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Background: Between 52–86% of people who menstruate in the United States use tampons—cotton and/or rayon/viscose ‘plugs’—to absorb menstrual blood in the vagina. Tampons may contain metals from agricultural or manufacturing processes, which could be absorbed by the vagina’s highly absorptive tissue, resulting in systemic exposure. To our knowledge, no previous studies have measured metals in tampons. Objectives: We evaluated the concentrations of 16 metal(loid)s in 30 tampons from 14 tampon brands and 18 product lines and compared the concentrations by tampon characteristics. Methods: About 0.2 – 0.3 g from each tampon (n = 60 samples) were microwave-acid digested and analyzed by inductively coupled plasma mass spectrometry (ICP-MS) to determine concentrations of arsenic, barium, calcium, cadmium, cobalt, chromium, copper, iron, manganese, mercury, nickel, lead, selenium, strontium, vanadium, and zinc. We compared concentrations by several tampon characteristics (region of purchase, organic material, brand type) using median quantile mixed models. Results: We found measurable concentrations of all 16 metals assessed. We detected concentrations of several toxic metals, including elevated mean concentrations of lead (geometric mean [GM] = 120 ng/g), cadmium (GM = 6.74 ng/g), and arsenic (GM = 2.56 ng/g). Metal concentrations differed by region of tampon purchase (US versus European Union/United Kingdom), by organic versus non-organic material, and for store- versus name-brand tampons. Most metals differed by organic status; lead concentrations were higher in non-organic tampons while arsenic was higher in organic tampons. No categoriy had consistently lower concentrations of all or most metals. Discussion: Tampon use is a potential source of metal exposure. We detected all 16 metals in at least one sampled tampon, including some toxic metals like lead that has no “safe” exposure level. Future research is needed to replicate our findings and determine whether metals can leach out of tampons and cross the vaginal epithelium into systemic circulation.

Summary: Background: Better understanding of the association between characteristics of patients hospitalized with coronavirus disease 2019 (COVID-19) and outcome is needed to further improve upon patient management. Methods: Immunophenotyping Assessment in a COVID-19 Cohort (IMPACC) is a prospective, observational study of 1164 patients from 20 hospitals across the United States. Disease severity was assessed using a 7-point ordinal scale based on degree of respiratory illness. Patients were prospectively surveyed for 1 year after discharge for post-acute sequalae of COVID-19 (PASC) through quarterly surveys. Demographics, comorbidities, radiographic findings, clinical laboratory values, SARS-CoV-2 PCR and serology were captured over a 28-day period. Multivariable logistic regression was performed. Findings: The median age was 59 years (interquartile range [IQR] 20); 711 (61%) were men; overall mortality was 14%, and 228 (20%) required invasive mechanical ventilation. Unsupervised clustering of ordinal score over time revealed distinct disease course trajectories. Risk factors associated with prolonged hospitalization or death by day 28 included age ≥ 65 years (odds ratio [OR], 2.01; 95% CI 1.28–3.17), Hispanic ethnicity (OR, 1.71; 95% CI 1.13–2.57), elevated baseline creatinine (OR 2.80; 95% CI 1.63– 4.80) or troponin (OR 1.89; 95% 1.03–3.47), baseline lymphopenia (OR 2.19; 95% CI 1.61–2.97), presence of infiltrate by chest imaging (OR 3.16; 95% CI 1.96–5.10), and high SARS-CoV2 viral load (OR 1.53; 95% CI 1.17–2.00). Fatal cases had the lowest ratio of SARS-CoV-2 antibody to viral load levels compared to other trajectories over time (p=0.001). 589 survivors (51%) completed at least one survey at follow-up with 305 (52%) having at least one symptom consistent with PASC, most commonly dyspnea (56% among symptomatic patients). Female sex was the only associated risk factor for PASC. Interpretation: Integration of PCR cycle threshold, and antibody values with demographics, comorbidities, and laboratory/radiographic findings identified risk factors for 28-day outcome severity, though only female sex was associated with PASC. Longitudinal clinical phenotyping offers important insights, and provides a framework for immunophenotyping for acute and long COVID-19. Funding: NIH.

The sub-marginal ligula cels of the water fern, Isoetes lacustris, were investigated with the electron microscope. Their most conspicuous ultrastructural elements, a well developed tubular ER and a cisternal rER, as well as numerous active dictyosomes, indicate a high activity of protein synthesis and intracellular transport. Several dictyosomes show interassociations and partly direct interconnections with each other and with the tubular ER, the latter occurring at the fenestrated regions of the Golgi cisternae. These details, demonstrated by sections parallel and perpendicular to the cisternal planes of the dictyosomes, point to the existence of a functionally homogeneous endomembrane system. The results are discussed with regard to the question whether the endomembrane concept (Morré and Mollenhauer [32]) be of general validity, or whether it needs to be restricted to the intracellular transport of secretion proteins.

Ovary gland cells of Aptenia cordifolia were exposed to 100 micrograms/ml cytochalasin B (cyt B) for 30 or 60 min during the phase of granulocrine polysaccharide secretion. The drug caused a congestion of Golgi vesicles around the dictyosomes, probably resulting from an inhibition of the vesicle migration towards the plasma membrane. The ultrastructural feature of the Golgi apparatus in control and cyt B treated cells was analyzed using stereological methods in order to estimate the mean area of vesicular membrane produced by a single dictyosome during a 30 min period of effective cyt B action. Assuming that the rate of vesicle congestion can be equated with the rate of vesicle production, the 236 dictyosomes found to be present in the non-growing ovary gland cells form 7517 vesicles in total, or approximately 32 vesicles each within a period of 30 min. This corresponds to a membrane turnover rate of 70.4 micrometers/min (this equals approximately 10% of the total plasma membrane area per min), since the mean vesicle surface area was calculated to be 0.281 microns2. The turnover time of a single Golgi cisterna was determinated to be 7.34 min, and the average vesicle life time to be 8.86 min. Discussion focuses upon the way by which the relatively high amount of vesicular membrane material incorporated into the plasmalemma is recycled into the endomembrane system. Since a bulk membrane retrieval in the form of vesicles, as well as a bulk vesicle migration from the ER to the dictyosomes could not be observed, we suggest that a transfer of membrane subunits is involved in the maintenance of membrane equilibrium in the Golgi apparatus.