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In a previously formulated hypothesis of alcohol related glucose dependent system of error monitoring and processing, we suggested mechanisms for alcohol's indirect disruption of the error monitoring and processing system (referred here as the mistake system of the brain). Reviewing recent breakthroughs in ethanol metabolism and the associated enzymes, tissue prevalence of their polymorphic forms, as well as blood brain barrier structure-functions relationship, we suggest that a direct pathway is possible in the disruption of the mistake system of the brain. The major arguments supporting the direct disruption of the mistake system of the brain include the following: the molecular size and spatial configuration of the ethanol molecule or its metabolites and the ‘free pass’ size and the molecular configuration of the blood brain barrier; advanced radiological studies of brain cells and functions at different organismal states; metabolic diversity of ethanol and its metabolic forms and the kinetics of the associated enzymes in brain cells at different regions; prevalence rate of the polymorphic forms of ethanol metabolizing enzymes. The direct pathway of ethanol related disruption of the mistake system of the brain represent an improvement on the formerly suggested indirect mechanism of alcohol related glucose dependent system of error monitoring and processing. Therefore, both direct and indirect pathways are involved in the disruption of the error monitoring and processing system of the brain.

One of the most important concerns about alcohol harm is on the psychophysiological sphere, especially in conditions of longterm alcohol use. In fact this remains a very important concern to alcohol users too. Hence, indices of psychophysiological functions could well serve the most important indicators for defining “moderate” and “problematic” level of use. While up-todate definition of moderate alcohol use varies across scientific studies, there is a growing need for unification and guidelines for unit specification. The different concentrations of endogenous synthesized ethanol in different categories of people also compound the problem of guideline unification, besides differences in the definition of endogenous synthesis. In this study we analyze the range of values for moderate and problematic alcohol use, based on solid and flexible psychophysiological parameters. We also analyze the frequency and number of peer-reviewed literature (in scientific databases) defining moderate, and problematic use, and non-alcohol use, and their corresponding dose classification. The results of this study show that cells are very sensitive to slight increase in endogenous alcohol (caused by increased endogenous and exogenous intake or variations in internal and external milieu). The resultant effect is the remodeling of physiological functions of the cells; both intracellular and extracellular signaling mechanisms are affected. Physiological cellular changes resulting from increase in both intracellular and extracellular ethanol concentration will serve a useful criterion for formulating moderate threshold of exogenous ethanol.

The negative effect of alcohol use on academic performance has been reported in several studies. The results of our research conducted for the past half-decade show that before the start of alcohol use, students who were then abstainers had a better academic performance. However, conducted statistical analysis used in several studies had been a bidirectional approach which limits conclusion on the negativity of alcohol use on academic performance. Although a cause-effect relation might be there, bidirectional or bivariate approach does confirm this kind of relationship. Critics have argued that not only alcohol use can result in reduction in academic performance, the opposite might be the case too. Besides, other factors might also affect academic performance. In this present study, we further confirm in a sample of university students using regression analysis that alcohol use result in reduction of academic performance.

Recent literature data suggests that the system that is necessary for the monitoring and processing of error is a dynamic one. Importantly, the number of brain regions involved in error monitoring and processing varies with age [for review, see Pontifex et al., 2010]. Two major reasons are possible: maturation of the neural systems that identifies different errors (see Stevens et al., 2009); and neural plasticity. While, the other factors might determine the capacity of the brain's error monitoring and processing, present research does not provide adequate evidence for this relationship. Frankly, the vast aspect of brain error monitoring and processing research is still barren and much is needed to be unraveled. Here, we only focus on a recent study we conducted on university students as regards to error processing dynamics relationship with glycemia. The involved determination of cognitive abilities based on a model we had earlier designed revealed important results in this area of research. Conducted correlation and regression analyses reveal important findings. The phenomenon of increased error commission following decrease in blood glucose level, we refer to the “error processing effect”. We also suggest a mechanism (of complex systems) for this phenomenon.

To date, the effect of alcohol on type 2 diabetes risk remains controversial. This present review is conducted on reviews to ascertain the present trend, views, and problems resulting to these controversies. Howard et al. (2004) noted that 1–3 standard drinks per day reduce the risk of diabetes by 33–56%. By drinking more than 3 drinks per day, the risk increased by 43%. Seike et al. (2008) and Evans et al. (2008) found inconsistencies in the relationship for different studies. Koppes et al. (2005) and Baliunas et al. (2009) found a U-shaped relationship. In conclusion, data on the effect of moderate alcohol use on type 2 diabetes risk remains inconclusive, partly due to the structure and design of studies, differences in body mass index of participants, gender/age differences, genetic differences and predisposition for alcohol problems and diabetes, duration/quantity ranking criteria for alcohol use, comorbid conditions. Other problems found across studies were differences in the definition of diabetes used in the various study designs, definition of standard drinks. There is need for more up-to-date and accurate evidence based approach, putting into consideration all the stated problems that hamper conclusion in studies of alcohol's effect on type 2 diabetes risk.

The Alcohol Use Disorders Identification Test (AUDIT) scores actually vary from place to place for many reasons. The traditional/cultural/ethnic, as well as gender peculiarities of alcohol problems in the given population may affect the AUDIT cut-off recommendation. Most studies have used a cut-off point of 8, others have suggested lower or higher cut-offs. Cut-off points between 5 and 8 and/or 9 and 10 have been suggested for problem drinking. How the AUDIT cut-off point varies from study to study is somewhat misleading as validation results actually show a lower AUDIT cut-off as compared to the recommended one. In this study we analyzed the various scores (0*ndash;40) of the AUDIT using psychophysiological parameters among a sample of university students in Belarus. The statistical value for significance was set at p < 0.05. This study reveals that the AUDIT cut-off which was highly informative for problem drinking among the males is 8 and above. For the females, any positive score (i.e. from 1 through 10) on the AUDIT was highly informative for problem drinking. Hence, any positive score on the AUDIT for a female and 8 for the males needs specific attention and therapeutic confirmation with additional consultation.

How the psychophysiological functions (cognition, attention, memory, neuropsychic functions) change after alcohol use at different doses remains poorly understood. This study examines the extent to which the psychophysiological functions are restored after moderate dose of alcoholic beverages. University students (non-alcohol users; alcohol users after 1–2 weeks and 3–6 weeks of drinking) approved their participation on a consent form after the aims and objectives of the study had been explained. Continuous Tests using psychphysiological methods were applied to produce maximum stressed condition for the participants. The statistical value for significance was set at p < 0.05. No significant changes in the psychophysiological functions were noted among the non-alcohol users. There was a significant decrease in psychophysiological functions of alcohol users in course of the study. Restoration of the psychophysiological functions was recorded only among drinkers of 3–6 weeks after alcohol use. Restoration of psychophysiological functions after alcohol use may take 3–6 weeks interval (abstinence time frame i.e. psychophysiological abstinence).

Present researches on students drinking behavior have laid down the mechanism of low academic performance among alcohol users (Welcome et al 2010). Although we had earlier shown that alcohol significantly reduces academic performance of students, how various parameters of academic performance (e.g. frequency of resit examinations) vary among alcohol users, compared to non-alcohol users remains unknown. In this study, we examined the relative risk of resit examinations among alcohol users, compared to non-alcohol users. Students of the Belarusian State Medical University, Minsk, Belarus participated after the study aims and objectives had been explained. The AUDIT screening instrument, Academic performance questionnaire according to (Welcome et al 2010) was employed with modifications. The number of times a given student had taken the same examination was stated and numbered from 0 (zero i.e. no resit) through 3 (maximum number of times to sit for a given examination). The statistical value for significance was set at p < 0.05. The risk of resit examinations was statistically higher among alcohol users, compared to the non-alcohol users by about half-times (p< 0.05). Also, the average grade point of alcohol users was lower than that of the non-alcohol users. According to the results of this study, the risk of resit examination associated with alcohol use significantly increases among alcohol users. This is not the case for non-alcohol users.