The Impact of Pedestrian and Nonmotorized Vehicle Violations on Vehicle Emissions at Signalized Intersections in the Real World: A Case Study in Beijing

Emission around intersections has become an issue in the urban traffic network. This paper aims to investigate the impact of pedestrian and nonmotorized vehicle violations on emissions at mixed-traffic flow intersection based on the volumes of vehicles, nonmotor vehicles, and pedestrians. Also, it focuses on the arterial and collector intersections with high vehicle volume and limited space. Running red light and crossing intersection diagonally are two critical violations, accounting for 91.75% of effective violations (interference with vehicles’ operation). In this context, a violation blocking model is developed to estimate the blocking probability for each vehicle based on the volumes of pedestrians and nonmotor vehicles. The model includes two scenarios. (1) Through phase: the violation blocking model of running red light is developed based on the survival curve (the relationship between waiting time and running red light probability). (2) Left-turn phase: the violation blocking model at this phase includes two parts: (i) crossing the intersection diagonally model is developed for the first vehicle and (ii) running red light model is developed for subsequent vehicles. The existing emission model can estimate the emissions based on the blocking positions. In the case study, emissions increase with the vehicle volume approaching the saturated flow rate and the volumes of nonmotor vehicles and pedestrians increasing. Results show that the maximum emission increase of CO (carbon monoxide) for through phase and left-turn phase can reach 16.7% and 36.4%.

MODERN VIEWS FOR THE TREATMENT OF ACUTE UNCOMPLICATED APPENDICITIS: APPENDECTOMY OR ANTIBIOTICS?

Summary. The paper reviews the results of randomized controlled trials and meta-analysis data from comparisons of antibiotics and appendectomy in the treatment of acute uncomplicated appendicitis ) is carried. It has been shown that appendectomy remains in most cases the gold standard for the treatment of acute uncomplicated appendicitis is proved. At the same time, it is noted that in separate groups of patients with no risk of development of complications and / or with high operational risk in persons with critical violations of vital functions of the body, in case of impossibility to perform an operation, antibiotic therapy can be a highly effective and safe method of treatment is established. Preparations of choice are carbapenems (mepenes), fluoroquinolones III (levofloxacin) and metronidazos/ornizol is indicated.

The effect of Foodsafe Level 1 Training on inspection report results

Food handlers equipped with food safety knowledge prevent foodborne illnesses. This study examined the relationship between worker Foodsafe level 1 training and critical violations reported on inspection results of non-chain restaurants in the Burnaby Fraser Health region. A total of 25 food service establishments with no critical violations on their routine inspections and 25 that had at least one critical violation participated in the telephone survey. Using the Mann-Whitney U two tailed t-test, it was shown that food service establishments with no critical violations on inspections had no significantly (p = 0.72) different proportions of Foodsafe level 1 trained staff than those with at least one critical violations on inspections. This study suggested that having more food handlers with food safety training does not impact how well restaurants score on inspections.

Inspecting inspection reports, does the type of restaurant change the risk?

Background An estimated of 4 million Canadians (one in eight people) become ill every year from a food-borne illness (Thomas et al., 2013). The economic and social burdens of these illnesses are vast. As restaurants are a big sector of the food industry, improving their food safety would reduce the risk of food-borne illnesses. Environmental Health Officers (EHOs) are on the front line, educating restaurant operators in order to improve food safety. In Metro Vancouver there are many different types of ethnicities and types of restaurants; this provides a challenge for EHOs to know where to allocate their time and resources. Methods The author analyzed 150 Fraser Health inspection reports in the Burnaby, New Westminster and Surrey municipalities. The restaurants fell into three different categories: i) Independently owned ethnic, ii) Independently owned, non-ethnic and iii) chain non-ethnic restaurants. Hazard ratings, number of critical and number of non-critical violations from their latest inspection report were compared. Each violation code was also recorded to identify any infraction trends that exist. Results Analysis of the number of critical violations identified ethnic, chain non-ethnic, and independent non-ethnic restaurants as not being significantly different (p=0.09). The number of non-critical violations was different (0.033), with ethnic restaurants having the most. The number of critical violations, when treating each ethnicity as its own category, is however significantly different (p=0.044) between restaurant types. There was a significant association between hazard rating and restaurant type, with independent ethnic restaurants having the worst hazard rating (p=0.017). Conclusion The type of ownership (independent vs chain) and the restaurant type were not a factor when looking at number of critical violations that a restaurant commits. Independent ethnic restaurants had a slightly higher mean number of critical violations. Japanese restaurants had the highest number of critical violations out of the three ethnicities studied. These findings suggest a slight disparity in risk to public health between ethnic and non-ethnic restaurants.

Accuracy of the freehand technique for 3 fixation methods in the C-2 vertebrae

Object Intraoperative imaging often does not provide adequate visualization to ensure safe placement of screws. Therefore, the authors investigated the accuracy of a freehand technique for placement of pars, pedicle, and intralaminar screws in C-2. Methods Sixteen cadaveric specimens were instrumented freehand by 2 experienced cervical spine surgeons with either a pars or pedicle screw, and bilateral intralaminar screws. The technique was based on anatomical starting points and published screw trajectories. A pedicle finder was used to establish the trajectory, followed by tapping, palpation, and screw placement. After placement of all screws (16 pars screws, 16 pedicle screws, and 32 intralaminar screws), the C-2 segments were disarticulated, radiographed in anteroposterior, lateral, and axial planes, and meticulously inspected by another spine surgeon to determine the nature and presence of any defects. Results A total of 64 screws were evaluated in this study. Pars screws exhibited 2 critical defects (1 in the foramen transversarium and 1 in the C2–3 facet) and an insignificant dorsal cortex breech, for an overall accuracy rate of 81.3%. Pedicle screws demonstrated only 1 insignificant violation (inferior facet/medial cortex intrusion of 1 mm) with an accuracy rate of 93.8%, and intralaminar screws demonstrated 3 insignificant violations (2 in the ventral canal, 1 in the caudad lamina breech) for an accuracy rate of 90.6%. Pars screws had significantly more critical violations than intralaminar screws (p = 0.041). Conclusions Instrumentation of the C-2 vertebrae using the freehand technique for insertion of pedicle and intralaminar screws showed a high success rate with no critical violations. Pars screw insertion was not as reliable, with 2 critical violations from a total of 16 placements. The freehand technique appears to be a safe and reliable method for insertion of C-2 pedicle and intralaminar screws.

A Prolonged Outbreak of Salmonella Montevideo Infections Associated with Multiple Locations of a Restaurant Chain in Phoenix, Arizona, 2008

An outbreak of Salmonella serotype Montevideo infections associated with multiple locations of restaurant chain A in Phoenix, AZ, was identified in July 2008. One infected individual reported eating at a chain A catered luncheon where others fell ill; we conducted a cohort study among attendees to identify the vehicle. Food and environmental samples collected at six chain A locations were cultured for Salmonella. Restaurant inspection results were compared among 18 chain A locations. Routine surveillance identified 58 Arizona residents infected with the outbreak strain. Three chain A locations, one of which catered the luncheon, were named by two or more case patients as a meal source in the week prior to illness onset. In the cohort study of luncheon attendees, 30 reported illness, 10 of which were later culture confirmed. Illness was reported by 30 (61%) of 49 attendees who ate chicken and by 0 of 7 who did not. The outbreak strain was isolated from two of these three locations from uncooked chicken in marinade, chopped cilantro, and a cutting board dedicated to cutting cooked chicken. Raw chicken, contaminated before arrival at the restaurant, was the apparent source of this outbreak. The three locations where two or more case patients ate had critical violations upon routine inspection, while 15 other locations received none. Poor hygiene likely led to cross-contamination of food and work areas. This outbreak supports the potential use of inspections in identifying restaurants at high risk of outbreaks and the need to reduce contamination of raw products at the source and prevent cross-contamination at the point of service.

Certified Kitchen Managers: Do They Improve Restaurant Inspection Outcomes?†

Restaurants are associated with a significant number of foodborne illness outbreaks in the United States. Certification of kitchen managers through an accredited training and testing program may help improve food safety practices and thus prevent foodborne illness. In this study, relationships between the results of routine restaurant inspections and the presence of a certified kitchen manager (CKM) were examined. We analyzed data for 4,461 restaurants in Iowa that were inspected during 2005 and 2006 (8,338 total inspections). Using logistic regression analysis, we modeled the outcome variable (0 = no critical violations [CVs]; 1 = one or more CVs) as a function of presence or absence of a CKM and other explanatory variables. We estimated separate models for seven inspection categories. Restaurants with a CKM present during inspection were less likely to have a CV for personnel (P < 0.01), food source or handling (P < 0.01), facility or equipment requirements (P < 0.05), ware-washing (P < 0.10), and other operations (P < 0.10). However, restaurants with a CKM present during inspection were equally likely to have a CV for temperature or time control and plumbing, water, or sewage as were restaurants without a CKM present. Analyses by type of violation within the temperature and time control category revealed that restaurants with a CKM present during inspection were less likely to have a CV for hot holding (P < 0.05), but the presence of a CKM did not affect other types of temperature and time control violations. Our analyses suggest that the presence of a CKM is protective for most types of CVs, and we identify areas for improving training of CKMs.