sarkoy district of Tekirdag province of northwestern Türkiye against Escherichia coli (ATCC 25922), Helicobacter pylori (ATCC 43504), Pseudomonas aeruginosa (ATCC 27853), and Staphylococcus aureus (ATCC 29213). Their chemical constituents were detected via liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS). They were used in a molecular docking approach to search the interactions between the propolis compounds. A total of 24 phenolic compounds were detected in all samples. 3-4 dimethoxycinnamic acid, caffeic acid and genistein were indicated to be the predominant phenolic compounds in propolis extracts by LC-MS/MS, while rutin was found in the lowest concentration. Phenolic compounds were detected in a high concentration of the propolis samples collected from the Tarsus district of Mersin province. The broth microdilution method determined minimum inhibition concentration (MIC) values. MIC values ranged from 0.02 to 14 mg.mL-1. E. coli and S. aureus examined were as susceptible to the propolis extracts except for Mersin and Tekirdag propolis samples. The propolis sample collected from the Tarsus district of Mersin province presented the highest antibacterial activity on P. aeruginosa with MIC values of 1 mg.mL-1. Active substances in propolis were docked to the relevant target proteins (5LMM, 4NX9, 5YHG, and 5FXT) representing E. coli (ATCC 25922), H. pylori (ATCC 43504), P. aeruginosa (ATCC 27853), and S. aureus (ATCC 29213), and with the help of molecular simulation. With this study, we indicated that the ethanol extract of propolis had a stronger antibacterial activity on S. aureus isolates than that of E. coli, H. pylori, and P. aeruginosa. Although each component of propolis contributed to the antibacterial activity, the contribution of the vitexin component to the antibacterial activity was found to be quite significant.

İzmit Bay, a 50 km long inlet at the eastern end of the Marmara Sea, is crucial for the region’s economy, culture, and marine ecosystem. The bay’s water circulation regulates nutrient distribution, stratification, sedimentation, oxygen levels, heat, and pollution levels. It is also influenced by meteorological events, such as short-term moderate to strong wind conditions. This study investigated the sensitivity of İzmit Bay Water Circulation to wind speed, direction, and duration using the MITgcm model with Orlanski boundary conditions and process-oriented modeling. The simulations showed that under weak forcing conditions, seawater temperature, salinity, and stratification do not significantly vary. However, strong forcing and wind speeds (statistically defined by percentiles of observation data) of 4.9 m/s (75%), 6.7 m/s (90%), and 10.1 m/s (99%) generate significant mesoscale and sub-mesoscale processes, depending on the direction. Westerly component winds cause downwelling at the eastern coastline, while easterly component winds bring sub-surface water to the surface. Strong winds from N, NE, and E sectors lead to the rise in lower-layer waters in the western basin, forcing them to overflow through the Hersek Delta sill into the central basin. Overall, severe wind events greater than 4.9 m/s (75%) significantly affect the bay’s hydrography by transforming the upper layer, with a decrease in temperature up to 5 °C and an increase in salinity up to 10 ppt.

Abstract Recent cross-cultural and neuro-hormonal investigations have suggested that love is a near universal phenomenon that has a biological background. Therefore, the remaining important question is not whether love exists worldwide but which cultural, social, or environmental factors influence experiences and expressions of love. In the present study, we explored whether countries’ modernization indexes are related to love experiences measured by three subscales (passion, intimacy, commitment) of the Triangular Love Scale. Analyzing data from 9474 individuals from 45 countries, we tested for relationships with country-level predictors, namely, modernization proxies (i.e., Human Development Index, World Modernization Index, Gender Inequality Index), collectivism, and average annual temperatures. We found that mean levels of love (especially intimacy) were higher in countries with higher modernization proxies, collectivism, and average annual temperatures. In conclusion, our results grant some support to the hypothesis that modernization processes might influence love experiences.

Objective: Many neurological symptoms due to central nervous system, peripheral nervous system and musculoskeletal system damage have been reported in more than a third of patients with coronavirus disease-2019 (COVID-19). Although optic neuritis has been reported in patients with COVID-19, they are extremely rare. The aim of this study was screening optic nerve involvement in COVID-19 with visual evoked potential (VEP) in asymptomatic patients without a history of visual impairment. Materials and Methods: Pattern reversal VEP measurements were made in 101 adult patients with COVID-19 without a history of visual impairment after they completed COVID-19 treatments and the quarantine period. VEPs were recorded with the 4-channel electromyography-evoked device in a dark room. P100 latencies and amplitudes were analyzed by the same neurologist. Results: A total of 34 (33.7%) patients had P100 latency prolongation. There was no significant difference in terms of gender, age or outpatient/inpatient treatment status. There was no significant correlation between the time of polymerase chain reaction diagnosis and VEP values. Conclusion: Contrary to previous studies, asymptomatic optic nerve involvement after COVID-19 was detected by VEP measurements. Prolongation of P100 latency shows the probable linkage between COVID-19 virus and angiotensin converting enzyme 2 receptors in human eyes.

Purpose: This study aims to examine the effect of ileal transposition (IT) on plasma levels of the total antioxidant status (TAS), total oxidant status (TOS), Oxidative Stress Index (OSI), Superoxide dismutase (SOD), Nicotinamide adenine dinucleotide phosphate oxidase (NOX), Catalase (CAT), Reduced Glutathione (GSH) in both rats with Metabolic syndrome (MetS) and healthy controls. Materials and Methods: In the MetS model, newborn male Wistar albino rats were given MSG (4 g/mg) on days 0, 2, 4, 6, 8, and 10. The control group was injected only saline. In the 5th month, sham and IT animals underwent selected surgery. 2 months after surgery TOS, TAS, OSI, SOD, NOX, CAT, and GSH levels were assessed in the plasma. Results: IT procedure significantly increased SOD and CAT levels in MetS + IT group when compared to the MetS group (SOD; MetS 1.75 ± 0.04, MetS+IT 2.1 ± 0.15, CAT; MetS 32.02 ± 1.73, MetS+IT 41.64 ± 1.18,). As expected, while GSH levels was increased in MetS+IT rats compared to MetS rats, but the difference was not significant (MetS 243.31 ± 6.36, MetS+IT 269.76 ± 9.17). The NOX activity was significantly lower in MetS+IT group than MetS and MetS+S groups (MetS 610.35 ± 26.25, MetS+IT 348.86 ± 14.12). Conclusion: These data revealed the healing effect of IT surgery against oxidative stress associated with MetS. The available data endorses IT surgery as an effective strategy to reduce oxidative damage in rats with MetS by modulating systemic oxidant and antioxidant responses.

Tricuspid valve disease, particularly tricuspid regurgitation (TR), has been a 'neglected valvulopathy' for many years. In patients with left heart pathologies, chronic pressure overload on the right ventricle causes functional TR and is associated with a poor prognosis.1 Treatment of severe symptomatic TR has usually been restricted to diuretics and mostly remained ineffective.2 Moreover, patients undergoing surgical repair of isolated tricuspid valve disease have the highest mortality of all valves, due to advanced right ventricular dysfunction and coexisting comorbidities.3 Thus, transcatheter tricuspid valve therapy (TTVT) has emerged as a novel strategy for patients with high or prohibitive surgical risk. In this case, we performed bicaval valve implantation using TricValve to reduce caval backflow on a symptomatic patient with severe functional TR and successfully managed device migration complications.