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Genetic variants may also have different effects in different populations because of unmeasured (and perhaps unknown) environmental risk factors.
The success in the application of the methodological techniques to study epistatic effects in different populations has been limited.
IL23R is a CD susceptibility gene, but different IL23R variants are likely to carry variable disease-modifying effects in different populations.
The greatest gains in power are achieved under a model of heterogeneity in which the causal variant has opposing effects in different populations, although it is not clear how realistic this scenario is likely to be.
In addition, as MDM2 status status has been demonstrated to affect the overall age of onset of various cancers, with differential effects in different populations [ 4, 26], we have explored its effects in this unique population.
Milne et al [ 24] suggested in their review that future research should focus on the effects of different characteristics of application, such as total duration of treatment and intensity of CPM interventions, and on effects in different populations.
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Assessment of different effects in different population strata is also relevant for targeted interventions, as the effects might be different across population subgroups even within a disadvantaged group.
In particular, decisions should be made about how to balance near-term and long-term effects; weigh the potential effects in different population groups; balance the more certain, quantifiable potential effects with those that are less certain and not quantifiable; and balance the interests of the various stakeholder groups (Lehto and Ritsatakis, unpublished data).
The reason is that the different methods are effectively estimating the effect in different populations, with different distributions of covariates.
For a specific susceptibility variant, there may also exist genuine diversity of its genetic effect in different populations [27].
Overall, these studies confirm IL23R as a CD susceptibility gene, but demonstrate differences for certain IL23R variants regarding the strength of their disease-modifying effect in different populations.
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