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Recently, a cancer panel based on high-depth next-generation sequencing technology was used to accurately identify mutations in numerous oncogenes18,19,20.
Genetic anomalies have been described in POI and mutations in numerous genes have been definitively related to the pathogenesis of the disease.
The goal is to better understand the roots of the disorder by looking for areas where mutations in numerous disparate genes lead to deficiencies in a much smaller number of biochemical pathways.
But if there are many mutations in numerous pathways, the harmful impacts of these mutations cannot be compensated.
This clinical diversity is reflected in genetic heterogeneity, and at present more than 30 genetic loci have been mapped, with causative mutations in numerous genes identified [ 2– 4].
Since that description, well over a thousand mutations in numerous genes have been described as disease causing, most commonly involving eight major sarcomeric genes (Table 1 ).
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Genetic diagnosis in HHT is difficult, as mutations occur in numerous different locations in the linked genes, without particular mutations being highly frequent (as opposed to, for instance, the ΔF508 mutation in cystic fibrosis).
It is well recognized that EGFR dysregulation is a powerful oncogenic driver with overexpression and activating mutations documented in numerous tumors of epithelial origin [ 44].
Thus, protein coding regions of genes encoding 3FTxs [ 39- 41], Kunitz-type serine protease inhibitors [ 42], PLA2 enzymes [ 7, 43, 44] and serine proteases [ 8] appear to be undergoing accelerated point mutations, resulting in numerous isoforms.
Of the genes normally present in land plant chloroplast genomes, four (Fig 3) are pseudogenes (detectable but truncated and containing various frameshift mutations resulting in numerous premature stop codons) and 15 are completely absent (at least we were unable to detect any remnants of them in the genome).
When this analysis was repeated, however, with non-silent mutations in genes, numerous statistically significant outliers were uncovered.
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