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This monoubiquitinated substrate is then subject to additional successive rounds of ubiquitination, in which additional ubiquitin molecules are conjugated through Lys48 residues of the proceeding ubiquitin protein, producing a Lys48-polyubiquitinated chain attached to the substrate

Congress reduced Medicaid DSH payments in the Affordable Care Act, reasoning that hospitals would care for fewer uninsured patients as health coverage expanded