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3-11.8 mm). Mean ratio of MF to total fibular width was 0.46 mm (SD, 0.07 mm; range, 0.3-0.65 mm). Mean MF to total fibular depth was 0.42 mm (SD, 0.07 mm; range, 0.28-0.58 mm). There was a difference in dimensions of patients with screws at risk of MF violation compared with those without (MF height 13.77 vs 12.56, P=.02; MF width 7.98 vs 7.30, P=.05; MF to fibula width ratio 0.49 vs 0.44, P=.01; MF to fibula depth ratio 0.43 vs 0.42, P=.05). The MF violation is a previously unreported but potentially prevalent pitfall of lateral distal fibular plate fixation. Surgeons should be aware of the MF size and exhibit caution when placing screws in the distal locking holes during fibula fixation. [Orthopedics. 2020;43(x)xx-xx.]. Copyright 2020, SLACK Incorporated.OBJECTIVE There is currently no diagnostic test for PMR. A characteristic pattern of extracapsular inflammation as assessed by contrast-enhanced MRI (ceMRI) has recently been described in the pelvis of patients with PMR. We aimed to evaluate the performance of inflammatory ceMRI signals at predefined pelvic sites as a diagnostic test for PMR. METHODS Pelvic MRI scans of patients with pelvic girdle pain (n = 120), including 40 patients with an expert diagnosis of PMR and 80 controls with other reasons for pelvic pain were scored by three blinded radiologists, who evaluated the degree of contrast enhancement at 19 predefined tendinous and capsular pelvic structures. Different patterns of involvement were analysed statistically. RESULTS The frequency of bilateral peritendinitis and pericapsulitis including less common sites, such as the proximal origins of the m. rectus femoris and m. adductor longus, differed significantly between PMR cases and controls 13.4 ± 2.7 vs 4.0 ± 2.3. A cut-off of ≥10 inflamed sites discriminated well between groups (sensitivity 95.8%, specificity 97.1%). Bilateral inflammation of the insertion of the proximal m. rectus femoris or adductor longus tendons together with ≥3 other bilaterally inflamed sites performed even better (sensitivity 100%, specificity 97.5%). CONCLUSION This study confirms that a distinctive MRI pattern of pelvic inflammation (bilateral peritendinitis and pericapsulitis and the proximal origins of the m. rectus femoris and m. adductor longus) is characteristic for PMR. The high sensitivity and specificity of the set of anatomical sites evaluated suggests their clinical usefulness as a confirmatory diagnostic test. © The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. click here All rights reserved. For permissions, please email journals.permissions@oup.com.INTRODUCTION We examine the current status of the military relevance of opioids, their use and misuse in military and veteran populations, the national security consequences of opioid use in our military age population, public health implications, and military, veteran, and government solutions for opioid addiction. MATERIALS AND METHODS A literature search of recent published research, federal government, and related open source materials was conducted using PubMed, Google, and Google Scholar, and all materials retrieved were manually identified, screened, and evaluated for inclusion. A modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach was used for the selection of relevant articles. Heath policy literature and relevant demographic information published within the last 5 years was also included to provide current information and search for solutions to address the escalating national opioid crisis. RESULTS Synthetic opioids are used for pain and trauma management, he states for addiction surveillance and intervention may help create measures to address the proliferation of opioid addiction with increased death rates. Anticipated results from these federal efforts should help inform opioid programs in military and veterans' health systems. Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2020. This work is written by (a) US Government employee(s) and is in the public domain in the US.INTRODUCTION Obesity is prevalent among users of Veteran's Health Administration services, where it is comorbid with depression, post-traumatic stress disorder, type 2 diabetes, cardiovascular disease, colon, and breast cancer. Among obese subjects, severe obesity represents a subpopulation with the highest risk of depression. We investigate the antidepressant effect of a local VA weight management program (Managing Overweight Veterans Everywhere - MOVE) among depressed veterans with severe obesity. MATERIAL AND METHODS In a 10-week prospective pilot study, 14 clinically depressed veterans with severe obesity were recruited from (1) the 2-week residential based intense MOVE program (IMP) (N = 7) and (2) the 10-week educational module of self-management MOVE program (SMP) (N = 7). Subjects had a Beck Depression Inventory, 2nd edition (BDI-II) score > 12 and BMI > 40 or BMI > 35 with associated to comorbid conditions. Concurrent treatment for depression such as medications or psychotherapy was excluded. The pribehalf of the Association of Military Surgeons of the United States 2020. This work is written by (a) US Government employee(s) and is in the public domain in the US.Little attention has been paid to the potential impact of paternal marijuana use on offspring brain development. We administered Δ9-tetrahydrocannabinol (THC, 0, 2, or 4 mg/kg/day) to male rats for 28 days. Two days after the last THC treatment, the males were mated to drug-naïve females. We then assessed the impact on development of acetylcholine (ACh) systems in the offspring, encompassing the period from the onset of adolescence (postnatal day 30) through middle age (postnatal day 150), and including brain regions encompassing the majority of ACh terminals and cell bodies. Δ9-Tetrahydrocannabinol produced a dose-dependent deficit in hemicholinium-3 binding, an index of presynaptic ACh activity, superimposed on regionally selective increases in choline acetyltransferase activity, a biomarker for numbers of ACh terminals. The combined effects produced a persistent decrement in the hemicholinium-3/choline acetyltransferase ratio, an index of impulse activity per nerve terminal. At the low THC dose, the decreased presynaptic activity was partially compensated by upregulation of nicotinic ACh receptors, whereas at the high dose, receptors were subnormal, an effect that would exacerbate the presynaptic defect.