Michigan runs one of the nation’s longest and most varied portfolios of Produce Prescription Programs (PPPs), which provide fruit-and-vegetable benefits to patients facing diet-related chronic disease and food insecurity. Despite more than a decade of starting these programs, no synthesis has examined how these interventions are delivered statewide or whether they meet their stated goal of consistently improving diet, cardiometabolic risk, and local economies. We systematically reviewed implementation models and quantified dietary, clinical, and economic outcomes reported for Michigan PPPs implemented between January 2010 and May 2025. We searched PubMed, Scopus, Google Scholar, and targeted grey-literature sources (state health-department sites, farmers-market association reports, media releases) for English-language records published January 2010–May 2025. 81 unique records were independently screened by two reviewers; discrepancies were resolved by consensus. Initial screening yielded 43 documents, and 16 met our prespecified inclusion criteria. Data showed that uncontrolled diabetes participants increased their fruit and vegetable intake by 0.70 to 1.0 cups per day and reduced their HbA1c levels 0.7%. Mean systolic blood pressure (SBP) of participant children also fell 12 percentiles. The data from the included programs recorded redemption rates over 90% of vouchers, and varying funding expenses. The short duration of the intervention periods prevented reports of significant reductions in BMI. The short follow up durations of included materials restricted the ability to observe long-term weight loss and/or cardiovascular health improvements. Overall, PPPs in Michigan show significant increases in fruit and vegetable consumption, improvement of selected clinical markers, and increased revenue for local food systems.

Background: Adjuvant radiation therapy for breast cancer improves survival but may expose thoracic organs to low-dose radiation, potentially increasing the risk of second primary lung cancer (SPLC). Prior studies have not adequately examined how SPLC risk varies across racial and ethnic groups or whether social factors influence incidence and survival outcomes. Objectives: To quantify racial and ethnic disparities in SPLC incidence and survival among breast cancer survivors treated with radiation and assess the potential protective role of marital status. Methods: We used SEER-17 registry data to identify patients diagnosed with a first malignant primary breast cancer from 2000 to 2022 who received radiotherapy. Patients who died within two months of diagnosis were excluded. Standardized incidence ratios (SIRs) were calculated to compare observed to expected SPLC cases across racial and ethnic groups, stratified by latency intervals (2–11, 12–59, 60–119, and ≥120 months) and marital status. Racial categories included White, Black, Asian or Pacific Islander (API), and American Indian or Alaska Native (AI/AN); ethnicity was categorized as Hispanic or non-Hispanic. Five-year overall survival after SPLC was estimated using Kaplan–Meier analysis, and mean age at death was calculated by subgroup. Results: Among 558,493 radiotherapy-treated breast cancer patients, 6,674 developed SPLC (1.19%). Risk varied significantly by race (p < 0.05). Black survivors had a 21% excess risk (SIR 1.21, 95% CI: [1.12–1.31]), peaking 5–10 years post-treatment (SIR 1.44, [1 .26-1.63]) and remaining elevated beyond 10 years (SIR 1.24, [1.05-1.45]). API patients had a 23% overall excess risk (SIR 1.23, [1.11-1.36]), while AI/AN patients had the highest overall risk (SIR 1.82, [1.24-2.57]), particularly in the 12–59 month window (SIR 2.29, [1.25-3.84]) and ≥120 months (SIR 2.38, [1.19-4.26]). White survivors had no sustained increased risk (SIR 0.96, [0.93-0.98]), aside from a short-term rise in the first post-treatment year. Hispanic patients had consistently lower SPLC risk (overall SIR 0.72, [0.65-0.79]), while non-Hispanics had a transient early increase but an overall neutral risk (SIR 1.01, [0.99-1.04]). Marital status was protective: married individuals had a 12% lower SPLC incidence (SIR 0.88, 95% CI 0.85–0.91). Five-year overall survival after SPLC was 28.0%, with significant variation by race and ethnicity (p = 0.002). API (32.2%) and AI/AN (32.5%) patients had the highest survival, followed by White (28.0%) and Black patients (25.6%). Hispanic patients had the best outcomes, with 37.4% five-year survival and a mean age at death of 65.5 years, compared to 27.0% and 55.0 years for non-Hispanics (p = 0.005). Married patients had higher five-year survival (31.8%) and older mean age at death (64.3 years) compared to unmarried patients (25.0%, 48.6 years; p < 0.001). Conclusion: Radiation-associated SPLC risk and prognosis vary significantly by race, ethnicity, and marital status. Black and API survivors face sustained elevated risk; AI/AN survivors experience high early and long-term risk, while White and Hispanic survivors show no increased risk overall. Hispanic and married patients experience better survival after SPLC. These findings underscore the need for race and context aware survivorship counseling and suggest consideration of personalized lung cancer screening thresholds for breast cancer survivors receiving radiotherapy.

Marcus Gunn jaw-winking syndrome (MGJWS) is a congenital synkinetic ptosis characterized by involuntary eyelid movement with jaw motion. Various surgical interventions, including levator excision and frontalis suspension, have been employed to improve functional and aesthetic outcomes. However, the optimal approach remains debated due to variable success rates and recurrence risks. This study aims to systematically review the effectiveness of different interventions for MGJWS. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), analyzing studies on surgical interventions for MGJWS. Predefined inclusion and exclusion criteria were used. Surgical intervention was found to be effective for the management of MGJWS, but long-term follow-up and additional clinical data are needed to determine optimal techniques and minimize the recurrence risks of the phenomenon.

Background: Adjuvant radiation therapy for breast cancer improves survival but may expose thoracic organs to low-dose radiation, increasing the risk of second primary lung cancer (SPLC). Racial and ethnic disparities and social factors influencing SPLC risk remain underexplored. Objectives: We quantified racial and ethnic differences in SPLC incidence and survival among radiotherapy-treated breast cancer survivors and assessed the potential protective role of marital status. Methods: Using SEER-17 (2000–2022), we identified patients with first primary breast cancer receiving radiotherapy, excluding those who died within two months. Standardized incidence ratios (SIRs) assessed observed versus expected SPLC cases by race and ethnicity and marital status, and five-year overall survival (OS) after SPLC and mean age at death were calculated. Racial categories included White, Black, Asian or Pacific Islander (API), and American Indian or Alaska Native (AI/AN); ethnicity was categorized as Hispanic or non-Hispanic. Results: Among 558,493 patients, 6674 developed SPLC (1.19%). Risk varied significantly by race (p < 0.05). AI/AN patients had the highest overall risk (SIR 1.82), particularly 12–59 months and ≥120 months post-treatment. Black (SIR 1.21) and API (SIR 1.23) survivors had sustained elevated risk, while White survivors showed no overall increase (SIR 0.96) and Hispanic survivors had lower risk (SIR 0.72). Married individuals had 12% lower SPLC incidence (SIR 0.88). Five-year overall survival after SPLC was 28.0%, with significant variation by race and ethnicity (p = 0.002). API (32.2%) and AI/AN (32.5%) patients had the highest survival, followed by White (28.0%) and Black patients (25.6%). Married patients had higher five-year survival (31.8% vs. 25.0%) and older mean age at death (64.3 vs. 48.6 years) compared to unmarried patients. Conclusions: SPLC risk and prognosis after breast radiotherapy differ by race, ethnicity, and marital status. These findings highlight the importance of context-aware survivorship counseling and support the consideration of personalized lung cancer screening for breast cancer survivors.

Crohn's disease has limited effective treatments, and direct comparative data for Janus kinase (JAK) inhibitors are scarce. We conducted a dose‐dependent network meta‐analysis of randomized controlled trials in adults, searching PubMed, Cochrane Library, Scopus, and Web of Science through February 17, 2025. A Bayesian dose–response model (Emax) was implemented with the MBNMA package in R, estimating risk ratios (RRs) with 95% credible intervals, and risk of bias was assessed with RoB 2. Nine trials ( n = 4838) evaluated upadacitinib, tofacitinib, and filgotinib across multiple doses. Upadacitinib 45 mg once daily achieved the greatest improvement in CDAI remission versus placebo (RR 1.8, 95% CrI 1.1–3.0). SUCRA rankings placed upadacitinib highest for overall clinical remission, CDAI mean change, and CDAI remission. Meta‐regression showed higher doses were associated with higher remission rates ( p = 0.041). Dose–response parameters indicated upadacitinib had a higher Emax and lower ED50 than comparators, suggesting greater efficacy and potency. Serious adverse events were more frequent with JAK inhibitors versus placebo (RR 1.61, 95% CI 1.15–2.25; p = 0.0082), with increases in sepsis, cardiovascular events, and elevated liver enzymes ( p < 0.05). Adverse event risk differed by agent ( p = 0.0008); upadacitinib increased overall adverse events versus placebo (RR 1.19, 95% CI 1.07–1.33) and serious infections (RR 5.39, 95% CI 2.98–9.74). JAK inhibitors improve clinical outcomes in Crohn's disease, with upadacitinib showing the most consistent efficacy, but safety risks warrant careful monitoring and head‐to‐head, long‐term studies.