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In contrast, MphIS111R/T166E/P211L and MphIM40A/S111R/T166E lost the ability to confer C3 cladinose macrolide resistance, indicating that a binary combination of both mutations is required.
Furthermore, a more complete molecular characterization of these cases, comprehending not only the so-called 'driver' mutations, is required to better understand whether or not these cases represent only a prodromal or advanced phases of the classic BCR ABL1-negative myeloproliferative neoplasms.
If resistance testing is not possible or the patients needs to commence treatment before resistance results are available in case of low CD4 numbers, it may be advisable to initiate treatment with a boosted PI-regimen [40], Taking into account that boosted PIs have a higher barrier to develop resistance, an accumulation of mutations is required to induce PI-related resistance.
Ultimately, a large number of mutations is required to significantly alter GC-composition.
Proper analysis of mtgenome mutations is required for accurate correlation of homoplasmic mutations with tumor tissue and stage.
Further knowledge of the molecular biology and functional consequences of these mutations is required prior to integration into clinical care.
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When 4 or more oncogenic mutations are required, mutator pathways predominate.
When 2 or fewer oncogenic mutations are required, non-mutator pathways predominate.
In retinoblastoma, few oncogenic mutations are required, but as the mutator mutation is also the pathognomonic oncogenic mutation, its occurrence is favored.
Correspondingly, the likelihood of the cancer having evolved a mutator phenotype decreased when fewer driver mutations were required for cancer (Fig. S2B).
In general mutator pathways are favored when 5 or more oncogenic mutations are required for malignant transformation and not favored when 2 or fewer oncogenic mutations are required.
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