Bon Sante (Good Health): Factors Influencing PrEP Use Among Haitians/Haitian Americans.

BACKGROUND: The HIV/AIDS epidemic has disproportionately affected Black individuals in the USA, and this health disparity has increased over time. Despite the effectiveness of pre-exposure prophylaxis (PrEP) as a prevention tool for HIV, there are disparities in its use, and uptake of this intervention remains low among racial and ethnic minorities, including Haitians/Haitian Americans. In this study, factors influencing PrEP use among Haitians/Haitian Americans in Miami, FL, are explored to provide necessary data to address disparities. METHODS: The research team collaborated with local organizations to recruit 30 individuals (Haitians/Haitian Americans) between February 4 and October 1, 2021, and conducted semi-structured interviews. All interviews were audio-recorded and transcribed, and NVivo® was used to analyze the transcripts for emergent themes. RESULTS: The study sample comprised 30 adults of Haitian descent in Miami, FL (50% female, approximately 67% with a high school education or more, mean age = 43.7 ± 13 years, and 74.2% born in Haiti). Four primary themes emerged from the analysis: (1) limited PrEP awareness, (2) underutilization of PrEP, (3) inadequate discussion of HIV prevention strategies, and (4) PrEP delivery encompassing barriers and facilitators for PrEP delivery and promotion strategies. CONCLUSION: This study indicated that there is a critical need to increase Haitians/Haitian Americans' knowledge regarding PrEP. Health communication interventions tailored specifically for Haitians/Haitian Americans that target stigma, attitudes toward HIV, and risk perception may be significant in increasing PrEP in this population.

Breast Development and Cancer.

The human breast, as mentioned by Gudjonsson and co-authors [...].

BRCA1 Mutation: An Insidious Enemy with Multiple Facets .

Epidemiological studies suggest that around 10% of breast cancers are due to hereditary predisposition. The risk of cancer is exponentially increased in patients harboring BRCA1 or BRCA2 mutations. Cumulative breast cancer risk by age 80 is estimated to 72% for BRCA1 mutation carriers and 69% for BRCA2. The cumulative risk estimates for developing ovarian cancer by age 80 are 44% for BRCA1 mutation carriers and 17% for BRCA2. We present here the case of a 59-year-old woman who developed a left breast cancer in 2014 treated by conservative surgery, radiotherapy, and endocrine therapy with letrozole. The diagnosis of BRCA1 mutation was performed in 2015. In 2018, the patient was referred to our institution for treatment of an aggressive angiosarcoma developed in the same breast. She had undergone radical hysterectomy by the age of 49 years for a benign uterine pathology. In 2020, she developed a tumor in the gastric wall; histological analysis confirmed a serous papillary carcinoma of ovarian origin. She was treated - after gastrectomy and lymphadenectomy - with 6 courses of carboplatin and paclitaxel followed by olaparib therapy. In 2021, she suffered from a chest recurrence of high grade angiosarcoma. New resection with free margins was performed. We discuss the link between angiosarcomas and BRCA mutations, the therapeutic options for angiosarcoma and ovarian cancer of extra ovarian origin and the follow-up modalities.

Effects of Hormones on Breast Development and Breast Cancer Risk in Transgender Women.

Transgender women experience gender dysphoria due to a gender assignment at birth that is incongruent with their gender identity. Transgender people undergo different surgical procedures and receive sex steroids hormones to reduce psychological distress and to induce and maintain desired physical changes. These persons on feminizing hormones represent a unique population to study the hormonal effects on breast development, to evaluate the risk of breast cancer and perhaps to better understand the precise role played by different hormonal components. In MTF (male to female) patients, hormonal treatment usually consists of antiandrogens and estrogens. Exogenous hormones induce breast development with the formation of ducts and lobules and an increase in the deposition of fat. A search of the existing literature dedicated to hormone regimens for MTF patients, their impact on breast tissue (incidence and type of breast lesions) and breast cancer risk provided the available information for this review. The evaluation of breast cancer risk is currently complicated by the heterogeneity of administered treatments and a lack of long-term follow-up in the great majority of studies. Large studies with longer follow-up are required to better evaluate the breast cancer risk and to understand the precise mechanisms on breast development of each exogenous hormone.

Interobserver variability in the assessment of stromal tumor-infiltrating lymphocytes (sTILs) in triple-negative invasive breast carcinoma influences the association with pathological complete response: the IVITA study.

High stromal tumor-infiltrating lymphocytes (sTILs) in triple-negative breast cancer (TNBC) are associated with pathological complete response (pCR) after neoadjuvant chemotherapy (NAC). Histopathological assessment of sTILs in TNBC biopsies is characterized by substantial interobserver variability, but it is unknown whether this affects its association with pCR. Here, we aimed to investigate the degree of interobserver variability in an international study, and its impact on the relationship between sTILs and pCR. Forty pathologists assessed sTILs as a percentage in digitalized biopsy slides, originating from 41 TNBC patients who were treated with NAC followed by surgery. Pathological response was quantified by the MD Anderson Residual Cancer Burden (RCB) score. Intraclass correlation coefficients (ICCs) were calculated per pathologist duo and Bland-Altman plots were constructed. The relation between sTILs and pCR or RCB class was investigated. The ICCs ranged from -0.376 to 0.947 (mean: 0.659), indicating substantial interobserver variability. Nevertheless, high sTILs scores were significantly associated with pCR for 36 participants (90%), and with RCB class for eight participants (20%). Post hoc sTILs cutoffs at 20% and 40% resulted in variable associations with pCR. The sTILs in TNBC with RCB-II and RCB-III were intermediate to those of RCB-0 and RCB-I, with lowest sTILs observed in RCB-I. However, the limited number of RCB-I cases precludes any definite conclusions due to lack of power, and this observation therefore requires further investigation. In conclusion, sTILs are a robust marker for pCR at the group level. However, if sTILs are to be used to guide the NAC scheme for individual patients, the observed interobserver variability might substantially affect the chance of obtaining a pCR. Future studies should determine the 'ideal' sTILs threshold, and attempt to fine-tune the patient selection for sTILs-based de-escalation of NAC regimens. At present, there is insufficient evidence for robust and reproducible sTILs-guided therapeutic decisions.

Polymerization/depolymerization of chiral metallo-supramolecular assembly induced by redox change.

We report on the polymerization/depolymerization of chiral metallo-supramolecular assembly by CuI /CuII redox change. By combining a monotopic enantiopure ligand with a ditopic ligand of opposite configuration, ML2 -type complexes are generated with chiral self-recognition or self-discrimination depending on the oxidation state of copper. In presence of CuI , the formation of heterochiral complexes is favored, thus generating dinuclear species whereas CuII advocates for the formation of homochiral species, namely, a mixture of mononuclear species and metallo-supramolecular polymeric species. Thus, cyclic voltammetry was used to study such a chirality-induced stimulus sensitive polymerization/depolymerization process.

Artefactual Epithelial Displacement in a Papilloma with Extensive Usual Duct Hyperplasia Mimics a Solid Papillary Carcinoma with Invasive Growth.

Mammary solid papillary carcinoma and usual duct hyperplasia (UDH) of the breast are morphological look-alikes, characterized by cellular streaming, solid growth, and a lack of high-grade nuclear atypia. Here, we report a challenging papillary lesion in the breast of a 48-year-old woman that presented with a double pitfall. A core needle biopsy showed a solid papillary proliferation of epithelial cells with oval to round overlapping nuclei, surrounded by a sclerotic stroma. This distorted lesion contained peripheral clefts and cellular streaming, without high-grade nuclear atypia. Immunohistochemistry showed diffuse heterogenous immunoreactivity for estrogen receptor and cytokeratin 5, and no immunoreactivity for chromogranin and synaptophysin. The immunohistochemical profile distinguished this sclerosed papilloma with extensive UDH from a solid papillary carcinoma. The lumpectomy specimen revealed a second challenge, where multiple epithelial islets without surrounding myoepithelial cells were observed near the papilloma, mimicking an invasive carcinoma. These islets displayed the same immunohistochemical profile as the sclerosed papilloma and they were surrounded by steatonecrosis and reactive fibroblasts, indicating epithelial displacement within the biopsy needle tract. A sclerosed papilloma with extensive UDH is a morphologically challenging mimic of a solid papillary carcinoma. Immunohistochemistry is helpful to distinguish both entities from one another. Extensive epithelial displacement in the biopsy tract made this case particularly challenging, as the displaced epithelial islets mimicked an invasive carcinoma. Pathologists should be aware of this uncommon double pitfall to prevent misdiagnosis.

Chiral stimuli-responsive metallo-supramolecular assembly induced by CuII/CuI redox change.

We investigated the selective formation of homoleptic and heteroleptic metal complexes controlled by means of the chiral molecular instruction of the ligand and the coordination geometry of the metal. Our results showed that chiral self-recognition or self-discrimination may be induced by the CuI/CuII redox transition using cyclic voltammetry. The further use of chiral ditopic ligands led to metallo-supramolecular copolymers with stimuli-responsive controlled arrangement.

Observation of hyperpositive non-linear effect in catalytic asymmetric organozinc additions to aldehydes.

Asymmetric amplification is a phenomenon that is believed to play a key role in the emergence of homochirality in life. In asymmetric catalysis, theoretical and experimental models have been investigated to provide an understanding of how chiral amplification is possible, in particular based on non-linear effects. Interestingly, it has been proposed a quarter century ago that chiral catalysts, when not enantiopure might even be more enantioselective than their enantiopure counterparts. We show here that such hyperpositive non-linear effect in asymmetric catalysis is indeed possible. An in-depth study into the underlying mechanism was carried out, and the scheme we derive differs from the previous proposed models.

Giant intraosseous ganglion of the fibula: multimodality imaging.

Intraosseous ganglia around the knee are most commonly located in the proximal tibia and limited to the epiphyseal-metaphyseal region. We report the case of a giant intraosseous ganglion of the fibula. MRI demonstrated the fluid avascular content of the lesion. CT arthrography of the knee demonstrated partial opacification of the lesion through a cortical bone defect. The lesion was treated with curettage and bone grafting. Anatomopathological examination confirmed the medical imaging diagnosis of intraosseous ganglion. This case highlights the value of joint opacification with CT arthrography to demonstrate the communication between the articular cavity and the ganglion.

Synthesis, characterization, catalytic and biological application of half-sandwich ruthenium complexes bearing hemilabile (κ2-C,S)-thioether-functionalised NHC ligands.

A series of cationic Ru(ii)(η6-p-cymene) complexes with thioether-functionalised N-heterocyclic carbene ligands have been prepared and fully characterized. Steric and electronic influence of the R thioether substituent on the coordination of the sulfur atom was investigated. The molecular structure of three of them has been determined by means of X-ray diffractrometry and confirmed the bidentate (κ2-C,S) coordination mode of the ligand. Interestingly, only a single diastereomer, as an enantiomeric couple, was observed in the solid state for complexes 1c, 1i and 1j. DFT calculations established a low energy inversion barrier between the two diastereomers through a sulfur pyramidal inversion pathway with R donating group while a dissociative/associative mechanism is more likely with R substituents that contain electron withdrawing group, thus suggesting that the only species observed by the 1H-NMR correspond to an average resonance position of a fluxional mixtures of isomers. All these complexes were found to catalyse the oxydant-free double dehydrogenation of primary amine into nitrile. Ru complex bearing NHC-functionalised S-tBu group was further investigated in a wide range of amines and was found more selective for alkyl amine substrates than for benzylamine derivatives. Finally, preliminary results of the biological effects on various human cancer cells of four selected Ru complexes are reported.

Hyperpositive non-linear effects: enantiodivergence and modelling.

The chiral ligand N-methylephedrine (NME) was found to catalyse the addition of dimethylzinc to benzaldehyde in an enantiodivergent way, with a monomeric and a homochiral dimeric complex both catalysing the reaction at a steady state and giving opposite product enantiomers. A change in the sign of the enantiomeric product was thus possible by simply varying the catalyst loading or the ligand ee, giving rise to an enantiodivergent non-linear effect. Simulations using a mathematical model confirmed the possibility of such behaviour and showed that this can lead to situations where a reaction gives racemic products, although the system is composed only of highly enantioselective individual catalysts. Furthermore, depending on the dimer's degree of participation in the catalytic conversion, enantiodivergence may or may not be observed experimentally, which raises questions about the possibility of enantiodivergence in other monomer/dimer-catalysed systems. Simulations of the reaction kinetics showed that the observed kinetic constant k obs is highly dependent on user-controlled parameters, such as the catalyst concentration and the ligand ee, and may thus vary in a distinct way from one experimental setup to another. This unusual dependency of k obs allowed us to confirm that a previously observed U-shaped catalyst order vs. catalyst loading-plot is linked to the simultaneous catalytic activity of both monomeric and dimeric complexes.

Chiral Self-Sorting Process with Ditopic Ligands: Alternate or Block Metallopolymer Assembly as a Function of the Metal Ion.

We report an extensive study on the coordination behavior of chiral ditopic bridging ligands, which lead to metallosupramolecular polymers in the presence of Zn(II) and Cu(II) in solution. With the help of UV-vis and circular dichroism spectroscopies, we show that the metallopolymer sequence can be controlled by chirality and by the choice of the metal ion. Although the formation of a block metallopolymer proceeds through the assembly of homoleptic complexes, an alternate metallopolymer may be obtained only when heteroleptic complexes are formed. This demonstrates how the prevalent coordination geometries at metal centers may be used to control the sequences of the metallopolymers.

Synthesis of alternating metallocopolymers by chiral recognition.

We report the synthesis of chiral enantiopure polytopic bridging ligands, which may lead to the formation of metallosupramolecular polymers with zinc (II) as metal linker. We show that chiral C2 -symmetric bisoxazoline ligands are useful moieties to efficiently generate heterochiral complexes and thus polymeric entities. The corresponding metallopolymers were further characterized by powder X-ray diffraction (PXRD) to obtain information on the level of crystallinity of our different metallopolymers.

Easy Ruthenium-Catalysed Oxidation of Primary Amines to Nitriles under Oxidant-Free Conditions.

A dehydrogenation of primary amine to give the corresponding nitrile under oxidant- and base-free conditions catalysed by simple [Ru(p-cym)Cl2 ]2 with no extra ligand is reported. The system is highly selective for alkyl amines, whereas benzylamine derivatives gave the nitrile product together with the imine in a ratio ranging from 14:1 to 4:1 depending on the substrate. Preliminary mechanistic investigations have been performed to identify the key factors that govern the selectivity.

Homo- and Heteropolymetallic Complexes of the Hybrid, Ambidentate N-Heterocyclic Carbene Ligand IMes-acac.

The anionic 5-acetylimidazol-2-ylidene-4-olate 1 -, named as "IMes-acac", is composed of fused diaminocarbene and acetylacetonato units in the same IMes-based imidazolyl ring. The bifunctional compound 1 - is shown to act as an effective, ditopic bridging ligand for transition metal centers. Several new complexes supported by this ligand were prepared, including the complex [RuCl(p-Cym)(κ2 O,O-1·H)](BF4) (2), which can be regarded as a metallated imidazolium salt, the homobimetallic complex [((COD)Rh)(RhCl(COD))(µ-1κ2 O,O:2κ1 C-1)] (4), the heterobimetallic complexes [((p-Cym)ClRu)(RhCl(COD))(µ-1κ2 O,O:2κ1 C-1)] (3), [((p-Cym)ClRu)(RhCl(CO)2)(µ-1κ2 O,O:2κ1 C-1)] (5), [((p-Cym)ClRu)(Cu(IPr))(µ-1κ2 O,O:2κ1 C-1)] (9), the anionic homoleptic Cu(I) complexes [Cu(κ1 C-1)2]K ([10]K) and [Cu(κ1 C-1)2](NEt4) ([10](NEt4)), and the heterotrimetallic complex [((p-Cym)RuCl)2(Cu)(µ-1κ2 O,O:3κ1 C-1)(µ-2κ2 O,O:3κ1 C-1)](PF6) (11). Preliminary studies on the possible preparation of supramolecular metallopolymers and electrochemical studies on the series of complexes are also reported.

Well-defined cationic alkyl- and alkoxide-aluminum complexes and their reactivity with epsilon-caprolactone and lactides.

We describe the synthesis, structure, and reactivity of low-coordinate Al-alkyl and -alkoxide cationic complexes incorporating the sterically bulky aminophenolate bidentate ligand 6-(CH(2)NMe(2))-2-CPh(3)-4-Me-C(6)H(2)O- (N,O). These complexes are derived from the ionization of neutral dialkyl Al complexes (N,O)Al2) (1 a, R=Me; 1 b, R=iBu), readily obtained by alkane elimination between AlR3 and the corresponding aminophenol ligand, with the alkyl abstracting reagents B(C(6)F(5))3 and [Ph(3)C][B(C(6)F(5))4]. The reactions of 1 a,b with B(C(6)F(5))3 yield complicated mixtures or decomposition products, however the ionization of the Al-diisobutyl derivative 1 b with [Ph(3)C][B(C(6)F(5))4] affords a stable four-coordinate Al-PhBr cationic adduct [(N,O)Al(iBu)(PhBr)]+ (3+), as deduced from elemental analysis data. Complex 3+ readily coordinates Lewis bases such as THF to form the corresponding adduct [(N,O)Al(iBu)(thf)]+ (4+), and also rapidly chain-transfers with 1-hexene to yield the three-coordinate Al-hexyl cation [(N,O)Al-hexyl]+ (5+). Both cations 3+ and 5+ slowly dimerize to form unprecedented organoaluminum dications [(N,O)AlR+]2 (3'++, R=iBu; 5'++, R=hexyl) as deduced from X-ray crystallographic analysis. Cation 3+ reacts quickly with iPrOH to form a stable Lewis acid/base adduct [(N,O)Al(iBu)(HOiPr)]+ (6+), which constitutes the first X-ray characterized adduct between an Al-alkyl complex and a simple ROH. The Al-ROH proton in 6+ is readily abstracted by NMe(2)Ph to form the neutral isopropoxide Al complex [(N,O)Al(iBu)(OiPr)] (7). Upon reaction with THF, cation 6+ undergoes an intramolecular proton transfer to yield the ammonium Al-THF complex [(eta1-HN,O)Al(iBu)(OiPr)(thf)] (8 b+), in which the aminophenolate is eta1-coordinated to the Al center. Cation 8 b+ can then be converted to the desired Al-alkoxide derivative [(N,O)Al(OiPr)(thf)](+) (10+), by an intramolecular protonolysis reaction, as confirmed by X-ray crystallography. The synthesized Al-alkyl cations form robust four-coordinate adducts in the presence of cyclic esters such as epsilon-caprolactone and (D,L)-lactide, but no insertion chemistry occurs, illustrating the poor ability of the Al-R+ moiety to ring-open. In contrast, the Al-alkoxide cation 10+ polymerizes epsilon-caprolactone in a controlled manner with excellent activity, but is inactive in the polymerization of (D,L)-lactide and L-lactide. Control experiments with L-lactide show that cation 10+ ring-opens L-lactide to yield a robust five-coordinated Al--lactate cation [(N,O)Al(eta2-L-lactate-OiPr)(thf)]+ (13+), derived from a monoinsertion of L-lactide into the Al--OiPr bond of 10+, that does not further react. Cation 13+ may be regarded as a structurally characterized close mimic of the initial intermediate in the ring opening polymerization (ROP), of lactides by [{LX}M(OR)(L)] (where LX-=bidentate monoanionic ligand and L=labile ligand) metal complex initiators.

Synthesis and structural characterization of an azatitanacyclobutene: the key intermediate in the catalytic anti-Markovnikov addition of primary amines to [small alpha]-alkynes.

Reaction of the imidotitanium complexes [Ti(N(t)Bu)(N(2)N(py))(py)](1) and [Ti(N-2,6-C(6)H(3)(i)Pr(2))(N(2)N(py))(py)](2) with phenyl acetylene and tolyl acetylene in toluene gave the corresponding [2+2] cycloaddition products [Ti(N(2)N(py))[kappa(2)-N((t)Bu)CH[double bond]CR]](R = Ph:3, Tol:4) and [Ti(N(2)N(py))[kappa(2)-N(2,6-C(6)H(3)(i)Pr(2))CH[double bond]CR]](R = Ph:5, Tol: 6). Complex 6 is the first example of a key intermediate in the anti-Markovnikov addition of a primary amine to a terminal acetylene which has been structurally characterized by X-ray diffraction.