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Extreme heat and weather threaten health at nearly every stage of life, WHO says

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Extreme heat and weather threaten health at nearly every stage of life, WHO says

As the planet continues its streak of record-breaking heat, the World Health Organization has issued urgent new warnings about the ways in which climate change is affecting the most vulnerable members of society at almost every stage of life.

Pregnant people, newborns, children, adolescents and seniors are all facing serious health complications from global warming, yet the needs of each group have been largely neglected, researchers argue in a series of papers published recently in the Journal of Global Health.

“These studies show clearly that climate change is not a distant health threat, and that certain populations are already paying a high price,” read a statement from Anshu Banerjee, the WHO’s director of maternal, newborn, child and adolescent health and aging. “While awareness of climate change has increased, actions to safeguard the lives of those at most risk has barely scratched the surface of what’s needed. For climate justice to be achieved, this must be urgently redressed.”

Aggressive and impactful reporting on climate change, the environment, health and science.

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Among the studies is a review of the effects of climate change and air pollution on maternal and newborn health, which found links between exposure to heat and pollutants and adverse birth outcomes — particularly preterm birth. The analysis found evidence of a 16% increase in the odds of preterm birth during heat waves compared with non-heat-wave days, as well as an average increase in the odds of preterm birth for each degree of warming.

In 2019, 35.7% of global preterm births were attributable to particulate matter exposure — the equivalent of 5,870,103 newborns, the review says. Air pollution also appeared to be linked to congenital anomalies.

In fact, high temperatures and ambient air pollution were associated with a number of issues, including gestational diabetes and other hypertensive pregnancy disorders, miscarriage, stillbirth and increased risk of hospitalization for newborns and infants, among others. Lower birth weights were more commonly observed in warmer months of the year after exposure to a heat wave.

While all people are exposed to climate change, those pregnant, infants and children are particularly susceptible to such hazards in part because of a set of “physiological, clinical, behavioral, and social factors that characterize these unique stages of life,” the study says.

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For example, pregnancy increases vulnerability to vector-borne diseases, while infants and children are prone due to their immature immune systems and impaired ability to regulate body temperature. Women and children are also often at greater risk in the aftermath of disasters, particularly when access to care is disrupted.

“It is time for policy action and financing to consider the specific needs of [maternal and newborn health] in climate change hazards,” the study says.

But pregnancy and birth aren’t the only stages of life affected by climate change.

Another study in the package found consistent evidence that climate-related hazards and events are associated with greater negative outcomes for children and adolescents — including increases in post-traumatic stress and other mental health disorders; increases in asthma, respiratory illnesses and vector-borne diseases; increases in malnutrition and reduced growth; and disruptions to caregiving and family functioning.

“The world’s changing climate affects the fundamental rights of children to survive, thrive and reach their full potential,” the paper says. “Exposure to climate change-related events during childhood can have long-lasting effects throughout the lifetime.”

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A pregnant woman in a green bikini has her hands on her belly while sitting in an inflatable pool

Sofia Gonzalez, who is nine months pregnant, cools off in her backyard in April 2020.

(Wally Skalij / Los Angeles Times)

In fact, the United Nations Children’s Fund, or UNICEF, has found that half the world’s children are at an extremely high risk of climate change effects due to exposure to multiple hazards, as well as a lack of access to essential health and other services to help mitigate and recover from climate-related events. More than a third of people displaced internationally in 2022 due to climate change were children.

The WHO review focused primarily on extreme weather-related disasters and rising temperatures. It found a wide range of PTSD outcomes for children and adolescents in the wake of such disasters, as well as elevated rates of phobias, sleep disruption, attachment disorders, depression, panic and anxiety.

It also looked at the growing trend of eco-anxiety — or grief, stress, fear, anger and other emotions that arise in response to an awareness of climate change. Though it found some associations, it concluded that there remains a relative lack of data on the prevalence and severity of those mental health effects, and urged more research into the matter.

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“Much remains unknown about the causal pathways linking climate-change-related events and mental and physical health, responsive relationships and connectedness, nutrition, and learning in children and adolescents,” review authors wrote. “This evidence is urgently needed so that adverse health and other impacts from climate change can be prevented or minimized through well-timed and appropriate action.”

The review also uncovered the ways in which families can be disrupted by climate change, including ripple effects on children and teens. Added stressors on parents and caregivers can affect their ability to provide care, while climate disasters can also compromise social support structures such as religious organizations and community groups.

In one example, low-income mothers in the New Orleans area were found to have higher levels of depressed moods after Hurricane Katrina, which was linked to less effective parenting, the study says.

“These findings suggest that responsive caregiving, connectedness and caregiver mental health are central factors in child health and well-being outcomes post-disaster.”

Seniors also can’t escape the threats of climate change, as a third assessment found that global warming is directly affecting older people’s longevity and healthy aging. Extreme temperatures, wildfire, drought, flooding, storms, sea level rise, air quality issues, infectious diseases, food and water insecurities, migration, relocation, and health and social care system displacement are all pathways to such effects.

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For instance, an assessment of floods across 761 global communities found higher mortality risks in areas with larger proportions of older people. Meanwhile, 71% of fatalities during Hurricane Katrina were older people, despite seniors representing only 15% of the population.

Similarly skewed numbers have also been observed in California. All four people who died in 2022’s McKinney fire were over age 70. The majority of the 85 people who died in the 2018 Camp fire were older than 65. The study notes that older people may need more time to evacuate, more support in the case of power shortages and may be more vulnerable to particulate matter from wildfire smoke.

Three children, two swimming, in a portable wading pool

Youngsters cool off in the 115-degree heat in the early evening outside their trailer in Thermal, Calif., in July 2023.

(Gina Ferazzi / Los Angeles Times)

As in the case of children, older people also have a harder time regulating their body temperature and recognizing temperature changes, and so are particularly vulnerable to extreme heat, which is getting worse due to climate change. Not only does extreme heat expose this group to greater risks of heart failure, heatstroke, dehydration, kidney and renal issues and worsened respiratory health, but it can also exacerbate preexisting medical conditions such as cardiovascular disease, diabetes and asthma, the study says.

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“Despite this, as a group, older persons have often been neglected in studies on the impact of climate change. This is a major oversight for older persons living in all regions and countries,” the study authors wrote, noting that the proportion of older people is increasing globally, with 1 in every 6 people projected to be 60 or older by 2030.

“There is a crucial need to harmonize the concerns of older individuals and environmental sustainability to safeguard the rights of older people, particularly given the escalating impacts of the climate change crisis,” it says.

The WHO’s findings come as international climate officials issue urgent warnings that humanity is moving in the wrong direction. May marked the 12th consecutive month of record-breaking global temperatures, and yet planet-warming carbon dioxide emissions continue to climb.

“Like the meteor that wiped out the dinosaurs, we are having an outsized impact,” United Nations Secretary-General António Guterres said during a speech Wednesday. “In the case of climate, we are not the dinosaurs — we are the meteor. We are not only in danger — we are the danger. But we are also the solution.”

Indeed, a fourth report from the WHO concludes that comprehensive action is needed.

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“The effects of climate change can either be exacerbated by existing inequalities and the interaction with other crises or be mitigated through good governance, which draws on collective intelligence for the common good, evidence-based policies, the engagement of people, and the involvement of all sectors,” the report says.

The report outlines opportunities for adaptation, including infrastructure upgrades, expanded workforce capacities and the need to address the root sources of planet-warming emissions.

At the same time, the health agency warned that frameworks for maternal care and child care, as well as elder care, have received minimum attention and must be taken into account.

“A healthy environment underpins health throughout life, enabling healthy growth and development in childhood and adolescence, healthy pregnancies and healthy aging,” read a statement from WHO scientist Anayda Portela. “There is an urgent need to mitigate climate change by reducing greenhouse gas emissions and to build climate resilience; to take specific actions that protect health at these various life stages, and to ensure continuity of health services for those most at risk when climate disasters occur.”

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Antibiotics wreak havoc on the gut. Can we kill the bad bugs and spare the good ones?

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Antibiotics wreak havoc on the gut. Can we kill the bad bugs and spare the good ones?

Inside every human is a thriving zoo of bacteria, fungi, viruses and other microscopic organisms collectively known as the microbiome. Trillions of microbes live in the digestive tract alone, a menagerie estimated to contain more than 1,000 species.

This ecosystem of tiny stuff affects our health in ways science is only beginning to understand, facilitating digestion, metabolism, the immune response and more. But when serious infection sets in, the most powerful antibiotics take a merciless approach, wiping out colonies of beneficial bacteria in the digestive tract and often prompting secondary health problems.

“Increasingly, researchers are recognizing the benefits of protecting the human gut microbiome, particularly because its integrity and diversity is linked to metabolic influences on mental health and physical health conditions,” said Dr. Oladele A. Ogunseitan, a professor of population health and disease prevention at UC Irvine.

Drug-resistant bugs are evolving faster than new medicines are being developed, rendering the current arsenal of medicines increasingly ineffective. But the more we understand about the microbiome, the clearer it is that we need antibiotics that are discerning in their targets.

With that goal in mind, a chemistry team at the University of Illinois Urbana-Champaign is experimenting with a compound that attempts to address both problems. The antibiotic, lolamicin, both successfully vanquished several drug-resistant pathogens in mice while sparing the animals’ microbiome. The results were published in the journal Nature.

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“Only recently has it been recognized that killing these [beneficial] bacteria is having many deleterious effects on patients,” said Paul J. Hergenrother, a chemistry professor at the University of Illinois Urbana-Champaign who co-led the study. “We have been interested for some time in finding antibiotics that would be effective without killing the good bacteria.”

The team set out to create an antibiotic that would both preserve the gut microbiome while targeting gram-negative bacteria, a particularly hardy category of superbugs. Encased in both an inner and outer membrane that antibiotics struggle to cross, gram-negative bacteria are resistant to most currently available therapies. They are responsible for the majority of the estimated 35,000 deaths in the U.S. each year from drug-resistant infections, according to the U.S. Centers for Disease Control and Prevention.

Worldwide, antimicrobial resistance kills an estimated 1.27 million people directly every year and contributes to the deaths of millions more.

Not all gram-negative bugs make us sick. Bacteria populations in the average human gut are roughly split between gram-negative and gram-positive types, said Kristen Munoz, a former doctoral student at the University of Illinois who co-led the study.

Broad spectrum antibiotics can’t tell which bugs to spare, she said. As a result, anything strong enough to treat a bad infection “is going to wipe out a good amount of your gut microbiome,” she said, even though they “aren’t doing anything wrong.”

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The team focused its search for a new drug on compounds that suppress the Lol system, which shuttles lipoproteins between the inner and outer membranes in gram-negative bacteria.

The Lol system’s genetic code looks different in harmful bacteria than it does in beneficial ones, which suggested to researchers that medicines that targeted the Lol system would be able to distinguish good bugs from bad ones.

The team designed multiple versions of these Lol-inhibiting compounds. When tested against 130 drug-resistant strains of Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae, one in particular proved especially potent.

They tested this antibiotic, which they named lolamicin, on mice that had been infected with drug-resistant strains of septicemia or pneumonia. All of the mice with septicemia survived after receiving lolamicin, as did 70% of the mice with pneumonia.

To measure the effect on gut bacteria, the researchers gave healthy mice either lolamicin, a placebo or one of two common antibiotics, amoxicillin and clindamycin. After collecting baseline stool samples, they sampled the animals’ poop seven, 10 and 31 days after treatment.

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Mice treated with amoxicillin or clindamycin had lower beneficial bacteria counts and less diversity of gut bacteria. In contrast, the guts of lolamicin-treated mice appeared largely the same.

“It was exciting to see that lolamicin did not really cause any changes in the microbiome, whereas the other clinically used antibiotics did,” Munoz said.

A disrupted microbiome can have immediate consequences for people battling infection. When beneficial microbes are decimated, dangerous bugs have fewer competitors and secondary infections can take hold.

Clostridium difficile is a notorious opportunistic pathogen, so the researchers did an experiment where they exposed mice treated with lolamicin, amoxicillin or clindamycin to C. difficile. The mice who took standard antibiotics were soon crawling with C. difficile. The lolamicin mice showed little to no infection.

The lab hopes to one day take lolamicin or a version of it to clinical trials, Hergenrother said. (Munoz received her doctorate last year and now works as a scientific analyst in Los Angeles.) Yet these are still early days for the drug. While the concept of a discerning antibiotic is a welcome development, it must clear significant barriers before it could make a difference for patients.

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“Distinguishing a quote-unquote ‘bad bug’ from a quote-unquote ‘good bug’ is not always as straightforward as it may seem,” said Dr. Sean Spencer, a Stanford University gastroenterologist and physician scientist who was not involved with the research.

Some beneficial bugs in the gut bear a striking genetic resemblance to harmful pathogens, he said. Others are benign in some contexts and dangerous in others: “In a critically ill individual, a good bug can do bad things.”

Years can pass between a new antibiotic’s proof of concept and its entry to the market, and the vast majority never make it to the end of that pipeline. It’s also not clear how easily or how quickly bacteria will develop resistance, which is perhaps the most formidable obstacle that lolamicin or any new antibiotic faces.

“One of the biggest problems is that bacteria are so smart. You can tackle one particular protein system or protein target in bacteria, but they will quickly find a resistance mechanism,” Munoz said. “They just have so many inherent mechanisms to overcome antibiotics.”

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Doctors and dentists at L.A. County-run hospitals will get bonuses under tentative deal

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Doctors and dentists at L.A. County-run hospitals will get bonuses under tentative deal

Unionized doctors and dentists who work at hospitals and other health facilities run by Los Angeles County will get cost-of-living increases and bonuses under new agreements with the county, reached after more than two years of bargaining and threats of a strike.

The tentative agreements with a pair of bargaining units represented by the Union of American Physicians and Dentists are expected to be voted on this month by the Los Angeles County Board of Supervisors.

Members of the Union of American Physicians and Dentists had geared up to go on strike in December, complaining that inadequate benefits had hampered recruitment and retention and driven up vacancy rates for crucial positions in county facilities, including for psychiatrists in its jails.

Much of the dispute centered on the “Megaflex” benefits package that L.A. County provides to more than 14,000 employees including managerial and administrative staff, most of whom are not unionized. That package gives workers an additional 14.5% to 19% over their base pay to buy benefits and allows them to keep any unspent portion as income, according to county officials.

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UAPD pushed for its members to get those benefits. The Department of Health Services countered that they already had an “extensive benefits package” — the same one in place for more than 35,000 other county workers — and that giving all of them a more costly package would prevent the county from concentrating its incentives on the hardest-to-recruit workers.

The two sides also sparred over the costs of expanding Megaflex: At one point, UAPD officials estimated the added costs at roughly $20 million a year based on current wages, but county officials had pegged the expected expense at more than $86 million a year, with costs rising with any salary increase.

The planned strike in December was put on hold after the county and the union agreed to seek opinions from outside experts about the implications of expanding Megaflex.

In late April, the UAPD announced that its negotiating teams had reached tentative agreements with the county, which were ratified by union members by the end of May.

Under the deal, the workers would get cost-of-living increases that match those received by other county employees, with additional hikes for some positions ranging from 2.75% to 19.25%, according to the county chief executive office. Starting wages were also increased for some medical specialties such as neurology.

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In addition, the county agreed to bolster benefits “no later than January 1, 2026,” according to the chief executive office. The added benefits include a 401(k) plan, as well as short-term disability benefits for physicians, who had complained that doctors were not getting enough paid time off to recover from childbirth.

The existing set of benefits put female physicians planning to become pregnant “at a disadvantage compared to private hospitals in the area,” said Dr. Michelle Armacost, a physician specializing in neurology at one of the county facilities, in a statement released by the union. “We demanded equitable benefits, and we were willing to strike for them. The county heard us, and we prevailed.”

Beyond those increases, county workers who are not covered by Megaflex will get an annual bonus of $14,000 on top of their base salary, according to the chief executive office. Union officials also said the deal features a “physician loyalty bonus for residents who choose to remain with the county after residency.”

“These new agreements set competitive wages and attractive benefits that we hope will allow us to fill critical vacancies at our county-run hospitals and other facilities and retain the talented healthcare workers already providing essential services to our county residents,” the chief executive office said in a statement.

County officials did not immediately provide an estimate of the costs of the new contract with the unionized doctors.

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Benefits have long been a bone of contention for county physicians. Doctors employed by L.A. County were cut off from Megaflex benefits more than two decades ago, a few years after they had voted to unionize.

At the time, county officials said such benefits were available only to nonunionized employees. “The doctors, they knew full well what they were getting into,” then-Supervisor Don Knabe said in 2001.

Labor officials decried it as a move to break the fledgling union, calculating the value of the benefits package at $19,000 or more to some senior doctors at the time. State lawmakers then banned the county from removing workers from a benefits plan because they unionized, making the law retroactive to before the L.A. County move. The UAPD also sued the county, eventually securing over $10 million in settlement.

The union later negotiated a new agreement with the county that grandfathered in existing workers on Megaflex, but put new hires on a different plan, the county chief executive office said. As of December, only a small number of UAPD members — fewer than 200 — had Megaflex benefits, according to the county.

In a report last year to county supervisors, Dr. Christina R. Ghaly, director of the Department of Health Services, said that over the years, “steady increases in salary were negotiated while factoring in that this group does not receive Megaflex benefits.”

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UAPD President Dr. Stuart Bussey rejected the idea that they had “bargained Megaflex away” at a public rally last year. In the past, “recruitment wasn’t as bad as it is now,” and a state law limiting pension benefits for government employees wasn’t in effect, Bussey told the crowd. “Times have changed.”

In a recent statement to union members, Bussey said that UAPD members had “refused to settle until we secured a collective bargaining agreement that prioritizes patient care with competitive pay and benefits.”

“Your determination and patience paid off, and we look forward to collaborating with the county to fill vacant positions.”

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Ed Stone, JPL director and top scientist on Voyager mission, dies at 88

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Ed Stone, JPL director and top scientist on Voyager mission, dies at 88

Ed Stone, the scientist who guided NASA’s breakthrough Voyager mission to the outer planets for 50 years and led the Jet Propulsion Laboratory when it landed its first rover on Mars, died Tuesday. He was 88.

A physicist who got in on the ground floor of space exploration, Stone played a leading role in NASA missions to Mars, Jupiter, Saturn, Uranus and Neptune. The discoveries made under his watch revolutionized scientists’ understanding of the solar system and fueled humanity’s ambition to explore distant worlds.

Carolyn Porco, who worked on imaging on JPL’s Voyager and Cassini missions, called Stone “a thoroughly lovely man” who was “as close to perfect as a project scientist could ever be.”

“When two science teams were in contention over some spacecraft resource, and Ed had to decide between the two, even the guy who lost went away thinking, ‘Well, if this is what Ed has decided, then it must be the right answer,’” Porco said by email Tuesday. “I feel blessed to have known Ed. And like many people today, I’m very sad to know he’s gone.”

Stone was a 36-year-old Caltech physics professor in 1972 when he was asked to serve as chief scientist for an audacious plan to send a pair of spacecraft to explore the solar system’s four giant planets for the first time.

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It was the opportunity of a lifetime, but he wasn’t sure he wanted the gig.

“I hesitated because I was a fairly young professor at that point. I still had a lot of research I wanted to do,” he recalled 40 year later.

He took it anyway, and from the mission’s first encounter with Jupiter in 1979 to its final flyby of Neptune in 1989, Stone became the scientific face of the Voyager mission. He guided the science agenda and helped the public make sense of revolutionary images and data not just from Jupiter, Saturn, Uranus and Neptune, but from many of their fascinating moons.

Stone and his more than 200 science collaborators were the first to discover lightning on Jupiter and volcanoes on its moon Io. They spotted six never-before-seen moons around Saturn and found evidence of the largest ocean in the solar system on Jupiter’s moon Europa, as well as geysers on Neptune’s moon Triton.

“It seemed like everywhere we looked, as we encountered those planets and their moons, we were surprised,” Stone told the Los Angeles Times in 2011. “We were finding things we never imagined, gaining a clearer understanding of the environment Earth was part of. I can close my eyes and still remember every part of it.”

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The Voyager 1 spacecraft became the first manmade object to reach interstellar space in 2012, and Voyager 2 followed suit in 2018.

Stone, pictured with a model of the Voyager spacecraft, said the discovery of volcanoes on Io was a highlight of the mission.

(NASA)

The twin probes continue to send weekly communications to Earth from interstellar space. Stone retired in 2022 on the mission’s 50th anniversary.

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“A part of Ed lives on in the two Voyager spacecraft. The fingerprints of his dedication and keen leadership are woven into the Voyager mission,” said Linda Spilker, who joined the mission in 1977 and succeeded him as project scientist.

The Voyager mission was Stone’s crowning achievement, but hardly his only one.

He was a principal investigator on nine NASA missions and a co-investigator on five others, including several satellites designed to study cosmic rays, the solar wind and the Earth’s magnetic field.

He became director of the Jet Propulsion Laboratory in La Cañada Flintridge in 1991, a role he held for a decade.

It was an era of cost-cutting at NASA, but Stone still managed to launch Galileo’s five-year mission to Jupiter and send the Cassini spacecraft to Saturn. He was also at the agency’s helm when Mars Pathfinder delivered the Sojourner rover to the Red Planet. It marked the first time that humans had put a robotic rover on the surface of another planet.

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Throughout his tenure at JPL, Stone continued to work and teach at Caltech, even teaching freshman physics during some of Voyager’s long cruise times between planets.

He also served as chairman of the board of the California Assn. for Research in Astronomy, which is responsible for building and operating the W.M. Keck Observatory and its two 10-meter telescopes on Mauna Kea, Hawaii.

Edward Carroll Stone Jr. was born in Iowa on Jan. 23, 1936, and grew up in Burlington, where his father ran a small construction business and his mother kept the company books.

The eldest of two brothers, Stone was attracted to science from a young age. Under his father’s watchful eye, he learned how to take apart and reassemble all varieties of technology, from radios to cars.

“I was always interested in learning about why something is this way and not that way,” Stone told an interviewer in 2018. “I wanted to understand and measure and observe.”

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After studying physics at Burlington Junior College, he received his master’s and doctorate at the University of Chicago. Shortly after he began his graduate studies, news broke in 1957 that the former Soviet Union had launched Sputnik, the world’s first artificial satellite.

“Just like that, because of the Cold War and our need to match Sputnik, a whole new realm absolutely opened up,” he said.

Stone built a device for measuring the intensity of solar energetic particles above the atmosphere that hitched a ride to space aboard an Air Force satellite in 1961. Unfortunately the spacecraft’s transmitter didn’t work, so only a very limited quantity of data was returned to Earth. However, it was still enough to indicate that the intensity of the particles was lower than expected.

Despite the transmitter glitch, Stone said the project was thrilling. “We were taking the first steps in a whole new area of research and exploration,” he said. “We were right at the beginning.”

He joined the faculty at Caltech in 1964 and created more space experiments, this time for NASA.

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Stone’s particular area of interest was cosmic rays — high-speed atomic nuclei that can originate from explosive events on the sun or from violent events beyond the solar system.

One of his cosmic-ray experiments was included among the 11 major Voyager experiments.

Ed Stone gestures in front of a reddish background

Ed Stone in 2011, about a year before Voyager 1 entered interstellar space.

(Al Seib / Los Angeles Times)

Colleagues praised Stone for his leadership of the Voyager science team.

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“He was a great hero, a giant among men,” said Porco, adding that Stone was known to treat everyone — from top scientists to graduate students — with respect.

Voyager team scientist Thomas Donahue put it this way: “Over the years, Ed Stone has proved to be remarkably adept at keeping a bunch of prima donnas on track.”

Stone was elected to the National Academy of Sciences in 1984 and received the National Medal of Science from President George H.W. Bush in 1991 in recognition of his leadership of the Voyager mission. He won the Shaw Prize in Astronomy in 2019, an honor that comes with a $1.2-million award. In 2012 his hometown of Burlington, Iowa, named its new middle school after him.

“This is truly an honor because it comes from the community where my exploration journey began,” Stone told a local newspaper.

Decades after Voyager’s launch he was asked to select his favorite moment from the mission. He chose the discovery of volcanoes on Jupiter’s moon Io.

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“Finding a moon that’s 100 times more active volcanically than the entire Earth, it’s really quite striking,” he said. “And this was typical of what Voyager was going to do on the rest of its journey through the outer solar system.

“Time after time, we found that nature was much more inventive than our models,” he said.

His wife, Alice, whom he met on a blind date at the University of Chicago and married in 1962, died in December. The couple are survived by their two daughters, Susan and Janet Stone, and two grandsons.

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