038 (p = 0.080) between the visit before PDT and final visit. There was no significant correlation between CVI and BCVA at the measured time points, in both the HSML group (p = 0.885), and in the PDT group (p = 0.904). Moreover, no significant changes in CVI occurred in the unaffected eye at any time point. CONCLUSIONS PDT and HSML do not significantly affect CVI, and therefore a CVI change may not be primarily responsible for the treatment effect. The positive treatment effect of both interventions may rely on other mechanisms, such as an effect on choriocapillaris and/or retinal pigment epithelium function.BACKGROUND In view of the large number of patients and error-prone activities, legal requirements for quality assurance (QA) are of great importance for modern ophthalmology. OBJECTIVE This article discusses the need and formats of QA using the example of intravitreal operative medication injection therapy (IVOM). MATERIAL AND METHODS The legal framework conditions are briefly referenced and improvement potentials of the status quo are discussed. RESULTS The first quality control instruments were implemented for IVOM therapy; however, important quality indicators (number of treatments per patient/year, loss of follow-up, course of function) are not yet evaluated nationwide in Germany and cannot therefore be taken into account for continuous improvement and QA reports. To date, not all ophthalmologists involved have been under review in the field of basic diagnostics and follow-up. Limiting QA to ophthalmic surgeons alone does not improve quality and many statutory health insurances actively prevent scientific investigations within selective contracts. CONCLUSION For the QA of imaging diagnostics, similar proficiency measures (random samples, round robin testing) are required in ophthalmology as in radiological disciplines. The communication of transparent quality indicators can reduce the risk in the medium term. The quality of treatment and results must not be left to chance, cost pressure or convenience. The manufacturers of software and diagnostic equipment should be oriented towards radiology, where the exchange of voxel-oriented image formats is now less and less hindered by proprietary formats.PURPOSE This study investigated the length changes of the anterior bundle of the medial collateral ligament (AMCL) and the lateral ulnar collateral ligament (LUCL) in forearm pronation and supination under axial load in vivo. METHODS Six healthy volunteers (2 males and 4 females, the average age of 44.6 years) were included in the study. CT scan of elbow joints was obtained at positions of forearm pronation and supination before and after load with the elbow extension. Mimics, Geomagic Studio, 3-matic Medical and Geometry Sketchpad were used to reconstruct three-dimensional models and analyze length changes of AMCL and LUCL. The AMCL and LUCL were divided, respectively, to three parts the medial part, the middle part and the lateral part. RESULTS Our results showed the length of the medial and middle parts of the AMCL significantly decreased from pronation to supination without load (0.46 mm, P  less then  0.05 and 0.43 mm, P  less then  0.05). With load, the length of the medial part and the middle of the AMCL significantly decreased from pronation to supination (0.62 mm, P  less then  0.05 and 0.44 mm P  less then  0.05). However, the length of the LUCL almost remained static for the forearm pronation and supination regardless of the axial load. CONCLUSION The results showed that tension of the AMCL increases in forearm pronation, and increased tension on the ligament during impact may pave the way to injury. The AMCL of elbow may be easier to be injured in forearm pronation.OBJECTIVES Burnout is a stress-related, psychological syndrome due to high levels of job stressors. Saracatinib price It has been found to be related to impairments of well-being, health, and job outcomes. Alterations of glucocorticoid secretion might be a mechanism explaining the linkage between burnout and reduced psychophysical functioning. Regarding hair cortisol as indicator this assumption, so far, has been only examined in cross-sectional studies. Therefore, we aimed to compare cross-sectional and prospective associations between different burnout symptoms and hair cortisol, additionally investigating potential nonlinear associations. METHODS The prospective study sample comprises 194 employees (95% nurses) from German geriatric care. We assessed burnout symptoms at baseline (t1) and 6 months later (t2) and collected hair samples for cortisol analyses at t2. RESULTS We found significant cross-sectional and prospective nonlinear (i.e., exponential) but not linear relationships between an aggregated measure of the burnout subscales emotional exhaustion, cynicism, and reduced efficacy and hair cortisol, even after adjusting for BMI and depressive mood. None of the single subscales of burnout was related to hair cortisol after adjusting for confounders. CONCLUSIONS Our findings further support the assumption that accumulated burnout symptoms and hypercorticolism are positively related.PURPOSE This article summarises a systematic literature review of skin exposure assessment methods and concepts for deriving skin (dermal) exposure limits for metals, using the construction industry, where there is a high prevalence of occupational skin exposures as a test environment. METHODS A systematic literature review was undertaken across ten databases key to Occupational Health and Safety. Articles were considered for inclusion if they evaluated skin or surface exposure to metals or discussed the feasibility of establishing skin or surface exposure limits in an occupational setting. Only full text, peer-reviewed articles were retrieved. All publications up to 30/06/2019 were considered. The quality of evidence was evaluated based on methodology. RESULTS A total of 71 studies were selected for inclusion in the review with 49 on skin exposure assessment methods for metals and 22 relating to the derivation of skin exposure limits. The use of wipe sampling methodologies was shown to be standardised and effective for sampling skin exposures to metals.