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.