Objective: Robust scientific and clinical evidence of how to appropriately manage denture plaque is lacking. This two-part study (i) developed an in vitro model of denture plaque removal, and (ii) assessed effectiveness of these approaches in a randomised clinical trial.Method: (i) a complex denture plaque model was developed using the dominant microbial genera from a recent microbiome analyses. Biofilms formed on polymethylmethacrylate were brushed daily with a wet toothbrush, then either treated daily for 5 days or only on Days 1 and 5 with Polident® denture cleanser tablets (3 min soaking). Quantitative and qualitative microbiological assessments were performed. (ii), an examiner-blind, randomised, crossover study of complete maxillary denture wearers was performed (n = 19). Either once-daily for 7 days or on Day 7 only, participants soaked dentures for 15 min using Corega® denture cleansing tables, then brushed. Denture plaque microbiological assessment used sterilized filter paper discs.Results: The in vitro model showed daily cleaning with denture cleanser plus brushing significantly reduced microbial numbers compared to intermittent denture cleaning with daily brushing (p < 0.001). The clinical component of the study showed a statistically significant reduction in denture plaque microbial numbers in favour of daily versus weekly treatment (aerobic bacteria p = 0.0144). Both in vitro and in vivo studies showed that denture plaque biofilm composition were affected by different treatment arms.Conclusions: This study demonstrated that daily denture cleansing regimens are superior to intermittent denture cleansing, and that cleansing regimens can induce denture plaque compositional changes. Clinicaltrials.gov registration: NCT02780661.
The City of Atlanta has contracted the Program Management Team (PMT) under Clean Water Atlanta Program (CWA) to assist them with compliance to a Consent Decree, issued by the U.S Department of Justice in 1999, to reduce the number of overflows from their collection system. PMT is comprised of a joint venture -Montgomery Watson-Harza and KHAFRA, as well as numerous sub-contractors. This paper will focus on how enterprise web-based mapping tools can dramatically change and improve the method in which cities conduct day-to-day wastewater operations and hopefully, aid in compliance to the Consent Decree.Working side by side with Watershed Management, Engineering Information System Division, KHAFRA was tasked with building an enterprise-wide GIS system. In an effort to improve the city's mapping system CADD based sewer drawings were converted to a GIS format therefore transforming a purely graphical representation of the city's collection system to a multi-dimensional information based system. These data are stored in an Oracle database and accessed through ESRI's Spatial Database Engine (SDE). Enterprise-wide GIS is a term used to indicate that many different users can access and update a GIS database simultaneously without loss of information or corruption of datasets. This becomes very important in large organizations for the reason that other departments can have access to and assist with maintaining different datasets used in the Geographic Information System. KHAFRA has also implemented a system, whereby this GIS information can be accessed/distributed via customized Internet Mapping interfaces and web-based tools. This effort allows every employee access to the GIS information, through their web browser, without requiring the user to load and maintain expensive, sometimes complicated, GIS software on their personal computer system. Since users with various skill sets and requirements have a need to access mapping information each site is customized with the target user in mind. The Internet Mapping sites vary in complexity, starting from a very basic location querying tool and progressing to a much more complex interactive, analytical tool. In addition, techniques were developed to automatically upload data to the Hansen Work Management system from the GIS. Field InputThis site was designed by the CWA GIS group to allow people who work in the field a method to graphically communicate information to the GIS team. It works much the same as the manhole and street search however it contains an extra tool that allows the user to depict a feature or problem by drawing or sketching on top of the map ( Figure 16). This modification or sketch is captured as a .JPEG image and is automatically emailed to the GIS team ( Figure 17). This tool is useful for people performing work on the sewer line
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