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BackgroundRecent studies suggest a link between the Klotho protein, sex hormones, and insulin-like growth factor-1 (IGF-1), indicating that α-Klotho levels may rise during puberty, including in central precocious puberty (CPP) cases. This study aimed to explore α-Klotho levels in girls with CPP to assess its potential as a diagnostic and monitoring tool for this condition.MethodsIn total, 139 girls, comprising 82 patients diagnosed with CPP and 57 healthy prepubertal controls, were enrolled in this study. From March 2020 to May 2023, we assessed both α-Klotho levels and clinical parameters. α-Klotho concentrations were measured using an α-Klotho ELISA kit. For the girls with CPP, we additionally analyzed samples taken 6 months after GnRH agonist treatment.Resultsα-Klotho levels were higher in the CPP group compared with the control (CPP group: 2529 ± 999 ng/mL; control group: 1802 ± 675 pg/mL) (P < 0.001), and its level modest decreased after 6 months of GnRH agonist treatment (2147± 789 pg/mL) (P < 0.001). The association between α-Klotho and IGF-1 SDS, follicular stimulating hormone and baseline luteinizing hormone was assessed by partial correlation after adjusting for age, BMI SDS (r= 0.416, p=

Purpose This study aims to investigate the effect of gonadotropin-releasing hormone agonist (GnRHa) on the growth hormone (GH)-insulin-like growth factor-1 (IGF-1) axis and to evaluate whether -202 A/C IGF binding protein-3 (IGFBP-3) promoter polymorphism affects growth velocity in females with central precocious puberty (CPP) during treatment. Methods Data was collected from 97 females younger than 9 years, diagnosed with precocious puberty and treated with GnRHa for at least 1 year at Kangdong Sacred Heart Hospital from 2014 to 2015. Their body height, weight, change in height standard deviation score (∆SDS), serum IGF-1, serum IGFBP-3, bone age, and -202 A/C IGFBP-3 promoter polymorphism were measured before and after GnRHa treatment. The interrelationships between the variables were calculated. Results During treatment, height SDS, IGF-1 SDS, IGFBP-3 SDS, and IGF-1/IGFBP-3 ratio significantly decreased. A significant correlation was observed between ∆IGF-1 SDS and ∆height SDS (r=0.405, P

Titanium nitride (TiN) is a material of interest for electrodes owing to its high-temperature stability, robustness, low-cost, and suitable electrical properties. Herein, we studied the surface morphology and electrical properties of TiN thin film deposited onto an Si/SiO2 substrate through direct current (DC) sputtering with a high-purity TiN target in an argon-gas environment. The electrical properties and surface morphology of TiN thin film significantly improved with increased source power and decreased working pressure. The improved electrical properties could be attributed to the suppressed secondary phase (Ti2N) formation and the reduced electron scattering on smoother surface. Consequently, high-quality TiN thin film with the lowest resistivity (ρ = 0.1 mΩ·cm) and the smallest surface roughness (RMS roughness, Rq = 0.3 nm) was obtained under the optimized condition. The TiN film was further used as the bottom electrode for a metal–insulator–metal (MIM) capacitor. Results demonstrated that the electrical properties of TiN film were comparable to those of noble-metal thin films. Therefore, the TiN thin film fabricated by DC sputtering method had excellent electrical properties and good Rq, indicating its potential applications in MIM capacitors and Si technology.

In this work, thermally healable graphene-nanoplate/epoxy (GNP/EP) nanocomposites were investigated. GNPs were used as reinforcement and crosslinking platforms for the diglycidyl ether of bisphenol A-based epoxy resin (DGEBA) through the Diels-Alder (DA) reaction with furfurylamine (FA). The GNPs and FA could then be used as a derivative of diene and dienophile in the DA reaction. It was expected that the combination of GNPs and FA in DGEBA would produce composites based on the interfacial properties of the components. We confirmed the DA reaction of GNPs and FA at the interface during curing of the GNP/EP nanocomposites. This procedure is simple and solvent-free. DA and retro DA reactions of the obtained composites were demonstrated, and the thermal healing properties were evaluated. The behavior of the GNP/EP nanocomposites in the DA reaction is similar to that of thermosetting polymers at low temperatures due to crosslinking by the DA reaction, and the nanocomposites can be recycled by a retro DA reaction at high temperatures.

Electronic packaging materials with high thermal conductivity and suitable viscosity are necessary in the manufacturing of highly integrated electronic devices for efficient heat dissipation during operation. This study looked at the effect of boron nitride (BN) platelets on the rheology and thermal conductivity of composites based on alumina (Al2O3) and epoxy resin (EP) for the potential application as electronic packaging. The viscosity and thermal conductivity of the composite were increased upon increasing filler content. Furthermore, thermal conductivity of the BN/Al2O3/EP was much higher than that of Al2O3/EP at almost the same filler loadings. These unique properties resulted from the high thermal conductivity of the BN and the synergistic effect of the spherical and plate shapes of these two fillers. The orientation of BN platelets can be controlled by adjusting their loading to facilitate the formation of higher thermally conductive pathways. The optimal content of the BN in the Al2O3/EP composites was confirmed to be 5.3 vol %, along with the maximum thermal conductivity of 4.4 W/(m·K).

Thermally self-healing graphene-nanoplate/polyurethane (GNP/PU) nanocomposites were prepared via a bulk in-situ Diels–Alder (DA) reaction. Graphene-nanoplate (GNP) was used as a reinforcement and crosslinking platform by a DA reaction with a furfuryl-based chain extender of polyurethane (PU). Results showed that a DA reaction occurred in GNP during the PU forming cure process. This procedure is simple and solvent free because of the absence of any independent surface modification process. Through the calculation of the interfacial tensions, the conditions of the bulk in-situ DA reaction were determined to ensure that GNP and the furfuryl group can react with each other at the interface during the curing process without a solvent. The prepared composites were characterized in terms of thermal, mechanical, and thermally self-healing properties via the DA reaction. In the PU capable of a DA reaction (DPU), characteristic peaks of DA and retro DA reactions were observed in the Fourier transform infrared (FT-IR) spectroscopy and endothermic peaks of retro DA reactions appeared in differential scanning calorimetry (DSC) thermograms. The DPU showed significantly enhanced physical properties and chemical resistance. The thermally self-healing capability was confirmed at 110 °C via the retro DA reactions. It is inferred that thermally self-healable crosslinked GNP/PU nanocomposites via DA reactions could be prepared in a simple bulk process through the molecular design of a chain extender for the in-situ reaction at the interface.

Edge computing is proposed to solve the problem of centralized cloud computing caused by a large number of IoT (Internet of Things) devices. The IoT protocols need to be modified according to the edge computing paradigm, where the edge computing devices for analyzing IoT data are distributed to the edge networks. The MQTT (Message Queuing Telemetry Transport) protocol, as a data distribution protocol widely adopted in many international IoT standards, is suitable for cloud computing because it uses a centralized broker to effectively collect and transmit data. However, the standard MQTT may suffer from serious traffic congestion problem on the broker, causing long transfer delays if there are massive IoT devices connected to the broker. In addition, the big data exchange between the IoT devices and the broker decreases network capability of the edge networks. The authors in this paper propose a novel MQTT with a multicast mechanism to minimize data transfer delay and network usage for the massive IoT communications. The proposed MQTT reduces data transfer delays by establishing bidirectional SDN (Software Defined Networking) multicast trees between the publishers and the subscribers by means of bypassing the centralized broker. As a result, it can reduce transmission delay by 65% and network usage by 58% compared with the standard MQTT.

Previously, we reported that Lactobacillus gasseri BNR17 (BNR17), a probiotic strain isolated from human breast milk, inhibited increases in body weight and adipocyte tissue weight in high-sucrose diet-fed Sprague-Dawley (SD) rats and reduced glucose levels in type 2 diabetes mice. In the current study, we conducted further experiments to extend these observations and elucidate the mechanism involved. C57BL/6J mice received a normal diet, high-sucrose diet or high-sucrose diet containing L. gasseri BNR17 (10(9) or 10(10) CFU) for 10 weeks. The administration of L. gasseri BNR17 significantly reduced the body weight and white adipose tissue weight regardless of the dose administered. In BNR17-fed groups, mRNA levels of fatty acid oxidation-related genes (ACO, CPT1, PPARα, PPARδ) were significantly higher and those of fatty acid synthesis-related genes (SREBP-1c, ACC) were lower compared to the high-sucrose-diet group. The expression of GLUT4, main glucose transporter-4, was elevated in BNR17-fed groups. L. gasseri BNR17 also reduced the levels of leptin and insulin in serum. These results suggest that the anti-obesity actions of L. gasseri BNR17 can be attributed to elevated expression of fatty acid oxidation-related genes and reduced levels of leptin. Additionally, data suggested the anti-diabetes activity of L. gasseri BNR17 may be to due elevated GLUT4 and reduced insulin levels.

Tungsten diselenide (WSe2) is one of the promising transition metal dichalcogenides (TMDs) for nanoelectronics and optoelectronics. To enhance and tune the electronic performance of TMDs, chemical functionalization via covalent and van der Waals approaches has been suggested. In the present report, the electric and structural transition of WSe2 oxidized by exposure to O3 is investigated using scanning tunneling microscopy. It is demonstrated that the exposure of WSe2/high-ordered pyrolytic graphite sample to O3 induces the formation of molecular adsorbates on the surface, which enables to increase in the density of states near the valence band edge, resulting from electric structural modification of domain boundaries via exposure of atomic O. According to the work function extracted by Kelvin probe force microscopy, monolayer WSe2 with the O3 exposure results in a gradual increase in work function as the exposure to O3. Therefore, the present report demonstrates the potential pathway for the chemical functionalization of TMDs to enhance the electric performance of TMDs devices. [ABSTRACT FROM AUTHOR]

Atomic layer deposition of a silicon rich SiNx layer on Si0.7Ge0.3(001), Si0.5Ge0.5(001), and Si0.5Ge0.5(110) surfaces has been achieved by sequential pulsing of Si2Cl6 and N2H4 precursors at a substrate temperature of 285 °C. XPS spectra show a higher binding energy shoulder peak on Si 2p indicative of SiOxNyClzbonding while Ge 2p and Ge 3d peaks show only a small amount of higher binding energy components consistent with only interfacial bonds, indicating the growth of SiOxNy on the SiGe surface with negligible subsurface reactions. Scanning tunneling spectroscopy measurements confirm that the SiNxinterfacial layer forms an electrically passive surface on p-type Si0.70Ge0.30(001), Si0.50Ge0.50(110), and Si0.50Ge0.50(001) substrates as the surface Fermi level is unpinned and the electronic structure is free of states in the band gap. DFT calculations show that a Si rich a-SiO0.4N0,4 interlayer can produce lower interfacial defect density than stoichiometric a-SiO0.8N0.8, substoichiometric a-Si3N2, or stoichiometric a-Si3N4 interlayers by minimizing strain and bond breaking in the SiGe by the interlayer. Metal-oxide-semiconductor capacitors devices were fabricated on p-type Si0.7Ge0.3(001) and Si0.5Ge0.5(001) substrates with and without the insertion of an ALD SiOxNy interfacial layer, and the SiOxNylayer resulted in a decrease in interface state density near midgap with a comparable Cmax value. [ABSTRACT FROM AUTHOR]

An ideal cancer therapeutic strategy involves the selective killing of cancer cells without affecting the surrounding normal cells. However, researchers have failed to develop such methods for achieving selective cancer cell death because of shared features between cancerous and normal cells. In this study, we have developed a therapeutic strategy called the cancer-specific insertions–deletions (InDels) attacker (CINDELA) to selectively induce cancer cell death using the CRISPR-Cas system. CINDELA utilizes a previously unexplored idea of introducing CRISPR-mediated DNA double-strand breaks (DSBs) in a cancer-specific fashion to facilitate specific cell death. In particular, CINDELA targets multiple InDels with CRISPRCas9 to produce many DNA DSBs that result in cancer-specific cell death. As a proof of concept, we demonstrate here that CINDELA selectively kills human cancer cell lines, xenograft human tumors in mice, patient-derived glioblastoma, and lung patient-driven xenograft tumors without affecting healthy human cells or altering mouse growth. [ABSTRACT FROM AUTHOR]

Molybdenum diselenide (MoSe2) has attracted attention as a potential semiconductor platform. However, the as-synthesized MoSe2 field-effect transistors (FETs) tend to exhibit the arbitrary properties of n-type, p-type, or ambipolar behavior due to the uncontrolled growth condition. Here, two-step functionalization is proposed to achieve n-doping effect and long-term stability in chemical vapor deposition (CVD)-grown MoSe2 FETs using oxygen plasma treatment followed by the deposition of an Al2O3 layer. After the two-step surface functionalization procedure, three types of multilayer MoSe2 FETs are all converted to n-type with the improvement of their electrical characteristics and stability; the n-doped multilayer MoSe2 FETs exhibit an enhancement in field-effect mobility from 12.23 to 31.57 cm2 V-1 s-1 and a 3 times higher Ion/Ioff, compared to pristine multilayer MoSe2 FETs. This enhancement of electric performance is attributed to the oxidation of topmost MoSe2 to interfacial MoOx with SeOx induced by the oxygen plasma treatment, as well as to the existence of fixed positive charges in deposited Al2O3. The functionalized devices exhibit excellent stability against stress, as confirmed with negative bias illumination stress tests for 7200 s. Moreover, an environmental stability test for 21 days reveals no degradation in electric performance of MoSe2 FETs. [ABSTRACT FROM AUTHOR]

Many DNA repair proteins have additional functions other than their roles in DNA repair. In addition to catalyzing PCNA polyubiquitylation in response to the stalling of DNA replication, SHPRH has the additional function of facilitating rRNA transcription by localizing to the ribosomal DNA (rDNA) promoter in the nucleoli. SHPRH was recruited to the rDNA promoter using its plant homeodomain (PHD), which interacts with histone H3 when the fourth lysine of H3 is not trimethylated. SHPRH enrichment at the rDNA promoter was inhibited by cell starvation, by treatment with actinomycin D or rapamycin, or by depletion of CHD4. SHPRH also physically interacted with the RNA polymerase I complex. Taken together, we provide evidence that SHPRH functions in rRNA transcription through its interaction with histone H3 in a mammalian target of rapamycin (mTOR)-dependent manner. [ABSTRACT FROM AUTHOR]

Severalproposed beyond-CMOS devices based on two-dimensional (2D) heterostructuresrequire the deposition of thin dielectrics between 2D layers. However,the direct deposition of dielectrics on 2D materials is challengingdue to their inert surface chemistry. To deposit high-quality, thindielectrics on 2D materials, a flat lying titanyl phthalocyanine (TiOPc)monolayer, deposited via the molecular beam epitaxy, was employedto create a seed layer for atomic layer deposition (ALD) on 2D materials,and the initial stage of growth was probed using in situSTM. ALD pulses of trimethyl aluminum (TMA) and H2O resultedin the uniform deposition of AlOxon theTiOPc/HOPG. The uniformity of the dielectric is consistent with DFTcalculations showing multiple reaction sites are available on theTiOPc molecule for reaction with TMA. Capacitors prepared with 50cycles of AlOxon TiOPc/graphene displaya capacitance greater than 1000 nF/cm2, and dual-gateddevices have current densities of 10–7A/cm2with 40 cycles. [ABSTRACT FROM AUTHOR]

Brown adipocytes are a specialized cell type that is critical for adaptive thermogenesis, energy homeostasis, and metabolism. In response to cold, both classical brown fat and the newly identified "beige" or "brite" cells are activated by β-adrenergic signaling and catabolize stored lipids and carbohydrates to produce heat via UCP1. Once thought to be non-existent in adults, recent studies have discovered active classical brown and beige fat cells in humans, thus reinvigorating interest in brown and beige adipocytes. This review will focus on the newly discovered transcription factors and microRNAs that specify and orchestrate the classical brown and beige fat cell development. [ABSTRACT FROM AUTHOR]

CuPc ultrathin films (5 monolayers) are employed to detect NO2 in chemFETs [organic thin film transistors (OTFTs)]; while the NO2 causes OTFT degradation, H2O restores OTFT performance. To develop an atomic understanding of this H2O induced performance recovery, NO2/CuPc/ Au(111) was exposed to H2O, then observed using ultrahigh vacuum scanning tunneling microscopy. After dosing NO2 (10 ppm for 5min) onto CuPc monolayers under ambient conditions, domain fracture is induced in CuPc monolayers, and CuPc aggregates are formed near new grain boundaries, consistent with dissociative O adsorption between CuPc molecules and Au(111). Conversely, after exposing H2O onto a fractured CuPc monolayer for 30 min, fractured domains merge, then large area domains are generated. As the duration of H2O exposure increases to 4 h, second layer growth of CuPc molecules is observed on the CuPc monolayers consistent with H2O breakdown of CuPc aggregates which have formed at the domain boundaries. The results are consistent with H2O driving the removal of atomic O between CuPc molecules and Au(111) consistent with previous sensing results. [ABSTRACT FROM AUTHOR]

The oncogenic fusion gene EWS-WT1 is the defining chromosomal translocation in desmoplastic small roundcell tumors (DSRCT), a rare but aggressive soft tissue sarcoma with a high rate of mortality. EWS-WT1 functions as an aberrant transcription factor that drives tumorigenesis, but the mechanistic basis for its pathogenic activity is not well understood. To address this question, we created a transgenic mouse strain that permits physiologic expression of EWS-WT1 under the native murine Ews promoter. EWS-WT1 expression led to a dramatic induction of many neuronal genes in embryonic fibroblasts and primary DSRCT, most notably the neural reprogramming factor ASCL1. Mechanistic analyses demonstrated that EWS-WT1 directly bound the proximal promoter of ASCL1, activating its transcription through multiple WT1-responsive elements. Conversely, EWS- WT1 silencing in DSRCT cells reduced ASCL1 expression and cell viability. Notably, exposure of DSRCT cells to neuronal induction media increased neural gene expression and induced neurite-like projections, both of which were abrogated by silencing EWS-WT1. Taken together, our findings reveal that EWS-WT1 can activate neural gene expression and direct partial neural differentiation via ASCL1, suggesting agents that promote neural differentiation might offer a novel therapeutic approach to treat DSRCT. [ABSTRACT FROM AUTHOR]

Ambient NO2 adsorption onto copper(II) phthalocyanine (CuPc) monolayers is observed using ultrahigh vacuum (UHV) scanning tunneling microscopy (STM) to elucidate the molecular sensing mechanism in CuPc chemical vapor sensors. For low doses (1 ppm for 5 min) of NO2 at ambient temperatures, isolated chemisorption sites on the CuPc metal centers are observed in STM images. These chemisorbates almost completely desorb from the CuPc monolayer after annealing at 100 °C for 30 min. Conversely, for high NO2 doses (10 ppm for 5 min), the NO2 induces a fracture of the CuPc domains. This domain fracture can only be reversed by annealing above 150 °C, which is consistent with dissociative chemisorption into NO and atomic O accompanied by surface restructuring. This high stability implies that the domain fracture results from tightly bound adsorbates, such as atomic O. Existence of atomic O on or under the CuPc layer, which results in domain fracture, is revealed by XPS analysis and ozone-dosing experiments. The observed CuPc domain fracturing is consistent with a mechanism for the dosimetric sensing of NO2 and other reactive gases by CuPc organic thin film transistors (OTFTs). [ABSTRACT FROM AUTHOR]

Components of silk including silk fibroin have long been used as anti-diabetic remedies in oriental medicine. However, detailed mechanisms underlying these antidiabetic effects remain unclear. In this study, we examined the anti-diabetic activity of silk fibroin hydrolysate (SFH) in C57BL/KsJ-db/db (db/db) mice, a well-known animal model of non-insulin dependent diabetes mellitus. When the db/db mice were administered SFH in drinking water for 6 weeks, hyperglycemia in the animals gradually disappeared and the level of glycosylated hemoglobin decreased, indicating that SFH plays important role in reducing the symptoms of diabetes. In addition, SFH-treated db/db mice exhibited improved glucose tolerance with increased plasma insulin levels. Immunohistochemical and morphological analyses showed that SFH up-regulated insulin production by increasing pancreatic β cell mass in the mice. In summary, our results suggest that SFH exerts anti-diabetic effects by increasing pancreatic β cell mass in a non-insulin dependent diabetes mellitus mouse model. [ABSTRACT FROM AUTHOR]

Ostericum koreanum maximowicz (Umbelliferae), a medicinal herb in Korean Oriental Medicine, has been applied to treat cold, headache, neuralgia and arthralgia. The ethyl acetate fraction of O. koreanum root was subjected to in vitro antioxidant activity with different methods for free radical scavenging activities. In addition, the cell viability and nitric oxide release assays were performed here for the first time in neuroblastoma (Neuro-2a) cell cultures. Among all the tested methods, the ethyl acetate fraction was expressed very active, exhibiting a good Trolox equivalent values and IC50, comparable to that of the commercial antioxidants, Trolox and ascorbic acid, respectively. The results showed that there was a reduction of cell viability by the fraction in a concentration dependent manner. These results suggest that O. koreanum shows good antioxidant activities in vitro by inhibiting free radicals. These findings provide a rationale for the in vivo testing. Also, the major constituents behind the antioxidant mechanisms of this fraction warrant further study. [ABSTRACT FROM AUTHOR]

Licochalcone A (LicA), a major phenolic constituent of licorice, has antiproliferative and anti-inflammatory properties in human and murine cell lines. We previously showed that LicA down-regulates the expression of cyclooxygenase (COX)-2 and inducible nitric oxide synthase (iNOS) via the modulation of nuclear factor-κB and activator protein-1 activation in cell culture. We therefore tested whether LicA inhibits carcinogenesis and metastasis in mouse models. To induce colon carcinogenesis, C57BL/6 mice were given a single intraperitoneal injection of azoxymethane (10 mg/kg body weight), followed by 1% dextran sulfate sodium in the drinking water. Additionally, we also assessed the effect of LicA on liver metastasis by intrasplenic injection of BALB/c mice with CT-26 cells. Feeding the mice with LicA (5, 15, and 30 mg/kg body weight) significantly reduced tumor formation as well as the number of cells expressing proliferating cell nuclear antigen, β-catenin, COX-2, and iNOS in the colon. LicA also decreased colon levels of proinflammatory cytokines and chemokines. In addition, LicA significantly increases survival of animals and inhibited liver metastasis as well as the expression of matrix metalloproteinase-9 in the liver. These preclinical studies indicate that LicA has potent antitumor and antimetastatic activity, suggesting that LicA could increase efficacy and improve patient outcomes in colorectal cancer. [ABSTRACT FROM AUTHOR]

In order to compare the characteristic according to the use of the spiral or the lamination stator in an axial field slotless machine, this paper experimentally introduces the comparison of the electromagnetic and mechanical characteristic, such as phase back-EMF, core loss, frequency response function (FRF) characteristic, resonant frequency, and sound pressure level (SPL). From the comparison, this research is usefully used to select of stator type on the initial design stage of axial flux type machines. [ABSTRACT FROM AUTHOR]

Abstract The Ames test is used worldwide to initially screen the mutagenic potential of new chemicals. In the standard Ames test, S. typhimurium strains (TA100, TA98, TA1535, and TA1537) and Escherichia coli (WP2uvrA) are treated with substances with/without cytochrome P450s (CYPs)-induced rat S9 fractions for identifying mutagens and pro-mutagens. However, many substances show completely different toxicity patterns depending on whether the liver S9 fraction belongs to rats or humans. The natural product Polygoni Multiflori Radix (PMR) can also show bacterial reverse mutation, followed by the rat or human liver S9 fraction. While PMR elicits reverse mutations in the TA1537 strain in rat liver S9 but not in human liver S9, this mechanism has not been verified yet. To explain this, the differences in metabolic enzymes compositions commonly observed between rats and humans have been implicated. This study aimed to explore the key factors that cause differences in the genotoxicity of PMR between rat and human liver S9 metabolic enzymes. The results of next-generation sequencing (NGS) analysis showed that both rat and human metabolic enzymes caused similar mutations in TA1537. However, when the metabolic enzymes in each S9 fraction were analyzed using ion mobility tandem mass spectrometry (IM-MS), rat- and human-specific enzymes were identified among the cytochrome (CYP) family, especially aryl hydrocarbon receptor (AHR)-related CYPs. These findings suggest that CYP1A1 isoforms contribute to the mechanism of PMR in the Ames test. Therefore, an in vitro Ames test might be more reliable in predicting genotoxicity for both rodents and humans. This will also help overcome the limitations of laboratory animal-based toxicity evaluations, which provide unreliable results due to interspecies differences between humans and rodents.

Background/Aims Inflammatory bowel disease (IBD), including Crohn's disease and ulcerative colitis, is a chronic inflammatory disorder of the gastrointestinal tract that requires lifetime management. Therefore, many studies have tried to establish questionnaires or parameters to assess the quality of care for IBD patients. However, there is no study that investigates the type of patients using the Q methodology, which is subjective and systematically studied, to identify and categorize patient's opinions and subjective thinking. The purpose of this study is to investigate the subjective thinking and necessity of IBD patients. Methods Q-methodology, which provides a method of analyzing the subjectivity of each item, was used. Thirty-four selected Q-statements received from 50 adults were classified into a shape of normal distribution using a 9-point scale. The collected data was analyzed using a QUANL PC program. Results Four types of attitudes toward life sustaining treatment were identified. Type I is called physician dependent type. Type II is called relationship focused type. Type III is called information driven type. Type IV is called social awareness type. Conclusions The results of this study show that IBD patients have four types when they receive treatment. Based on this study, further individualized therapeutic approach is needed for IBD patient. [ABSTRACT FROM AUTHOR]