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    "text": " Greetings fellow hackers, biohackers, and friends of Four Thieves Vinegar. This is Michael Laufer, recording for you from a secure undisclosed location. And don't worry, we'll actually have a live Q&A after this session, so I will be available and excited to chat with all of you. I am chief spokesperson for the Four Thieves Vinegar Collective, and I do want to emphasize the fact that we are a collective. Oftentimes it gets forgotten because the many people who do the work for this are in the shadows. They have to, for understandable reasons, keep themselves safe and can't be known to the public. But there are so many people who work on the Four Thieves projects, and there are so many teams who do so much amazing work. And I just want to emphasize that it really does take a village, and when you're going for a project like this it takes a lot of people with a lot of expertise. And I just want to recognize how amazing all of these people that I'm lucky enough to get to work with are. And maybe some of you out there will be inspired to come and help us, because you can always use more people with great talents. So I want to go through and talk about some of the things that we have coming up. I can't talk about all of them, of course. We have about 11 different projects on the boards, but I'd like to talk about three or four of them, and specifically how they connect and relate to our main mission. Our main mission being that we look to develop ways that people can get access to medicines and medical technologies without having to interface with the medical infrastructure, do-it- yourself methodologies, which of course rings with the hacker spirit. First thing I want to chat about is drug delivery methodologies. Now we often sort of forget about this, that somebody says they're taking a drug, or that some medication was administered to them. But the way that drug is administered we sometimes forget. Usually we think about taking pills, but there are so many other ways that a drug can make its way into your body. Oftentimes you'll get an injection, of course. There are different types of injections. We've seen, of course, that there are also different types of pills. There are tablets, and there are capsules, and there are time-release versions, and instantaneous-release versions. Additionally, you see things that are more advanced nowadays. You see things like transdermal patches, of course. Everybody's familiar with nicotine patches, but you see that also with nitroglycerin, other medications that make their way through. Even fentanyl is delivered in a patch for people who have chronic pain. Inhalers, of course. And so looking at some of these images here, I wanted to just take a moment to remember this really fun workshop that we did last year at DEF CON here in Biohack Village, where we were talking about hacking different drug delivery methodologies. And that you see that that's actually, of course, not an inhaler. That's a vape pen. But you can hijack a vape pen to work as an inhaler. And there are certain things that make their way into your body more efficiently through the lungs than they do through other means. Transdermal patches, when you buy them off the shelf, of course, are made with these specialized gelatins. But you can make them yourself using gauze pads and DMSO and some saran wrap and some medical tape. These things are all hackable. But these aren't the ones I wanted to talk about. There's a different one that is very exciting. So take a moment and see if this looks familiar to you at all in any regard. What you're looking at here is a cylindrical piece of flexible plastic. And what it is, it is a piece of plastic, which is biocompatible. And it's doped with the active pharmaceutical ingredient, which needs to be put into a person's body. Now, I'm sure some of you have heard of this before. In the 90s, the first generation of this was called Norplant. And it was a birth control drug. It's placed in the upper arm and you can see the more modern version that's called Nexoplanon. And it's being inserted with a hollow needle here in the upper arm of someone you can see in the upper right hand corner. Now, for those of you who are not familiar with this, or just seeing it for the first time, and those of you who've seen it before, take a moment to just look and see if this reminds you of anything. And let that percolate in your brain while we move on. Now, the question is, of course, how is this made? And how do you use it? Now, the uses are incredibly widespread. Now, it's been already used for birth control. And it's currently being tested. I believe it's in phase 2A trials for pre-exposure prophylaxis, which is really huge. You think about something that could be put under your skin, that could protect you from HIV infection for a decade. That's extraordinarily powerful. And this really applies to anything that is something that anybody has to take regularly, and where adherence is a big problem. Sovaldi is arguably the most incredible thing that's ever been put out by the pharmaceutical industry. It literally cures hepatitis C in 12 weeks. The problem is, is that if you do not take that pill every day, in the same way, at the same time, and you fall off adherence, it doesn't take and then you have to start over. And that's an $82,000 treatment. It shouldn't be and needn't be for reasons that you all know. But of course, it's tragic when you get it together to get treatment to somebody and it doesn't happen because somebody just forgot a dose one day. If this could instead be put into an implant, and somebody could get it put under their skin and 12 weeks later gets taken out and their hepatitis C free, that would solve that particular problem, then you'd get 100% adherence instead of only 40%. Again, looking at all manner of things, if you think for a moment about whether you or anybody who know, has any medication that they take every day, why take the time and the attention to take it every day when you could merely have something put under your skin and it would just sit there and you wouldn't have to worry about that autoimmune issues. Hormone replacement therapy is one that I'm very excited about. I know so many trans people who are so worried about having their pipeline interrupted. And if we could instead place hormones in an implant, which we know is possible because it was done with birth control and say, hey, you don't have to worry about taking your shots or interface with the medical infrastructure for five, maybe 10 years at a time. I think that would solve a lot of really amazing problems. The naloxone pro drug that we were looking at a couple of years ago would be really great to be able to put into this. This would essentially be an overdose safeguard antidote that you could put under somebody's skin and they wouldn't overdose. I mean, amazing. Even things as basic as vitamins. Most people are vitamin B deficient. And you could just have a vitamin B complex implant that would continue to dose your body with vitamin B around the clock for years. And again, anything where people have to take something every day. If you know anybody over the age of 60 in the United States, they have several medications typically that they take every day. And again, as years go on and days blur together, it can be harder and harder to remember to take something at the same time every day. And that takes care of that particular problem. So it's a very exciting technology in general. Of course, the question is, you know, how do we hijack it? How is it made? So the plastic has to actually be extruded. And so you have this big industrial machine that's full of the active pharmaceutical ingredient as well as the plastic and then it's pushed down through this screw and then heated along the way. And it's pressed out a dye. Here's a diagram that sort of shows that and you can see the spot there where everything's put into the feeder and that's the pharmaceutical ingredient along with the plastic. The plastic is usually PLA or PLA and another plastic. Again, some of you will start to see where this is heading. And it gets pressed out a dye at the end and then you get these little pieces of filament which are then broken off. And the question is, well, how do we do that? Well, this is the same as the 3D printing filament that is made by hobbyists all over the world. People who are enthusiasts of 3D printing, of course, take their old failed prints, shred them up, and re-extrude them. And if you can look at the image on the right, you can, of course, get ones that are manufactured in such a way that they're kind of a commercial. There are the kits like the filler extruder in the upper right and there are ones that are home-built like on the lower right. And this is basically all it takes. Concerns, of course, of trying to make sure the densities are homogenous and you don't get the active pharmaceutical ingredients separating away from the plastic is simple to fix at a small scale. You merely extrude the plastic, shred it again, and then re-extrude. And eventually you can have something where you merely load it into the same sort of thing that you use to plant an RFID implant into your hand and be able to put these in however you need them. Now, of course, the natural question that comes up is, well, then what do you do about getting the active pharmaceutical ingredient? And, of course, there are ways to source those in some cases. But one of the big things that we've been focusing on for a very long time is how do you manufacture your own drugs? And so I'm very excited to present to all of you the new Apothecary Microlab. And this is a picture of me holding the 3D printed case that has the brains of the machine in it. And you can see at the top there, there's the embossed logo and there's the touchscreen interface. And inside you have a Raspberry Pi and a shield that sits on top of that with relays. And it is connected then also to an Arduino which has a CNC shield on top of it. And I'll show you a little diagram for each of those sub-assemblies. Here's the Raspberry Pi and the relay board and then the touchscreen interface. And then this is a separate part, the CNC shield that sits on top of the Arduino. Arduino sends over G-code then sends information. So I put this together because the part of this graphic was actually put together by some yellow journalists who were trying to shame us when I was quoted as saying, shouldn't be any harder than putting together IKEA furniture to build the micro lab. And at this point, it really isn't. And the hardware team has done a just spectacular job of coming together with finding parts that are literally off the shelf. No manufacturing required and no soldering required. These literally snap together, which is so cool. It really means that anybody could build it. And here's a little diagram of how everything's connected. Those are stepper motors that drive the syringe pumps. And also that drive the stirring motor. And there's a sensor with the heat thermocouple and all bits and pieces. What you're looking at here is a video in real time of the head of the hardware team actually assembling the entire micro lab. And in addition to the fact that this is happening real time, what you see on the table here as he's working is everything that is required. And including the tools, I guess it's just slightly out of frame, but his three tools are a hex key, a small screwdriver, and a pair of scissors. And using nothing else, it takes him about 25 minutes to assemble this. So it probably won't finish quite by the time I'm done. But hopefully if the editing goes well, what will occur here is that as I go to the next slide, this video will go into a corner and you'll be able to see it continue in real time as I continue to talk about some of the other stuff that we've been working on. So you see these 3D printed parts that he's bolting onto the stepper motors. Those are the syringe pumps. The electronics that he snapped together just a moment ago was the control module that I talked about. And the circular piece that's 3D printed on the lower right of the screen that you see is the core for the actual reaction chamber. And then you see some miscellaneous parts along the left side of the screen tubing, the fish pumps that circulate the water, along with the bars and the threaded rod that allows the syringe pumps to work. So hopefully this will now move into the corner and you'll be able to continue to watch it while I talk about the other developments. Now, of course, the big question always is the chemistry. And this is where our chemistry team has done such great work in the past of trying to find ways to synthesize, to actually manufacture the active pharmaceutical ingredients from things that were easily available, cheap, having high margins for error, having no specialized materials needed or specialized techniques used. This was fairly tricky. And some of you, I'm sure, remember that in the early days, we had a deal with a company called Comatica that had developed some very sophisticated machine learning algorithms that would crawl through the databases of chemistry and give good guesses as to what might or might not work in terms of trying to do retrosynthesis on chemistry. Now, they, of course, were bought by Merck and that process is now proprietary, used internally, they don't farm it out, they don't share it. And one thing that we had this idea to do was to say, gosh, you know, we have a data science team, and they looked at some things and they said, you know, we could probably do the same thing, it wouldn't be that hard. And if you look on the right, this is the the NIST database that we had used with only 1000 reactions. And of course, it had the same structure. But Reaxis, the one that Comatica used, which is premium and paid for, of course, has 6 million reactions. Well, some of you remember the narrative and one thing and another, we got our hands on that data. And we're able to actually run an analog of that software. Now, the problem is, is you need a supercomputer for this. A very congenial fellow was working with me, and he tried to put together a Raspberry Pi cluster. And then when he looked at the software, the data science team had passed along, he said, Oh, this isn't going to work. And I asked why. And he said, Well, this is not something that lends itself to parallel computing, you need a traditional supercomputer, you need something with a tremendous amount of RAM, and you need a lot of cores running. And so when you need a supercomputer, the regular thing that most people will suggest is using Google Cloud. And I have some opinions on that. And then other people will suggest using Amazon Web Services. And I have feelings about that too, which I'm sure most of you share. And so the question is, if you need a supercomputer, and you don't want to play ball and pay for it, what do you do? Well, we figured out a solution to this. And we got very lucky. This is the Glitter supercomputer. And it's an HP ProLiant DL580. It's a 4U rack mount unit. And it's extremely powerful. If you look at the specs, this is a 40 core unit with half a terabyte of RAM. It's optimized in a lot of ways, it draws a tremendous amount of power. But we were very lucky that we managed to find one used for $300. Usually these go for upwards of $6,000. I mean, I think that's what the baseline unit costs. And I think it's more like, you know, double that for something with the specs that we have. But we just got very lucky that we found a used one that some company just wasn't using and managed to get our hands on it. In addition to running the software, we're hoping that this can actually become an open source supercomputer that everybody in the hacker community can use. So if somebody has something that they want to run, and they need a supercomputer for it, that they can just use some time on the supercomputer. So I'm gonna try and pull it up here. This is sort of what it'll look like. These are sort of mockups, but just so you can get sort of a sense of what things should look like when the machine is booting and running. Just wanted to give you guys a sense. And of course, you know, you want things to look pretty while they're starting. So if you'll bear with me here. Alright, so this is sort of what the should look like when you start things up. And when it says the smile string smiles is a it's a protocol for being able to use essentially ASCII to input the structure of molecule. And you'll see this looks a little goofy. But at the same time, you can see it's sort of suggested of of the structure of molecule that, of course, is a double bonded O. And here you have, again, another group that's specified and where it is. And this is all standardized in databases. So it's it's good, and it's easy to use. And if this is all work, then this should be go there. And you'll see the computer come up here now with recommendations. And along the right column, you'll see how likely it is that this is actually going to be plausible. And point 999, of course, is is really good. When you see the one that means they are actually found it in the literature. 994 may seem like it's pretty good. But again, this is fairly iffy. The thing that's important to remember when looking at this sort of thing is that the really great strength of machine learning and AI is not to replace human intuition, but to augment it. So this is something that could change things so that instead of needing, say, oh, months to years with a team of really gifted chemists, you could have this with a good chemist, and just one of them and be able to do it in a few days. When you see these things that say cannot buy, that's part of one of the kinks we're working out is, you know, trying to show what's available commercially. And if something isn't available commercially, you'll notice that each of these are, of course, hyperlinks. And what you can do is you can actually click on them and then do the retrosynthesis on one of those and work your way back to see, do you have to make the thing that you need to make the next thing? And again, what is purity and yield look like and how you work forward from there? So to sort of sum up as we're going, you look for treating yourself. When you look for taking control of your own health, the thing to do, of course, is at the end is you need to package your treatment, right? You need that delivery mechanism, whether it's something that you load into a syringe or something that you pack into a tablet, or something to load into an inhaler, you need to package it. But of course, before that, you need to manufacture it, you need to generate that active pharmaceutical ingredient, somehow. And again, the packaging, we have these ideas for specifically, we're trying to develop these, these implants, which is really exciting. The manufacturer, we're hoping to make happen with the new version of the micro lab. And of course, developing a process for manufacture, we're hoping to do with the glitter computer and chemhactica, the new system for trying to do retrosynthesis. But there's one extra piece, which of course, before all of that, having all these things at your fingertips means almost nothing. If you don't know what it is you actually need to manufacture. This is sort of the antecedent problem that comes before everything. And the question comes, of course, how do you determine what it is you need? We all have health issues, but going from I understand what's wrong, or I understand what is not right, I recognize my symptoms, to understanding what is ailing you and what would ameliorate that is quite a jump. So I'm very excited to announce this that we're working on. This is the anarchist medical book, and we're trying to develop a compendium that will be a reference that people can use when they are not well, and yet do not wish to interface with the medical infrastructure. We're really excited. We have a bunch of things that are going into this book. And of course, to all of you out there, if you have things that you think should be included about this, if you know some cool trick, or some secret, some treatment that is not popular, that very few people know about, that other people could benefit from, please, please, please get in touch and let us know about it so that we can include it. We're trying to make this the best book we can, and try to include as much as we can gather. And so all the secret little folk wisdom of all the wonderful hacker anarchist communities out there, we'd really love to pack it in. So please send us anything you can. We'd love to see all of it. This is about where I end. And I always end with this slide. Because it's a, it's an important reminder that that helps not on the way that we really need to work to help each other, keep each other safe. And there's nobody but us. So let's take care of each other. Thank you all so much. It's been wonderful being with you. And after this video closes out, we'll have a little q&a. And I look forward to talking with all of you. Thanks so much. Rest in peace. Here's another warrior song. Here's a toast to the dead for children with cancer and AIDS. A cure exists and you probably could have been saved. Sad to see medicine divorce morality. Corporate homewreckers pipping up the salary."
}