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CONCLUSIONS: Over one-third of pregnant individuals who used alcohol also used at least one additional substance. Observed associations with maternal mental health and SES highlight opportunities for targeted policy, enhanced screening, and tailored interventions to support maternal and child health.

CONCLUSION: Employers want industry-tailored information during a public health emergency; providing that remains a challenge.

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CONCLUSIONS: LFA-REAL showed comparable performance relative to SLEDAI and BILAG in detecting clinician-rated change. There was a statistically significant advantage over SLEDAI for detection of improvement. These findings support its utility as a metric for disease activity in clinical practice and research.