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[PubMed: 10097359] 107

Well-designed RCT's with standardized protocols, mechanistic endpoints, and extended follow-up periods are urgently needed to clarify their role

Diphthamide is an evolutionarily conserved post-translational modification that occurs at a single histidine residue of translation elongation factor 2 (EF-2), which is needed for accurate protein translation by preventing -1 frameshift slippage during translation (Liu et al, 2012)