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John Clements, Whose Research Saved Thousands of Babies, Dies at 101

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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.

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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.

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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.

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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.

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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.

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Virus that can cause paralysis in children is on the rise in California: A few safeguards

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Virus that can cause paralysis in children is on the rise in California: A few safeguards

A respiratory virus that in rare cases can cause polio-like paralysis in children is on the rise in California and across the nation, according to wastewater analyses.

Enterovirus D68 was detected in 207 out of 268 samples taken from wastewater sites across the nation in the last 10 days, says the nonprofit WastewaterSCAN.

In the same time period, EV-D68 was detected at a medium level at 17 wastewater sites in California, including facilities in Los Angeles, San Diego, San Francisco, Sacramento and San Jose. Because humans shed viruses in waste, wastewater sampling is used to measure the prevalence of infection in a community.

Most people who contract EV-D68 will experience slight respiratory symptoms or none at all, according to the Centers for Disease Control and Prevention. Nevertheless, its spread is troubling because the virus can lead to a rare and debilitating neurological condition called acute flaccid myelitis, or AFM.

AFM attacks motor neurons in the spinal cord’s gray matter, which controls movement. This causes muscles and reflexes to weaken and, in severe cases, can lead to paralysis and death, according to the CDC.

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Around 90% of cases occur in children, and there is no known treatment.

Dr. Robert Kim-Farley, an epidemiologist and infectious diseases expert with the UCLA Fielding School of Public Health, told The Times that the best way to avoid contracting EV-D68 is to practice common respiratory hygiene.

“This is covering your coughs and sneezes, it’s washing hands,” he said, “If you’ve been around someone who’s coughing and sneezing … make sure that you haven’t touched contaminated surfaces that they’ve been touching or shared cups or utensils.”

This year, the CDC has confirmed 13 cases of AFM, including one in California, as of Sept. 3.

The largest known outbreak of the illness took place in 2018, when 238 cases were confirmed across the country. Cases also spiked in 2014 and 2016.

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Most cases of EV-D68 will be mild and feel like a common cold. However, children with asthma are at higher risk of experiencing more severe symptoms, according to the CDC.

Here are some common symptoms of EV-D68:

  • Runny nose
  • Sneezing
  • Cough
  • Body aches
  • Wheezing and difficulty breathing

If the virus progresses to cause AFM, symptoms include:

  • Arm or leg weakness
  • Difficulty swallowing or slurred speech
  • Difficulty moving the eyes and drooping in the eyelids and face

Kim-Farley recommends people seek medical care if they develop any evidence of paralysis or weakness in the limbs or muscles after having had a respiratory or fever-inducing illness one to two weeks prior.

The paralysis caused by AFM is very similar to that caused by polio — which, like EV-D68, is also an enterovirus.

Polio was eradicated in the Unites States in 1979, thanks to a widespread vaccination campaign, according to the CDC. Unfortunately, there is no vaccine for EV-D68.

“Even though [EV-D68] is not vaccine-preventable, it’s always a good opportunity to realize there are other diseases that cause paralysis, like polio, that are vaccine-preventable” and against which children can be inoculated, Kim-Farley said.

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He also recommended getting the latest COVID-19 vaccine.

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Brett Favre, testifying at welfare fraud hearing, reveals he has Parkinson's

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Brett Favre, testifying at welfare fraud hearing, reveals he has Parkinson's

Testifying Tuesday before the House Ways and Means Committee, Hall of Fame quarterback Brett Favre said in a prepared statement that he was recently diagnosed with Parkinson’s disease.

Favre, 54, was testifying about welfare abuses in Mississippi and allegations that he and others used Temporary Assistance for Needy Families state funds for personal and corporate gains. Favre, who earned about $140 million during a 20-year NFL career that ended in 2010, said in his statement that he was unaware he was receiving welfare funds and was misled by public officials.

A Mississippi state audit found that $5 million in TANF funds paid for the construction of a volleyball arena at the University of Southern Mississippi — Favre’s alma mater — and that $1.7 million was paid to Prevacus, a company developing concussion medication. Favre’s daughter was a volleyball player at Southern Mississippi at the time and Favre is an investor in Prevacus, whose founder, Jacob VanLandingham, pleaded guilty to wire fraud in July.

Favre, who has not been charged criminally, repaid $1.1 million in TANF money for speeches he never gave. The Mississippi Department of Human Services filed a civil lawsuit against him and other defendants, citing text messages between Favre and officials as evidence of his involvement in embezzling funds.

Favre, a Green Bay Packers legend, played in more than 300 NFL games and has long advocated research into concussions and resulting brain trauma. Asked on the “Today” show in 2018 how many concussions he suffered, Favre replied that he was diagnosed with “three or four” but believed the true number was far higher.

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“When you have ringing of the ears, seeing stars, that’s a concussion,” Favre said on the show. “And if that is a concussion, I’ve had hundreds, maybe thousands, throughout my career, which is frightening.”

A 2020 study published in the journal Family Medicine and Community Health determined that “regardless of age, sex, socioeconomic status and residence, having suffered a single concussion in one’s lifetime increased the likelihood of later being diagnosed with Parkinson’s disease by 57%.”

“Sadly, I also lost an investment in a company that I believed was developing a breakthrough concussion drug I thought would help others, and I’m sure you’ll understand why it’s too late for me because I’ve recently been diagnosed with Parkinson’s,” Favre told the House committee Tuesday.

Favre was portrayed in court filings in the embezzlement case as a willing participant in the scheme that allegedly diverted millions of dollars meant for the poorest people in the nation’s poorest state.

Court documents and text messages outlined his alleged involvement in diverting TANF money. Favre and then-Mississippi Gov. Phil Bryant discussed via text using $5 million to help build the volleyball arena at Southern Mississippi.

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Favre also exchanged text messages with Nancy New, executive director of the education center responsible for allocating millions in government funds.

“If you were to pay me, is there any way the media can find out where it came from and how much?” Favre reportedly asked her in 2017.

New, who later pleaded guilty to 13 felony counts of fraud, bribery and racketeering for her role in the theft of TANF funds, replied: “We never have that information publicized.”

Journalist Anna Wolfe of Mississippi Today revealed the payouts in a Pulitzer Prize-winning series of articles starting in April 2022.

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Concern grows as bird flu outbreaks continue to rise among California dairy herds

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Concern grows as bird flu outbreaks continue to rise among California dairy herds

Reports of H5N1 bird flu outbreaks at California dairy herds are continuing to rise as the nation’s largest milk producer scrambles to contain the spread.

On Monday, officials reported that the number of infected dairy herds in the Central Valley had doubled over the weekend, rising from 17 to 34.

A spokesman for the California Department of Food and Agriculture said they expect more cases to be announced in the coming days and weeks, as testing continues.

With roughly 1,100 dairy herds in California — and 90% located in the San Joaquin Valley — concern is palpable, say industry insiders. Outbreaks interrupt milk production at affected dairies. Not only are the infected herds quarantined, but special testing must be conducted at nearby dairy farms as well.

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“Farmers are genuinely worried about the virus and do not feel it’s under control,” said Anja Raudabaugh, CEO of Western United Dairies, the trade association of California dairy farmers. She added the industry is hoping a vaccine for cows will be developed “that would protect our animals” and be compliant under trade agreements.

The threat to humans is considered low. However, infectious disease experts worry that the longer the the virus remains present in dairy farms, the greater the likelihood it could mix with a human virus and pose a greater risk to people.

Both state and federal health officials say milk is safe to drink, as long as it has been pasteurized.

Steve Lyle, an agriculture department spokesman, said the agency’s call to to test dairies within six miles of infected herds, as well dairies that share share personnel or equipment with infected herds, has allowed officials to detect infected dairies “at about the time or just before they are showing clinical signs –- during their incubation period.”

The U.S. Department of Agriculture is working on a bovine vaccination for bird flu, but noted in a statement that this does not mean efforts to control the virus have failed.

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“The pursuit of bovine vaccine development does not mean that biosecurity measures have failed,” the agency said in a prepared statement. “Nor does it mean that USDA believes the virus is here to stay. Vaccine development is one part of an overall strategy that includes enhanced and strengthened biosecurity efforts to contain the virus and help mitigate spread.”

The statement went on to say that a vaccine could prove helpful in eliminating the virus from the nation’s dairy cattle, but it’s just one tool.

“We continue to deploy all available efforts, including biosecurity and mandating the testing of lactating dairy cattle moving across state lines,” the statement said.

It is still unclear how the virus got into the state, but genetic sequencing suggests the virus is similar to that found in infected cattle in other states — and that it did not come from wild birds.

It is also unclear what impact the disease will have on milk production in the state, although Raudabaugh said it will not affect milk prices.

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“Dairy is a ‘loss leader’ at the grocery store,” she said, and is often the major incentive for other items in the store.

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