Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Friday, August 12, 2022

Viruses Leaping the Species Barrier

"[The Langya virus does not appear to] look like a repeat of COVID-19 at all."
"[The new virus is far less lethal than other henipaviruses and] probably doesn't transmit easily from human to human."
"[But this discovery serves as] yet another reminder of the looming threat caused by the many pathogens circulating in populations of wild and domestic animals that have the potential to infect humans."
Francois Balloux, computational systems biology professor, University College London
An Ussuri white-toothed shrew. Scientists in China have detected a novel virus in the species.
An Ussuri white-toothed shrew. Scientists in China have detected a novel virus in the species.
 
Zoonotics -- viruses that are endemic to animal species and that cross the animal-human barrier to infect humans, are not uncommon, since an estimated 70 percent of emerging infectious diseases in humans are of zoonotic origin. On the very tail end of humanity's global bout of infection with the SARS-CoV-2 virus that causes COVID-19's many variants and sub-variants, yet another virus appears to have crossed the species barrier to infect humans.
 
The recent discovery of the Langya virus infecting 35 patients in two eastern Chinese provinces has drawn attention by medical scientists. Researchers based in China, Singapore and Australia have produced a study published in the peer-review New England Journal of Medicine, detailing the Langya virus's discovery. The researchers failed to find evidence the virus was transmitted between people, possibly due to the small sample size studied.
 
The hypothesis reached by the researchers is that before the virus was found in humans it was likely to have been hosted by shrews. Tiny mammals forced to consume their body weight in insects to feed their high metabolic rate, on a daily basis. The first sample of the Langya virus was from a farmer in Shandong province in late 2018 looking for medical treatment for a fever. In a two-year period that followed, another 34 people were found with the infection in Shandong and neighbouring Human, mostly among farmers.
 
The pathogen, according to genetic sequencing of the virus, is within the family called henipavirus within which group five other known viruses are identified, two considered highly virulent, associated with high case-fatality ratios. None of the Langya patients identified died of their condition, according to the study.
 
Of the 35 patients, 26 were infected only with the Langya virus and all of the 26 featured fever, half of them in addition showing fatigue, decreased white blood  cell count and cough. Impaired kidney and liver function are among the more severe symptoms of the virus affecting the group. 
 
The virus's genetic material was "predominantly detected" in shrews, leading the team of researchers to suggest it is these small mammals that represent a "natural reservoir for the virus", after they had tested 25 other small wild animal species for the Langya virus.  There was no detection of sources of exposure common among those infected. 
 
A shrew is seen in this 2019 photo. (Hyun-tae Kim/WikiMedia/CC BY 4.0)
A shrew is seen in this 2019 photo. (Hyun-tae Kim/WikiMedia/
"From a medical and scientific perspective, there is a concern because we need to understand how distributed is this virus. And more importantly, what's the range of disease severity that you can get with this virus? And that's what we don't know."
"I think what we need to do is let the medical and scientific community focus on their concerns and get that information. Because until we have that information, there's really no need to panic."
"One of the things that Nipah virus [another henipavirus virus] can do in addition to the flu symptoms, is it can actually infect the lungs or give you pneumonia. But more importantly, it can also infect the brain,"
"Unfortunately, we have no drugs or vaccines against Nipah virus. We certainly have nothing against this new Langya virus and that question mark is a concern."
"Animals and insects … they have a habitat, they have a niche. And they also have their own biome, in a sense that they have germs, viruses and bacteria and other stuff that's inherent to them."
"Human encroachment into the environment has consequences to human health."
Dr. Donald Vinh, infectious disease specialist, McGill University Health Centre, Montreal

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Thursday, August 11, 2022

Return of the Dread Poliomyelitis

"Based on earlier polio outbreaks, New Yorkers should know that for every one case of paralytic polio observed, there may be hundreds of other people infected."
"Coupled with the latest waste water findings, the department is treating the single case of polio as just the tip of the iceberg of much greater potential spread."
New York State Health Commissioner Mary Bassett
 
"Many of you may be too young to remember polio, but when I was growing up, this disease struck fear in families, including my own."
The fact that it is still around decades after the vaccine was created shows you just how relentless it is."
"Do the right thing for your child and the greater good of your community and have your child vaccinated now."
New York County Executive Ed Day
Children in iron lungs receive treatment for polio at the King George Hospital in Winnipeg in 1953. The Beaver
 
There was an old saying "When it rains it pours" and that seems appropriate at a time when a zoonotic virus that originated in China two-and-a-half years ago speedily swept virulently across the globe, infecting hundreds of millions of people, hospitalizing tens of millions, killing millions. Viruses have always been with us; science is aware of viruses having swept through human communities in the ancient past. And at this critical time when the international community of medical science still doesn't know how the SARS-CoV-2 virus will ultimately play out along comes an old viral enemy, one thought to have been vanquished decades ago.
 
An old commercial for a brand of salt used to turn that old adage around with "When it rains it pours" and that too applies in that we're beginning to come around to the idea that there is an endless supply in nature, of viruses and they will continue to surface, no matter how industriously medical science seeks to find cures beyond preventive vaccines. Now, just as the COVID pandemic has become in our minds, endemic, a virus we will have to live with in its many recurring forms, New York and London have discovered a polio resurgence.
 
Many people infected with polio don’t show any symptoms. Some become temporarily paralyzed; for others, it’s permanent. In 1952, the polio epidemic reached a peak in U.S.: almost 58,000 reported cases and more than 3,000 deaths.

Back in the 1940s and '50s, poliomyelitis surged through global communities, killing children and leaving many others in a condition of permanent paralysis, while countless others suffered no lasting ill effects. Now, suddenly, on July 21 the first polio case in 40 years surfaced with a resident of Rockland County became paralyzed and diagnosed a month later. He was a young, unvaccinated adult. According to the New York State Department of Health the case might have originated outside the United States.

The NYSDOH two weeks on. announced the discovery of the polio virus in waste water samples from Orange and Rockland Counties. In the United Kingdom in June, a rare "national incident" was declared after traces of the contagious virus were discovered in London sewage. 115 polio viruses from 19 sewage samples had been identified by the U.K Health Security Agency in London.

Polio is spread mostly through contamination by fecal matter. No cure exists for it, but vaccination brought the pathogen that killed and paralyzed thousands of children worldwide annually, close to eliminating the disease. Largely eradicated in most countries of the world, polio is still endemic to two countries; Pakistan and Afghanistan. Both countries are affected by a type which has the potential risk of international spread.

Iron Lung

This undated photo shows an iron lung. Used to help weakened polio patients breathe, the machine was displayed as part of a Mayo Clinic exhibit.

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Wednesday, August 10, 2022

Curating an Intimate Relationship

"We found women are barometers. Their perceptions of how happy they are do predict their own experience in future, and also their partner's. But we found the exact same pattern for men, and just as strongly."
"We think this obviously challenges this accepted lore that women's experience takes primacy or is intrinsically more diagnostic. We find men's experiences matter just as much, for their predictive value at least."
"Nobody really knows how far out women should have this more predictive ability."
"All of us could do a little better, being reflective and aware of those fluctuations in how things are going, and knowing that if things are abnormal for you, either good or bad, chances are that's an indication things continuing either short- or long-term in going the same way."
Matthew D. Johnson, professor of family science, University of Alberta
“Happy wife, happy life” has a strong theoretical context, which may explain some of its durability in both science and culture.
A generally accepted metric of couple satisfaction has been reduced to the catchy phrase: "Happy wife, happy life", as though this sums up the reason behind successful marriages. Unspoken but related is the injunction to men that it is their responsibility to ensure their wives are content and pleased with the relationship, making this his focus to derive his own satisfaction through his selfless attention to his wife's. As though if a man in an intimate relationship has the good sense to ensure his wife is happy, the relationship will be stable. A comforting, male-directed, male-onus formula. That just happens to be wrong.

The health of any intimate relationship is dependent on both actors' attention toward the other to derive fulfillment in maintaining the union and enjoying it. A new, detailed statistical analysis of a large data set of daily diary entries people in opposite sex relationships kept along with surveys of opposite-sex couples over time where relationship highs and lows of thousands of people were tracked, resulted in the conclusion that it is incumbent on both man and woman to be aware of each other's state of comfort in the relationship.

It is, after all is said and done, common sense. In fact, it's a peculiar turn of sensibilities, given the fact that traditionally in earlier eras, it was always impressed upon women that their duty as a wife was to ensure the husband was always satisfied with her performance as housewife, mother, and any other metric of service to the marriage from a woman's perspective. Long outdated as well, and for good reasons.

The paper was co-authored alongside researchers from Europe and North America. Professor of psychology at University of Toronto, Emily Impett, gathered much of the data the study was focused on. Theory had it that women's experience should be predictive of the long-term health of an intimate relationship. Social psychology engages with the roles expected by society of women, while evolutionary psychology focuses on their destiny as child bearers.

Study researchers looked at daily diary studies from 901 North American couples and a longer-term survey of 5,400 German couples; two parallel studies. A key finding was fluctuations in relationship satisfaction does not reverse minute to minute, but lingers; both good times and bad. The paper identifies them as 'emotional residue'.

If all is going well, suggests Dr.Johnson, be aware, contemplate why this is, and "harness that". Pay close attention to the negative, manage it and contain it "so that less than typical happiness does not continue to follow you into the future". Also common sense advice.


"Testing the barometer idea across two time scales -- day-to-day and year-to-year -- is an important feature of this investigation, as there has yet to be any specification of the period over which the barometer phenomenon should be evident. If we extend the barometer metaphor [i.e., something that registers and predicts short-term changes], we might expect more consistent evidence on the daily level, such that fluctuations in women's relationship satisfaction should more robustly predict their own and/or their partner's satisfaction. Alternatively, prior studies invoked the barometer metaphor to explain findings based on the analysis of long-term panel data, indicating many scholars view this as a longer-term process."
"Counter to expectations from long-held views in relationship science, our analysis of over 50,000 reports of relationship satisfaction from more than four thousand mixed-gender couples found no evidence that women's satisfaction was a stronger predictor of couples' relationship satisfaction than men's satisfaction at the daily or yearly level."
New Study Paper published in the journal Proceedings of the National Academy of Sciences

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Tuesday, August 09, 2022

The Russian Military, Conscripts, Thugs and Criminals

"Three prisoners told human rights activists that businessman Yevgeny Prigozhin was allegedly coming to the colony."
"Firstly, recruiters show interest in those convicted for murder and robbery. Those inmates in prison for drug and sex offences are normally not selected."
"Wagner recruiters refuse elderly people and those with serious illnesses."
"To check, they are asked to do push-ups on the floor, sit-ups and perform other physical exercises."
Verstka news Website 
Putin and Prison
Putin is turning to prisons to recruit frontline personnel (Image: Getty)

First there were rumours months ago that Russia was sending raw recruits, young Russian men conscripted into the Russian military, half-trained and never informed initially where they were going and why, into Ukraine for Russia's 'special military operation'. Russian mothers of these young men receiving confused messages from their sons were outraged and many complained vociferously. Now, many among them mourn the loss of those young recruits, with the conflict burning through countless Russian and Ukrainian military servicemen.

From raw recruits, alongside seasoned veterans who have gained a reputation for themselves and for Russia as war criminals, not merely soldiers in their penchant for attacking and murdering Ukrainian civilians, for bombing civilian infrastructure, for raping and looting, a critical shortage of military personnel, not only at the lower levels, but leaders and commanders, is sending the Kremlin through the intervention of Putin supporters, to prisons.

The issue of insufficient numbers of frontline personnel has influenced a Kremlin insider, Yevgeny Prigozhin, chief of the secretive Wagner Group, a militia known as brutal mercenaries for hire. They have seen action in some of the world's hot spots, including Africa, where their fighting expertise minus any persuasive sense of morality has earned them an unenviable reputation for brutality and efficiency as a conflict tool any group can hire.

But it is loyal to Russia, and Prigozhin is a personal friend and ally of Russian President Vladimir Putin, in service to his interests, and his interests at the present time is the total destruction of Ukraine as a nation imagining itself sovereign and democratic. The "Russian Sitting" charity whose purpose for existence is the support of families of convicts, worked alongside the Wagner Group to help recruit prisoners to fight in Ukraine. They did caution inmates this option did not represent an easy escape from a prison sentence.

Russian Tank
Russia has lost over 42,000 troops since the start of the war (Image: Getty)

On its website, the "Russian Sitting" charity informed the families of the convicts that all the promises made by Wagner and other Russian mercenary groups such as Shield, Slavic Corps, Patriot and Redut are legally impossible to enforce and that they should not be trusted. That's called 'eyes wide open'. Recruits to Wagner are offered 200,000 roubles (€3,202) as a monthly salary along with a presidential pardon and a “coffin payment” to the family of the mercenary if he is killed.

Once the inspection procedure is completed, those convicts that are accepted into the program are sent to basic military training before joining frontline forces in the Donbas region. The report published in the Verstka news website claimed that up to a thousand criminals from 17 prisons were persuaded by Wagner to sign up to fight in Ukraine once their physical  condition was verified as well as a stated allegiance to "defend the Motherland"; top recruiting criteria.

Wagner Group
The Wagner group have wide support in Pro-Putin circles (Image: Getty)

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Monday, August 08, 2022

Safe Haven Baby Boxes

"Abandonments are happening everywhere, but people are not aware of it because it's not happening in their backyard."
"We can all agree a baby should be placed in my box and not in a dumpster to die."
"When a woman is given options, she will choose what's best for her. And if that means that in her moment of crisis she chooses a baby box, we should all support her in her decision."
Monica Kelsey, founder, "Safe Haven" Baby Drop Boxes
Safe Haven Baby Box

Unwanted babies born to girls and women who have no intention of raising and nurturing them for whatever reason, who are placed in areas where they will be seen and rescued, have taken place since time immemorial.  Houses of worship were often places where babies and infants were left abandoned to chance. Infanticide was always another option. With the greater availability of medical interventions to interrupt a pregnancy those abandonments were significantly lessened.

As a means of disposing of the unwanted burden by a woman who was raped, or one already raising too many children, or coping with poverty or any number of other reasons, abandonment of babies since the U.S. Supreme Court abandoned the right of women to seek safe medical abortions, giving the green light to states who seek to enact tougher laws restricting abortions or going to the extreme of making them illegal, are certain to be on the increase.

In 1999 after infants were discovered in garbage bins, safe haven legislation known as the "Baby Moses" law, was passed in Texas, a state which strictly forbids abortion under the law. Aborting a fetus doesn't fly in Texas, but abandoning babies in garbage bins as a solution doesn't, either. Enabling a woman under duress, desperate enough to consign a baby to death, to have an alternative disposal route by leaving a baby in a box, is considered a humane option. As a solution to an untenable choice, it is.
 
BABYBOX
Now that Roe vs Wade has been overturned, the inevitable uptick in abandoned babies has resulted in the humanely compassionate promotion of adoption as an alternative to abortion. Leaving an unwanted baby into a drop-off bin resembles a disposal method commonly used in small-town communities in the 19th century. Such boxes can now be found at disparate public places from fire stations and hospitals to other sites where staff have received training in handling abandoned babies.

This completely anonymous solution to a difficult and heart-wrenching problem has seen over a dozen states pass laws to permit the use of drop boxes. Most of the 100 drop boxes currently in use in the United States are in Indiana where the movement began when Monica Kelsey, who discovered she had herself been abandoned mere hours after birth, felt a compassionate obligation to help both mothers and babies with a solution to an age-old dilemma.

A box installed at a fire station in Carmel, California received three babies this year following its disuse for the previous three years. Three more babies were left at boxes elsewhere in the state over the summer. Indiana last week became the first state to approve abortion restrictions in the wake of the Supreme Court ruling overturning Roe vs Wade.

Safe haven laws protecting mothers who surrender their babies have been passed in all 50 states. The Safe Haven movement promotes awareness of safe haven laws. Their hotline latterly has received over 8,000 calls from across the United States. Over 100 babies have been left with them, 21 of them surrendered through the safe haven boxes.

Safe Haven Baby Box

 

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Sunday, August 07, 2022

Aiding Ukraine in Coping With Critically War-Wounded

"Many of them have amputated legs or hands. Before the war, we had only civilian problems -- people who fall on the ground, break their leg -- not running from rockets."
"We always need blood donors."
"We have injuries we didn't have before. We need some doctors that worked in Afghanistan, in all the hot points." 
"We need doctors that know everything about war trauma, doctors who can  help us with different kinds of it."
Zoriana, hospital administrator, Ukraine

"We can use it everywhere. In the field, in the hospital, in the emergency ambulance."
You don't need a supply of oxygen, or even electricity. You can use it for a few hours [on battery]."
Dr. Yurii, anesthesiologist, Ukraine

"If there isn't medevac capability available, if the country doesn't have control of the skies, the patient may have to be taken care of at the point of injury for an extended period of time."
"This device can be used wherever the war fighter is injured."
"Obviously, there was a dire need."
Lesley Gouldie, CEO, Thornhill Medical Company, Toronto
Thornhill Medical’s portable life-support system shown in a simulated battlefield scene. The gear mimics the capability of an ICU and can be used in almost any setting. The Toronto firm donated some of the equipment to Ukraine, where it is being used to treat war casualties.
A new medical system named MOVES SLC combines an oxygen-conserving ventilator, an oxygen 'concentrator', equipment for monitoring vital signs and suction for clearing airways, all in a 'rugged' 18-kilogram package about the size of a small golf bag. The concentrator is one of its key features, creating oxygen by absorbing air and removing nitrogen, eliminating the need to carry about bulky oxygen tanks. Entirely battery-powered.

What better place to have this kind of portable, life-saving equipment than a battlefield? The second most vital place would be a hospital suddenly immersed in the need to admit battle-injured servicemen
during an all-consuming, violent altercation between nations, one determined to destroy the second, the attacked nation even more determined to stop the existential threat and drive back the attackers.

Now, a major hospital in Lviv, coping with the impact of Russia's Ukraine invasion has been supplied with state-of-the-art, technically advanced hospitals-in-a-bag to simplify and modernize their critical war-trauma equipment in service to the thousands they have been treating over the last five months, both civilian and military.

A Toronto-area medical devices company has donated unique cutting-edge technology to the hospital in a humanitarian gesture to make it easier for hospital medical personnel to cope with the unprecedented number of emergency cases, and restore hope for the future of the seriously wounded. Samples of its portable life-support systems were flown by Thornhill Medical to the intensive-care unit of the hospital.

Each single unit is capable of providing most of the treatment and monitoring of an intensive care unit. The single unit incorporating these many functions can be slung over someone's shoulder. In addition, similar, on-the-go anaesthesia machines were also supplied by Thornhill with gear allowing health workers to provide advanced life support and surgery in areas where such services would be impossible, otherwise.
 
Thornhill Medical’s portable life support system in a Ukrainian ambulance. The gear mimics the capability of an ICU and can be used in almost any setting. The Toronto firm donated some of the unique equipment to Ukraine, where it’s being used to treat war casualties.
Thornhill Medical’s portable life support system in a Ukrainian ambulance. The gear mimics the capability of an ICU and can be used in almost any setting. The Toronto firm donated some of the unique equipment to Ukraine, where it’s being used to treat war casualties. Photo by Handout
 
This transference of modern medical equipment to Ukraine emphasizes its broad needs under a situation of all-out war. Weaponry supplied by Ukraine's allies is vital for its survival against a far-larger and better-equipped attacker, but Ukraine is also in dire need of medical assistance to enable it to cope with a huge burden and responsibility, to save countless lives of those injured by an incessant rain of bombs and artillery.

Co-founder of Thornhill, Dr.Joe Fisher, an anesthesiologist at Toronto's University Health Network, has urged the government of Canada to place greater emphasis on providing medical assistance to Ukraine. "If we flagged that we were sending  his type of equipment [as opposed to war machines], we would be the envy and the honoured of the world. Why would we not do this?", he stated.

The equipment has already been used elsewhere, purchased by the militaries of the U.S., Canada, Australia, Israel and elsewhere. In the Donbas region at the height of fighting, some 100 Ukrainian soldiers were killed and 300 injured each day of the conflict. Training was provided to hospital workers in Ukraine by a team of Thornhill employees who accompanied the machines.

Thornhill Medical’s portable life support system in Ukraine. The gear mimics the capability of an ICU and can be used in almost any setting. The Toronto firm donated some of the unique equipment to Ukraine, where it’s being used to treat war casualties.
Thornhill Medical’s portable life support system in Ukraine. The gear mimics the capability of an ICU and can be used in almost any setting. The Toronto firm donated some of the unique equipment to Ukraine, where it’s being used to treat war casualties. Photo by Handout

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Saturday, August 06, 2022

"If It Works I Will Use It"

"This is the landmark case that is going to legalize psychedelics in Canada."
"The hoops that patients with cancer need to jump through to get access to their medicine is barbaric."
"For two years, we've done absolutely everything in our power to play nicely with the government. If we get this, nobody in Canada will ever have to go to court again for access to psilocybin. No more people will be dying waiting for access. This is what we've been working toward."
"The outright prohibition of psilocybin is against our Charter and that was made evident with cannabis."
Spencer Hawkswell, CEO, TheraPsil

"If it works, I will use it."
"That's my whole litmus test. Cannabis, I felt, was a very effective tool. I believe that psilocybin will also be an effective tool."
"I have had anxiety for so long, I had sort of forgotten what it feels like to not have it."
"To experience the lack of anxiety I have had this week is beyond words [2020]. It's amazing. I have no idea how long this particular benefit will last, but so long as it's here, it's really, really amazing and good."
Thomas Hartle, stage four cancer patient
Samples of mushrooms and a small pill capsule.
Psilocybin can be extracted from psychedelic mushrooms and then processed into pill form. (Camille Vernet/Radio-Canada)
 
IT professional from Saskatoon, Thomas Hartle. shortly following being diagnosed with cancer became a medical cannabis consumer at age 46. Now, he is among a group of eight Canadians who have filed a challenge against the Government of Canada and the minister of health for denying them access to magic mushrooms, psilocybin. The group is comprised of seven patients and a health-care practitioner.

Their Charter-based argument is that current modes of accessing psilocybin fail their needs -- thus representing a violation of Section 7 of the Canadian Charter of Rights and Freedoms, guaranteeing the right to life, liberty and security of the person. The situation has a parallel in the landmark court case, R v Parker whose outcome led to the first medical cannabis laws in Canada.

The current challenge sees support from a British Columbia based non-profit, TheraPsil, whose fundraising covers legal fees. Their support of the plaintiffs has also extended toward aiding them in securing legal access to psilocybin. Their Charter challenge argues that the three existing pathways to legal access of psilocybin for medical purposes fail to adequately serve patients' needs.

The three pathways -- obtaining a personal exemption from the Minister of Health under the Controlled Drugs and Substances Act; working with a doctor to obtain an authorization through a Special Access Program; or enrolling in a clinical trial, are all cumbersome, time-consuming and give no guarantees of success. 
Hartle was granted the CDSA exemption for one year on Aug. 2020.
Hartle was granted the CDSA exemption for one year on Aug. 2020. Photo by Michelle Berg /Saskatoon StarPhoenix
 
Mr. Hartle's experience with the use of the existing protocols itself, proves the point. With guidance from TheraPsil, Hartle applied for the exemption in 2020 and by August the exemption for a one-year period was granted, enabling Hartle to undergo psilocybin-assisted psychotherapy, becoming the first person in Canada to legally use psilocybin for medical purposes. This resulted in a significant decrease in his distress and anxiety, with no side effects typical of pharmaceuticals.

Then the exemption expired, just as his cancer spread throughout his abdominal cavity. The months of relief he experienced following psilocybin therapy sessions have evaporated. Since his exemption period expired, he no longer can access psilocybin. In October of 2021 he submitted an application for a n extension of the exemption, and to the present there has been no response.

As for the other plaintiffs wishing to pursue psilocybin therapy, they have been forced to do so illegally after having been denied exemptions, or having had to wait for over a year with no response to their applications. Several of whom also bear terminal cancer diagnoses; others suffer major depression disorder, anxiety and addiction. One plaintiff suffered four separate bouts of sepsis and lives in constant pain.

The CEO of TheraPsil notes that his non-profit has been overwhelmed by applications over the past two years from Canadians needing help in accessing medical care. Their wait list stands at over 800 patients. To manage the situation they have focused mostly on patients with terminal cancer. Their statement of claim sent to Health Canada argues a framework for constitutionally viable access to psilocybin exists within the cannabis law.

In 2020 an Ontario court agreed that the prohibition of cannabis by the Controlled Drugs and Substances Act contravenes section 7 of the Charter, leading to the creation of Canada's first medical cannabis laws. The belief is that the current Charter challenge should logically be channeled in a similar pathway. "This is a near replica of Parker. The outright prohibition of psilocybin is against our Charter and that was made evident with cannabis", points out Hawkswell.

Close-up of a person pouring mushrooms into a zip-top bag.
Some health-care providers are treating certain mental health conditions with psilocybin, an active ingredient in magic mushrooms, in a clinical setting as part of more traditional psychotherapy. Other drugs could include ketamine, LSD or MDMA, the active ingredient in ecstasy. (Richard Vogel/The Associated Press)

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