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Clinical trials carried out to establish the efficacy of treatment must be conducted on a significant number of subjects using fundamental methodological features such as a credible control condition and random assignment to the experimental and control intervention

The conjugation is supervised by Atg7 and Atg3, which are ubiquitin-like enzymes [41]

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Although various bio-safety evaluations have provided a series of evidences that MSNs are biocompatible in vivo within desirable dose and they can be degraded and expelled from the body via urine and feces 58,59,60,61 , there remain many challenges that need to be overcome since the in vivo therapeutic use requires more strict performance modulation to satisfy the complicated physiological environment so as to avoid unwanted bio-performances of MSNs

Then consider what percentage of that investment you are willing to lose to preventable degradation