Reassessing the role of urban green space in air pollution control.

The assumption that vegetation improves air quality is prevalent in scientific, popular, and political discourse. However, experimental and modeling studies show the effect of green space on air pollutant concentrations in urban settings is highly variable and context specific. We revisited the link between vegetation and air quality using satellite-derived changes of urban green space and air pollutant concentrations from 2,615 established monitoring stations over Europe and the United States. Between 2010 and 2019, stations recorded declines in ambient NO2, (particulate matter) PM10, and PM2.5 (average of -3.14% y-1), but not O3 (+0.5% y-1), pointing to the general success of recent policy interventions to restrict anthropogenic emissions. The effect size of total green space on air pollution was weak and highly variable, particularly at the street scale (15 to 60 m radius) where vegetation can restrict ventilation. However, when isolating changes in tree cover, we found a negative association with air pollution at borough to city scales (120 to 16,000 m) particularly for O3 and PM. The effect of green space was smaller than the pollutant deposition and dispersion effects of meteorological drivers including precipitation, humidity, and wind speed. When averaged across spatial scales, a one SD increase in green space resulted in a 0.8% (95% CI: -3.5 to 2%) decline in air pollution. Our findings suggest that while urban greening may improve air quality at the borough-to-city scale, the impact is moderate and may have detrimental street-level effects depending on aerodynamic factors like vegetation type and urban form.

Environmental justice in a very green city: Spatial inequality in exposure to urban nature, air pollution and heat in Oslo, Norway.

Poorer citizens are often more exposed to environmental hazards due to spatial inequalities in the distribution of urban blue-green space. Few cities have managed to prevent spatial and social inequality despite sustainable development strategies like compact city planning. We explore whether environmental injustice exists in a city where one would least expect to find it: a city with abundant nature, an affluent population governed by a left leaning social democratic city council, and an aggressive densification strategy; Oslo, Norway. Green space was measured with a satellite-derived vegetation index which captures the combined availability of gardens, street trees, parks and forest. Blue space was defined by the proximity of residential areas to the closest lake, river or fjord. We found that poorer city districts, often with greater immigrant populations, have less available blue-green spaces and are disproportionately exposed to hazardous air pollution levels, but not extreme heat compared to wealthier city districts. Citizens living within 100 m of a water body are likely to earn US$ 20,000 more per year than citizens living 500 m away from water, and a US$ 3000 increase in annual income corresponds to a 10 % increase in green space availability. Hazardous air pollution concentrations in the poorest city districts were above levels recommended by the WHO and Oslo municipality. Historical trends showed that districts undergoing population densification coincide with the lowest availability of blue-green space, suggesting that environmental justice has been overlooked in compact city planning policy. Despite Oslo's affluence and egalitarian ideals, the patterns of inequality we observed mirror the city's historical east-west class divide and point to spatial concentration of wealth as a core factor to consider in studies of green segregation. Urban greening initiatives in Oslo and other cities should not take spatial equality for granted, and instead consider socio-economic geographies in their planning process.

Accuracy of a Factory-Calibrated Continuous Glucose Monitor in Individuals With Diabetes on Hemodialysis.

OBJECTIVE: Continuous glucose monitoring (CGM) improves diabetes management, but its reliability in individuals on hemodialysis is poorly understood and potentially affected by interstitial and intravascular volume variations. RESEARCH DESIGN AND METHODS: We assessed the accuracy of a factory-calibrated CGM by using venous blood glucose measurements (vBGM) during hemodialysis sessions and self-monitoring blood glucose (SMBG) at home. RESULTS: Twenty participants completed the protocol. The mean absolute relative difference of the CGM was 13.8% and 14.4%, when calculated on SMBG (n = 684) and on vBGM (n = 624), and 98.7% and 100% of values in the Parkes error grid A/B zones, respectively. Throughout 181 days of CGM monitoring, the median time in range (70-180 mg/dL) was 38.5% (interquartile range 29.3-57.9), with 28.7% (7.8-40.6) of the time >250 mg/dL. CONCLUSIONS: The overall performance of a factory-calibrated CGM appears reasonably accurate and clinically relevant for use in practice by individuals on hemodialysis and health professionals to improve diabetes management.

Is green space associated with reduced crime? A national-scale study from the Global South.

Assumptions about the link between green space and crime mitigation are informed by literature that overwhelmingly originates in the Global North. Little is known about the association between green spaces and crime in the Global South. We utilized 10 years of precinct-level crime statistics (n = 1152) over South Africa, a global crime hotspot, to test the hypothesis that green space is associated with reduced crime rates. We found that, after controlling for a number of socio-demographic confounders (unemployment, income, age, education, land use and population density), for every 1% increase in total green space there is a 1.2% (0.7 to 1.7%; 95% confidence interval) decrease in violent crime, and 1.3% (0.8 to 1.8%) decrease in property crime, with no effect on sexual crimes. However, the direction of the association changed for property crimes when exploring the effect of green space characteristics including tree cover and park accessibility. Property crimes increase by 0.4% (0.1 to 0.7%) with a percentage increase in tree cover, and by 0.9% (0.5 to 1.3%) with every kilometer increase in proximity to a public park. Further research, including experimental studies, is needed to better isolate causal mechanisms behind crime-green space associations, especially considering that green space may map to race and income inequality and that there may be more crime reporting in affluent areas. Nevertheless, our results provide a complementary contribution to the evidence from the Global North, highlighting the need for more nuanced definitions of green space and its characteristics when considering links to crime. When viewed in light of the broader suite of ecosystem services provided by green space, our results support urban greening as a major strategy towards achieving just and sustainable cities and towns.

Mobility in Blue-Green Spaces Does Not Predict COVID-19 Transmission: A Global Analysis.

Mobility restrictions during the COVID-19 pandemic ostensibly prevented the public from transmitting the disease in public places, but they also hampered outdoor recreation, despite the importance of blue-green spaces (e.g., parks and natural areas) for physical and mental health. We assess whether restrictions on human movement, particularly in blue-green spaces, affected the transmission of COVID-19. Our assessment uses a spatially resolved dataset of COVID-19 case numbers for 848 administrative units across 153 countries during the first year of the pandemic (February 2020 to February 2021). We measure mobility in blue-green spaces with planetary-scale aggregate and anonymized mobility flows derived from mobile phone tracking data. We then use machine learning forecast models and linear mixed-effects models to explore predictors of COVID-19 growth rates. After controlling for a number of environmental factors, we find no evidence that increased visits to blue-green space increase COVID-19 transmission. By contrast, increases in the total mobility and relaxation of other non-pharmaceutical interventions such as containment and closure policies predict greater transmission. Ultraviolet radiation stands out as the strongest environmental mitigant of COVID-19 spread, while temperature, humidity, wind speed, and ambient air pollution have little to no effect. Taken together, our analyses produce little evidence to support public health policies that restrict citizens from outdoor mobility in blue-green spaces, which corroborates experimental studies showing low risk of outdoor COVID-19 transmission. However, we acknowledge and discuss some of the challenges of big data approaches to ecological regression analyses such as this, and outline promising directions and opportunities for future research.

Crowdsourced air temperatures contrast satellite measures of the urban heat island and its mechanisms.

The ubiquitous nature of satellite data has led to an explosion of studies on the surface urban heat island (SUHI). Relatively few have simultaneously used air temperature measurements to compare SUHI with the canopy UHI (CUHI), which is more relevant to public health. Using crowdsourced citizen weather stations (>50,000) and satellite data over Europe, we estimate the CUHI and SUHI intensity in 342 urban clusters during the 2019 heat wave. Satellites produce a sixfold overestimate of UHI relative to station measurements (mean SUHI 1.45°C; CUHI 0.26°C), with SUHI exceeding CUHI in 96% of cities during daytime and in 80% at night. Using empirical evidence, we confirm the control of aerodynamic roughness on UHI intensity, but find evaporative cooling to have a stronger overall impact during this time period. Our results support urban greening as an effective UHI mitigation strategy and caution against relying on satellite data for urban heat risk assessments.

Mapping soil organic carbon stocks and trends with satellite-driven high resolution maps over South Africa.

Estimation and monitoring of soil organic carbon (SOC) stocks is important for maintaining soil productivity and meeting climate change mitigation targets. Current global SOC maps do not provide enough detail for landscape-scale decision making, and do not allow for tracking carbon sequestration or loss over time. Using an optical satellite-driven machine learning workflow, we mapped SOC stocks (topsoil; 0 to 30 cm) under natural vegetation (86% of land area) over South Africa at 30 m spatial resolution between 1984 and 2019. We estimate a total topsoil SOC stock of 5.6 Pg C with a median SOC density of 6 kg C m-2 (IQR: interquartile range 2.9 kg C m-2). Over 35 years, predicted SOC underwent a net increase of 0.3% (relative to long-term mean) with the greatest net increases (1.7%) and decreases (-0.6%) occurring in the Grassland and Nama Karoo biomes, respectively. At the landscape scale, SOC changes of up to 25% were evident in some locations, as evidenced from fence-line contrasts, and were likely due to local management effects (e.g. woody encroachment associated with increased SOC and overgrazing associated with decreased SOC). Our SOC mapping approach exhibited lower uncertainty (R2 = 0.64; RMSE = 2.5 kg C m-2) and less bias compared to previous low-resolution (250-1000 m) national SOC mapping efforts (average R2 = 0.24; RMSE = 3.7 kg C m-2). Our trend map remains an estimate, pending repeated measures of soil samples in the same location (time-series); a global priority for tracking SOC changes. While high resolution SOC maps can inform land management decisions aimed at climate mitigation (natural climate solutions), potential increases in SOC are likely limited by local climate and soils. It is also important that climate mitigation efforts such as planting trees balance trade-offs between carbon, biodiversity and overall ecosystem function.

Air pollution declines during COVID-19 lockdowns mitigate the global health burden.

The lockdown response to COVID-19 has resulted in an unprecedented reduction in global economic activity and associated air pollutant levels, especially from a decline in land transportation. We utilized a network of >10,000 air quality stations distributed over 34 countries during lockdown dates up until 15 May 2020 to obtain lockdown related anomalies for nitrogen dioxide, ozone and particulate matter smaller than 2.5 µm in diameter (PM2.5). Pollutant anomalies were related to short-term health outcomes using empirical exposure-response functions. We estimate that there were a net total of 49,900 (11,000 to 90,000; 95% confidence interval) excess deaths and 89,000 (64,700 to 107,000) pediatric asthma emergency room visits avoided during lockdowns. In China and India alone, the PM2.5-related avoided excess mortality was 19,600 (15,300 to 24,000) and 30,500 (5700 to 68,000), respectively. While the state of COVID-19 imposed lockdown is not sustainable, these findings illustrate the potential health benefits gained by reducing "business as usual" air pollutant emissions from economic activities primarily through finding alternative transportation solutions.

COVID-19 lockdowns cause global air pollution declines.

The lockdown response to coronavirus disease 2019 (COVID-19) has caused an unprecedented reduction in global economic and transport activity. We test the hypothesis that this has reduced tropospheric and ground-level air pollution concentrations, using satellite data and a network of >10,000 air quality stations. After accounting for the effects of meteorological variability, we find declines in the population-weighted concentration of ground-level nitrogen dioxide (NO2: 60% with 95% CI 48 to 72%), and fine particulate matter (PM2.5: 31%; 95% CI: 17 to 45%), with marginal increases in ozone (O3: 4%; 95% CI: -2 to 10%) in 34 countries during lockdown dates up until 15 May. Except for ozone, satellite measurements of the troposphere indicate much smaller reductions, highlighting the spatial variability of pollutant anomalies attributable to complex NOx chemistry and long-distance transport of fine particulate matter with a diameter less than 2.5 µm (PM2.5). By leveraging Google and Apple mobility data, we find empirical evidence for a link between global vehicle transportation declines and the reduction of ambient NO2 exposure. While the state of global lockdown is not sustainable, these findings allude to the potential for mitigating public health risk by reducing "business as usual" air pollutant emissions from economic activities. Explore trends here: https://nina.earthengine.app/view/lockdown-pollution.

COVID-19 lockdowns cause global air pollution declines with implications for public health risk

The lockdown response to COVID-19 has caused an unprecedented reduction in global economic activity. We test the hypothesis that this has reduced tropospheric and ground-level air pollution concentrations using satellite data and a network of >10,000 air quality stations. After accounting for the effects of meteorological variability, we find remarkable declines in ground-level nitrogen dioxide (NO2: -29 % with 95% confidence interval -44% to -13%), ozone (O3: -11%; -20% to -2%) and fine particulate matter (PM2.5: -9%; -28% to 10%) during the first two weeks of lockdown (n = 27 countries). These results are largely mirrored by satellite measures of the troposphere although long-distance transport of PM2.5 resulted in more heterogeneous changes relative to NO2. Pollutant anomalies were related to short-term health outcomes using empirical exposure-response functions. We estimate that there was a net total of 7400 (340 to 14600) premature deaths and 6600 (4900 to 7900) pediatric asthma cases avoided during two weeks post-lockdown. In China and India alone, the PM2.5-related avoided premature mortality was 1400 (1100 to 1700) and 5300 (1000 to 11700), respectively. Assuming that the lockdown-induced deviations in pollutant concentrations are maintained for the duration of 2020, we estimate 0.78 (0.09 to 1.5) million premature deaths and 1.6 (0.8 to 2) million pediatric asthma cases could be avoided globally. While the state of global lockdown is not sustainable, these findings illustrate the potential health benefits gained from reducing "business as usual" air pollutant emissions from economic activities. Explore trends here: www.covid-19-pollution.zsv.co.za Significance statementThe global response to the COVID-19 pandemic has resulted in unprecedented reductions in economic activity. We find that lockdown events have reduced air pollution levels by approximately 20% across 27 countries. The reduced air pollution levels come with a substantial health co-benefit in terms of avoided premature deaths and pediatric asthma cases that accompanied the COVID-19 containment measures.

Linking green infrastructure to urban heat and human health risk mitigation in Oslo, Norway.

The predicted extreme temperatures of global warming are magnified in cities due to the urban heat island effect. Even if the target for average temperature increase in the Paris Climate Agreement is met, temperatures during the hottest month in a northern city like Oslo are predicted to rise by over 5 °C by 2050. We hypothesised that heat-related diagnoses for heat-sensitive citizens (75+) in Oslo are correlated to monthly air temperatures, and that green infrastructure such as tree canopy cover reduces extreme land surface temperatures and thus reduces health risk from heat exposure. Monthly air temperatures were significantly correlated to the number of skin-related diagnoses at the city level, but were unrelated to diagnoses under circulatory, nervous system, or general categories. Satellite-derived spatially-explicit measures revealed that on one of the hottest days during the summer of 2018, landscape units composed of paved, midrise or lowrise buildings gave off the most heat (39 °C), whereas units composed of complete tree canopy cover, or mixed (i.e. tree and grass) vegetation maintained temperatures of between 29 and 32 °C. Land surface temperatures were negatively correlated to tree canopy cover (R2 = 0.45) and vegetation greenness (R2 = 0.41). In a scenario in which each city tree was replaced by the most common non-tree cover in its neighbourhood, the area of Oslo exceeding a 30 °C health risk threshold during the summer would increase from 23 to 29%. Combining modelling results with population at risk at census tract level, we estimated that each tree in the city currently mitigates additional heat exposure of one heat-sensitive person by one day. Our results indicate that maintaining and restoring tree cover provides an ecosystem service of urban heat reduction. Our findings have particular relevance for health benefit estimation in urban ecosystem accounting and municipal policy decisions regarding ecosystem-based climate adaptation.

Epidemiological and Molecular Analysis of an Outbreak of Highly Pathogenic Avian Influenza H5N8 clade 2.3.4.4 in a German Zoo: Effective Disease Control with Minimal Culling.

Outbreaks of highly pathogenic avian influenza A virus (HPAIV) subtype H5N8, clade 2.3.4.4, were first reported in January 2014 from South Korea. These viruses spread rapidly to Europe and the North American continent during autumn 2014 and caused, in Germany, five outbreaks in poultry holdings until February 2015. In addition, birds kept in a zoo in north-eastern Germany were affected. Only a few individual white storks (Ciconia ciconia) showed clinical symptoms and eventually died in the course of the infection, although subsequent in-depth diagnostic investigations showed that other birds kept in the same compound of the white storks were acutely positive for or had undergone asymptomatic infection with HPAIV H5N8. An exception from culling all of the 500 remaining zoo birds was granted by the competent authority. Restriction measures included grouping the zoo birds into eight epidemiological units in which 60 birds of each unit tested repeatedly negative for H5N8. Epidemiological and phylogenetical investigations revealed that the most likely source of introduction was direct or indirect contact with infected wild birds as the white storks had access to a small pond frequented by wild mallards and other aquatic wild birds during a period of 10 days in December 2014. Median network analysis showed that the zoo bird viruses segregated into a distinct cluster of clade 2.3.4.4 with closest ties to H5N8 isolates obtained from mute swans (Cygnus olor) in Sweden in April 2015. This case demonstrates that alternatives to culling exist to rescue valuable avifaunistic collections after incursions of HPAIV.

Live cell imaging of septin dynamics in Ustilago maydis.

Septins are highly conserved cytoskeletal proteins involved in a variety of biological processes such as cell polarization and cytokinesis. In humans, functional defects in these proteins have been linked to cancer and neuronal diseases. In recent years, substantial progress has been made in studying the structure of septin subunits and the formation of defined heteromeric building blocks. These are assembled into higher-order structures at distinct subcellular sites. An important microscopic approach in studying septin assembly and dynamics is the use of septins tagged with fluorescent proteins. This revealed, eg, that septins form rings during cytokinesis and that septins build extended filaments partially colocalizing with actin cables and microtubules. Here, we describe extensive live cell imaging of septins in the model microorganism Ustilago maydis. We present techniques to study dynamic localization of protein and septin mRNA on shuttling endosomes as well as colocalization of proteins at these highly motile units. Moreover, FLIM-FRET experiments for analyzing local protein interactions are presented. Importantly, these imaging approaches transfer well to other fungal and animal model systems for in vivo analysis of septin dynamics.

[The treatment of chronic wounds in the head and neck area after radiotherapy with medical honey]. / Die Behandlung chronischer Wunden im Kopf-Hals-Bereich nach Radiatio mit medizinischem Honig.

BACKGROUND: Wound healing problems and chronic wounds can be a therapeutic challenge are a frequent problem after radiotherapy. They can appear spontaneously or after further surgery. The permanently altered tissue is associated with recurrent bacterial infections with weeping wounds, which cannot be treated sufficiently by conventional conservative wound care. The topical application of medical honey seems to have a positive effect in such cases. The aim of this prospectively study is to check this effectiveness in the treatment of wound healing problems and chronic wounds in the head and neck area of irradiated patients. PATIENTS AND METHODS: In the period of July 2012 until August 2013 nine patients were treated with medical honey. All pa-tients had previously radiotherapy in the head and neck area. 5 patients had protracted wound healing problems after salvage surgery. The remaining 4 cases had spontaneously dehiscenced wounds at the beginning of the study. The wound healing was confirmed by measurement of the wound edges and depth and by adequate photo documentation. RESULTS: In all cases, the conventional wound care was unsuccessfully. In 8 of 9 cases, the wounds could be brought to cure by the application of medical honey over 3-8 weeks. Side effects or allergic reactions to the medical honey were not seen in any -cases. CONCLUSION: Based on our clinical experience we believe that the topical application of medical honey in non-healing or recurrent wounds in the head and neck area after radiotherapy is a reason-able and successful alternative therapy.

Blebs produced by actin-myosin contraction during apoptosis release damage-associated molecular pattern proteins before secondary necrosis occurs.

Apoptosis is a fundamental homeostatic mechanism essential for the normal growth, development and maintenance of every tissue and organ. Dying cells have been defined as apoptotic by distinguishing features, including cell contraction, nuclear fragmentation, blebbing, apoptotic body formation and maintenance of intact cellular membranes to prevent massive protein release and consequent inflammation. We now show that during early apoptosis limited membrane permeabilization occurs in blebs and apoptotic bodies, which allows release of proteins that may affect the proximal microenvironment before the catastrophic loss of membrane integrity during secondary necrosis. Blebbing, apoptotic body formation and protein release during early apoptosis are dependent on ROCK and myosin ATPase activity to drive actomyosin contraction. We identified 231 proteins released from actomyosin contraction-dependent blebs and apoptotic bodies by adapted SILAC (stable isotope labeling with amino acids in cell culture) combined with mass spectrometry analysis. The most enriched proteins released were the nucleosomal histones, which have previously been identified as damage-associated molecular pattern proteins (DAMPs) that can initiate sterile inflammatory responses. These results indicate that limited membrane permeabilization occurs in blebs and apoptotic bodies before secondary necrosis, leading to acute and localized release of immunomodulatory proteins during the early phase of active apoptotic membrane blebbing. Therefore, the shift from apoptosis to secondary necrosis is more graded than a simple binary switch, with the membrane permeabilization of apoptotic bodies and consequent limited release of DAMPs contributing to the transition between these states.

Magnetic proximity effects in antiferromagnet/ferromagnet bilayers: the impact on the Néel temperature.

We present a study of the ordering temperature of an ultrathin antiferromagnetic film in the proximity of a ferromagnetic layer. The Néel temperature of a single-crystalline antiferromagnetic FexMn1-x film on Cu(001) in contact with a ferromagnetic Ni layer was monitored by the discontinuity in the coercivity as a function of temperature by magneto-optical Kerr effect measurements. It decreases by up to 60 K if the magnetization axis of the ferromagnet is switched from out of plane to in plane by deposition of a Co overlayer. These results give clear evidence for a magnetic proximity effect in which the ferromagnetic layer substantially influences the ordering temperature of the antiferromagnetic layer.

The "bioeffect assessment index" (BAI). A concept for the quantification of effects of marine pollution by an integrated biomarker approach.

The "bioeffect assessment index" (BAI) is based on the integration of several pathological endpoints measured in the liver of European flounder (Platichthys flesus (L.)) during a long term study of biological effects of pollution in the German Bight. The BAI represents a modification of the "health assessment index" since it includes solely validated biomarkers reflecting toxically induced alterations at different levels of biological organisation in order to quantify the effects of environmental pollution. The concept of the BAI is based on the observation of progressive deleterious effects from early responses to late effects. Specific "key events" were detected, representing progressive stages of functional deterioration. The biomarkers selected from a whole battery of cellular markers for the BAI calculation reflect deleterious effects of various classes of contaminants such as heavy metals, organochlorines, pesticides, PAHs, and therefore reflect general toxicity in an integrative manner. Selected biomarkers were: lysosomal perturbations (reduced membrane stability), storage disorders (lipid accumulation) as early markers for toxic effects of liver cells, and the size of macrophage aggregates and their acid phosphatase activity. The latter two markers are indicative for the modulation of non-specific immune response which represents longer time scale responses after chronic exposure.

Ramsey county day treatment services:.

Ramsey County Extended Day Treatment is designed for persons with a serious and persistent mental illness such as major depression, schizophrenia, bipolar disorder or personality disorder. The uniqueness of the model is the combination of an intake and referral group with six levels of group psychotherapy. Additionally, single issue groups provide a concentrated focus on employment or community contribution, anger management, and peer relationships. The result is a well-structured, non-residential program where a client can work in a treatment environment based on one's ability to participate. This article describes the intake and referral group, outlines the six separate programs, and describes the use of occupational therapy and cognitive behavioral therapy throughout the model.

VDRL antibodies enhance phagocytosis of Treponema pallidum by macrophages.

Although reactivity in nontreponemal tests develops in patients with untreated syphilis, no immunologic function has been ascribed to these antibodies. This study demonstrates that rabbit antibodies induced by immunization with VDRL antigen and VDRL antibodies affinity-purified from syphilitic rabbit serum enhance phagocytosis of Treponema pallidum. The proportion of macrophages ingesting treponemes in the presence of these antisera was 45% +/- 5% and 27% +/- 4%, respectively, versus 14% +/- 3% for normal serum (P < .001 and P < .01). Both IgG and IgM fractions contained opsonic activity. Absorption of VDRL antibodies from syphilitic serum diminished but did not eliminate opsonization, suggesting at least two classes of target molecules. Despite opsonic capacity, VDRL antibodies fail to facilitate macrophage-mediated killing of T. pallidum. Nevertheless, VDRL-immunized rabbits are partially protected against T. pallidum infection, developing fewer lesions (delayed and smaller) than do unimmunized controls. These results suggest a heretofore unrecognized functional role for VDRL antibodies in syphilis infection.

Characterization of the serum requirement for macrophage-mediated killing of Treponema pallidum ssp. pallidum: relationship to the development of opsonizing antibodies.

Serum pools were collected from rabbits bled at various times after intra-testicular infection with Treponema pallidum ssp. pallidum. These were tested for their ability to opsonize T. pallidum and promote killing of the organisms by macrophages. Compared to normal sera, significant opsonization was first seen on day 10 of infection as measured by both ingestion (P < 0.001) and macrophage-mediated killing (P = 0.006); significant levels of functional antibodies persisted through 300 days of infection. Although opsonic activity peaked early in infection, antibodies that promoted optimal macrophage-mediated killing developed much later, suggesting that these two functions may represent activities of antibodies with differing specificities or affinities. The initial development of antibodies that augment both phagocytosis and killing corresponds with the in vivo clearance of treponemes from the primary site of infection. These observations support the hypothesis that macrophages are the major effector mechanism for elimination of T. pallidum during early syphilis infection.