Science
John Clements, Whose Research Saved Thousands of Babies, Dies at 101
Dr. John A. Clements, a towering figure in the field of pulmonary research who in the 1950s solved one of the great mysteries of the human lung, then helped to save thousands of lives by designing a drug to treat lung failure in premature infants, died on Sept. 3 at his home in Tiburon, Calif., north of San Francisco. He was 101.
The death was confirmed by his daughter Carol Clements.
In 1949, Dr. Clements was fresh out of Cornell University Medical College (now Weill Cornell Medical College) and working for the Army as a physiologist when he became intrigued by the miraculous mechanics of human breathing.
How could the millions of tiny air sacs in the lungs deflate when a person breathes out, but not collapse like a balloon? Dr. Clements theorized that there must be some chemical relaxing the surface tension of the air sacs, and he went on to identify the substance as a surfactant, a class of lubricants that work like household detergents.
In a 1956 paper, based on research done with a crude instrument he built himself, Dr. Clements demonstrated the presence of a surfactant in the lungs.
His work led to a breakthrough three years later by two Harvard researchers whom Dr. Clements advised: Pulmonary surfactant, they found, was absent in premature babies with undeveloped lungs who died of respiratory distress syndrome, or R.D.S.
The condition was once the leading cause of neonatal mortality in the United States, responsible for about 10,000 deaths annually in the 1960s.
One high-profile R.D.S. death was Patrick Bouvier Kennedy, the second son of President John F. Kennedy and Jacqueline Kennedy, who was born five and a half weeks prematurely in August 1963 and died within days.
“Back in the 1950s and early ’60s, if they had full-blown respiratory distress syndrome, more than 90 percent would die,” Dr. Clements said in a 2017 interview with iBiology Science Stories, a YouTube channel.
The discovery that premature babies lacked lung surfactant set off a worldwide rush to find a treatment. Some researchers tried replacement surfactants derived from sheep and cow lungs, but Dr. Clements believed animal surfactants were risky for tiny babies.
So, in response to a request from the premature infant nursery at the University of California, San Francisco, where he was a professor of pulmonary biology and pediatrics, Dr. Clements set out to develop a synthetic surfactant.
“It sounds incredibly naïve, or maybe at the other pole, really arrogant,” he said in a 2017 interview published on the university’s website, “but I said, ‘Well, I’ll make one for you’ — trying to accomplish in a few weeks or months what had taken divine providence millions of years — if you believe in evolution.”
His research led to the first synthetic lung surfactant, which the University of California licensed to the drugmaker Burroughs Wellcome and Company. Its drug Exosurf was the first replacement surfactant for clinical use approved by the Food and Drug Administration, in 1990.
Eventually, further study found that animal-derived surfactants worked better, and they are most often used today. Infant deaths from R.D.S. in the United States have declined to fewer than 500 a year.
In 1994, Dr. Clements won the Albert Lasker Clinical Medical Research Award for what was “widely regarded as the most important discovery in pulmonary physiology in the last 50 years,” according to the award citation.
Dr. Jordan U. Gutterman, the head of the awards at the time, noted how extraordinary it was for a scientist to be responsible for both a breakthrough in basic research and the development of a marketable treatment.
“It’s an incredible story of one man who looked at a problem and studied the physiology” and then solved the problem, he told The New York Times.
Dr. Clements donated the $25,000 in prize money to UNICEF.
John Allen Clements was born on March 16, 1923, in Auburn, N.Y., in the Finger Lakes region, the youngest of four children of Harry, a lawyer, and May Victoria (Porter) Clements. Both parents encouraged his childhood interest in scientific experiments. He rigged a shoe box with a flashing light that read “Scientist” and hung it in the window of the house. He made his own Tesla coil from scrounged-up parts, which the police told him he had to switch off after 6 p.m. because it was interfering with the neighbors’ radio.
Dr. Clements took advantage of an Army-paid accelerated program to complete his undergraduate work and an M.D. in five and a half years from Cornell. After his graduation in 1947, he worked for the Army Chemical Center in Maryland.
In 1949, he married Margot S. Power, a classical singer who went on to perform with the Baltimore Symphony, the Marin Symphony and the Carmel Bach Festival.
She died in 2022. In addition to their daughter Carol, Dr. Clements is survived by another daughter, Christine Clements.
At the University of California, San Francisco, which recruited Dr. Clements in 1959, he trained generations of physicians and researchers in his pulmonology lab.
After he retired in 2004, and into his 90s, he continued to drive to an office at the university two or three days a week, where he pursued research and advised others.
He parked his car in the same space for 50 years. Carol Clements said it exemplified his depth of focus: His laboratory work was always on his mind, and if he had parked in a different place, he would never be able to remember where.
Science
Political stress: Can you stay engaged without sacrificing your mental health?
It’s been two weeks since Donald Trump won the presidential election, but Stacey Lamirand’s brain hasn’t stopped churning.
“I still think about the election all the time,” said the 60-year-old Bay Area resident, who wanted a Kamala Harris victory so badly that she flew to Pennsylvania and knocked on voters’ doors in the final days of the campaign. “I honestly don’t know what to do about that.”
Neither do the psychologists and political scientists who have been tracking the country’s slide toward toxic levels of partisanship.
Fully 69% of U.S. adults found the presidential election a significant source of stress in their lives, the American Psychological Assn. said in its latest Stress in America report.
The distress was present across the political spectrum, with 80% of Republicans, 79% of Democrats and 73% of independents surveyed saying they were stressed about the country’s future.
That’s unhealthy for the body politic — and for voters themselves. Stress can cause muscle tension, headaches, sleep problems and loss of appetite. Chronic stress can inflict more serious damage to the immune system and make people more vulnerable to heart attacks, strokes, diabetes, infertility, clinical anxiety, depression and other ailments.
In most circumstances, the sound medical advice is to disengage from the source of stress, therapists said. But when stress is coming from politics, that prescription pits the health of the individual against the health of the nation.
“I’m worried about people totally withdrawing from politics because it’s unpleasant,” said Aaron Weinschenk, a political scientist at the University of Wisconsin–Green Bay who studies political behavior and elections. “We don’t want them to do that. But we also don’t want them to feel sick.”
Modern life is full of stressors of all kinds: paying bills, pleasing difficult bosses, getting along with frenemies, caring for children or aging parents (or both).
The stress that stems from politics isn’t fundamentally different from other kinds of stress. What’s unique about it is the way it encompasses and enhances other sources of stress, said Brett Ford, a social psychologist at the University of Toronto who studies the link between emotions and political engagement.
For instance, she said, elections have the potential to make everyday stressors like money and health concerns more difficult to manage as candidates debate policies that could raise the price of gas or cut off access to certain kinds of medical care.
Layered on top of that is the fact that political disagreements have morphed into moral conflicts that are perceived as pitting good against evil.
“When someone comes into power who is not on the same page as you morally, that can hit very deeply,” Ford said.
Partisanship and polarization have raised the stakes as well. Voters who feel a strong connection to a political party become more invested in its success. That can make a loss at the ballot box feel like a personal defeat, she said.
There’s also the fact that we have limited control over the outcome of an election. A patient with heart disease can improve their prognosis by taking medicine, changing their diet, getting more exercise or quitting smoking. But a person with political stress is largely at the mercy of others.
“Politics is many forms of stress all rolled into one,” Ford said.
Weinschenk observed this firsthand the day after the election.
“I could feel it when I went into my classroom,” said the professor, whose research has found that people with political anxiety aren’t necessarily anxious in general. “I have a student who’s transgender and a couple of students who are gay. Their emotional state was so closed down.”
That’s almost to be expected in a place like Wisconsin, whose swing-state status caused residents to be bombarded with political messages. The more campaign ads a person is exposed to, the greater the risk of being diagnosed with anxiety, depression or another psychological ailment, according to a 2022 study in the journal PLOS One.
Political messages seem designed to keep voters “emotionally on edge,” said Vaile Wright, a licensed psychologist in Villa Park, Ill., and a member of the APA’s Stress in America team.
“It encourages emotion to drive our decision-making behavior, as opposed to logic,” Wright said. “When we’re really emotionally stimulated, it makes it so much more challenging to have civil conversation. For politicians, I think that’s powerful, because emotions can be very easily manipulated.”
Making voters feel anxious is a tried-and-true way to grab their attention, said Christopher Ojeda, a political scientist at UC Merced who studies mental health and politics.
“Feelings of anxiety can be mobilizing, definitely,” he said. “That’s why politicians make fear appeals — they want people to get engaged.”
On the other hand, “feelings of depression are demobilizing and take you out of the political system,” said Ojeda, author of “The Sad Citizen: How Politics is Depressing and Why it Matters.”
“What [these feelings] can tell you is, ‘Things aren’t going the way I want them to. Maybe I need to step back,’” he said.
Genessa Krasnow has been seeing a lot of that since the election.
The Seattle entrepreneur, who also campaigned for Harris, said it grates on her to see people laughing in restaurants “as if nothing had happened.” At a recent book club meeting, her fellow group members were willing to let her vent about politics for five minutes, but they weren’t interested in discussing ways they could counteract the incoming president.
“They’re in a state of disengagement,” said Krasnow, who is 56. She, meanwhile, is looking for new ways to reach young voters.
“I am exhausted. I am so sad,” she said. “But I don’t believe that disengaging is the answer.”
That’s the fundamental trade-off, Ojeda said, and there’s no one-size-fits-all solution.
“Everyone has to make a decision about how much engagement they can tolerate without undermining their psychological well-being,” he said.
Lamirand took steps to protect her mental health by cutting social media ties with people whose values aren’t aligned with hers. But she will remain politically active and expects to volunteer for phone-banking duty soon.
“Doing something is the only thing that allows me to feel better,” Lamirand said. “It allows me to feel some level of control.”
Ideally, Ford said, people would not have to choose between being politically active and preserving their mental health. She is investigating ways to help people feel hopeful, inspired and compassionate about political challenges, since these emotions can motivate action without triggering stress and anxiety.
“We want to counteract this pattern where the more involved you are, the worse you are,” Ford said.
The benefits would be felt across the political spectrum. In the APA survey, similar shares of Democrats, Republicans and independents agreed with statements like, “It causes me stress that politicians aren’t talking about the things that are most important to me,” and, “The political climate has caused strain between my family members and me.”
“Both sides are very invested in this country, and that is a good thing,” Wright said. “Antipathy and hopelessness really doesn’t serve us in the long run.”
Science
Video: SpaceX Unable to Recover Booster Stage During Sixth Test Flight
President-elect Donald Trump joined Elon Musk in Texas and watched the launch from a nearby location on Tuesday. While the Starship’s giant booster stage was unable to repeat a “chopsticks” landing, the vehicle’s upper stage successfully splashed down in the Indian Ocean.
Science
Alameda County child believed to be latest case of bird flu; source unknown
California health officials reported Tuesday that a child in Alameda County tested positive for H5 bird flu last week.
The source of infection is not known — although health officials are looking into possible contact with wild birds — and the child is recovering at home with mild upper respiratory symptoms.
Health officials have confirmed the “H5” part of the virus, not the “N1.” There is no human “H5” flu; it is only associated with birds.
The child was treated with antiviral medication, and the sample was sent to the U.S. Centers for Disease Control and Prevention for confirmatory testing.
The initial test showed low levels of the virus and, according to the state health agency, testing four days later showed no virus.
“The more cases we find that have no known exposure make it difficult to prevent additional” infections, said Jennifer Nuzzo, professor of epidemiology and director of the Brown University School of Public Health’s Pandemic Center. “It worries me greatly that this virus is popping up in more and more places and that we keep being surprised by infections in people whom we wouldn’t think would be at high risk of being exposed to the virus.”
A statement from the California Department of Public Health said that none of the child’s family members have the virus, although they, too, had mild respiratory symptoms. They are also being treated with antiviral medication.
The child attended a day care while displaying symptoms. People the child may have had contact with have been notified and are being offered preventative antiviral medication and testing.
“It’s natural for people to be concerned, and we want to reinforce for parents, caregivers and families that based on the information and data we have, we don’t think the child was infectious — and no human-to-human spread of bird flu has been documented in any country for more than 15 years,” said CDPH Director and State Public Health Officer Dr. Tomás Aragón.
The case comes days after the state health agency announced the discovery of six new bird flu cases, all in dairy workers. The total number of confirmed human cases in California is 27. This new case will bring it to 28, if confirmed. This is the first human case in California that is not associated with the dairy industry.
The total number of confirmed human cases in the U.S., including the Alameda County child, now stands at 54. Thirty-one are associated with dairy industry, 21 with the poultry industry, and now two with unknown sources.
In Canada, a teenager is in critical condition with the disease. The source of that child’s infection is also unknown.
Genetic sequencing of the Canadian teenager’s virus shows mutations that may make it more efficient at moving between people. The Canadian virus is also a variant of H5N1 that has been associated with migrating wild birds, not cattle.
Genetic sequencing of the California child’s virus has not been released, so it is unclear if it is of wild bird origin, or the one moving through the state’s dairy herds.
In addition, WastewaterScan — an infectious disease monitoring network led by researchers from Stanford University and Emory University, with laboratory support from Verily, Alphabet Inc.’s life sciences organization — follows 28 wastewater sites in California. All but six have shown detectable amounts of H5 in the last couple of weeks.
There are no monitoring sites in Alameda Co., but positive hits have been found in several Bay Area wastewater districts, including San Francisco, Redwood City, Sunnyvale, San Jose and Napa.
“This just makes the work of protecting people from this virus and preventing it from mutating to cause a pandemic that much harder,” said Nuzzo.
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