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Allowing multiple simultaneous mutations also greatly increases the number of accessible pathways.
Strikingly, these amino-acid changes required multiple simultaneous mutations in the genomes of naturally occurring H5 isolates.
We develop an approximate calculus for multiple simultaneous mutations.
However, the existence of multiple simultaneous mutations in these tolerant strains often complicates the analyses [ 18].
At a broader level, patients with complex genotype and multiple simultaneous mutations may have more severe or early disease expression, related to a gene dosage effect.
The multi-target Highly Active Antiretroviral therapies (HAART) exert a high level of evolutionary pressure on the virus by effectively requiring multiple simultaneous mutations to produce resistant strains [ 17- 19].
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Mutation is thus limited to non-critical regions or would require multiple, simultaneous compensatory mutations that preserve function.
Alanine shaving is a process of making multiple simultaneous alanine mutations, thus cooperativity and additivity can be measured by comparing the simultaneous free-energy change to the sum of the free-energy changes attributed to single mutations.
As HP resistance to entecavir only occurs with multiple simultaneous HP mutations, it would be of great interest to determine if entecavir-mediated priming inhibition contributes to this increased barrier to viral resistance.
Based these results, we suggest that choosing a correct residue for mutation in multi subunit proteins results in multiple site conversions which equals to several simultaneous mutations.
Multiple simultaneous mechanisms of action against microbes would require a variety of synchronous DNA mutations in the same microbial cell for the development of resistance; therefore, it is difficult for bacterial cells to become resistant to nanoparticles and nanomaterials.
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