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TOMBOLA was instigated because of uncertainty over the most effective means of managing such women, the principal alternatives being immediate referral to colposcopy, with treatment if indicated, and cytological surveillance (Papanicoulou smear tests at six-monthly intervals) until the abnormality is seen to regress or progress [ 19].
Activation of the UPR causes (1) upregulation of ER-resident protein expression to facilitate the proper folding of misfolded proteins; (2) reduced activity of the secretory pathway by decreasing the expression of secretory cargo; (3) increased degradation of terminally misfolded proteins; and (4) restrained translational initiation until the abnormality has been minimised.
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The IR for laboratory abnormalities was defined as subjects with an abnormality per number of post-baseline visits until the first abnormality occurred.
If changes in the laboratory variables after the start of treatment occurred so that a leukocyte count of >3000 μl−1 or a neutrophil count of >1500 μl−1or any of the other entry eligibility criteria for the study were not met, subsequent courses of treatment were withheld until the noted abnormality had resolved.
20 The etiologic events that generate structural abnormalities typically occur within the first 2 to 8 weeks post-conception, but the recognition of the abnormality may not occur until later in pregnancy (during ultrasound evaluation), at birth, in early childhood, or in adulthood, or the abnormality may never be recognized.
This could be particularly controversial as the abnormality is very hard to detect until late in the pregnancy.
So, what was the abnormality?
Treatment is directed at correcting the abnormality.
They were found to have a consistent chromosome abnormality in certain blood cells, the abnormality in this case consisting of the loss of part of a chromosome.
At the other extreme, red-top papers emphasise the abnormality of a murderer.
"But the question is, what is the abnormality?
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Since I tried Ludwig back in 2017, I have been constantly using it in both editing and translation. Ever since, I suggest it to my translators at ProSciEditing.

Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com