The importance of vertical velocity variability for estimates of the indirect aerosol effects

The activation of aerosols to form cloud droplets is dependent upon vertical velocities whose local variability is not typically resolved at the GCM grid scale. Consequently, it is necessary to represent the subgrid-scale variability of vertical velocity in the calculation of cloud droplet number concentration. This study uses the UK Chemistry and Aerosols community model (UKCA) within the Hadley Centre Global Environmental Model (HadGEM3), coupled for the first time to an explicit aerosol activation parameterisation, and hence known as UKCA-Activate. We explore the range of uncertainty in estimates of the indirect aerosol effects attributable to the choice of parameterisation of the subgrid-scale variability of vertical velocity in HadGEM-UKCA. Results of simulations demonstrate that the use of a characteristic vertical velocity cannot replicate results derived with a distribution of vertical velocities, and is to be discouraged in GCMs. This study focuses on the effect of the variance (σw2) of a Gaussian pdf (probability density function) of vertical velocity. Fixed values of σw (spanning the range measured in situ by nine flight campaigns found in the literature) and a configuration in which σw depends on turbulent kinetic energy are tested. Results from the mid-range fixed σw and TKE-based configurations both compare well with observed vertical velocity distributions and cloud droplet number concentrations. The radiative flux perturbation due to the total effects of anthropogenic aerosol is estimated at −1.9 W m−2 with σw = 0.1 m s−1, −2.1 W m−2 with σw derived from TKE, −2.25 W m−2 with σw = 0.4 m s−1, and −2.3 W m−2 with σw = 0.7 m s−1. The breadth of this range is 0.4 W m−2, which is comparable to a substantial fraction of the total diversity of current aerosol forcing estimates. Reducing the uncertainty in the parameterisation of σw would therefore be an important step towards reducing the uncertainty in estimates of the indirect aerosol effects. Detailed examination of regional radiative flux perturbations reveals that aerosol microphysics can be responsible for some climate-relevant radiative effects, highlighting the importance of including microphysical aerosol processes in GCMs.

On the microphysical effects of observed cloud edge charging

Liquid layer clouds are abundant globally. Lacking strong convection, they do not become electrified by the usual thunderstorm mechanisms of collisional electrification between hydrometeors of different phases. Instead, the background global circuit current flow in fair weather is largely unaffected by the layer cloud’s presence, and, if the layer cloud is extensive horizontally, the vertical fair weather conduction current passes through the cloud. A consequence of the vertical current flow is that, at the cloud-air boundary where there is a conductivity transition and droplets form or evaporate, droplet charging occurs. Charge can affect both droplet evaporation and droplet-droplet collisions. Using new radiosonde instrumentation, the charge observed at layer cloud edges is evaluated for both these microphysical droplet processes. This shows that the charging is more likely to affect collision processes than activation, for small droplets. Enhancing the collection efficiency of small droplets modifies their evolution and propagates through the size distribution to shorten the autoconversion timescale to rain drops, and the cloud radiative properties. Because the conduction current density is influenced by both external (e.g. solar modulation of high energy particles) and internal (e.g. ENSO) factors, current flow leading to layer cloud edge charging provides a possible route for expressing solar influences on the climate system and a teleconnection mechanism for communicating internal climate variability.

Effect of high-hydrostatic pressure and pH treatments on the emulsification properties of gum arabic

This study investigated the emulsification properties of the native gums and those treated at high pressure (800 MPa) both at their “natural” pH (4.49 and 4.58, respectively) and under “acidic and basic” pH (2.8 and 8.0) conditions. The emulsification behaviour of KLTA gum was found to be superior to that of the GCA gum. High pressure and pH treatment changed the emulsification properties of both gums. The acidic amino acids in gum arabic were shown to play an important role in their emulsification behaviour, and mechanisms of emulsification for the two gums were suggested to be different. The highly “branched” nature of the carbohydrate in GCA gum was also thought to be responsible for the “spreading” of droplet size distributions observed. Coomassie brilliant blue binding was used to indicate conformational changes in protein structure and Ellman’s assay was used to estimate any changes in levels of free thiols present.

Joint retrievals of cloud and drizzle in marine boundary layer clouds using ground-based radar, lidar and zenith radiances

Active remote sensing of marine boundary-layer clouds is challenging as drizzle drops often dominate the observed radar reflectivity. We present a new method to simultaneously retrieve cloud and drizzle vertical profiles in drizzling boundary-layer clouds using surface-based observations of radar reflectivity, lidar attenuated backscatter, and zenith radiances under conditions when precipitation does not reach the surface. Specifically, the vertical structure of droplet size and water content of both cloud and drizzle is characterised throughout the cloud. An ensemble optimal estimation approach provides full error statistics given the uncertainty in the observations. To evaluate the new method, we first perform retrievals using synthetic measurements from large-eddy simulation snapshots of cumulus under stratocumulus, where cloud water path is retrieved with an error of 31 g m−2 . The method also performs well in non-drizzling clouds where no assumption of the cloud profile is required. We then apply the method to observations of marine stratocumulus obtained during the Atmospheric Radiation Measurement MAGIC deployment in the Northeast Pacific. Here, retrieved cloud water path agrees well with independent three-channel microwave radiometer retrievals, with a root mean square difference of 10–20 g m−2.

Effect of high pressure homogenisation and heat treatment on physical properties and stability of almond and hazelnut milks

The effect of high pressure homogenisation (HPH) and heat treatments on physicochemical properties and physical stability of almond and hazelnut milks was studied. Vegetable milks were obtained and homogenised by applying 62, 103 and 172 MPa (MF1, MF2 and MF3, respectively). Untreated and MF3 samples were also submitted to two different heat treatments (85 °C/30 min (LH) or 121 °C/15 min (HH)). Physical and structural properties of the products were greatly affected by heat treatments and HPH. In almond milk, homogenised samples showed a significant reduction in particle size, which turned from bimodal and polydisperse to monodisperse distributions. Particle surface charge, clarity and Whiteness Index were increased and physical stability of samples was improved, without affecting either viscosity or protein stability. Hazelnut beverages showed similar trends, but HPH notably increased their viscosity while change their rheological behaviour, which suggested changes in protein conformation. HH treatments caused an increment of particle size due to the formation oil droplet-protein body clusters, associated with protein denaturation. Samples submitted to the combined treatment MF3 and LH showed the greatest stability.

Control of nanomaterial self-assembly in ultrasonically levitated droplets

We demonstrate that acoustic trapping can be used to levitate and manipulate droplets of soft matter, in particular, lyotropic mesophases formed from selfassembly of different surfactants and lipids, which can be analyzed in a contact-less manner by X-ray scattering in a controlled gas-phase environment. On the macroscopic length scale, the dimensions and the orientation of the particle are shaped by the ultrasonic field, while on the microscopic length scale the nanostructure can be controlled by varying the humidity of the atmosphere around the droplet. We demonstrate levitation and in situ phase transitions of micellar, hexagonal, bicontinuous cubic, and lamellar phases. The technique opens up a wide range of new experimental approaches of fundamental importance for environmental, biological, and chemical research.

Constraining the aerosol influence on cloud fraction

Aerosol-cloud interactions have the potential to modify many different cloud properties. There is significant uncertainty in the strength of these aerosol-cloud interactions in analyses of observational data, partly due to the difficulty in separating aerosol effects on clouds from correlations generated by local meteorology. The relationship between aerosol and cloud fraction (CF) is particularly important to determine, due to the strong correlation of CF to other cloud properties and its large impact on radiation. It has also been one of the hardest to quantify from satellites due to the strong meteorological covariations involved. This work presents a new method to analyze the relationship between aerosol optical depth (AOD) and CF. By including information about the cloud droplet number concentration (CDNC), the impact of the meteorological covariations is significantly reduced. This method shows that much of the AOD-CF correlation is explained by relationships other than that mediated by CDNC. By accounting for these, the strength of the global mean AOD-CF relationship is reduced by around 80%. This suggests that the majority of the AOD-CF relationship is due to meteorological covariations, especially in the shallow cumulus regime. Requiring CDNC to mediate the AOD-CF relationship implies an effective anthropogenic radiative forcing from an aerosol influence on liquid CF of −0.48 W m−2 (−0.1 to −0.64 W m−2), although some uncertainty remains due to possible biases in the CDNC retrievals in broken cloud scenes.

Effect of extrusion on the emulsifying properties of soybean proteins and pectin mixtures modelled by response surface methodology

The objective of this study was to apply response surface methodology to estimate the emulsifying capacity and stability of mixtures containing isolated and textured soybean proteins combined with pectin and to evaluate if the extrusion process affects these interfacial properties. A simplex-centroid design was applied to the model emulsifying activity index (EAI), average droplet size (D-[4.3]) and creaming inhibition (Cl%) of the mixtures. All models were significant and able to explain more than 86% of the variation. The high predictive capacity of the models was also confirmed. The mean values for EAI, D-[4.3] and Cl% observed in all assays were 0.173 +/- 0.015 mn, 19.2 +/- 1.0 mu m and 53.3 +/- 2.6%, respectively. No synergism was observed between the three compounds. This result can be attributed to the low soybean protein solubility at pH 6.2 (<35%). Pectin was the most important variable for improving all responses. The emulsifying capacity of the mixture increased 41% after extrusion. Our results showed that pectin could substitute or improve the emulsifying properties of the soybean proteins and that the extrusion brings additional advantage to interfacial properties of this combination. (C) 2008 Elsevier Ltd. All rights reserved.

On spermiogenesis, sperm cell morphology and accompanying secretions of Copidognathus (Acari: Halacaridae)

The genus Copidognathus includes one-third of the species of Halacaridae described to date. This article describes spermiogenesis, sperm cell morphology and accompanying secretions from three species of Copidognathus. Initial spermatids have electron-dense cytoplasm with scattered mitochondria, a well-developed Golgi body, and nuclei with patches of heterochromatin. The cytoplasm and nuclei of these cells undergo intense swelling. The second spermatids are large electron-translucent cells, with small mitochondria in row along the remains of the endoplasmatic reticulum. In the succeeding stage, most of the cytoplasmatic structures and mitochondria have disappeared or have undergone profound transformations. Nuclei and cells elongate and chromatin begins to condense near the nuclear envelope. An acrosomal complex appears at the tip of the nucleus. The acrosomal filament is thick and runs the entire length of the nucleus. Plasmalemmal invaginations at the cell surface give rise to tubules filled with an electron-dense material. Sperm cell maturation is completed in the ventral portion of the germinal part, near the testicular lumen. As a final step in spermiogenesis, cytoplasm of the last spermatid undergoes a moderate condensation and the cariotheca disappears. Mature sperm cells were found in a matrix of ""simple"" and ""complex"" corpuscles, the latter consisting of flattened, spindle-shaped secreted bodies. Rather than in individual sperm aggregates, spermatozoa were contained in a single droplet inside the vas deferens, on a large secretion mass, structured as rows of platelets sunk in a fine grained matrix. Each mature sperm cell is covered by a thick secreted coat. In contrast to the genera Rhombognathus and other Actinotrichida, Copidognathus displays a set of features that must be regarded as apomorphic. The absence of usual mitochondria, the presence of electro-dense tubules and secretions similar to those present in Thalassarachna and Halacarellus, and the pattern of nuclear condensation are possibly shared apomorphies with these latter genera. (C) 2010 Elsevier GmbH. All rights reserved.

The novel ruthenium-gamma-linolenic complex [Ru(2)(aGLA)(4)Cl] inhibits C6 rat glioma cell proliferation and induces changes in mitochondrial membrane potential, increased reactive oxygen species generation and apoptosis in vitro

The present study reports the synthesis of a novel compound with the formula [Ru(2)(aGLA)(4)Cl] according to elemental analyses data, referred to as Ru(2)GLA. The electronic spectra of Ru(2)GLA is typical of a mixed valent diruthenium(II,III) carboxylate. Ru(2)GLA was synthesized with the aim of combining and possibly improving the anti-tumour properties of the two active components ruthenium and gamma-linolenic acid (GLA). The properties of Ru(2)GLA were tested in C6 rat glioma cells by analysing cell number, viability, lipid droplet formation, apoptosis, cell cycle distribution, mitochondrial membrane potential and reactive oxygen species. Ru(2)GLA inhibited cell proliferation in a time and concentration dependent manner. Nile Red staining suggested that Ru(2)GLA enters the cells and ICP-AES elemental analysis found all increase in ruthenium from <0.02 to 425 mg/Kg in treated cells. The sub-G1 apoptotic cell population was increased by Ru(2)GLA (22 +/- 5.2%) when analysed by FACS and this was confirmed by Hoechst staining of nuclei. Mitochondrial membrane potential was decreased in the presence of Ru(2)GLA (44 +/- 2.3%). In contrast, the cells which maintained a high mitochondrial membrane potential had an increase (18 +/- 1.5%) in reactive oxygen species generation. Both decreased mitochondrial membrane potential and increased reactive oxygen species generation may be involved in triggering apoptosis in Ru(2)GLA exposed cells. The EC(50) for Ru(2)GLA decreased with increasing time of exposure from 285 mu M at 24h, 211 mu M at 48 h to 81 mu M at 72 h. In conclusion, Ru(2)GLA is a novel drug with anti proliferative properties in C6 glioma cells and is a potential candidate for novel therapies in gliomas. Copyright (C) 2009 John Wiley & Sons, Ltd.

Phase behavior of the orange essential oil/sodium bis(2-ethylhexyl)sulfosuccinate/water system

The ternary phase diagram for the orange essential oil (OEO)/sodium bis(2-ethylhexyl)sulfosuccinate (AOT)/water system was constructed at 25 degrees C. It indicates a large single phase region, comprising an isotropic water-in-oil (W/O) microemulsion (ME) phase (L(2)), a liquid crystal (LC) (lamellar or hexagonal) and a large unstable emulsion phase that separates in two phases of normal and reverse micelles (L(1) and L(2)). In this communication the properties of the ME are investigated by viscosity, electric conductivity and small angle X-ray scattering (SAXS) indicating that the isotropic ME phase exhibits different behaviors depending on composition. At low water content low viscous ""dry"" surfactant structures are formed, whereas at higher water content higher viscous water droplets are formed. The experimental data allow the determination of the transition from ""dry"" to the water droplet structures within the L(2) phase. SAXS analyses have also been performed for selected LC samples. (C) 2009 Elsevier B.V. All rights reserved.

Biodritin microencapsulated human islets of langerhans and their potential for type 1 diabetes mellitus therapy

Background. Microencapsulation of pancreatic islets with polymeric compounds constitutes an attractive alternative therapy for type 1 diabetes mellitus. The major limiting factor is the availability of a biocompatible and mechanically stable polymer. We investigated the potential of Biodritin, a novel polymer constituted of alginate and chondroitin sulfate, for islet microencapsulation. Methods. Biodritin microcapsules were obtained using an air jet droplet generator and gelated with barium or calcium chloride. Microencapsulated rat insulinoma RINm5F cells were tested for viability using the [3-(4,5-dimetyl-thiazol-2-yl)-2,5-diphenyl-tetrazoliumbromide] [MTT] colorimetric assay. Microencapsulated rat pancreatic islets were coincubated with macrophages derived from mouse peritoneal liquid to assess the immunomodulatory potential of the microcapsules, using quantitative real time-PCR (qPCR). Biodritin biocompatibility was demonstrated by subcutaneous injection of empty microcapsules into immunocompetent Wistar rats. Insulin secretion by microencapsulated human pancreatic islets was evaluated using an electrochemoluminescent assay. Microencapsulated human islets transplanted into chemically induced diabetic mice were monitored for reversal of hyperglycemia. Results. The metabolic activity of microencapsulated RINm5F cells persisted for at least 15 days. Interleukin-1 beta expression by macrophages was observed during coculture with islets microencapsulated with Biodritin-CaCl2, but not with Biodritin-BaCl2. No statistical difference in glucose-stimulated insulin secretion was observed between nonencapsulated and microencapsulated islets. Upon microencapsulated islet transplantation, the blood glucose level of diabetic mice normalized; they remained euglycemic for at least 60 days, displaying normal oral glucose tolerance tests. Conclusion. This study demonstrated that Biodritin can be used for islet microencapsulation and reversal of diabetes; however, further investigations are required to assess its potential for long-term transplantation.

Vitrificação de embriões Mus domesticus domesticus contidos em volumes diferentes de 9,0 m de etileno glicol.

Os experimentos tiveram como objetivo determinar a taxa de eclosão dos embriões vitrificados em volumes diferentes de 9,0 M de etileno glicol. Simultaneamente, testou-se dois procedimentos de estocagem dos fios de teflon, denominados caixa de aço inoxidável e globete/raque. No experimento I, os 881 embriões coletados foram distribuídos em 4 tratamentos: tratamento 1 (T1= controle): 307 embriões foram cultivados in vitro em meio PBSm, acrescido de 0,4% de BSA; tratamento 2 (T2): 292 embriões foram expostos à solução de glicerol 10% acrescida de 0,4% de BSA, envasados em palhetas de 0,25 mL e submetidos ao congelamento pelo método rápido em Biocool; tratamento 3 (T3): 138 embriões foram expostos durante 2 minutos à solução de desidratação (10% de EG + 6% BSA em PBSm) e então transferidos para a solução de vitrificação (50% de EG + 6% de BSA em PBSm), onde permaneceram por 30 segundos e foram colocados em volume de 1 μL no interior de um fio de teflon, medindo 0,4 mm de diâmetro, 2,0 cm de comprimento e 0,05 mm de espessura. Os fios foram acondicionados em uma caixa de aço inoxidável para serem armazenados em nitrogênio líquido; tratamento 4 (T4): 144 embriões foram expostos à solução de desidratação (10% de EG + 6% BSA em PBSm) e após 2 minutos, foram transferidos para a solução de vitrificação (50% de EG + 6% BSA em PBSm), onde permaneceram por 30 segundos, sendo após transferidos para um volume de 1 μL no interior do fio de teflon. Os fios de teflon foram estocados em globetes unidos às raques e mantidos em nitrogênio líquido. Após o aquecimento, os embriões foram cultivados em PBSm suplementado com 0,4% de BSA. As taxas de eclosão embrionária observadas foram: T1=76,29% (245/307); T2=41,05% (117/292); T3=37,98% (54/138) e T4=26,78% (37/144). No segundo experimento, 747 embriões foram distribuídos em 3 tratamentos: tratamento 1 (T1= controle): 80 embriões foram cultivados in vitro em meio KSOM acrescido de 0,4% de BSA; tratamento 2 (T2): 334 embriões expostos em solução de glicerol 10% acrescida de 0,4% de BSA, foram envasados em palhetas de 0,25 mL e submetidos ao congelamento pelo método rápido em Biocool; tratamento 3 (T3): 333 blastocistos foram expostos durante 2 minutos à solução de desidratação (10% de EG + 0,4% BSA em PBSm) e então transferidos para tubos eppendorf de 2,0 mL em contato com a solução de vitrificação (50% de EG + 0,4% BSA em PBSm). Após o cultivo in vitro, as taxas de eclosão embrionária observadas nos 3 tratamentos foram respectivamente: 88,75% (71/80), 40,44% (141/334) e 19,70% (66/333). Baseado nesses resultados conclui-se que embriões Mus domesticus domesticus submetidos à técnica de vitrificação após exposição à solução de 9,0 M de etileno glicol e envase em fios de teflon assegurou índices satisfatórios de sobrevivência embrionária. As taxas de sobrevivência dos embriões Mus domesticus domesticus foi independente do procedimento de estocagem em botijão de nitrogênio líquido. A vitrificação em solução de 9,0 M de etileno glicol com envase em tubos eppendorf não foi eficiente para promover altas taxas de sobrevivência embrionária, mas proporcionou segurança biológica aos embriões, durante o armazenamento.

Morfologia do cromossomo Y, função gonadal e extragonadal em touros de raças sintéticas com alterações na qualidade do sêmen

O motivo deste estudo foi o percentual elevado de descarte de touros por alterações reprodutivas, precisamente qualidade de sêmen, que se apresenta em determinados sistemas produtivos nos quais estão inseridas as raças sintéticas. Através de cinco experimentos foi permitido observar o comportamento da espermatogênese de touros de raças sintéticas do nível cromossômico ao funcional do epitélio seminífero. O experimento I, avaliou por seis meses as características seminais de 12 touros, seis de uma raça pura e seis de uma sintética, contendo em cada grupo touros aptos e inaptos a reprodução classificados por qualidade de sêmen. Os animais do grupo sintético não apresentaram recuperação das características seminais durante o período de avaliação, como os puros, indicando um quadro degenerativo permanente neste conjunto de indivíduos. O experimento II buscou identificar uma relação entre a morfologia do cromossomo Y e tipos de cruzamentos, com a qualidade seminal de touros de duas raças sintéticas, Braford e Brangus-Ibagé. A relação da morfologia do Y com a condição reprodutiva não foi comprovada, no entanto considerando os tipos de cruzamentos para obtenção de touros 3/8, os cruzamentos que utilizam fêmea ¼ com macho ½ sangue filho de Nelore proporcionam um maior percentual de animais considerados inaptos ao exame de sêmen. Este experimento sugere medidas práticas para evitar o cruzamento que traz maiores prejuízos econômicos. O experimento III foi proposto para a avaliar a intensidade de redução de células espermáticas anômalas ao longo do epidídimo em touros de uma raça sintética. A redução da freqüência de gota citoplasmática proximal foi distinta entre os grupos de touros classificados quanto a morfologia espermática e entre as regiões do epidídimo, sendo portanto um indicador sensível da qualidade espermática e classificação da fertilidade potencial de animais de raças híbridas. O experimento IV avaliou a freqüência dos túbulos seminíferos nos diferentes estádios do ciclo espermatogênico em touros de duas raças sintéticas. Nas fases iniciais do ciclo espermatogênico, todos os touros apresentam gametogênese semelhante. Nas fases em que ocorrem as divisões meióticas, os touros inaptos apresentaram maior freqüência e a na fase de maturação das espermátides os touros aptos apresentaram maior freqüência. Estes resultados indicam que nos touros inaptos ocorre um bloqueio na fase das meioses, diminuindo a freqüência dos estádios de maturação das espermátides. O experimento V identificou a expressão diferencial de um fator de crescimento (transforming growth factor alpha- TGFα) no epitélio seminífero de touros Braford e Brangus-Ibagé, aptos e inaptos à reprodução, e também avaliou a freqüência de células de Sertoli nestes animais, como um estudo inicial do controle parácrino da espermatogênese. A maior freqüência da expressão de TGFα foi observada nos estádios I e III, e também na raça Brangus-Ibagé. O número médio das células de Sertoli foi semelhante entre estádios e raças dos touros. Em todos experimentos em que as raças Braford e Brangus-Ibagé foram confrontadas, os resultados obtidos foram diferentes. As maiores freqüências de alterações na qualidade seminal não podem ser extrapoladas para todas as raças sintéticas, cabendo a prerrogativa para cada raça de um estudo específico e ajustado às suas condições de criação.

Desenvolvimento de nanosistemas farmacêuticos para terapia gênica

Gene therapy is one of the major challenges of the post-genomic research and it is based on the transfer of genetic material into a cell, tissue or organ in order to cure or improve the patient s clinical status. In general, gene therapy consists in the insertion of functional genes aiming substitute, complement or inhibit defective genes. The achievement of a foreigner DNA expression into a population of cells requires its transfer to the target. Therefore, a key issue is to create systems, vectors, able to transfer and protect the DNA until it reaches the target. The disadvantages related to the use of viral vectors have encouraged efforts to develop emulsions as non-viral vectors. In fact, they are easy to produce, present suitable stability and enable transfection. The aim of this work was to evaluate two different non-viral vectors, cationic liposomes and nanoemulsions, and the possibility of their use in gene therapy. For the two systems, cationic lipids and helper lipids were used. Nanoemulsions were prepared using sonication method and were composed of Captex® 355; Tween® 80; Spam® 80; cationic lipid, Stearylamine (SA) or 1,2-dioleoyl-3-trimethylammoniumpropane (DOTAP) and water (Milli-Q®). These systems were characterized by average droplet size, Polidispersion Index (PI) and Zeta Potential. The stability of the systems; as well as the DNA compaction capacity; their cytotoxicity and the cytotoxicity of the isolated components; and their transfection capacity; were also evaluated. Liposomes were made by hydration film method and were composed of DOTAP; 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE), containing or not Rhodaminephosphatidylethanolamine (PE- Rhodamine) and the conjugate Hyaluronic Acid DOPE (HA-DOPE). These systems were also characterized as nanoemulsions. Stability of the systems and the influence of time, size of plasmid and presence or absence of endotoxin in the formation of lipoplexes were also analyzed. Besides, the ophthalmic biodistribution of PE-Rhodamine containing liposomes was studied after intravitreal injection. The obtained results show that these systems are promising non-viral vector for further utilization in gene therapy and that this field seems to be very important in the clinical practice in this century. However, from the possibility to the practice, there is still a long way