Pickled cabbage, a traditional fermented food rich in functional microorganisms, can effectively control hyperuricemia and gout. In this study, a Priestia megaterium ASC-1 strain with strong uric acid (UA) degradation ability was isolated from pickled cabbage. After oral administration for 15 days, ASC-1 was stably colonized in the rats in this study. ASC-1 significantly reduced UA levels (67.24%) in hyperuricemic rats. Additionally, ASC-1 alleviated hyperuricemia-related inflammatory response, oxidative stress, and blood urea nitrogen. Intestinal microbial diversity results showed that ASC-1 restored intestinal injury and gut flora dysbiosis caused by hyperuricemia. These findings suggest that P. megaterium ASC-1 may be used as a therapeutic adjuvant for the treatment of hyperuricemia. Full article

This paper presents a reliability study of a conventional 650 V SiC planar MOSFET subjected to pulsed HTRB (High-Temperature Reverse Bias) stress and negative HTGB (High-Temperature Gate Bias) stress defined by a TCAD static simulation showing the electric field distribution across the SiC/SiO₂ interface. The instability of several electrical parameters was monitored and their drift analyses were investigated. Moreover, the shift of the onset of the Fowler–Nordheim gate injection current under stress conditions provided a reliable method to quantify the trapped charge inside the gate oxide bulk, and it allowed us to determine the real stress conditions. Moreover, it has been demonstrated from the cross-correlation, the TCAD simulation, and the experimental ΔV_th and ΔV_FN variation that HTGB stress is more severe compared to HTRB. In fact, HTGB showed a 15% variation in both ΔV_th and ΔV_FN, while HTRB showed only a 4% variation in both ΔV_th and ΔV_FN. The physical explanation was attributed to the accelerated degradation of the gate insulator in proximity to the source region under HTGB configuration. Full article

Breast cancer (BC) is a complex disease affecting one in eight women in the USA. Advances in population genomics have led to the development of polygenic risk scores (PRSs) with the potential to augment current risk models, but replication is often limited. We evaluated 2 robust PRSs with 313 and 3820 SNPs and the effects of multiple genotype imputation replications in BC cases and control populations. Biological samples from BC cases and cancer-free controls were drawn from three European ancestry cohorts. Genotyping on the Illumina Global Screening Array was followed by stringent quality control measures and 20 genotype imputation replications. A total of 468 unrelated cases and 4337 controls were scored, revealing significant differences in mean PRS percentiles between cases and controls (p < 0.001) for both SNP sets (313-SNP PRS: 52.81 and 48.07; 3820-SNP PRS: 55.45 and 49.81), with receiver operating characteristic curve analysis showing area under the curve values of 0.596 and 0.603 for the 313-SNP and 3820-SNP PRS, respectively. PRS fluctuations (from ~2–3% up to 9%) emerged across imputation iterations. Our study robustly reaffirms the predictive capacity of PRSs for BC by replicating their performance in an independent BC population and showcases the need to average imputed scores for reliable outcomes. Full article

As internal curing self-healing agents in concrete repair, the basic properties of superabsorbent polymers (SAPs), such as water absorption and release properties, are generally affected by several factors, including temperature and humidity solution properties and SAP particle size, which regulate the curing effect and the durability of cementitious composites. This study aimed to investigate the water retention capacities of SAPs in an alkaline environment over extended periods by incorporating liquid sodium silicate (SS) into SAP–water mixtures and examining the influence of temperature. The influence of SAP particle size on mortar’s water absorption capacity and mechanical behavior was investigated. Two mixing techniques for SAPs (dry and pre-wetting) were employed to assess the influence of SAP on cement mortars’ slump, mechanical properties, and cracking resistance. Four types of SAPs (SAP-a, SAP-b, SAP-c, and SAP-d), based on the molecular chains and particle size, were mixed with SS to study their water absorption over 30 days. The results showed that SAPs exhibit rapid water absorption within the first 30 min, exceeding 85% before reaching a saturation point, and the chemical and temperature variations in the water significantly affected water absorption and desorption. The filtration results revealed that SAP-d exhibited the slowest water release rate, retaining water for considerably longer than the other three types of SAPs. The mechanical properties of SAP mortar were reduced due to the addition of an SAP and the improved cracking resistance of the cement mortars. Full article

Clofazimine and Arbidol have both been reported to be effective in vitro SARS-CoV-2 fusion inhibitors. Both are promising drugs that have been repurposed for the treatment of COVID-19 and have been used in several previous and ongoing clinical trials. Small-molecule bindings to expressed constructs of the trimeric S2 segment of Spike and the full-length SARS-CoV-2 Spike protein were measured using a Surface Plasmon Resonance (SPR) binding assay. We demonstrate that Clofazimine, Toremifene, Arbidol and its derivatives bind to the S2 segment of the Spike protein. Clofazimine provided the most reliable and highest-quality SPR data for binding with S2 over the conditions explored. A molecular docking approach was used to identify the most favorable binding sites on the S2 segment in the prefusion conformation, highlighting two possible small-molecule binding sites for fusion inhibitors. Results related to molecular docking and modeling of the structure–activity relationship (SAR) of a newly reported series of Clofazimine derivatives support the proposed Clofazimine binding site on the S2 segment. When the proposed Clofazimine binding site is superimposed with other experimentally determined coronavirus structures in structure–sequence alignments, the changes in sequence and structure may rationalize the broad-spectrum antiviral activity of Clofazimine in closely related coronaviruses such as SARS-CoV, MERS, hCoV-229E, and hCoV-OC43. Full article

Background: The primary purpose of this study was to preliminarily examine the effects of autonomic nervous system activity on the dorsolateral prefrontal cortex. Recent studies have examined approaches to modulating autonomic activity using invasive and non-invasive methods, but the effects of changes in autonomic activity during cognitive tasks on the dorsolateral prefrontal cortex have not been fully investigated. The purpose of this preliminary investigation was to examine changes in autonomic activity and blood oxygen saturation in the dorsolateral prefrontal cortex during reading tasks induced by vagus nerve stimulation using a microcone patch. Methods: A cohort of 40 typically developing adults was enrolled in this study. We carefully examined changes in autonomic nervous system activity and blood oxygen saturation in the dorsolateral prefrontal cortex during a reading task in two conditions: with and without microcone patch stimulation. Results: Significant changes in brain activation in the dorsolateral prefrontal cortext due to microcone patch stimulation were confirmed. In addition, hierarchical multiple regression analysis revealed specific changes in reading task-related blood oxygen saturation in the dorsolateral prefrontal region during microcone patch stimulation. Conclusions: It should be recognized that this study is a preliminary investigation and does not have immediate clinical applications. However, our results suggest that changes in autonomic nervous system activity induced by external vagal stimulation may affect activity in specific reading-related regions of the dorsolateral prefrontal cortex. Further research and evaluation are needed to fully understand the implications and potential applications of these findings. Full article

The ongoing occurrence of foodborne diseases and the imperative need for efficient spoilage and pathogen control in food products constitute a critical challenge for the food industry. The rising demands of consumers for safe, healthy, and clean-label food products have led to an increased interest in natural antimicrobial alternatives. Lactic acid bacteria (LAB) have proven their value in the food industry in recent years, also in reason of their antagonistic properties against undesired microbes and their significant related protechnological attributes. The natural antimicrobial compounds produced by LAB exhibit inhibitory effects on pathogens and effectively inhibit the activities of food spoilage-related organisms. Applying secondary metabolites of LAB, notably bacteriocins, organic acids, and others, has found commercial utility across multiple food sectors, effectively preventing the proliferation of undesirable microorganisms and simultaneously enhancing the sensory properties and overall quality of various food products. This review comprehensively explores the natural microbial compounds produced by LAB, specifically focusing on their antimicrobial action in supporting effective and sustainable microbial management. Additionally, it highlights their strategic application across various technological contexts within the food industry. Full article

In the realm of programming education, enhancing student commitment is pivotal for both academic success and practical application. Traditional methodologies often fall short in catering to the evolving needs of today’s learners. Addressing this gap, this paper introduces a web-based gamified tool designed to transform the pedagogical approach in programming courses. The study’s theoretical contribution lies in its exploration of gamification as a strategy to augment student commitment, bridging the divide between conventional teaching and contemporary learning needs. From a practical standpoint, empirical data encompassing performance metrics, dropout rates, and student feedback demonstrate the tool’s significant positive impact. Notably, students exhibited improved pass rates and reduced dropout tendencies, underscoring the tool’s practical efficacy. Furthermore, feedback highlighted the tool’s usability and the enhanced satisfaction derived from its engagement. Aligned with the existing literature, the findings advocate for the broader adoption of gamification in programming education. This research substantiates the potential of gamification as both a theoretical model and a practical strategy, enriching the discourse on modern programming education. Full article

The rapid deployment of virtual primary care visits served as a first-line response to COVID-19 and can now be examined for insights, particularly as virtual care is playing an ongoing role in patient care and consultations. Input from primary care providers directly responsible for virtual care delivery is needed to inform policies and strategies for quality care and interactions. The overarching goal of this research study was to examine the use of virtual care as a mechanism for primary healthcare delivery. A phenomenological approach investigated the shift in primary care service delivery as experienced by primary care providers and initiated during the COVID-19 pandemic. Focus groups were conducted with primary care providers (n = 21) recruited through email, advertisements, and professional organizations, exploring how virtual care was delivered, the benefits and challenges, workflow considerations, and recommendations for future use. Integrating virtual care was performed with a great deal of autonomy as well as responsibility, and overwhelmingly depended on the telephone. Technology, communication, and workflow flexibility are three key operational aspects of virtual care and its delivery. Providers highlighted cross-cutting themes related to the dynamics of virtual care including balancing risk for quality care, physician work/life balance, efficiency, and patient benefits. Primary care providers felt that virtual care options allowed increased flexibility to attend to the needs of patients and manage their practice workload, and a few scenarios were shared for when virtual care might be best suited. However, they also recognized the need to balance in-person and virtual visits, which may require guidelines that support navigating various levels of care. Overall, virtual care was considered a good addition to the whole ‘care package’ but continued development and refinement is an expectation for optimizing and sustaining future use. Full article

Retinitis pigmentosa is a group of genetically determined retinal dystrophies characterized by primary photoreceptor apoptosis and can occur in isolated or syndromic conditions. This study reviewed the clinical data of 15 patients with syndromic retinitis pigmentosa from a Rare Disease Reference Center in Brazil and the results of their next-generation sequencing tests. Five males and ten females participated, with the mean ages for ocular disease onset, fundoscopic diagnosis, and molecular evaluation being 9, 19, and 29 years, respectively. Bardet–Biedl syndrome (n = 5) and Usher syndrome (n = 3) were the most frequent diagnoses, followed by other rare conditions. Among the patients, fourteen completed molecular studies, with three negative results and eleven revealing findings in known genes, including novel variants in MKKS (c.432_435del, p.Phe144Leufs*14), USH2A (c.(7301+1_7302-1)_(9369+1_9370-1)del), and CEP250 (c.5383dup, p.Glu1795Glyfs*13, and c.5050del, p.Asp1684Thrfs*9). Except for Kearn-Sayre, all presented an autosomal recessive inheritance pattern with 64% homozygosity results. The long gap between symptom onset and diagnosis highlights the diagnostic challenges faced by the patients. This study reaffirms the clinical heterogeneity of syndromic retinitis pigmentosa and underscores the pivotal role of molecular analysis in advancing our understanding of these diseases. Full article

Convolvulus arvensis is an herbaceous dicotyledonous plant in the Convolvulaceae family that is native to Europe and Asia. It is a perennial soboliferous plant and is one of the most harmful weeds. This weed is successful in many types of climates, including temperate, tropical, and Mediterranean climates, but it is most troublesome for agriculture throughout the temperate zone. In this study, several pathogenic isolates were collected from this host. The internal transcribed spacer (ITS) and large subunit (28S) or ribosomal DNA, partial DNA-directed RNA polymerase II subunit (rpb2), and β-tubulin (tub2) genes were amplified and sequenced for all the isolates studied. Further, both a multilocus phylogenetic analysis of DNA sequences and an analysis of morphological features were implemented. Based on the results obtained, all the studied isolates were found to be distinct from any described species in the genus Ascochyta and are, therefore, described here as a new species Ascochyta erotica sp. nov. The pathogenicity of A. erotica sp. nov. was also tested and confirmed on leaf segments of C. arvensis. Full article

One biostrategy to boost the sustainability of strawberry cultivation is the application of biostimulants to the growing substrate. Here, we investigated whether the use of biostimulants and their combinations affects the strawberry plants’ phyllochron, phenology, and fruit quality. We tested the absence (control) and presence of biostimulants (arbuscular mycorrhizal fungi (AMF), Ascophyllum nodosum (AN), Trichoderma harzianum (TH), AMF + AN, AMF + TH, AN + TH, and AMF + AN + TH). The experimental design used was in completely randomized blocks (four replications). AMF was represented by a multi-species on-farm inoculant; A. nodosum was represented by the commercial product Acadian^®; and T. harzianum was represented by the commercial product Trichodermil^®. The leaf emission rate, the occurrence and duration of phenological stages, and fruit quality were assessed. The greatest precocity in terms of harvesting the first fruit was observed in plants grown with AMF + TH, which also had the lowest phyllochron (77.52 °C day·leaf⁻¹). Those treated only with AMF were the latest (144.93 °C day·leaf⁻¹). More flavorful fruits were produced by plants grown with AMF + TH. Plants inoculated with the AMF community, whether or not associated with A. nodosum and T. harzianum, had more than 94% mycorrhizal colonization. We conclude that AMF, A. nodosum, T. harzianum, and their combinations influence the phenology, phyllochron, and fruit quality of strawberry plants. In the growing conditions of the Brazilian subtropics, the AMF and T. harzianum combination shortens the strawberry cycle, from transplanting the daughter plants to harvesting the first fruit, and improves the fruit flavor. Full article

Anthracnose, caused by Colletotrichum siamense, is a destructive disease of Pachira glabra in southern China. Early and proper monitoring and quantification of C. siamense is of importance for disease control. A calmodulin (CAL) gene-based TaqMan real-time PCR assay was developed for efficient detection and quantification of C. siamense, which reliably detected as low as 5 pg of genomic DNA and 12.8 fg (5800 copies) of target DNA. This method could specifically recognize all tested C. siamense isolates, while no amplification was observed in other closely related Colletotrichum species. The assay could still detect C. siamense in plant mixes, of which only 0.01% of the tissue was infected. A dynamic change in the amount of C. siamense population was observed during infection, suggesting that this real-time PCR assay can be used to monitor the fungal growth progression in the whole disease process. Moreover, the method enabled the detection of C. siamense in naturally infected and symptomless leaves of P. glabra trees in fields. Taken together, this specific TaqMan real-time PCR provides a rapid and accurate method for detection and quantification of C. siamense colonization in P. glabra, and will be useful for prediction of the disease to reduce the epidemic risk. Full article

The insulin-like growth factor (IGF) system has paracrine and endocrine roles in the central nervous system. There is evidence that IGF signalling pathways have roles in the pathophysiology of neurodegenerative disease. This review focusses on Alzheimer’s disease and Parkinson’s disease, the two most common neurodegenerative disorders that are increasing in prevalence globally in relation to the aging population and the increasing prevalence of obesity and type 2 diabetes. Rodent models used in the study of the molecular pathways involved in neurodegeneration are described. However, currently, no animal model fully replicates these diseases. Mice with triple mutations in APP, PSEN and MAPT show promise as models for the testing of novel Alzheimer’s therapies. While a causal relationship is not proven, the fact that age, obesity and T2D are risk factors in both strengthens the case for the involvement of the IGF system in these disorders. The IGF system is an attractive target for new approaches to management; however, there are gaps in our understanding that first need to be addressed. These include a focus beyond IGF-I on other members of the IGF system, including IGF-II, IGF-binding proteins and the type 2 IGF receptor. Full article

The paper provides a novel approach for controllably meshing traditional medium-voltage networks by means of a fast-charging parking station with multiple points of delivery connected to different radial feeders. Regulating power flows at each point of delivery while the charging service is being provided, which means actively controlling power exchanges between radial distribution feeders can significantly increase the hosting capacity of the power system. Remarkable benefits are expected when the distribution networks to which the charging infrastructure is connected differ in terms of main characteristics, e.g., rated voltage level, end-user type and operating profiles, and the number and type of renewable plants. The paper focuses on technical targets, such as loss reduction and power quality in terms of admitted voltage deviation from the rated value. The power exchanges between distribution feeders are made possible by a controlled DC link, where bi-directional DC/DC converters are connected so as to charge or discharge vehicles according to the Vehicle-To-Grid approach. A multiplexer topology in which several vehicles can be alternatively connected to the same DC/DC converter is modeled. The proposed concept can contribute to network flexibility by controllably meshing distribution feeders and, jointly, by modulating charging processes according to assigned charging constraints. Full article

This study investigated six-month outcomes of first models of ascending aortic replacement. The molds used to produce the Biotube were implanted subcutaneously in goats. After 2–3 months, the molds were explanted to obtain the Biotubes (inner diameter, 12 mm; wall thickness, 1.5 mm). Next, we performed ascending aortic replacement using the Biotube in five allogenic goats. At 6 months, the animals underwent computed tomography (CT) and histologic evaluation. As a comparison, we performed similar surgeries using glutaraldehyde-fixed autologous pericardial rolls or pig-derived heterogenous Biotubes. At 6 months, CT revealed no aneurysmalization of the Biotube or pseudoaneurysm formation. The histologic evaluation showed development of endothelial cells, smooth muscle cells, and elastic fibers along the Biotube. In the autologous pericardium group, there was no evidence of new cell development, but there was calcification. The histologic changes observed in the heterologous Biotube group were similar to those in the allogenic Biotube group. However, there was inflammatory cell infiltration in some heterologous Biotubes. Based on the above, we could successfully create the world’s first Biotube-based ascending aortic replacement models. The present results indicate that the Biotube may serve as a scaffold for aortic tissue regeneration. Full article

In recent years, Rwanda, especially its Eastern Province, has been contending with water shortages, primarily due to prolonged dry spells and restricted water sources. This situation poses a substantial threat to the country’s agriculture-based economy and food security. The impact may escalate with climate change, exacerbating the frequency and severity of droughts. However, there is a lack of comprehensive spatiotemporal analysis of meteorological and agricultural droughts, which is an urgent need for a nationwide assessment of the drought’s impact on vegetation and agriculture. Therefore, the study aimed to identify meteorological and agricultural droughts by employing the Standardized Precipitation Evapotranspiration Index (SPEI) and the Vegetation Health Index (VHI). VHI comprises the Vegetation Condition Index (VCI) and the Temperature Condition Index (TCI), both derived from the Normalized Difference Vegetation Index (NDVI) and Land Surface Temperature (LST). This study analyzed data from 31 meteorological stations spanning from 1983 to 2020, as well as remote sensing indices from 2001 to 2020, to assess the spatiotemporal patterns, characteristics, and adverse impact of droughts on vegetation and agriculture. The results showed that the years 2003, 2004, 2005, 2006, 2013, 2014, 2015, 2016, and 2017 were the most prolonged and severe for both meteorological and agricultural droughts, especially in the Southern Province and Eastern Province. These extremely dry conditions led to a decline in both vegetation and crop production in the country. It is recommended that policymakers engage in proactive drought mitigation activities, address climate change, and enforce water resource management policies in Rwanda. These actions are crucial to decreasing the risk of drought and its negative impact on both vegetation and crop production in Rwanda. Full article

The wavefront reconstruction is a crucial step in determining the performance of wavefront detection instruments. The wavefront reconstruction algorithm is primarily evaluated in three dimensions: accuracy, speed, and noise immunity. In this paper, we propose a hybrid zonal reconstruction algorithm that introduces slope and curvature information in the diagonal, anti-diagonal, horizontal, and vertical directions by dividing the neighbor sampling points into subregions in groups of four. By canceling the same parameters in integration equations, an algorithm using multi-directional slope–curvature information is achieved with only two sets of integration equations in each subregion, reducing the processing time. Simulation experiments show that the relative root-mean-square reconstruction error of this algorithm is improved by about 4 orders of magnitude compared with existing algorithms that use multi-directional slope information or slope–curvature information alone. Compared with the hybrid multi-directional slope–curvature algorithm, the proposed algorithm can reduce computation time by about 50% as well as provide better noise immunity and reconstruction accuracy. Finally, the validity of the proposed algorithm is verified by the null test experiment. Full article

In tunnel boring projects, wear and tear in the tooling system can have significant consequences, such as decreased boring efficiency, heightened maintenance costs, and potential safety hazards. In this paper, a fault diagnosis method for TBM tooling systems based on SAV−SVDD failure location (SSFL) is proposed. The aim of this method is to detect faults caused by disk cutter wear during the boring process, which diminishes the boring efficiency and is challenging to detect during construction. This paper uses SolidWorks to create a complete three−dimensional model of the TBM hydraulic thrust system and tool system. Then, dynamic simulations are performed with Adams. This helps us understand how the load on the propulsion hydraulic cylinder changes as the TBM tunneling tool wears to different degrees during construction. The hydraulic propulsion system was modeled and simulated using AMESIM software. Utilizing the load on the hydraulic propulsion cylinder as an input signal, pressure signals from the two chambers of the hydraulic cylinder and the system’s flow signal were acquired. This enabled an in−depth exploration of the correlation between these acquired signals and the extent of the tooling system failure. Following this analysis, a collection of normal sample data and sample data representing different degrees of disk cutter abrasions was amassed for further study. Next, an SSFL network model for locating the failure area of the cutter was established. Fault sample data were used as the input, and the accuracy of the fault diagnosis model was tested. The test results show that the performance of the SSFL network model is better than that of the SAE−SVM and SVDD network models. The SSFL model achieves 90% accuracy in determining the failure area of the cutter head. The model effectively identifies the failure regions, enabling timely tool replacement to avoid decreased boring efficiency under wear conditions. The experimental findings validate the feasibility of this approach. Full article

Interleukin (IL)-32 is produced by T lymphocytes, natural killer cells, monocytes, and epithelial cells. IL-32 induces the production of pro-inflammatory cytokines such as tumor necrosis factor (TNF)-α, IL-1β, IL-6, and IL-8, and IL-32 expression is highly increased in rheumatoid arthritis (RA) patients. Enolase-1 (ENO1) is a glycolytic enzyme and the stimulation of ENO1 induces high levels of pro-inflammatory cytokines in concanavalin A (Con A)-activated peripheral blood mononuclear cells (PBMCs) and macrophages in RA patients. In addition, there are many reports that anti-ENO1 antibody is correlated with the disease progression of RA. It implies that ENO1 could regulate IL-32 production during inflammation related to the pathogenesis of RA. Therefore, we investigated the role of ENO1 in IL-32 production using Con A-activated PBMCs and RA PBMCs. IL-32 expression is increased by ENO1 stimulation using real-time PCR and ELISA. In addition, we confirmed that IL-32 production was decreased in Con A-activated PBMCs and RA PBMCs pre-treated with NF-κB or p38 MAPK pathway inhibitors. Taken together, these results suggest that ENO1 plays an important role in inflammation through the induction of IL-32 production by the activation of the NF-κB and p38 MAPK pathways. Full article

Worldwide, oak species are threatened with extinction due to habitat loss, pathogens, and changing fire regimes. Ex situ conservation through tissue culture may protect the remaining genetic diversity of Quercus dumosa, or the coastal sage scrub oak, from further loss. We designed three basal salt formulations based on the mineral composition of shoot tips and first leaves from mature Q. dumosa and explored carbohydrate source, stress-mitigating compounds, and plant growth regulator concentrations to develop a method of cultivating many Q. dumosa culture lines in vitro. All three novel basal salt formulations led to decreased necrosis compared with commercial basal salt formulas WPM, MS, and DKW. Substitution of 30 g L⁻¹ sucrose with glucose and adding 250 mg L⁻¹ ascorbic acid, 5.2 mg L⁻¹ SNP sodium nitroprusside, and 103 mg L⁻¹ y-aminobutyric acid improved culture health overall. In an experiment involving 115 culture lines, 0.66 mg L⁻¹ 6-benzylaminopurine produced the highest average shoots per explant, but 0.33 mg L⁻¹ produced the greatest proportion of shoots 2 cm or greater. Incubation for 24 h in 20 mg L⁻¹ indole-3-butyric acid led to the most rooting. These methods show promise for the ex situ conservation of many genotypes of endangered Q. dumosa. Full article

Cascade genetic testing and surveillance reduce morbidity and mortality in Lynch syndrome. However, barriers to conveying information about genetic disorders within families result in low uptake of genetic testing. Provider-mediated interventions may increase uptake but raise legal and ethical concerns. We describe 30 years of national experience with cascade genetic testing combining family- and provider-mediated contact in Lynch syndrome families in the Danish Hereditary Non-Polyposis Colorectal Cancer (HNPCC) Register. We aimed to estimate the added value of information letters to family members in Lynch syndrome families (provider-mediated contact) compared to family members not receiving such letters and thus relying on family-mediated contact. National clinical practice for cascade genetic testing, encompassing infrastructure, legislation, acceptance, and management of the information letters, is also discussed. Cascade genetic testing resulted in 7.3 additional tests per family. Uptake of genetic testing was 54.4% after family-mediated and 64.9% after provider-mediated contact, corresponding to an odds ratio of 1.8 (p < 0.001). The uptake of genetic testing was highest in the first year after diagnosis of Lynch syndrome in the family, with 72.5% tested after provider-mediated contact. In conclusion, the Danish model combining family- and provider-mediated contact can increase the effect of cascade genetic testing. Full article