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The modification of peptidyl-histidine to 2\'-(3-carboxamido-3-(trimethylammonio)propyl)-L-histidine, known as diphthamide, found in translation elongation factor EF-2. The process occurs in eukaryotes and archaea but not eubacteria. [GOC:pde, PMID:20559380, RESID:AA0040]
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