Disgraced former Michigan State and USA Gymnastics team physician Larry Nassar was sentenced to a minimum of 40 years and up to 175 years in a Michigan state prison Wednesday, bringing an end to a marathon sentencing hearing that featured statements from more than 150 girls and women who asserted he sexually abused them.

The sentence, which is part of a plea deal in which Nassar admitted to 10 sex assault charges in two Michigan counties, comes on top of a 60-year federal sentence Nassar, 54, also faces for child pornography crimes he pleaded guilty to last year.

In a statement before being sentenced, Nassar apologized to the victims, saying "There are no words that can express the depth and breadth of how sorry I am." Afterward, Judge Rosemarie Aquilina read a letter Nassar had written to the court objecting to the length of the sentencing hearing. In issuing her sentence, Aquilina told Nassar, "I just signed your death warrant."

The hearing in Lansing, Michigan – which began last Tuesday and was expected to feature 88 victim's statements and take four days – ultimately spanned seven days as dozens more girls and women came forward to confront Nassar.

The parade of harrowing accounts of Nassar's alleged abuse – often done under the guise of pain therapy, often with parents in the room – introduced fresh national attention and outrage to a case whose core facts have been well-established for nearly a year.

On Monday, USA Gymnastics, whose former chief executive resigned last March over the Nassar case, announced that three board members had also resigned. On Tuesday, the NCAA, which had remained silent on the Nassar case, sent Michigan State a letter regarding potential rules violations, and AT&T became the latest sponsor to drop USA Gymnastics.

Michigan State University President Lou Anna Simon has resisted calls to resign, and the school's board of trustees has maintained its support of her leadership, but school officials last week acquiesced to requests from victims and their attorneys for an independent review of the university's culpability for Nassar's crimes. The state Attorney General's office has agreed to conduct the inquiry.

Victims have said they complained about Nassar's conduct to Michigan State athletics officials as far back as 1997, and in 2014 an investigation by the school's Title IX office cleared Nassar after a woman alleged he assaulted her. The school's attorneys have insisted Michigan State officials did not mishandle prior complaints, and asserted Nassar's methods of abuse – which many of his accusers acknowledge they didn't realize was not legitimate medical treatment until after an Indianapolis Star story in September 2016 – were particularly insidious and difficult to detect.