The bacterium Kluyvera georgiana MCC 3673 transfers electrons directly to the electrode for bio-electricity generation in microbial fuel cell (MFC). This could be due to the formation of biofilm on the surface of electrode or with through the extracellular appendages, or both. The role of extracellular appendages pili and flagella in exo-electron transfer mechanism was investigated. The expression level of the genes fli P and pil Q for pili and flagella, respectively, in K. georgiana MCC 3673 was compared in MFC and in shake flask. The transcript analysis was done by qRT-PCR at different times and conditions. The expression level of pil Q transcript in K. georgiana MCC 3673 showed over twofold higher expression during bio-electrogenic process, compared to the one inoculated in shake flask. Similarly, fli P had also showed similar kind of expression in MFC compared to that in shake flask. Higher level of pil Q and fli P transcripts were observed throughout bio-electrogenic process. The level of pil Q was found to be nearly fourfold higher in biofilm-forming cells forming compared to the cells in suspension form. The obtained results suggest that flagella have a role in movement of bacterium towards electrode for donating the electron in absence of oxygen, and pili aiding in adhering on the surface of electrode and forming biofilm. The cumulative effect of fli P and pil Q resulted in exo-electron transfer to the electrode and bio-electricity generation process. The open circuit potential (OCV) of + 0.7 V was produced with the maximum power density of 393 ± 14 mW/m2 in MFC. © King Abdulaziz City for Science and Technology 2020.INTRODUCTION Unprovoked venous thromboembolism (uVTE) may be the first manifestation of cancer. The main objectives of this study were to compare limited screening (LS) and extended screening (ES) and to make a protocol to approach these patients. METHODS This is a retrospective, unicentric observational study that included 245 patients with venous thromboembolism (VTE) admitted to an Internal Medicine Service for five years. The incidence of cancer and mortality during hospitalization, and at one and three years after admission were calculated in both LS and ES groups and compared. RESULTS Of the 245 patients with VTE, 59 (24.1%) had uVTE 35 (59.3%) were submitted to LS and 24 (40.7%) to ES, with 10 (4.1%) diagnosis of cancer. In the following three years, 10 more patients were diagnosed. There were no statistically significant differences in inpatient diagnosis rates (8.6% vs. 4.2%; p=0.51) or in-hospital mortality (2.9% vs. 4.2%; p=0.79) or mortality at one year (8.6% vs. 8.3%; p=0.97) and three years (20.0% vs. 20.8%; p = 0.94) between LS and ES groups respectively. The Computerized Registry of Patients with Venous Thromboembolism (RIETE) score was equal or superior to 3 in 69.5% (N=41) of the population with uVTE. DISCUSSION The results of our study are consistent with the literature; there are no differences between screenings, as the difference in the number of diagnoses does not reflect on mortality. CONCLUSION There were no statistically significant differences between the two types of screening in this population. We suggest a protocol that includes the RIETE score to better select the patients who might benefit the most from an ES. Copyright © 2020, Ferreira et al.Background and objective Cephalic excision of the lateral crus is the most used procedure in rhinoplasty when attempting to make the nasal tip smaller or narrower to improve the definition. However, due to its several drawbacks as external valve collapse, bossae formation, and alar retraction, a technique, known as the Turn-in flap, has been developed to overcome these complications and to provide better aesthetic and functional nasal tip outcomes. Therefore, we conducted this investigation to determine the long-term outcomes of such procedure. Methods During the period from 2007 to 2017, the charts of 120 patients who underwent the Turn-in flap procedure at King Saud University have been reviewed. The study included 42 males and 78 females with a mean age of 23 years. The follow-up duration ranged from one to 10 years with a mean duration of two years. Results The majority (30%) of our patients underwent Turn-in flap procedure due to combined lower lateral cartilage (LLC) convexity and bulbous tip. Satisfactory results have been observed in most cases with no post-operative complications. Only six cases required revision surgery. Conclusions The Turn-in folding of the cephalic part of lateral crus does not only provide functional support to the nose, but it also provides aesthetic improvement of the nasal tip with long-term satisfactory outcomes. Copyright © 2020, Alkarzae et al.BACKGROUND Acute kidney injury (AKI) complicating cardiogenic shock is associated with increased mortality. We hypothesize that renal replacement therapy (RRT) improves survival in cardiogenic shock supported by Impella-CP (Abiomed, Danvers, MA) complicated by AKI. METHODS A retrospective chart review identified 34 patients on Impella-CP for cardiogenic shock between January 2015 and December 2017. AKI was defined as an increase in serum creatinine≥0.3 mg/dL from baseline. Three groups were analyzed AKI plus RRT, AKI minus RRT, and no AKI. Pre-existing dialysis patients were excluded. The only indication for RRT was AKI not responding to diuretics. Thirty-day mortality was analyzed. RESULTS There were 13 patients with no AKI, 9 with AKI plus RRT groups, and 12 with AKI minus RRT. Thirty-day mortality was similar between no AKI and AKI plus RRT groups [30.8% (4/13) vs.22.2% (2/9), p=0.48; relative risk [RR] 2.25 (95% confidence interval [CI] 0.22-22.1)]. Blebbistatin mw Thirty-day mortality was higher in AKI minus RRT group compared to the no AKI group [75.0% (9/12) vs. 30.8% (4/13); p=0.03; RR 6.75 (95% CI 1.16-39.2)]. CONCLUSION In cardiogenic shock patients on Impella-CP, AKI minus RRT is associated with a higher 30-day mortality compared to patients without AKI and/or patients with AKI plus RRT. Short-term mortality may improve in cardiogenic shock patients with AKI who are treated with RRT. Copyright © 2020, Fahad et al.