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In the oxidation of these substrates, until they become medium-chain length, the water addition is catalyzed by an enoyl-CoA hydratase activity, the second oxidation step is catalyzed by an NAD + -dependent long-chain hydroxacyl-CoA dehydrogenase activity [long-chain 3-hydroxyacyl-CoA dehydrogenase (LCHAD) activity], and finally the cleavage into an acyl-CoA and an acetyl-CoA is catalyzed by a thiolase activity

Although HIPAA does not explicitly prohibit protected health information from being accessed or stored outside the United States, healthcare providers and their vendors remain responsible for safeguarding patient information and complying with state-specific restrictions that may limit or prohibit offshore subcontracting

PMID: 7475265