A Novel Classification of Juvenile and Adolescent Idiopathic Scoliosis for Conservative Treatment.

BACKGROUND: The operative classification of scoliosis is well-developed but inadequate for guiding conservative treatment. The current conservative classification for juvenile and adolescent idiopathic scoliosis (JAIS) exhibits noticeable deficiencies. This study aimed to establish the Peking Union Medical College Hospital (PUMCH) classification and assess its clinical value in the conservative treatment of JAIS. METHODS: This study consisted of 2 parts. First, it involved a retrospective analysis of patients treated for JAIS in the Department of Rehabilitation Medicine, the ∗∗∗ Union Medical College Hospital, between January 2013 and June 2020. Second, it involved an ambispective cohort study that enrolled patients with JAIS in the above hospital between July and December 2020. RESULTS: A total of 989 patients with JAIS were enrolled, with 899 patients for establishing the PUMCH classification and 90 patients with JAIS for validating the PUMCH classification. The classification demonstrated an average reliability of 88.22% with a kappa coefficient of 0.862. After 1 week, the remeasured results presented a mean reproducibility of 92.78% and a kappa coefficient of 0.908. After 1-year follow-up, the Cobb angle decreased significantly from 16.61 ± 2.88° to 12.16°± 9.97° (P = 0.002) in 51 patients with PUMCH-scoliosis-specific exercise (SSE) treatment, while the Cobb angle increased significantly from 15.74 ± 2.75° to 17.64 ± 5.60° (P = 0.014) in 39 patients without PUMCH-SSE treatment. CONCLUSIONS: The PUMCH-SSE classification demonstrates good inter-observer reliability and intra-observer reproducibility. In addition, the classification may be used to guide the conservative treatment of JAIS in clinical settings.

Feasibility of iron scraps for enhancing nitrification of domestic wastewater at low temperatures.

The development of an effective approach to improve low-temperature nitrification of domestic wastewater remains an important issue that needs to be urgently addressed. This study was intended to verify the feasibility of using iron scraps as an effective immobilization material to enhance nitrification activity in domestic wastewater-treatment systems at low temperatures. Iron scraps were tried and compared with one common immobilization material (PVA-SA embedded balls) in terms of low-temperature nitrification performances, anti-shock capacity, dynamics of microbial community, and economic costs. The results showed that compared with control, the average nitrification efficiency of iron scraps and PVA-SA embedded balls increased separately by 15.7% and 27.6% at low temperatures. Among these groups, the iron scrap-based group demonstrated the best anti-shock capacity and the smallest fluctuation (lower than 10%) with the shortening of HRT (hydraulic retention time) or the increase of inlet ammonium level. Nitrosomonas was found to be the dominant bacterial genera for these two immobilization materials. The increased costs of iron scraps and PVA-SA embedded balls were about ¥0.03 and ¥0.78 per ton of treated domestic wastewater. Taken together, iron scraps have some significant advantages including low costs, easy availability, and good anti-shock capacity, which make them a promising candidate for enhanced nitrification of domestic wastewater at low temperatures.