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Post-9/11 U.S. veterans exhibit elevated rates of hazardous drinking, alcohol use disorder, and co-occurring mental health conditions, yet many do not access behavioral health treatment. We evaluated BRAVE, a single-session, mobile phone-delivered intervention integrating personalized normative feedback, motivational interviewing, and values-based strategies to reduce alcohol use and promote treatment engagement. Post-9/11 young adult veterans aged 18-40 who screened positive for hazardous drinking and were not engaged in behavioral health care (N = 748) were recruited via targeted social media ads and randomized to BRAVE or an interactive resources-only control condition. Participants completed baseline and 3-, 6-, 9-, and 12-month follow-up surveys assessing alcohol use, alcohol-related consequences, mental health symptoms, treatment receipt, and readiness for care. Compared with control, BRAVE produced a significant sustained reduction in alcohol-related consequences over 12 months (B = -0.07). Post hoc analyses showed significant decreases in physical and interpersonal consequences from drinking. Though outcomes of drinking frequency, drinking quantity, binge drinking frequency, readiness to seek care, and behavioral health treatment receipt favored BRAVE, none of these treatment effects were significant, and effect sizes were very small in magnitude. In post hoc analyses restricted to veterans screening positive at baseline for alcohol use disorder, anxiety, depression, or posttraumatic stress disorder, we observed that among veterans screening positive for anxiety disorders, BRAVE participants were notably 15% more likely to receive treatment during follow-up. Findings indicate that this brief, mobile intervention can yield meaningful reductions in alcohol-related harm. Broader dissemination and exploration of multisession or peer-supported enhancements may strengthen long-term impacts. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Intimate partner violence (IPV) and substance use are closely linked and pose significant risks during the perinatal period. American Indian and Alaska Native (AI/AN) women experience disproportionately high rates of IPV and inequities related to perinatal substance use outcomes, yet research is limited regarding timing of IPV exposure and how it relates to perinatal substance use. This study examined associations between IPV exposure before and during pregnancy and patterns of alcohol use and cigarette smoking across the perinatal and postpartum periods among AI/AN women. We analyzed pregnancy risk assessment monitoring system (PRAMS) data from 2016 to 2022 in a cross-sectional design. IPV exposure was categorized as occurring before pregnancy, during pregnancy, or both. Outcomes included alcohol use frequency, heavy drinking (&#x2265;&#x2009;8 drinks per week), and cigarette smoking before pregnancy, during pregnancy, and postpartum. Survey-weighted ordinal logistic and logistic regression models were used, adjusting for sociodemographic and pregnancy-related factors. Predicted probabilities were calculated. Exploratory analyses examined associations between partner race and IPV. AI/AN women reported higher prevalence of IPV before and during pregnancy (p&#x2009;<&#x2009;0.001). In adjusted models, IPV before pregnancy was not associated with alcohol use frequency but was associated with higher odds of heavy drinking (aOR&#x2009;=&#x2009;1.75, 95% CI 1.07-2.85). AI/AN women had higher odds of heavy drinking compared with Non-Hispanic White (NHW) women (aOR&#x2009;=&#x2009;1.80, 95% CI 1.31-2.46), with the highest predicted probabilities observed among AI/AN women experiencing IPV (12.1%). IPV before pregnancy was also associated with higher odds of cigarette smoking before pregnancy, during late pregnancy, and postpartum (aORs 1.45-1.89), while IPV during pregnancy was associated with postpartum smoking (aOR&#x2009;=&#x2009;2.82, 95% CI 1.23-6.44). Predicted probabilities indicated higher smoking across periods among those with IPV exposure, particularly among AI/AN women. In exploratory analyses, partner racial concordance was associated with lower odds of reported IPV among AI/AN women. IPV exposure was associated with more severe and persistent patterns of perinatal substance use, with the highest predicted probabilities of heavy drinking and persistent smoking observed among AI/AN women experiencing IPV. These findings underscore the importance of trauma-informed, culturally grounded harm reduction approaches that address both IPV and substance use across the perinatal period. Efforts should be situated within the broader context of structural and historical inequities while recognizing Indigenous communities strengths and resilience.

The National Institute on Alcohol Abuse and Alcoholism's (NIAAA) definition of recovery from alcohol use disorder (AUD) expanded from an abstinence-based model to encompass remission from AUD symptoms and cessation from heavy drinking. However, many neuroimaging studies continue to use abstinence-based definitions of recovery. Many neuroimaging studies also report limited sample demographic information and diverse participants remain underrepresented in neuroimaging research. The aims of this systematic review were to: (i) update a review by Parvaz et&#xa0;al. (2022) on the topic of structural changes in the prefrontal cortex, (ii) apply the NIAAA's updated definition of recovery to studies in the original review and newly identified studies, and (iii) report demographic information from all included studies. The original review was extended by searching PubMed and PsycInfo for articles published between May 2021 and June 2025. Demographic reporting practices were reviewed and the Newcastle-Ottawa Quality Assessment Scale was used to assess bias in all included articles. There was one newly identified study which reported cessation from heavy drinking. However, the 19 original studies were abstinence-based and did not use the updated NIAAA definition of recovery. Demographic information in the 20 included studies was largely limited to age, sex assigned at birth, and educational attainment. Reporting on additional demographic information was scarce. Future neuroimaging studies should examine duration of alcohol use disorder symptom remission and cessation of heavy drinking as outcomes. Moreover, studies should include additional demographic information. These efforts would align with national guidelines and advance clinical science.

The alcohol harm paradox is where lower socioeconomic position (SEP) groups experience higher rates of alcohol-related health consequences than higher SEP populations, despite drinking less alcohol. The reasons behind this are not certain, and limited research has examined the acceptability of alcohol interventions. This study aimed to inform alcohol public health interventions targeted to lower SEP individuals by addressing two research questions: (1) What are the perspectives on alcohol public health interventions? (2) What are the experiences of alcohol use? Six focus groups (n&#x2009;=&#x2009;23) were conducted in community settings with individuals who drink alcohol. We recruited from community organisations located in relatively disadvantaged areas (identified by Index of Multiple Deprivation) and workplaces with routine and manual occupations. Questions explored were the: (1) acceptability of UK alcohol public health interventions and (2) behavioural drinking patterns and reasons for drinking. Inductive and deductive framework thematic analysis was used to develop two themes. Theme one highlighted a lack of trust towards the government's motivations for implementing alcohol interventions, including perceptions that the government does not care about alcohol-related health harms and that perceived unnecessarily high alcohol-related taxes represent the reason for its legal status. Perceived authoritative interventions and interference with free will was resented. There was scepticism towards the perceived effectiveness of interventions, including perceptions of negative outcomes and that interventions do not address the underlying reasons for alcohol use. Theme two highlighted social environmental facilitators of and barriers to alcohol use, including high alcohol availability locally. Motivations for and patterns of alcohol use were outlined, including alcohol use as a coping strategy for daily life stress and preferences for cheap high strength alcohol. Lack of trust in government alcohol intervention was salient in this sample and may be an important consideration for intervention design. Future research could examine levels of trust in government for providing alcohol health advice and how this may be affected by SEP, and which intervention sources would be most acceptable to different SEP populations. Tailored interventions could address high alcohol availability in underserved communities, and specific motivations for and patterns of alcohol use.

The purpose of this study was to compare the current U.S. Veteran Affairs (VA) contingency management incentives (vouchers to the VA Canteen) against other incentives for inducing intentions to use alcohol. Theory indicates that other incentives, such as debit cards, could be more effective at reducing drinking intentions. Sixty U.S. Armed Forces veterans who reported hazardous alcohol use were recruited for a virtual study through Prolific crowdsourcing. Participants responded on a 0-100 Likert scale of how likely they were to abstain from drinking if offered increasing compensation by vouchers, gift cards, and restricted and unrestricted debit cards. Price sensitivity and intensity of demand between each incentive type were compared. The sample was primarily male and White, and 68.9% of participants only utilized VA Canteens once per year or less. VA vouchers did not differ significantly on demand indices from VA gift cards; however, both debit cards produced higher likelihood of intentions to abstain from drinking than either VA gift cards or vouchers. This study is the first to assess the efficacy of incentive types within the VA contingency management framework and estimate their efficacy compared with vouchers. These results indicate that unrestricted and restricted debit cards should be assessed as alternatives to Canteen vouchers. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Coitus interruptus is an attempt at contraception wherein penile thrusts desist on the cusp of ejaculation, the penis is hastily withdrawn from the vagina, and semen is deposited externally. Pornography is extremely popular and multiple content analyses suggest that external ejaculation is the norm in pornographic depictions. Using campus-representative data collected from undergraduate and graduate students 18 and older at a large public U.S. university, the present study had three primary objectives: to provide the first estimate of the direction and magnitude of the association between pornography exposure frequency and coitus interruptus among men; to investigate whether the pornography exposure-coitus interruptus association is moderated by age, race, relationship status, binge drinking, or impulsivity; and to explore whether confounding and prediction models supported age, race, relationship status, binge drinking, and impulsivity as confounds or initiating predictors of the pornography exposure-coitus interruptus association. For every one-unit increase in pornography exposure frequency, the odds of coitus interruptus increased by 18%. This association was not moderated or confounded by age, race, relationship status, binge drinking, or impulsivity. Mediation models did suggest the importance of age, relationship status, and impulsivity as initiating predictors, however. Intervention and theoretical implications are discussed.

Sports wagering is associated with alcohol use and alcohol-related harm, and gambling can increase alcohol consumption and drinking urges. However, the effect of sports wagering on alcohol reward value remains unclear. The present study explored the interactive effect of placing a single-event sports wager and social context on alcohol demand (a behavioral economic measure of alcohol reward value) using context-adapted alcohol purchase tasks in a sample of individuals reporting past-month alcohol use and sports wagering (n = 425; Mage = 31.28; 71.29% male). Contrary to hypotheses, there were no differences in alcohol demand between context-adapted alcohol purchase tasks as a function of concurrent sports wagering (padj = .876-.924) or social context (padj = .170-.667). Exploratory analyses investigated relations between gambling motives and alcohol demand and the relations between various behavioral economic constructs and problem gambling. Omax was associated with an increased likelihood of problem gambling (OR = 1.02, padj = .03). Omax and elasticity were associated with financial gambling motives, but less so during concurrent gambling events, with concurrent sports wagering attenuating the relation between elasticity and financial motives (b = 0.34, padj = .003). Financial motives for gambling were positively associated with alcohol use broadly, but not with simultaneous drinking while gambling. These findings suggest relations between sports wagering and alcohol demand are complex-highlighting the need for future research into the sports wagering experience, specific sports wagering forms, and alcohol's role in sports culture to better understand the relation between alcohol use and sports wagering. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Two functional genetic polymorphisms, ADH1B rs1229984 and ALDH2 rs671, play key roles in ethanol metabolism and are especially prevalent in East Asian populations. The rs1229984 variant accelerates the conversion of ethanol to acetaldehyde, whereas rs671 reduces enzymatic activity for converting acetaldehyde into acetic acid. These variants affect alcohol use disorder risk and have been implicated in various systemic conditions. To investigate the broader associations of ADH1B rs1229984 and ALDH2 rs671 with habitual alcohol use in large, unselected populations. We analysed data from 146 374 Taiwanese adults (aged 20-90 years) enrolled in the Taiwan Biobank. Both variants showed clear associations with habitual alcohol use. The ADH1B rs1229984 CC genotype was associated with a higher prevalence of drinking, indicating a substantial contribution to alcohol-related behaviour. The ALDH2 rs671 A allele was linked to markedly reduced drinking, reflecting known intolerance among carriers rather than implying a uniformly larger effect than ADH1B. Beyond alcohol use, rs671 showed a protective association with gout, whereas rs1229984 was not significantly associated with chronic diseases after correction. In this large population sample, both ADH1B rs1229984 and ALDH2 rs671 demonstrate meaningful, genotype-dependent effects on habitual alcohol use. Their combined effects underscore the importance of evaluating gene-gene interactions rather than attributing disproportionate influence to a single locus.

Alcohol use disorder (AUD) is a chronic, relapsing psychiatric condition that contributes substantially to global morbidity. Although the health consequences of alcohol consumption have been widely studied, the association between AUD and incident end-stage kidney disease (ESKD) remains unclear. Nationwide population-based cohort study. We analyzed 4&#x2009;595&#x2009;974 Korean adults who completed the 2012 national health screening and were followed until 2022 (median follow-up, 9.4&#xa0;years). AUD was defined as at least one recorded International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10) F10 code within 5&#xa0;years before baseline. Baseline alcohol intake was assessed using a self-reported questionnaire and categorized into four sex-specific baseline drinking categories: 0-10, >10-30, >30-60 and >60&#x2009;g/day for men, and 0-10, >10-20, >20-50 and >50&#x2009;g/day for women. The primary outcome was incident ESKD. Multivariable time-to-event models assessed the associations of AUD and baseline alcohol intake with ESKD risk. The prevalence of AUD was 0.7% (n&#x2009;=&#x2009;33&#x2009;848). During follow-up, 13&#x2009;182 participants developed ESKD. AUD was associated with a higher risk of ESKD after full adjustment [hazard ratio (HR) = 1.50, 95% confidence interval (CI) = 1.31-1.72]. In competing-risk analyses treating death as a competing event, this association remained statistically significant [subdistribution hazard ratio (sHR) = 1.63,&#xa0;95% CI = 1.45-1.82]. Across the four baseline drinking categories from lowest to highest, the adjusted HRs for AUD vs. no AUD were 1.39 (95% CI = 1.17-1.66), 1.54 (95% CI = 1.13-2.11), 1.88 (95% CI = 1.32-2.67) and 1.73 (95% CI = 1.03-2.89), respectively, with no evidence of interaction (P for interaction&#x2009;=&#x2009;0.4634). In joint-category analyses, the highest risk was observed among those with both AUD and the highest baseline alcohol intake category, but there was no evidence of additive interaction. The association of AUD with ESKD was stronger among participants without baseline chronic kidney disease than those with (P for interaction&#x2009;=&#x2009;0.0067). In Korea, alcohol use disorder appears to be associated with a higher risk of incident end-stage kidney disease independent of self-reported baseline alcohol intake. These findings suggest that clinically identified alcohol use disorder may capture long-term renal risks not fully reflected by a single baseline measure of self-reported alcohol intake.

Wrist function is essential in performing activities of daily living (ADLs). However, there is limited experimental evidence on the functional impact of wrist Abduction-Adduction (Ab-Ad) joint assistance in upper limb exoskeletons (ULEs) during ADLs. This study provides the first implementation and demonstration of a clock spring-based wrist Ab-Ad joint into a five degree of freedom (DoF) ULE, EXOTIC2 exoskeleton and evaluates its effect, to support individuals with severe motor impairments. A compact, lightweight wrist module with tendon-driven abduction and spring-driven adduction was integrated into the EXOTIC exoskeleton. Eight adults with no motor disabilities completed drinking and scratching tasks under randomized wrist-enabled and wrist-locked conditions along with a preliminary feasibility test in one individual with Amyotrophic lateral sclerosis (ALS). Kinematic and task performance metrics including wrist range of motion, task completion time, spillage and leveling metrics were assessed. Implementing the wrist Ab-Ad DoF improved task success metrics. Spill incidence during the drinking task decreased from 56% to 3%, and leveling success for scratching task improved from 28% to 75%. Integrating wrist Ab-Ad assistance improved key functional task outcomes without increasing execution time. The study provides the experimental evidence that active wrist Ab-Ad control enhances task-level performance in exoskeleton-assisted ADLs and supports the inclusion of wrist deviation in future assistive exoskeletons.

Global declines in sperm quality urgently demand the identification of modifiable environmental risk factors. Dibromoacetic acid (DBA), a prevalent yet unregulated drinking water disinfection byproduct, is a suspected reproductive toxicant, but population evidence and clear mechanisms are lacking. By integrating epidemiology, network toxicology, and mechanistic validation, we first identified a significant negative association between urinary DBA (100% detection rate) and sperm concentration/count in 282 men. Histone-to-protamine replacement constitutes a critical step in sperm chromatin remodeling. In follow-up mechanistic experiments, we further verified that disruption of this process acted as a novel, central mechanism by which DBA triggered spermatogenic impairment in experimental models. Mechanistically, DBA activated the USF1-PIWIL1 axis to induce a specific piR-rno-9885 that post-transcriptionally suppressed Tnp1. Concurrently, it inhibited the chromatin remodelers CHD4/5. This dual-pathway synergy (piRNA-mediated Tnp1 suppression and CHD4/5 inhibition) compromised chromatin condensation. Moreover, DBA exposure perturbed hormonal homeostasis and triggered testicular inflammation, further disturbing the spermatogenic microenvironment. Collectively, our epidemiological data reveal an adverse human exposure association, while animal and cellular mechanistic assays validate DBA as a reproductive toxicant with a defined molecular mode of action. More broadly, our integrated approach establishes a translatable paradigm that bridges population-level association identification with in-depth mechanistic insight. This paradigm offers an actionable framework for drinking water monitoring, risk assessment, and regulation of DBA and analogous unregulated disinfection byproducts.

Per- and polyfluoroalkyl substances (PFAS) pose complex challenges for drinking water management, particularly in rural communities reliant on private wells that fall outside federal regulatory oversight. As regulators and communities grapple with evolving standards and limited resources, there is a critical need for scalable, accurate, and resource-efficient models to assess PFAS exposure risks. This study compares traditional mechanistic groundwater models to machine-learned Bayesian networks and hybrid approaches that integrate both model types. Using hexafluoropropylene oxide dimer acid, commonly known as GenX, contamination near North Carolina's Fayetteville Works Plant as a case study, we evaluate each model's (1) ability to identify wells exceeding health-based GenX thresholds, (2) robustness to incomplete data, and (3) development and calibration time. Results demonstrate that Bayesian networks match or exceed mechanistic models in classification performance, while offering superior robustness to missing data and varying decision thresholds, along with decreased modeling resource demands. Hybrid models incorporating mechanistic outputs into Bayesian networks achieve the highest performance, showing that mechanistic insights can improve Bayesian network predictions. These findings support a flexible modeling framework that can adapt to changing regulations and emerging contaminants without recalibrating full process-based models, offering practical tools for regulators and communities to advance PFAS risk management.