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Intracellular unesterified fatty acids must first undergo thio-esterification to coenzyme A, a process catalysed by acyl-CoA synthases and consuming the equivalent of two ATP, with formation of acyl-CoAs, i.e., to activate fatty acids

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Proc Nat Acad Sci 106(4) : 1285-1290

I've lost over 40 pounds under her care." "I've been a patient for over four years and followed her from two previous practices