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This mitochondrial DNA variant alters 12S rRNA structure to more closely resemble bacterial 16S rRNA, enhancing aminoglycoside binding approximately 5- to 10-fold at the ribosomal decoding site ( Population prevalence varies by ethnicity (Figure 4D): approximately 0.19% (1 in 520) in a European pediatric cohort ( Additional mitochondrial variants confer variable susceptibility

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