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Fecal transplant turns cancer immunotherapy non-responders into responders (eurekalert.org)
407 points by CharlesW 69 days ago | hide | past | favorite | 302 comments

When a possible link between gut biomes and disease progression was first proposed, the response by the established science was pretty harsh.

That people studying these links persisted and have created many reproducible experiments that demonstrate the connection is a testament both to perseverance and to science.

When people try to argue that science is "people making things up." as a reason for disbelieving science that challenges their beliefs, I use this example of fecal transplants as a real world case of how scientists challenge, confront, debate, and incorporate changes into their world views through process, review, and reproduction.

Same story for bacteria and stomach ulcers.

And I know at least one researcher who started looking more deeply into the impact of the gut biome on health because of the demonstrated link between bacteria and ulcers.

At some point, I would expect a fecal sample/biome to be part of one's periodic physical so that we could build a data set of biomes + medical history database that is a bit more comprehensive than the voluntary ones that exist today.

Is that true? Hitler was doing it, so it must have been known for a while.

Meanwhile, offering high quality FMT transplants is a huge startup opportunity. People who need FMT are very sick, desperate, and willing to pay thousands of dollars to get it done. Recently, I have spent $2000 to order poop from the internet.

Finding a high quality doctor is extremely difficult for a normal person. You have to find someone who is young, athletic, very healthy, never taken antibiotics, and then do some medical tests on them (pretty much everything that's wrong with a person can be transferred through FMT). Finding such person, bringing up the subject with them, and getting them agree to help is very hard.

A company who could find and screen high quality FMT donors could make thousands of dollars just selling poop. Hundreds, if you're willing to drop prices to help people.

All you have to do is find a healthy person who matches the criteria, and spend $2000-$3000 doing a number of blood/stool tests (and retest them every few months). Also figure out how to freeze/package/ship the transplants in a way that does the least harm to the microbes.

If you are a healthy person who fits the description (or know someone who is), and are willing to help - please send me an email - fmthelp@protonmail.com

> Finding a high quality doctor is extremely difficult

I'm pretty sure you meant "donor" there, no?

> never taken an antibiotic

I understand recent antibiotic use such as past 12-24 months, but never?

This is still an under researched field (with a lot of alternative medicine types surrounding it), but there have been some studies that even relatively minor antibiotic usage in childhood may have long-term impacts. And there are more (and better) studies that gut flora isn't back to normal 6 months after a course of antibiotics. It's something of an open question currently. It seems like there may be a few stable microbiomes that can develop in humans; some are better than others for health.

I think it would be helpful here to describe how very sick people looking for a fecal transplant usually are. And also how - even though it's only been clinically approved for Clostridium difficile infections - there are also controlled data that indicate it's effective for other intestinal illnesses.

Hacker news is one of the places where I often value the comments more than the linked articles themselves. But wow. This thread is full of pseudo-science type reasoning. Let’s be careful. We have science and the scientific methods to investigate things like this. It’s worked very well for us for a long time, let’s try to have som faith in it.

> Hacker news is one of the places where I often value the comments more than the linked articles themselves. But wow. This thread is full of pseudo-science type reasoning.

It's been this way for years. HN is really quite good when it comes to things in their wheelhouse (software, tech companies), but hilariously bad about diet and related issues, I suspect because it's a sore spot for many and they are in denial.

Diet is one of the things that's absolutely full of bad science, because it's hard to study. So claiming HN is somehow in denial implies there's an amazing scientific consensus. (Also even if we take the best studies at face value the relative risk differences are ridiculously low between diets. [At least as far as I know.])

> (Also even if we take the best studies at face value the relative risk differences are ridiculously low between diets. [At least as far as I know.])

See, this is exactly what I'm talking about. I'm willing to bet that just like me, you're not an expert in that field. And there are people who are experts in the field, reviewing the literature, and have come up with a pretty good consensus.

Here's the thing: It's pretty easy to chat with a bunch of experts and test your hypothesis.

In fact, I've recently done so owing to some recent health issues. As best I can tell there's almost no consensus among experts aside from "everything in moderation" and "eat a balanced diet" which isn't directed advice as much as hedging.

I have asked the various experts I've talked to why advice is so varied and their answer is that there is no consensus on many of these issues. Some had their own opinions about which parts might be right, others were clearly in the "it's a mess, just don't eat too much and wait and see" camp.

This is not a well developed field.

What if there is no field to talk about ? Most people cannot believe that some part of science are not as advanced as others. But there are good reasons, nobody care enough to throw enough money at tit. Look at obesity in the US, if someone cared about it, if would be fixed. Much more money was thrown at advancing internal combustion motors than improving diet of the average citizen of the USA.

I think it's reasonable for laymen to be skeptical of expert consensus in soft, non-experimental fields, especially when the consensus frequently changes significantly and is strongly influenced by industry, e.g. the views on dietary sugar/fat, cause of alzheimer's, lobotomies...

Particularly when consensus is not unanimous.

I never claimed I was.

I'm basically regurgitating the Bad Food Bible book (written by Aaron Carroll, the guy who hosts HealthCareTriage).

Well, I'm regurgitating a Dr. Greger of https://nutritionfacts.org, who is constantly reading studies and papers to get to the bottom of dietary science. You're welcome to spool through his hours of video on YouTube on the subject (where he quotes excerpts from studies he's read), or maybe just start with this one on gut flora and obesity:


Sources are under the video.

Yes, so. The linked video is about a n=30 observational study. "Diet science" is full of this. (At least this study explicitly noted that no inference regarding health outcomes were made.)

The guy is fighting the good fight (against USDA and so on), but this is still the HN is hilariously bad at diet and related issues.

Dude there is far from a 'consensus' in this field.

Recommending reading one guys opinion on it sorta proves the point.

Well, more than diet, anything that isn't technical in nature. Economics, (geo-)politics, biology (particularly humans), etc. There's a lot of that fallacy around here that being knowledgeable/smart in one area means that obviously it transfers to every other field.

I just remember a while back fecal transplants came up here (and other forums I frequent) as a "treatment" for obesity, as they found different gut flora between obese and healthy weight populations. So many people were thinking they could get a fecal transplant to cure their obesity, not stopping to ask maybe what was causing gut flora to be different between obese and healthy weight populations.

And as for diet, the studies are out there. I'm no expert, but I listen to people who could credibly be argued are (as one example Dr. Greger who reads tons of studies and cites them in his videos), and typically their advice comes down to common wisdom that people just don't want to hear: eat food, not too much, mostly plants.

The scientific method works at a very slow pace and goes even slower when public opinion is against an idea.

We have a lot of known unknowns about gut biota. And a lot of people whose gut biota are literally killing them. And a lot of friends and family of those people. They are of course going to be frustrated. Especially when they look at how long those question marks have existed. Get to it already!

Feyman’s wife died while the antibiotic that saved people like her was in drug trials. Can you imagine being that close to a cure and missing it? When I read about people dying of infections mid century I have to pull up my calendar and just pity them a little bit more.

> scientific method works at a very slow pace

Listening to a recap of the effort to test the theories of relativity, it occurred to me that confirming "truth" may be just as hard as refuting falsehoods. It's certainly not easy.

Brandolini's law https://en.wikipedia.org/wiki/Brandolini's_law

I am not sure what you mean by ‘the scientific method is slow’. Compared to what, really? Just winging it? But I think I see what you mean. And yes, science do take time. From discoveries in basic science, all the way to clinical trials and then treatment approval, there is significant lead time. And, of course, it is especially sad for those who suffer when treatment seem to be just around the corner.

But the alternative is surely worse; to not test, to not review or to base treatment on other things than facts.

And, one more thing. The speed at which we have scienced the shit out of Covid (the amount of science that we have done in response to this virus) is, at least to me, astounding. If we succeed, which it looks like we will, to win this battle using the vaccines which are already available, it, not only, is in favour of science in fact being very quick, but could also be considered one of humanities greatest feats.

> The speed at which we have scienced the shit out of Covid

Alternatively I have been absolutely appalled at how slow our institutions have been to respond correctly in so many ways.

1. Anosmia: it took months before I heard about it, and months before it got added to lists of symptoms. A common and distinctive signal back before we had testing was an opportunity lost.

2. The emphasis on hand washing and the de-emphasis of transmission by air... dangerously retarded.

3. The whole face masks bullshit - all the probabilities pointed towards their use being beneficial... because even small reductions to the speed of transmission can reduce exponential growth.

4. The lack of information about real-world testing of transmission - presumably virus transmission was tested on people in more than one authoritarian country, yet I never saw the results of that testing surface.

The above are only some of the significant delays that I saw in the transmission of science and fact during the epidemic, and I haven’t even really looked into the topic in depth (mostly I just skimmed HN for information).

I spent 10 years battling anxiety. Went away when I had a lumbar fusion. Surprise!

My best guess is my pinched nerve caused the sensation which I then experienced emotionally. Exactly no one any where suggested the possibility of a physical cause to an emotional state.

Scientific progress is not a straight line. More like bumps in the dark.

I definitely think that my back pain effects me emotionally and saps my happiness. I'm way grumpier than I ever used to be. (I also wonder if chronic inflammation causes an autoimmune-like response which is resulting in other new conditions like heartburn).

I think the body plays a much larger role in our emotional and mental states than we give it credit for.

It's incredible to me that you can look at the Covid response and see anything but an astonishing series of failures by public health authorities (vaccine development was a rare bright spot). Anyone with basic scientific literacy and critical thinking ability has consistently been _months_ ahead of public health recommendations. Early prep for the pandemic, the FDA's breathtaking negligence in historical ongoing limitation of tests[4], mask recommendations, indoor vs outdoor spread risk, fomite vs air spread risk, the priority and manner of the vaccine rollout, outdoor-protest risk, relative herd immunity in hard-hit places like NY.... it's very difficult to think of a shift in the science that the medical policy and communications establishment wasn't stubbornly holding on to weeks and months later than everyone scientifically-literate was fairly confident.

This isn't an argument for rushing consensus before the evidence is strong enough, but the reasoning behind the initial mistakes was consistently laughably stupid, relying on vague platitudes instead of intellectual rigor[1]. Medical culture is plagued with innumeracy, illusory hard binaries, poor critical thinking, and knee-jerk hyper-conservatism. While the first three are an unforgivable gap that the medical establishment needs to engage in some hard self-examination over, the latter is possibly a reasonable baseline culture for normal circumstances[2]. However, it's horribly maladaptive in a situation like a pandemic, where time is a critical factor and the baseline cost of inaction is thousands of lives a day, trillions of dollars, as well as the PV of the future cost of exponential spread.

As always, I'll clarify that this is not a criticism of _doctors_ as individuals. All of the doctors I know are at least moderately intelligent and well-intentioned, but professional culture is a powerful force and medical school is a heavy-duty indoctrination device that I've seen make too many people _worse_ at thinking. I'm fairly close socially to a lot of doctors of various ages, and I've only seen the most intelligent[3] ones I know manage to shake off this brainwashing enough to recover their critical thinking abilities.

Throw in the challenges of political engagement with expert fields....suffice it to say that Alex Tabarrok's fucking Twitter account was a better source of public health understanding than the WHO/CDC/FDA/policymakers combined.(I started that sentence as a joke, but I'm actually pretty sure that those ignoring the latter in favor of the former would have had a healthier, happier, safer pandemic experience).

[1] For example, Bob Wachter, the chairman of the Dept of Medicine at UCSF, came around to the idea of loosening the second-dose-reserved-at-all-costs orthodoxy after a little while, citing the basic math that the numerate among us had been screaming about since the beginning of the vaccine drive. His reason for his initial disagreement? "An unnecessary curveball". Doctors' misuse of and amateurish engagement with science would be amusing if it wasn't killing so many people.

[2] though the lever is probably jammed too hard in one direction due to liability concerns and inaction bias

[3] To the extent that pedigrees are useful for calibrating where this bar is: my double-Ivy-League-educated physician sister is miles below this intelligence bar

[4] As far as I'm concerned, the FDA has more blood on their hands than anyone at this point. Anybody who paid any attention to them before March 2020 should be completely unsurprised

I did not mention public health authorities. I think that the science community has done an astonishing job. Almost all funding and research in medicine have been redirected to COVID and we have a handful of vaccines that have been developed and tested in about 18 months. If that isn’t to “science the shit” out of it, I don’t know what would be.

But, as you elude to, none of that matters if public officials and decision makers don’t care for science.

I mean, full agreement here but the... that science should be done and not financially starved because the outcome serves no long-term financial interests.

If you're referring to fecal transplants, you're wrong. There is significant controlled clinical data that it's effective. Many more trials are underway. And there are masses of anecdotal case reports of truly miraculous recoveries.

But this particular study isn't one of them. It is completely uncontrolled. That's the problem with HN. People just can't tell the difference between good science and non-science, and they keep upvoting these junk articles.

I'm from the internet and I might not actually have a science degree, but I do have a Ph.D. in the thousands of beneficial uses of hemp.

Isn't all science "pseudo-science type reasoning" before someone goes out and proves/disproves it? I don't see a problem with some curious conversation.

No. There is difference. Science works by making observations, making hypothesis and then testing those. The result is some kind of knowledge which is useful for making predictions.

Reasoning in this world is based on that. We only make predictions when something is tested, established or pure fact.

What I mean by pseudo-science type reasoning is; not based on any fact, nor any position which has been tested (scientifically), nor any established knowledge. Instead it is often based on anecdotes or the reason is motivated or heavily biased.

Frankly, I don’t care too much about bad reasoning. But when there is risk that it might be understood as recommendations, and it might be unsafe for someone reading it, then I think it’s dangerous.

there's nothing wrong with sharing anecdotes, but it's not science until someone actually does the "proving/disproving" in a convincing way.

Well, it might be wrong to share anecdotes, IMO. We should always be careful when communicating online as we don’t know who we might be communicating with. Someone might take those anecdotes as proof that something works, and might go out and do something that might not be safe.

As an anecdote, I'm close to someone who had issues w/ their microbiome causing havoc for a year after taking antibiotics. They tried all kinds of diet and probiotic treatments to no avail. In desperation, a doctor prescribed an experimental approach where they'd take antibiotics again to kill the 'bad bacteria', then go on a heavy probiotic regimen. This worked thank god.

Could you share the specific antibiotics and probiotics they've used?

Stuff like this motivated me to do a minor in Immunology during university. And we still have no idea what is going on.

Do people who work on Septic tanks (or nightsoilmen) and such share a common profile in regards to their immune system?

Or is transplanting a requirement?

How would it work? Airborne poop particles? I've never seen my septic guy get poop on themselves and certainly not in themselves.

It seems reasonable that people in that line of work would get exposed to random folks' germs orders of magnitude more often than someone not working around waste, even if they aren't swimming in it.

I would definitely mention it in my Yelp review if they did.

Fantastic hypothesis.

I had a business idea a few years ago to do fecal transplants from famous people as a new LA business. There seems to be a lot of regulatory hurdles for doing it though. I would love to see someone do this both in disease treatment, as well as just to test out impact on things like mental or athletic performance.

In 2012, Brandon Cronenberg, son of David, released a movie called Antiviral about a niche product -- viruses and bacteria harvested from celebrities who become sick, in order to inject them into paying clients who want a "connection" with the famous.

What exactly was the rational behind that?

I mean, if people are willing to pay money for Gwyneth Paltrow's vagina eggs or Twitch streamer's bath water, I can only imagine the small fortune people would pay for a bacteria transplant from a famous person, even if it had no effect whatsoever(you can always craft a cleverly worded ad that suggests there are benefits but never actually states so as a fact).

It would have an effect though. That's a direct alteration to your gut microbiome. I guess, sure, fetishists are a thing. But I'm not sure it's a viable target market haha.

You could probably sterilise it so there's absolutely no live anything remaining and people would still buy it. But yes, it's probably a tough market :-P

is the pace faster though ? I had the impression that small progress came more often in this decade.

> Davar and colleagues collected fecal samples from patients who responded extraordinarily well to anti-PD-1 immunotherapy and tested for infectious pathogens before giving the samples, through colonoscopy, to advanced melanoma patients who had never previously responded to immunotherapy. The patients were then given the anti-PD-1 drug pembrolizumab. And it worked.

It's pretty crazy that your gut biome can change the way your body responds to skin cancer treatment.

Could this work for basically anything immune-related? Maybe people who got COVID but were asymptomatic could donate some poop.

This is something that I've been thinking for quite some time now (i.e. pre-COVID and just generally health related).

I was on lots of anti-biotics as a kid and I turned from skinny to fat at some point. We know already from experiments/treatments being made that fecal transplants can make a fat person skinny for example (no I didn't do that :))

Personally I transformed my life from being very lethargic and not being able to tolerate anything but small amounts of certain foods and also alcoholic beverages without getting major migraines by getting the right probiotics. To give you an idea, eating leftover lasagna two days in a row was a sure fire way to get a migraine, as was drinking a bottle of alcohol-free beer and anything with alcohol was even worse. Even just small amounts. We're talking migraines where you feel like you're gonna puke and my eyesight was affected as well.

I felt really sick for about 2 weeks after starting the right probiotics. And it wasn't just any probiotics that would do. I tried out different ones, until I found a specific one that mainly differs in one bacterium from all the others I tried. Bacillus subtilis in case you're wondering. During that time my then current microbiome would've been fighting with the newly introduced strains. After that, I was no longer lethargic and slowly but surely I was able to tolerate foods in normal quantities again. Leftover lasagna is just awesome now, like it should be!

So yeah that's just a personal anecdote on how gut health can really eff up your life and health. So I can very well believe that people with a 'broken gut' would die more easily from COVID or get infected more easily with other things as well. But where's the money in simply fixing peoples guts? Isn't it 'better' if we make them sick, so we can then prescribe them stuff?

What supplement/brand/company do you use?

The one I found is available to me here is Garden of Life - Primal Defense Ultra: https://www.gardenoflife.com/primal-defense-ultra-probiotic-...

It has Saccharomyces Boulardii, like many if not most Probiotics, which is already good and I tried that one in isolation before as well. Then it has various Lactobacillus strains that are common in most Probiotics in some combination or another. If you specifically have problems with histimine, like me, then the different strains actually matter, because some produce histamine, while some reduce it or have no effect on it. I had tried various other probiotics that basically had zero effect, while this one had an effect. I can't prove it, but the only real difference on the labels I found was that this one had Bacillus subtilis, while none of the others I tried had it.

There are actually some Lactobacillus, that made my condition _worse_. You may know Danone Actimel, which makes probiotic claims. I can attest that they are true. The do have active Lactobacillus casei. I know, because it caused me headaches, because Lactobacillus casei actually _produces_ histamines, which is the cause of my migraines.

Worst headache I've ever had in my life was with a Zinc pill. Back then I had no idea why I sometimes got headaches. The capsules were Zinc + Histidine. Histidine being converted by the body into Histamine ... Which btw. is (big part of) what makes your hangover headache.

The other good thing is that if I now have a "slipup", I just take a Benadryl and it's all gone :)

Just one more question: do you need to continuously take them to have good effect or after some time (months or bottle) you are fine also without them?

I haven't really tried not taking them at all for prolonged periods of time. But I did start off with just one a day, went to two a day, then three a day. That was to slowly ease into it, while the existing bacteria in my gut would 'fight it out' with the new guys and slowly introducing more and more of the ones I wanted to be in there to crowd out whatever was in there before.

Now I'm on one in the morning and one in the evening but I don't sweat it at all if I forget. I might be totally fine with just one.

Some of the strains definitely just stay for a little while. Saccharomyces Boulardii for example IIRC usually isn't capable of hanging around forever if it's not replenished from the outside. You can get a lot of these from eating things like Sauerkraut. AFAIK Bacillus Subtilis is a bacterium that people in previous times would have naturally gotten from eating stuff from their garden, i.e. it's a "soil bacterium", so if you ate cabbage from the garden and you couldn't get _all_ the dirt and included bacteria off it, you might have gotten some Bacillus Subtilis with it.

I do have a garden but don't eat enough stuff straight from it I suppose :)

Thank you for mentioning Bacillus subtilis. Will look into it more.

The question I have is how to evaluate the 'proper?' gut biome / fecal "recipe" to get the desired outcome?/Expression?

So what characteristics would a good vs bad donor gut biome/fecal biome be?

> The question I have is how to evaluate the 'proper?' gut biome / fecal "recipe" to get the desired outcome?/Expression?

You and the rest of the medical community. This is largely still an open question.

I actually know someone who is going through immunotherapy (for leukemia) and so suddenly this kind of news is quite a bit more relevant than just a interesting factoid.

Thankfully this person seems to be responding to therapy, but it makes me wonder whether they will end up benefiting from microbiome therapy in the future.

It's also being studied as a treatment for autism:


It seems like an outrageously simple and fundamental thing, to the point wherein one might wonder how many other positive things could be achieved - and - why on earth some people have such a deficit.

Could it be diet, exercise, other things?

If this response turns out to be valid, in that fecal transplants materially affect these kinds of therapies ... it would seem to me that we need to spend a few $Billion researching this immediately, the potential outcomes for relatively non-invasiveness ... seems like massive ROI opportunity.

Who needs fecal transplants when you've got splashback from shared toilets?

There has been a recent paper published around treatment of melanoma cancer with positive results as well. Interesting to see how the research in this area progresses. Hopefully making more of these devastating cancers more treatable.


Not sure if you read the linked article, but these appear to be the same study.

My bad! Quickly glanced - you are correct.

I hope that some day they break down the science in this method to find the exact cultures that are providing benefit. Many performance athletes already use probiotics rectally and are said to gain advantages from doing so. I've only seen limited scientific papers on the topic and more often anecdotal responses from athletes. Well now I have a weekend research project.

I just can’t even fathom having an original idea like this and then even more so having it work. Who thinks of this shit?

There’s been information about the power of FMT floating around out there for a while now.

I’m convinced that pharmaceutical corporations have nothing to benefit from more effective treatments, which could largely be why we see smaller players doing these types of honorable and groundbreaking studies.

One study I’d love to see is the effect of treated tap water on our microbiome. If tap water is designed to kill micro-organisms, what could it be doing inside us?

Given that there's a large body of work detailing the importance of the gut microbiome, which has effects on everything from cognition to the immune system, it wasn't as huge a stretch as it might seem. Perhaps only when you're not aware of the incremental progress so it may seem as a huge leap.

The article states that an AI algorithm directed the researchers to gut bacteria.

> Who thinks of this shit?


My sister got to move to immunotherapy after years of cancer treatment. It has been very effective.

Anecdotally, I have learned that immortality tends to be effective, and less hard on patients than other types of cancer treatment, but is held off because insurance providers don’t want to pay for it.

I'm curious if you could get the same effects by changing your diet, and what that diet is. I suspect this is at the bottom of all gut microbiome "problems", and furthermore that any fecal transplant will only have temporary effects if one continues to have a bad diet.

I think antibiotics can cause a lot of problems. You get strep throat, take antibiotics, and it kills off something in your gut you've had all your life. How do you get it back? Eat yogurt? That's nonsense. There are supplements that supposedly help rebuild your intestinal flora, but I'm pretty skeptical that they work.

So a bad diet can definitely kick your microbiome out of whack, but I don't think that's the only cause.

> So a bad diet can definitely kick your microbiome out of whack, but I don't think that's the only cause.

True, but I think it's just one of those truths people know but don't want to hear: a baseline of good health is behaviors/habits that boost it, and that includes things like getting enough good sleep, adequate exercise and a diet that is not just enough food (not too little and not too much), but the right kind of food. If we're going to go down the path of judging some gut flora as "better" than others, it behooves us to discover how to get those gut flora, and it only makes sense a large part of that is what we ingest.

And yeah, I'm opposed to overuse of antibiotics too. In the same vein, fecal transplants seem like a quick fix that might be justifiable (ie cancer cases), but shouldn't be seen as a "get out of jail free card" for bad habits.

Given all the weird shi... phrasing... stuff that has happened with performance enhancing drugs I have to wonder if there aren’t some sports doctors out there who know a bit more about this stuff than they’re letting on...

"Out of 15 advanced melanoma patients who received the combined FMT and anti-PD-1 treatment, six showed either tumor reduction or disease stabilization..."

It's a clue, at least. So much we don't know.

How about calling it the anti-douche. Who wouldn't want an anti-douche.

tl;dr: In a proof-of-concept phase 2 trial, researchers transplanted gut bacteria from patients who responded extraordinarily strongly to immunotherapy into the gut of patients who are completely nonresponsive to the therapy. N = 15, with 6 people experiencing reduction of tumors or stabilization.

It's definitely not a silver bullet... I feel like we still don't understand enough about the mechanisms surrounding the gut flora. This is flailing in the dark. Fingers crossed these results encourage more research into the biological chemistry behind this.

It will take decades if not more just to classify all bacteria, protists, viruses, etc who live in human gut. Even more to understand personal differences, mechanisms of influencing human immunity and behavior.

> N = 15

I'm not a scientist but isn't that a tiny sample?

As an author on the paper, that's reality. We'd all like cohorts with hundreds or thousands of people, but that's just not how things work in reality.

So the core idea in this study was actually determined by an algorithm to focus their attention:

> Artificial intelligence linked these changes to the gut microbiome, likely caused by FMT.

Is immunotherapy orally administered? Could it be simply changing the absorption efficiency?

They know about The Spice Melange! the spiiiccee

I heard about this on south park

I wonder if it could be simply inserted into the other end instead of being swallowed. Perhaps a suppository would do?

Says in the writeup that the transplant is done "through colonoscopy" so it is "inserted in the other end", right?

I have heard of fecal transplants being effective administered orally via capsule. Though that might be a bitter pill to swallow, I might prefer it to the other route...

Sorry, I skimmed through and didn’t get the colonoscopy part. I guess the bitter pill to swallow is no longer part of the practice though easier than a colonoscopy it was just grossing me out.

Will I now be obligated to yell at someone who cuts me off on the freeway "Eat sh%t and DON'T die?"

Now that's not too shitty an outcome!

So awesome.

So gross.

The procedure seems to have all kinds of benefits, but I think the name could've really used some of the good ol' marketingspeak. I bet a lot more people would be open to getting something like a "digestive microbiome transfer" than the more accurate but gross "fecal transplant".

"You stuff someone else's shit! Up your ass!"

I guess the counterpoint is that maybe we don't have to sanitize every damn thing in the world, since a sanitized world isn't a healthy world - and perhaps contributes to an individual's wonky biome.

I think you would only transplant healthy biomes, which have plenty of immune system action involved so that there are plenty of beneficial bacteria, and little or no say e coli.

It might actually be the transplanting of immune cells that helps strengthen the recipients' immune action

Related FDA advisory about a time where drug-resistant E.coli was transmitted via fecal transplant: https://www.fda.gov/vaccines-blood-biologics/safety-availabi...

The tone of the first half of your comment had me thinking the rest of it was about not sanitizing vocabulary, rather than talking about the hygiene hypothesis, haha.

I can’t wait until there exists a poop culture + social platforms around otherwise ordinary people with celebrity fecal matter.

Merch plop!

Surely you meant to say "poop culture"?

I don't think he did. We're already at poop culture level as far as I can tell.

Fixed x2

And wine tasting/perfume shop like experience? This must be one of those million dollar ideas.

And poopfluencers who have secret diets that give you psychedelic brain-gut experiences

will we have a new class of 'poop producers' who shepherd in the new generations in 2150 ?

E.g. everyone in a 250 mile radius get fresh poop injections from the mother queen

Almost perfect IMHO.. but word "transfer" sound to me like a transplant. May I suggest "digestive microbiome rejuvenation" ?

agreed that "transfer" sounds and feels similar to "transplant". But imo the "transplant" part in "fecal matter transplant" was not the part that was problematic for public perception lol.

I think both "digestive microbiome transfer" and "digestive microbiome transplant" sound perfectly fine, as both get rid of the "gross" part of the name. But I think that "transfer" is slightly better, because "transplant" invokes associations with something being surgically put into my body and attached to stay there permanently. While "transfer" doesn't have the same sense of permanence and seriousness attached to it.

You win today's INTERWEBS MARKETING ACHIEVEMENT BADGE.You may have a cookie;

People with cancer don't care what a medicine/treatment is called.

Are you a doctor?

I hear stories of people using alternative “medicine” and eschewing (normal|western)? medicine, so I think you are incorrect. Anecdotally I personally know of one person who used indigenous herbs to treat their cancer (I don’t know the outcome of that).

I’d guess most of people that need this treatment are very happy to overlook the name or even reality of what it is. If it leads to better health than they’re able to sustain right now, then yeah by all means.

"late digestive microbiome transfer"

"early digestive microbiome transfer" would be .. bar.. puk.. emetic reflux transplantation.

I assume that we could just isolate and culture the bacteria colonies in clean agar agar, solving the problem.

I suggest "Shithromax".

"Eat shit and NOT die!" seems like a winning campaign to me

On a Duke Nukem poster

They should learn from Chinese propaganda. They called the Myanmar coup a “cabinet reshuffle”

You may have a gift

Pfft. Eat shit! It's the hit!

You're right a lot of things has benefited from rebranding. For example instead of 'cow feet juice', it's now Jello.

Once upon a time there was a startup that made laser equipment. They called themselves Coherent Radiation.

Hmmm ... for some reason they decided to rebrand themselves as Coherent, Inc.


Dolphin Fish -> Mahi Mahi


Patagonia Toothfish -> Chilean Seabass

Dog salmon or chum salmon -> "keta" salmon, or "silverbrite" salmon.

Crushed parasitic beetles -> Starbucks strawberry drink [1]

[1] - https://inhabitat.com/starbucks-admits-its-strawberry-drinks...

I suppose by some definitions, this beetle is a parasite, but it feeds from a specific species of cactus, which makes it a herbivore, so in the context of a story ostensibly alerting starbucks customers (and if you're a starbucks customer you've probably got deeper ethical issues to introspect on) it's an odd adjective.

Aside - tracts of Australia, and doubtless elsewhere, have a major problem with the cactus that was introduced specifically to feed these beetles -- Opuntia aurantiaca, aka tiger pear.

A cousin of the better known (and edible-fruiting) prickly pear, this one has smaller pads, grows only about 30-50cm high, but has much fiercer spikes, propagates way more easily, and the biological controls (cochineal beetle) are woefully less effective than, say, the Cactoblastis moth that's used to control prickly pear.

Back to cochineal - for a very long time it was one of the very few ways to produce a reliable, consistent, persistent red dye. The incidence of anaphylactic shock and similarly strong reactions to cochineal, while non-zero, is tremendously low.

Artificial dyes also have some non-trivial health concerns [0], and some manufacturers are moving back to cochineal for this reason.

[0] https://www.google.com/search?q=artificial+red+coccine+dye+h...

Calling cochineal a "parasitic beetle" is pretty silly, since it is not a beetle, and its host is a nopal cactus.

A vanishingly tiny number of people care whether their food coloring contains crushed up bugs. I can guarantee you eat similar insects (aphids, etc.) on a regular basis in "vegetarian" or "vegan" food.

I agree with this. It is super easy to prove and many of them are still alive too. Just put a random set of vegetables in a container and wait. You will see flies, aphids and all manor of other bugs born in it. I sometimes even find fruit-flies when I do this. Same with meats. Meats contain larvae and well, I won't gross people out here. That is why I cook what I can and wash everything with apple cider vinegar, since I have so much of it anyway. Also important to keep stomach acid strong for this reason. I envy Vulchers for their super strong stomach acid.

Rapeseed -> Canola

Patagonian toothfish -> Chilean sea bass

Slimehead -> Orange Roughy

pervasive surveillance and tracking -> Advertising

Oppression -> safety measures.

Undesirable political views -> disinformation

disagreement -> downvote

Adam Back -> Satoshi Nakamoto

Oh please. Read some of the stuff Satoshi wrote, it's obviously not the same person.

Satoshi actively encouraged other blockchains, even encouraging namecoin to run their own chain separate from bitcoin back when the proposal was called "bitdns":


Back has been nothing but a frothing-at-the-mouth altcoin hater.

Comments like @gridder's do an injustice to Hal Finney.

I agree with you on Back and Finney and I apologize to whoever was offended, it was not my intention...


Yeah, taxation isn't extortion and tyranny isn't representative government tho but otherwise agreed!

I would argue the conversion is the one you're utilizing, from "taxation" to "extortion."

Extortion is a specifically defined crime, and of course, it is the role of the government to define criminal behavior. In the same way that getting arrested by the police isn't kidnapping, paying taxes isn't extortion.

The consent of the governed and all that.

> The consent of the governed and all that.

Can you explain what you mean by this?

Turns out if you don’t pay taxes or fines, at the extreme you can be shot to death. This is legal.

Lot of laws and rules are arbitrary, so a government official get a “fine”, sometimes massive fines, placed against you.

You pay it or lose everything, go to jail, or get shot for refusing.

Lots of struggling business owners are finding themselves in this situation lately.

Lots of small business owners are getting shot for not paying taxes? Generally you have to make profit to pay taxes. Otherwise they've been substantial beneficiaries of programs like the PPP.

Gyms and restaurants are opening despite orders.

Many have already been given major fines, had utilities shutdown, etc.

Friends our shutdown there restaurant last week.

That’s what happens when you break the law. It’s like talking about all your friends jailed for DUI, like ok, maybe don’t do that then?

Break the law? "Dictator" given mandates without scientific backing are "law" now?

Because everywhere you look... with or without lockdowns, COVID is spreading... California, New Jersey, Florida, Texas... all different approaches. All spreading in "2nd waves"...

Not everyone is okay with following "decree's from on high by a benevolent master" without end because "the war will never be over so give me more power"...

Just to be clear, the state and federal government have a long history of challenged (and ultimately upheld) sweeping authority to impose restrictions in support of public heath. Here's an analysis by the CATO institute, which is, dare I say, not exactly "left-leaning". [1]

There were pandemics and lockdowns all the way back to the founding fathers, which I still find very strange to hearken back to, they made a lot of poor decisions too - but I digress.

[1] https://www.cato.org/commentary/are-lockdown-orders-constitu...

Not in New Zealand though huh. Where they did the lockdowns properly, and it stopped Covid completely. Compliance is the issue not the approach.

So all laws are good? Is that what you would say to someone who broke Jim Crow?

> That’s what happens when you break the law. It’s like talking about all your friends jailed for DUI, like ok, maybe don’t do that then?

What law is being broken?

survival -> stimulus

Be evil -> Don't be evil.

Don't be evil -> Don't don't be evil


Oh... That makes so much more sense.

I have many ever-so-slightly aged cookbooks (Asian-themed, in particular) that would always recommend, "Use rapeseed oil for stir-frying, due to its high smoke point" and driving myself nuts trying to find rapeseed oil at grocery stores. Even at Asian marts! I could find grapeseed oil, but never rapeseed.

Thank you!

This might sound rude, but you never thought to google "rapeseed oil" and immediately clear up what it is?

I think resourcefulness is inexplicably decreasing in the age of information.

For example, it amazes me how many questions on r/Spanish could be answered in 5 seconds by pasting the title into Google, but OP also wrote two paragraphs to explain their predicament of being unable to translate a common word.

I don't want to pile on our friend above, but it's a good example. We are all seconds away from just looking up rapeseed oil and learning some interesting things about it, but we don't even do that (myself included in all of this).

It reminds me of the parable of the lumberjack who is found trying to cut down the same tree all day with a dull axe because he says he doesn't have time to sharpen it.

I just googled "rapeseed oil" (though I knew another name for it is "canola"), and literally the first result's title is "Rapeseed Oil (Canola Oil): Uses, Benefits, and Downsides".

I understand people asking about subjective stuff but objective stuff like this is so easy to Google.

It's also still the common term in some places (e.g. UK, iirc) so you may find it in current recipes.

Technically, it's a subset. Not all rapeseed oil is low-acid (the l-a in canola).

Fair point. In europe, say, would that be marketed as low acid rapeseed oil though, rather than canola?

"Rape blossom" is perhaps my favorite English word because of how starkly the feelings invoked by the individual words contrast each other.

I always wondered what the hell canola was (not enough to look it up, but, still)

CANadian Oil Low Acid, it’s lower in erucic acid than other rapeseed cultivars. In the early 70s there were studies in rats that showed that erucic acid caused heart disease so canola was marketed as being healthier.

That's the same acid which lead to mustard oil being banned, hence it being labelled 'for ceremonial purposes only' or something similar in Indian groceries in the US as a wink-wink workaround.

Is mustard oil used in a lot of Indian cuisine? I wonder if that has something to do with the high rates of heart disease in people of Indian descent?

I have no firsthand knowledge of Indian home cooking, but here's an article about it which claims it's common.


From what I've seen in passing most people attribute rising heart disease to economic prosperity leading to a more westernised diet but I haven't really looked into it.

More common in some northern states than in south India.

"Indian cuisine" is not a monolith and in fact, regional cuisines are disparate, contrary to the image derived from Indian restaurant menus abroad. Some parts of India like West Bengal (which is in east India) famously use mustard oil in a lot of their cooking. Other parts of the country never use it.

(I'm Indian.)

I've only seen it used to make Aam ka achaar (mango pickle)

It stands for CANadian Oil Low Acid.

"cow feet juice" is actually a euphemism in itself.

All kinds of connective tissue and meat plant scraps, as well as anything that grows in it during it's unrefrigerated transport and storage, go into gelatin.

Chinese Gooseberry -> Kiwi Fruit

alligator pear → avocado

Ooh, that one went the wrong way imho

Or rather: testicles -> alligator pear

But in actual reality: edible testicles -> mountain oysters.

(nahuatl) ahuakatl (testicles) -> (ES) aguacate -> (ES, EN) avocado

Source: https://www.etymonline.com/word/avocado

OMG! This is the worst TIL of my entire life. I eat a shameful amount of Jello as an adult, and I did not know this!

If it makes you feel better it's often pig feet, and sometimes various knees.

Also, gelatin is in EVERYTHING. Good luck eating virtually any dessert if you're a strict vegetarian.

I still remember (with a mixture of awe and horror) the video I saw that showed how gummy bears are made... in reverse. So you start with delicious looking things, and it just gets more and more nightmarish. It was brilliantly done, and I am pretty sure I think of it almost every time I think about gummy candies.

I think I found it again by searching for "reverse gummy bear video". I won't link it directly, so that if you really don't want to see it, there's less chance of reflexively clicking a link. ;)

Welp, guess I've eaten my last gummy bear. At least Swedish Fish are gelatin-free!

The video, for anyone wanting a direct link (be warned, it's exactly as gknoy described): https://vimeo.com/180163754

Fascinating, never thought about how they get the skin off. Think in terms of a cross between a large powered vegetable peeler and a packing tape dispenser (the kind with a handle).

The video is not actually gory - shows parts of the cleaning and butchering process, but not the slaughterhouse.

I had a callout a few years ago to fix some issues with a sheep pelter. I'd never seen one before and didn't have much context until the guy described how it was meant to work, at which point I... did not feel well. Ended up having weird OS comms issues with the PLC programming software and after a few hours of frustration wasn't able to connect anyway, but to this day that's the most morally compromised I've ever felt about my job. Which I guess is weird, I mean the sheep were already dead so it's not like it was gonna suffer more, but... ew. Ew ew ew. So much ew. Not gonna lie, a part of me was relieved that I couldn't help them.

I'm sitting here just opening and closing my mouth in that "I'm sure there's something to say about this but I'm not quite sure what" way.

Getting past that, I was pretty sure I knew what a sheep pelter was, but I did not expect that there is in fact a product (TM!) named the Pelt-O-Matic.

Reading the description it sounds very.... efficient.

Warning: Don't watch the same video for electronics (assuming it exists and gets back to the heavy metal mines)

Decomposing an alive pig into gummy bears is like making gold bars out of laptops.

As someone who eats plant based, that is definitely not the case in the US. Gelatin is very easy to avoid.

Outside of jello itself, the common desserts that contain it are chewy candies and some mousse type desserts. So canolli, mousse, and flan frequently have gelatin, along with things like Starbursts and some chewing gums, but other than that I have not found it to be a common ingredient.

Weird... In Australia (last I checked at least, maybe it's changed) it's commonly in chocolate, ice cream, and any kind of soft sweet, to the point where it's nigh impossible to get any of the above without it.

There are very good vegetarian substitutes for gelatine, they're just more expensive. So gelatine content can vary quite widely by market depending on the number of vegetarians. Here in the UK it used to be in a lot more things 20 years ago than it is now.

> chocolate

Definitely not in anything like a bar of chocolate.

> ice cream

Oddly, this seems to vary a lot by country. It's rare in the US, though. Guar gum is common, though.

People who keep kosher or halal mostly avoid gelatin, so countries with notable kosher, halal, and vegetarian/vegan populations probably see less gelatin use.

Expert vegan here. No, gelatin is never in plain chocolates, but often added to diced coconut!

For chocolates it might be in things with foams or nougat. Definitely in marshmallows.

Ah. chocolates != chocolate

Usually nougat uses egg whites so it doesn't need gelatin as a protein. Marshmallows are arguably nougat, though, since they're also sugar bound with protein. Marshmallow cream usually uses egg.

All of the major nougat US candy bars I can find use egg and not gelatin.

I've seen chocolates with marshmallow in them.

In Ireland it would be very rare for me to see it in ice-cream or chocolate, and I'm fairly religious about checking labels. Plenty of sweets / jellies, but these days there are more and more vegan / vegetarian options.

Not just food, gelatin is also found in shampoos, face masks, cosmetics in general, and all kinds of candy.

The theme in the US is things that are chewy and things that are stored cold and need to retain a texture.

The common places you might not expect it are sour cream, yogurt, fondant, and some Planters dry-roasted nuts.

Does Great Lakes gelatin have the same "random assortment" issue?

The history of gelatin as a food product is fascinating, as it exploded in popularity in the mid century - check out some of these.... interesting looking dishes.



I always thought it was made from the actual hoof... which I assume is keratin.

But this video shows it to be made from pig skin https://vimeo.com/180163754

And the red coloring in many foods (E120) is made from insects.


A different question could be why are you a strict vegetarian when your species evolved as an omnivore

Everybody turning strict vegetarian would create an ecological disaster at planetary level.

Why is that worse than the planetary-level ecological disaster that's currently being exacerbated by everyone in the developed world eating a ridiculous amount of meat?

My species also "evolved" to constantly fight wars against everyone not in my family; I'd say it's really good news that we were able to develop moral and conceptual systems to overwhelm our evolutionary tendencies.

So you live a hunter gatherer lifestyle, mostly outdoors, and definitely don't sit in a chair out of the sun for hours at a time? Since we're talking about evolution.

I'm not, I evolved as an omnivore. I also generally don't like meat though because I'm weird.

Do they still use horse parts for the glue that keeps the boxes shut?

Hopefully, what else are you going to do with hooves and bones otherwise, throw them away? That's wasteful!

(in reality there's almost no chance, synthetic glues are way easier to manufacture and manage, outside of gelatin animal glues would near-only be used for restoration or specialty applications e.g. some lutherie and other speciality woodworking)

'Terra Preta'

I hope so, horses are terrifying.

You know, it's kind of funny. Horses might have a better argument than any other animal for being the natural predator of humans. Specifically, nomadic depredations on preindustrial societies comprised armies with a proportionally small number of humans and a large number of horses pillaging towns and cities full of horseless humans. In 13th-century Asia, the average horse probably had a better life than the average human. The same thing happened shortly after the horse was (re)introduced to North America in the sixteenth century; settled agricultural societies were quickly overrun by horse-riding nomads.

No, but there are plenty of horse parts in red wine.

Not sure where you're from, but at least for American-made wines that's not often the case, as there are many more common and/or cheaper sources for chitin, casein, gelatin, etc. (pig and cow, as well as egg based sources for example). Also, blood-based fining agents have been outlawed in the US and Europe since the mid 90s thanks to the mad-cow scare.

Of course this conversation also ignores the fact that fining agents are removed from wine before bottling as part of their purpose - they bind with the crap you don't want in your wine. Typical store-bought wine will have no detectable amount of a fining agent in it.

It's contamination "by association." I don't think it's debatable that fewer people would drink wine with pleasure if I told them it was filtered through human bone char, even if I didn't include any in the bottle.

It's more common in white wine.

It’s good for you

I'd argue that cow feet are best for cows.

If people didn’t eat cows or drink milk, they’d be like most other large ruminants... extinct.

Being selected as a food species for a more successful species is a classic example of the conundrum of evolution; it’s great for the species and pretty bad for the individual.

They don't need them after they've been sent to the market.

luckily there are alternatives if you are vegan, such as agar and pectin

Wouldn't call it a successful rebranding. Cow feet soup is positively delicious (and rather expensive).

You're missing the point. Cow feet soup might be positively delicious, but from a North American standpoint (and probably most western cultures), it's not something people are lining up for.

I wouldn't necessarily say that, pig feet soups are extremely popular in the south, particularly in Cajun cuisine. It's not exactly the same but is rather similar. Almost everyone knows what it is and it doesn't both us that it is what it is despite being in NA.

> but from a North American standpoint (and probably most western cultures), it's not something people are lining up for.

I’m an Australian of Anglo-Celtic descent and I’ve always been keen to try “weird” foods. Never had cow feet soup, but sounds tasty. I’m sure I’m not the only Westerner with this attitude either

I think there's a sizable population of Koreans in Australia, so if you have access to a Korea town, try to find a restaurant with "gomtang" (thick broth soup) in its name (or something similar) - the cow feet soup is called "joktang" or "ujoktang". In case you're curious, they look like this: https://www.google.com/search?q=%EC%A1%B1%ED%83%95&tbm=isch

That said, they're an acquired taste, so you may think it's an overpriced sugar-free lump of Jello in greasy water... YMMV. :)

Chicken foot soup also tasty.

Burritos with an actual foot inside of, well coworkers say it’s good.

and immune system boosting. :)

Most ancient: Bee(s) vomit -> Honey!

Chicken periods -> eggs

Sushi vs cold, dead fish.

The way I heard it:

bait -> sushi

vs _raw_ dead fish :)

vs _cold_ _raw_ dead fish :)

Fraud -> Subprime mortgage crisis

Theft -> Quantitative Easing

Bank Fraud -> Identity Theft

Bank robbery -> Undocumented withdrawal

coagulated cow puss --> cheese (got this one from "What The Health" documentary on Netflix)

Hold up.. what?

Jello is called jello because it's made from gelatin. Which was some poor cow's hooves, among other things.

Affordable Care Act > ObamaCare

ObamaCare > RomneyCare

Anyone know if gelatin causes extra animals to be killed? If not, you probably could feel okay about it.

Morals of animal consumption aside, adding demand for any part of an animal will add some degree of financial benefit for using animals in general (ie: reducing waste by making use of an additional part means more $ in the farmer's pocket per cow).

What about that fancy organic fertilizer?

Well, maybe. By finding a valuable use for an otherwise unused part of the animal, you're increasing the value of raising and slaughtering animals, and increasing the value of something usually encourages more of it. But it's more interesting than that because the main market is for the meat, and if the availability of meat were to decrease because it's not as profitable, one would expect the price to go back up a bit, which would in turn encourage more production.

That's a strange way to frame it. Reducing waste will allow farmers to cover more of the production costs using non-meat revenue. In a competitive market, this will push them to lower the price of meat, stimulating its consumption, and increasing the number of animals, which in turn will lead to economies of scale, lower costs and prices, even higher demand and even more animals.

You don't know the elasticity of demand for the non-meat parts. Parent was hypothesising that the demand for it might be inelastic so the price would go up.

Further, a lower price for meat may stimulate demand but it will more likely suppress production rather than increase it. It depends on the costs of raising the animals and the opportunity costs of the farmers. Excess profit is what generally attracts competition and more production. Lower prices are not normally associated with larger profits. Only a few "markets" are much different; e.g. oil, gas, etc.

There's two sides to every price setting action, supply and demand. The current price is where they cross now, so the shapes of the respective curves aren't necessarily clear.

> Further, a lower price for meat may stimulate demand but it will more likely suppress production rather than increase it.

You might have missed the premise where the reduced prices in meat are a direct result of competition and increased profits due to better margins on non-meat products. The specific demand elasticity is irrelevant for this scenario - as long as pig hides and lard are not Veblen goods.

If more consumer money is put into the animal product market then there are two possible outcomes: either they all go into the profits of the manufacturers in a perfectly monopolistic market, or they go towards higher quantities being produced in a competitive market. It's economically impossible to depress production by increasing demand for the products of a certain industry - except very particular market anomalies, luxury and status goods etc.

Very unlikely as it's basically a way to get value out of low value parts. If sources on Wikipedia are to be trusted it's mostly made from pig and cow hides, which is why you can also find kosher gelatin (where the supply chain is known and free of pork products).

Probably not. Lot of parts can produce gelatin and they are usually not the ones eaten or are less preferable. So actually I think it likely did reduce waste.

Everything that increases the profit of a system, by being a revenue source or even just reducing the cost of the process, contributes to the system.

Yes, animals are being killed and ground up to make gelatin.

Picky Americans refusing to eat offal probably contributed to meat calories being wasted and therefore more animals being slaughtered to meet demand.

Not if you're vegetarians. Or Hindus.

"Can I smoke while I pray" vs. "Can I pray while I smoke"

Crossdresser -> transgender


Caviar vs fish babies.

HN has been devovling into Reddit for a while now. Smh.

Please see the last paragraph of https://news.ycombinator.com/newsguidelines.html, including the links there.

The Darwinist in me, honestly, welcomes the death of foolish men by their own hand, who would opt-out of a life-saving procedure for but a dislike of it's name.

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