Fecal transplants for autism deliver success in clinical trials (2019)
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I would fully expect that a monotonous diet leads to a heavy skew in the gut microbiome as specific bacterial species that thrive on that diet are selected for, others against. It makes some sense that a fecal transplant could repair the damage. If the diet has shifted or expanded, the transplant could lead to long term benefits by restoring newly-viable bacterial species, perhaps by facilitating digestion of the new types of food.
I’d be curious to see a factoring out of the diet composition, gut microbiome, genetics, and severity of autism symptoms.
Maybe I'm misinterpreting what the process of that daily transplant looked like, but I expect they ate a not insignificant amount of hospital food if there were 7-8 weeks of daily treatments.
This isn't a hospital procedure like an organ transplant. It's material placed into the recipients colon through an enema, nasogastric tube or possibly even just taking some pills.
So it might range from done at home to done during a 30 minute visit to a clinic.
which for many is not the case for a variety of social economic or behavioral reasons. Add in with explosions of bacterial populations due to alcohol or sugar and you can see how we can change our gut biome drastically from week to week.
Observing that if you eat/drink something specific then you get the shits is valid. Concluding that it is due to a specific mechanism is not valid unless you have something objective like a test supporting that.
It’s like if your train is late and you just conclude that it must be because the steam condenser’s gasket is leaking based on nothing. Maybe true, or maybe the conductor broke his leg, or there is a signaling failure.
Why do you need to know what the mechanism is to avoid mistakes? - if something fucks you, don’t do it.
Encourage others to do the same.
Not a controversial take!
“But what if it’s a big hoax and we create solid stools for nothing?”
This demand for peer-reviewed evidence in place of observation of known and basic mechanisms is out of control.
where you’d have to reply to “well-understood and basic mechanisms” being ignored.
Including the ones we know inhibit a healthy diverse microbiome!
Sticking with your chosen example:
If you lean an anvil on your foot, and start suffering from poor circulation or discoloration of the foot, remove the anvil.
Also, this bit is a non-factual read (don’t put words in my mouth, mate, I choose them carefully).
An uncharitable, bad-faith interpretation at best.
The theories for how gut-brain axis modulation works include altering the balance of nutrients that get absorbed and modulating the vagus nerve, primarily. For someone with autism it might be possible that altering some of these balances could make the condition better or worse, but that’s all theory without much foundation.
What is known, however, is that diet has a massive impact on the microbiome. Even the mechanism for that is obvious: Bacteria thrive on different foods, so if you eat more of one class of nutrients and less of another then the microbiome proportions will adjust based on which ones thrive on that diet.
It measured some bio markers and some dietary preferences and claims some correlation.
The correlation is that what you eat fuels the microbiome. So your diet influences the microbiome by fueling or starving different bacteria.
Complex theories about causality going the other way through complex chains of flavonoids to bacteria to neurotransmitters to the parasympathetic nervous system sound impressive with all of the big words, but it’s such a complex theory that would need other testing to even begin to understand if there was something there.
Testing the other direction is easy and obvious. You can grow many bacteria in a Petri dish and see that some grow better or worse with different nutrients.
What's the theory now? I didn't propose any specific theory -- just noted a mechanism of influence.
They didn’t run any experiments trying to change the diet or microbiome. They just correlated dietary preferences with some markers that might be correlated with the microbiome.
The paper does not say anything about how changing the microbiome might change preferences. The simplest and most well tested explanation is that dietary preference are driving the microbiome.
There’s a lot of woo-woo microbiome discussion out there that misses the really obvious basics of how the microbiome comes to exist and thrive: What you eat is what the microbiome eats, so changing what you eat will change the composition of bacteria that thrive. People who prefer chocolate are correlated with people who prefer sweet diets. High sugar intake is proven to alter the microbiome.
- what all studies show is some vague "craving" for something generic, e.g. the link between iron deficiency and craving for ice
- but what you see in autists is often a far stronger effect and not just for eating something, but also against eating most other food. A craving for chocolate does not remove appetite and willingness to eat other food. It just makes you really want to eat chocolate.
- more important the way autistic people get fixated on a monotonous diet is far more specific then any effects we have observed from gut bacteria or other similar sources AFIK. Like lets say your gut bacteria might make you crave fish. You autism on the other hand might make you crave dino formed fish sticks with a specific texture. And there is just no way gut bacteria care about your fish sticks being dino formed or the specific texture of them... But a autistic person often does care, quite a bit even.
1) Eating the same food frequently means I don't have to spend any of my cognitive cycles on deciding what to eat.
2) I know that this food will sit alright with my digestive system. Everyone I know personally on the spectrum has stress-related digestive issues.
For snacks and small meals I will eat citrus or microwave a small sweet potato and this helps with Vitamin C.
Autistic adults are not children and using dino-shaped fish sticks probably does not represent most adults on the spectrum.
I am forced into an extremely limited diet to avoid provoking my body any more than I have to. And, notably, one of the first reactions used to be something not tasting as good as it used to (or in one case tasting worse than it had.) It doesn't always happen but when it does it's a near 100% accurate test--the only time it ever fooled me the actual culprit turned out to be something my wife put on her face.
I saw what happened to my mother (very similar path, but started much later in life), I already knew how to isolate what was giving me trouble before it ever happened. Most people don't, though, especially when dealing with things where it isn't high on the ingredients list (or, sometimes, not at all--they are strong about requiring manufacturers to list what they put in, but there is no such requirement about noting what they fail to take out from a natural source. Not to mention being allowed to specify that most evil of ingredients "artificial flavors". The second most evil being "natural flavors.")
They never successfully identified what happened. Just diagnosed it generally as failure to thrive.
Case reports are unreliable due to placebo effect.
The antifungal myth has been tested by too many well-meaning parents with no results.
to stop pulling levers when they are not enjoying their time,
is medical injustice.
How long ago was it you were in threads calling the treatment method in TFA an unfounded crackpot myth?
often allowing the body to get a good run at any low-level chronic infections which have nested and protected themselves,
able to leave the biofilmed region and wreak havoc - even if only intermittently.
Very interesting, this impact of antifungals on longterm bacterial infections! Specifically known to be effective off-label for Bartonella.
autists have often a much much stronger need for habits and avoidance of change. This includes a change of, or a less repeting/habitual diet. The effect if applified due to autism being commonly comorbid with ADHD and hyper fixation on specific foods being a very common thing (not (mainly) caused by gut bacteria as the effect is too strong and too specific to be "just" a preference caused by gut bacteria)
but this can lead to a imbalance of gut bacteria and that can have an reinforcing effect on wanting a even more monotonous diet, but in the end this is AFIK "just" a secondary reinforcing reason not the root cause
just to play devil's advocate that it isn't an opposing possibility
You mean your parents were letting you eat just plain Cheerios? Otherwise I don’t understand what you mean at all.
that’s not going to help any.
The real danger was the havoc it'd play on my gut biome.
> About two-thirds of all scurvy is found in autistic people.
Now that is something that should be done more often - especially in science journalism, but not only. We cruelly lack long-term vision - not only forward but backwards too.
Maybe science journalism should just adopt a wiki-model instead, where there is one article per "subject" then any new (confirmed?) information/data goes into that, and interested people can subscribe to updates there instead.
Wikis generally have much better long-term maintenance given the right individuals running it, compared to a "publication journal" where things tend to get out of date eventually, with no way of actually seeing when old articles get updated.
There’s a subtext here that isn’t immediately obvious without reading more from the company trying to commercialize this formula: Their small phase 2 trial is underway but results haven’t fully been released as far as I can tell. It appears they’re trying to do a PR push based on their early claims of positive results, before publishing everything. If anyone can find more details please correct me if I’m wrong.
This can be a little suspicious when companies do this because before the full results are available because it’s usually associated with a rushed push to drive investor interest at the time they think it’s most optimal. When the optimal PR push timing is before full results are released, it’s not a good signal that the results are on track to be great.
It isn't a good one.
When I looked at preclinical for one of their competitors, that was the exact same thing, the issue was study design. Specifically, you are shoving something up an autistic kid's butt once a day or twice a day. They only did this to the placebo arm for 3 days, and only to healthy kids, whereas the treatment arm did this for 8 weeks.
If I punched you in the chest as hard as I could once or twice a day, do you think you'd have a behavioral change? That's their endpoint. If I called it a "medical" punch, does that change anything?
Can an autistic kid learn how to answer a test to get the thing to stop being shoved up their butt? I think so. By all means though, I encourage people to make this risky investment if they think this treatment pathway is real. It sort of is! If you want a behavioral change, we have a good idea of a way to get that from defenseless kids. But not for a good reason.
They’re always followed by thousands of self-experimenters where nobody can reproduce the result.
The explanation is almost always placebo effect. A parent or doctor is so convinced that they’ve found a cure that they change assume it worked, change their behavior toward the autistic person, and believe that a dramatic change has occurred.
This is also why the placebo arm of every autism study also shows improvement.
I don’t even think I understand your proposed mechanism here. So these kids have this treatment multiple times a day, for eight weeks, and nothing they do during that time changes it, but then suddenly it stops, but they modulate their behavior for many months, what, just in case it happens again? When their behavior changes during the treatment had no effect on whether they keep getting the treatment? How does that make any sense?
While I'm dubious about this specific case, the basic dynamic you're describing there is the core controversy around ABA "therapy", which is effectively conditioning autistic children to act "normal" [1], sometimes through social pressure, sometimes through physical punishment that rises to a level legally recognized as torture [2]. It generally results in immediate behavioral changes, but also results in long-term PTSD [2].
[1]: https://whyy.org/segments/how-a-therapy-once-seen-as-a-victo...
[2]: https://en.wikipedia.org/wiki/Judge_Rotenberg_Center#Condemn...
[3]: https://www.academia.edu/35842784/Evidence_of_increased_PTSD...
You can read their current study, its primary endpoint is severely treatment resistant GI symptoms, not "autism". That means they are trying to get a liquid FMT with two hero laxative doses per day approved for ASD kids who have failed two other standard of care GI treatments.
But then why not get it approved for adults without ASD? It's a simple question. As you are not very familiar with the therapeutics startup business, you wouldn't know that it's all about commercialization. They are gambling that parents will buy this drug anyway, for its secondary endpoint, which is supposed to be "less disobedient behavior while ASD" (my characterization of the evaluation they receive).
Look... parents can also punch their kids, and I'm sure it'll modify their behavior. Do you see? It's not complicated, there's no conspiracy, there's barely any science.
It is marked as having results submitted but quality review has not been completed.
N=60 and a placebo group, which is better than the N=18 and no placebo group of the first study.
There have been so many small scale trials showing amazing autism improvements that failed to replicate in larger, better controlled trials. I wouldn’t get excited yet.
The typical pattern is to show unbelievably good results in the first open-label trial with a small number of patients (their n=18 trial that claims to have cured severe autism in many children), squeak by with some marginal improvement in the next trial over placebo, then the third trial becomes a game of trying to keep the study small enough that they can hope to p-hack a result that the FDA might accept.
From the comments in the article above, it sounds like it may have failed it's primary outcome (autism symptoms). They only say there was significant benefit for "average of all symptoms", but it isn't clear if that is the same thing.
That's a slightly different clinical trial on adults, not children like the posted article. I think this is the clinical trial registration: https://clinicaltrials.gov/study/NCT02504554. Here's the followup report in 2019: https://www.nature.com/articles/s41598-019-42183-0
That said, your reasoning is probably still correct. There's no placebo group, and a lot can change over a 2-year follow-up, with participants aged 7-17. Maybe they went to speech therapy or just matured and learned more coping behaviors. The 2019 followup also notes that 12 of the 18 participants made other diet and medication adjustments. They claim the adjustments were minor but that's still more noise, and it doesn't account for unreported social/environmental changes.
> There have been so many small scale trials showing amazing autism improvements that failed to replicate in larger, better controlled trials. I wouldn’t get excited yet.
Unfortunately yeah, it's unlikely anything exciting will replicate in a larger RCT other than maybe the gut biome improvement since that seems directly mechanistic, but that's just a gut feeling.
> reduce autism symptoms
> chronic gastrointestinal issues are a harsh reality
> boosting microbial diversity
> when [...] treat those gastrointestinal problems, their behavior improves
Through my opinionated take is:
- gastrointestinal issue are a common comorbidity of autism
- fixing that help autistic people to mask better/easier
- which makes a lot of sense as gastrointestinal issue are very stressful and so is masking. It's quite common that autistic people under stress have a harder time masking
- and masking is removing many of the "symptoms" of autism at cost of stress and other risks (e.g. depression), and society(^1) is conditioning(^2) children to mask autism subconsciously all the time
(^1): Pretty much any society out there.
(^2): Both intentional and accidental. For most autistic people masking isn't a conscious choice, but something through live so strongly reinforced that it's done unconsciously even if they don't want to in any situation except a private one with at most some very trusted people around.
---
Through a much more disturbing implication from this article is that at least in US/Arizona children with gastrointestinal issues commonly do not get appropriate treatment... Or else they couldn't have done the test as they wouldn't have found a non highly selection biased sample of autistic children.
Like treating of gastrointestinal issues shouldn't be a thing you do to reduce autistic symptoms, but something you do anyway. Even if not for quality of live, then for the reason of such issues often causing much more server long term issues if they stay untreated for years.
I was a little surprised to see this.
So the university researchers use time and money from the university to make a discovery, extending on previous published research, and then patent it and start their own for-profit?
Excuse my ignorance, but is that how it's done generally? Where's the upside for all those who are potentially affected?
It kinda makes sense - Presumably the university is involved somewhere still, and it needs to be commercialised somehow, but..
Most universities have IP policies giving them ownership of most of the IP their academics create, and student IP may or may not be included. Some exceptions are Duke and Waterloo.
The alternatives are lengthy court battles between universities and their best (e.g. most commercial) researchers. This creates bad PR for the university and uncertainty for the researcher & their startups because potential investors don't like open court cases.
So people came around to make this kind of license fee contract and researchers check it before deciding to join a certain university.
Not a fan of gene / bacteria patents though.
Don’t worry, the money is usually coming from taxpayers so the universities don’t have to dip into their endowments
In terms of why the public funds research, your statement might be true, but isn’t addressing the concern that many in the public have raised before: the results of the research should be public, given that the research was publicly funded. We have laws about open access to government functions, so why is research different?
Yes this is what I meant. We fund research because we think pure research is valuable. It needs to be done without requiring a financial return. Products sometimes come out of it and that's also a public benefit, but direct results of the research are not a "product" they are the starting point to a possible product. There is still a lot of development that has to occur to get to the product stage.
Also you could argue that patents are open access. The whole point of a patent is you give a complete summary of what the invention is and how to replicate it (with a level of detail that would allow someone knowledgeable in the field to recreate it) in exchange for a time limited legal moat.
https://skysonginnovations.com/startups/list/
It's interesting they got a lot of funding from over 100 families with autism children:
Also keep in mind that most sciences usually don't produce commercially viable research (think social sciences, archeology, geography etc.)
And as others said: how the universities gets a cut from the spin offs differs from university to university.
I understand the researchers lean on the infrastructure of the university, but I’m sure they paid their dues both in money payments to the university, depraved sleep and sweat. People need to eat, so I see nothing wrong with them putting their effort to work if that means the research continues and gets to the people, the university likely gets a cut as others mentioned.
Universities love this and encourage it. Any big place will have an office of "technology transfer" or similar to help researchers make this happen.
> Pregabalin was discovered largely on the basis of publicly funded research at Northwestern University
it happens all the time, and in many countries. Its quite common in the UK.
Pretty incredible if true!
But then I've met people not on "the spectrum" who have an amazing memory, such as a professor I recently met with who could remember the page numbers for certain phrases in books. Perhaps Asperger-level people just have the ability with the added challenges of autism?
who knows
Maybe think of this as removing a long-standing distraction or irritant. Like turning down the music from 120 decibels to 80 while you're trying to work.
I'm struck by this quote, which I'd be surprised if they could be explained fully by the distraction-reduction mentioned:
> "Evaluation of symptoms on the Parent Global Impressions found that the treatment group at the end of part 2 improved more than the placebo group in part 1 on nearly all symptoms, with statistically significant improvements in GI, receptive language, and average of all symptoms. There were also marginally significant improvements in tantrums, stimming/perseveration, and cognition."
They basically wiped the gut clean with antibiotics then started treating and saw improvements.
Could be that GI issues increase irritability which makes the measured autism symptoms more aggressive but it looks very promising for families.
Not affiliated just read the study.
What we currently don’t understand is why for some people they never got them (we have techniques to transport the biota from the mother during birth for non-natural procedures) or they loose them.
Even with the transplant, the microbes won’t stick around on those people (not taking about autistic people here, but people in general).
Diverse food really helps, just as not eating ultraprocessed (they won’t reach the end of the intestines).
Fermented and other pre or probiotics will really help too.
But none of those will recover the biota in some people.
Or can they.
It’s (meant to be) an emergency procedure. Benefits: life. Downsides: plenty.
Maybe most relevant in the context of this thread:
“In this systematic review and meta-analysis of 61 studies comprising more than 20 million deliveries, birth by cesarean delivery was significantly associated with autism spectrum disorder and attention-deficit/hyperactivity disorder.“
Zhang, T., Sidorchuk, A., Sevilla-Cermeño, L., Vilaplana-Pérez, A., Chang, Z., Larsson, H., Mataix-Cols, D., Fernández de la Cruz, L., & D’Onofrio, B. M. (2019). Association of cesarean delivery with risk of neurodevelopmental and psychiatric disorders in the offspring: A systematic review and meta-analysis. JAMA Network Open, 2(8), e1910236. https://doi.org/10.1001/jamanetworkopen.2019.10236
A selection of some more:
Keag, O. E., Norman, J. E., & Stock, S. J. (2018). Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: Systematic review and meta-analysis. PLOS Medicine, 15(1), e1002494. https://doi.org/10.1371/journal.pmed.1002494
De Mucio, B., Serruya, S., Alemán, A., Castellano, G., & Sosa, C. G. (2019). A systematic review and meta-analysis of cesarean delivery and other uterine surgery as risk factors for placenta accreta. International Journal of Gynecology & Obstetrics, 147(3), 281–291. https://doi.org/10.1002/ijgo.12948
Sandall, J., Tribe, R. M., Avery, L., Mola, G., Visser, G. H. A., Homer, C. S. E., Gibbons, D., Kelly, N. M., Kennedy, H. P., Kidanto, H., Taylor, P., & Temmerman, M. (2018). Short-term and long-term effects of caesarean section on the health of women and children. The Lancet, 392(10155), 1349–1357. https://doi.org/10.1016/S0140-6736(18)31930-5
Li, H.-T., Zhou, Y.-B., & Liu, J.-M. (2013). The impact of cesarean section on offspring overweight and obesity: A systematic review and meta-analysis. International Journal of Obesity, 37(7), 893–899. https://doi.org/10.1038/ijo.2012.195
S., Fleming, J., Bromley, A., Shields, M. D., & Cardwell, C. R. (2008). A meta-analysis of the association between Caesarean section and childhood asthma. Clinical & Experimental Allergy, 38(4), 629–633. https://doi.org/10.1111/j.1365-2222.2007.02780.x
Mascarello, K. C., Horta, B. L., & Silveira, M. F. (2017). Maternal complications and cesarean section without indication: Systematic review and meta-analysis. Revista de Saúde Pública, 51, 105. https://doi.org/10.11606/S1518-8787.2017051000389
> Conclusions and relevance: The findings of this study suggest that the association between CD and increased risk of neurodevelopmental disorders in the children was most likely explained by unmeasured familial confounding.
Can you elaborate please? Type 1 or type 2? If type 1, does that mean your body can now produce insulin on its own? If type 2, does that mean the insulin sensitivity of your cells is now back to normal levels and you could eat sugary food without issues?
You feel satiated and you're reducing your caloric intake. You can only eat so much beef jerky compared to eating a whole bag of chips before getting sick. It's helpful for people who are binge eaters.
2 questions:
1) Did your constipation start right after you did strict carnivore? Or was it after 4 years?
2) List all foods that you ate on strict carnivore. (Include salt, water etc. I presume it won't be a long list)
2) beef, butter, chicken, pork, lamb, eggs, bacon, for > 95%. I do indulge in some processed meats with seasonings. Salt is the only seasoning I add, so I've become a salt snob and get the premium stuff.
After that unspicy diet, full strength kimchi is an experience.
Regarding full strength kimchi - did you make it yourself or did you buy it? If you bought it, what brand?
However they say they also have an adult trial running that seems to show similar effects, so there might be something more into it.
An environment in which one person can thrive, labour, and enjoy life could be boring or incomprehensible or unduly stressful to another. I know people who would be diagnosed "low-functioning" if assessed in an everyday environment, but "high-functioning" if assessed in a clinical environment, and I know people who might not be diagnosed at all in an everyday environment but would be diagnosed with several seconds of acronyms in a clinical environment; and I know people who've been able to fight to get themselves an everyday environment that works for them, and I know people with vast potential who have conceded that fight and are rotting in the social care system.
If you eliminate what "should not be a factor" from the diagnostic process, then you eliminate the high-functioning / low-functioning distinction entirely. But all models are wrong, and some models are useful: while I find this particular model distasteful, there are contexts where it is necessary to get people in an environment where they can thrive (which, for children, usually means getting their parents the support they need, and occasionally the education).
I see now it was the former.
Edit: Pre-empting the inevitable "how is this ableist?":
I don't mind the use of a reclaimed slur, I'm a big proponent of that, tbh. I use them all the time. What's ableist is the idea that spouses have to deal with their partners. The idea the autism must be a negative in a relationship removes agency from autistic people. My spouse is not my nurse, I am not someone they have to "deal with".
Mods, please see to this comment.
At the same time, gut microbiota is extremely complex to study.
So, this may be a plausible result. I cannot judge the plausibilities right away in the way you suggest it.
> Our phase 2 study for adults with autism found that the treatment group improved more than placebo on the primary outcome (autism symptoms) and on a secondary outcome (daily stool record),
I can't find full analysis but the primary autism-symptom outcome improved by 9% in treatment group and 4% in controls. I guess there is no statistical significance because that metric likely has high variance.
In abnormal stools there was 42% improvement in treatment vs 23% in control.
The combination of GI disorder and autism in these trials make blinding almost impossible. The patients will notice if the GI symptoms change. And the results seem to be that this fecal transplant has larger effect for the GI part anyway.
It's like the medical community wants all high functioning autistics to get bullied like hell in their formative years. Similar irony to "lisp" being unpronounceable by the very people who have a lisp.
I have IBS - which could lead to nutrient deficiencies - and I've passed the initial pre-screen gate for ADHD assessment (coming soon). I also suspect autism, but the reward to cost ratio for assessment of that doesn't thrill me at the moment.
A different gut microbiome might simply be a way to solve nutrient deficiencies.
An unexpected result for sure.
More like fecal food?
EDIT: looks like I was right, it can be done that way: https://en.wikipedia.org/wiki/Fecal_microbiota_transplant#Me...
My slightly more serious experience is that in my late 20s I started getting digestive problems and gaining weight. I feel like my neurodiversity got worse, but that could easily be that environmental factors exposed it.
How does one take advantage of a study like this? I would be difficult to get medically sanctioned poo right now. So what can I do? Coprophilia seems high risk.
I mean I can eat Kimchi and oats, but that seems more about encouraging the bugs that are already there than replacing missing bugs. Are we close to over the counter poo pills?
Or is the problem that there are different sets of issues, and finding the right mix of bacteria to fix the issue is difficult?
I understand a newborn gets its microbiota naturally by contact with the mom in the first days, maybe all the sterile environment involved in surgery changes that.
https://news.asu.edu/20190409-discoveries-autism-symptoms-re...
actual paper:
Just stop eating chicken nuggets and french fries, kids. Have some vegetables.
All applicants will be fed recycled byproducts for free.
> my deepest fantasy is that one day I'll be in the hospital for some random thing, they'll take blood for some test, and then when they read the results, their eyes will go wide and they'll call for a consult. The other doctor will read the results and say "you don't have the nutrient?! How do you live? You're so brave". They give me a shot, and just like that, I'm able to conduct myself in society, understand social cues, hold my attention on anything i want for any length of time, etc
... so perhaps the Nutrient is a product of a gut bacterium.
I DONT NEED CURING. There’s nothing wrong with me.
Is kind of impressive.
In fact it is the subject of the paper, not the MMR vaccine which was the cause of the "controversy".
(They run a tube through your nose, down your throat, through the stomach to the top of the intestines, and introduce the bacterial slurry there.)
The shortest safe path is via the nostril.
Also, "fecal transplant" is marketable only to weirdos. "Probiotic infusion" would work better.
For those who want to gain some artistic talent, there's this (but is expensive):
You want to land a substantial amount of, ahem, shit in there, since don't just want it to colonize one portion of the gut, and it's got quite a lot of competition.
So you would be talking a truly astonishing number of pills, I think, to compare to the volume you can manage with a tube.
WP suggests that it's about 100g (or 100000mg) of actual feces then mixed in a larger volume of saline or milk, and you'd probably need to have additional volume for assumed losses and whatever coating you think would work.
That is a _huge_ amount to put in pills.
> Prior to the study, 83% of participants had "severe" autism. Two years later, only 17% were rated as severe, 39% as mild or moderate, and incredibly, 44% were below the cut-off for mild ASD.
Emphasis mine. If you are below the cutoff for mild ASD you wouldn't be diagnosed at all.
(Without a control group, you have questions about how people of that age generally progress, and what other treatment/therapies they receive over those 2 years. The phase 1 trial was with children whose parents presumably sought ever possible way to help them, while the placebo controlled phase 2 was adults who may have plateaued.)
That makes sense, since ASD is a disorder classification and is mainly relevant for treatment and benefits. Plenty of autistic people are not diagnosed with ASD.
The article certainly could do more to differentiate between the autistic spectrum itself and the diagnosis of ASD, but as long as you know not to conflate the two, it seems perfectly clear to me.
Which leads me to wonder if for some of these children is the root cause just gut issues.
If all they have figured out how to so is treat significant gut issues that sounds very promising.
This comment should be deleted.
The contrast is obvious, though I'm not native, so YMMV.
And you'd lose the bet, in my case that would be a word that dual-serves as a directional preposition meaning "away"/"from" and depending on the situation it's an opposite of "for", but not exactly "against", closer to "for dealing with smth"/"for solving smth.".
If you think more about it, perhaps the stumble is understandable, if you conceptualize Autism not simply a disorder requiring treatment, but a type of neurodiversity. Then the intuition of interpreting the "for" as the "X for Y" conventional medical syntax does not trigger and the title reads awkward.
What’s your native language?
Absolutely not. In German itself it's "gegen" - "against". In French and Spanish you definitely wouldn't just omit "treatment" from "traitement de/pour"/"tratamiento de/por" and expect the meaning to not change, and both sometimes would use "contra", though less likely.
> You seem to be failing to grasp that someone who says something is “for” a problem
See above, the special-case medical reading of the construction triggers when the object is unequivocally considered a problem.
If someone's fighting anything, it's you, who fail to grasp that the title could actually read ambiguously, depending on your disposition towards Autism and conceptualization of a transplantation procedure.
Lear to embrace ambiguity as a source of humour and have fun, instead of trying to tell people they use a language wrong.
Nobody said the words can’t literally be ambiguous in English, I actually mentioned that above already, in case you missed it. It’s a common complaint, but complaining doesn’t fix it, and learning how it works does. It’s up to you. Das ist mir Wurst.
Even though you can misread the title, there are no people researching transplants that cause autism. The assumption you have to make to mis-read the title is relatively non-sensical. Even if you do make that assumption, since you are aware that “for” is ambiguous, making an assumption and acting on it clearly risks being wrong. Plus it takes all of 3 seconds to click on the article and realize what the title meant. My sympathy for your argument is somewhat limited. :P
You're really trying a bit too hard to prove a point, being just slightly condescending in the process, giving strangers life advice all while missing to address the specific argumentative points where you happened do be factually mistaken.
Mayhaps it's your idea of fun, then happy to entertain you.
Gehst du wegen Medikamenten zum Arzt? Gehst du wegen Schmerzen zum Arzt? Gehst du wegen Medikamenten oder Schmerzen zum Arzt? ¿Vas al médico por medicamentos o por dolor? Allez-vous chez le médecin pour des médicaments ou pour la douleur? Ga je naar de dokter voor medicijnen of voor pijn?
> So you are in fact claiming you were joking?
Never claimed so. The first message was making fun of the title (which should be obvious even to those struggling with nuance comprehension). It's, BTW, not exactly the same thing as joking. Everything posted further was pretty serious.
> instead of arguing about English
"Arguing about English" paints my part in the discussion in an overly aggressive light. I was mostly answering direct questions and disproving points that were aimed at me or my arguments.
> For multiple messages in a row, there’s no indication you were making fun.
It wasn't the theme of the discussion, reread it and look at what we were actually talking about. If you didn't parse my original message as playful, then, surely, the the fault is mine. I'll work on my eloquence. But I'd rather make a poor attempt at humour and let it fail than keep on repeating "this wasn't serious!" in every subsequent message.
> Because transplants for autism isn’t ambiguous to native speakers
Firstly, this is overgeneralization that you can't possibly posit as a fact, unless you're a linguist that happens to have the stats on hand.
Secondly, the crowd here is rather diverse, and I bet non-natives are not a negligible minority. At least for some of them the awkwardness of the condensed form chosen for the title is pretty obvious, as it was for me.
The bottom line here is the comprehension (including native) is never deterministic, but is context-driven. Temporary alternative parses (even if it converges to a specific interpretation with later context) is an established phenomenon which, to my taste, is a great source of fun. Though I admit this wasn't nearly my best attempt.
> I didn’t mean to be condescending
Then I don't believe you've succeeded. The problem is that you're arguing against a stronger claim than I’m making, whilst being just a bit too assertive, degrading the debate to lifestyle advice, etc.
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Regarding your multilingual examples, you're most likely not native to a Romance language, because you're missing the distinction between, for example, "por" and "para" which do not translate directly to English "for", so your examples aren't as effective as you probably hoped. "Ir al medico por dolor" translates better to "to go to the doctor because of pain", not "for pain". Same with "wegen", it's literally "because of", not "for".
> I only meant to contradict your apparent insistence that ‘transplants for autism’ is easily misunderstood, because it’s not.
Never said "easily". However, you seem to be adamant on dismissing the two main points I repeatedly tried to get across and which are the reason I made fun of the title in the first place:
1. "Transplant" is a procedure or the result of thereof, it does not lexically encode remediation to the same extent "treatment" or "medication" do. You can transplant a third arm to a human, this won't be considering a health-improving procedure. To rephrase, "transplant" is not inherently therapeutic but is always an intrusive procedure.
2. Again, not everyone conceptualizes an "Autism" of an unknown severity as a condition in need of a treatment involving body-intrusive procedures!
These two facts make the "X for Z" not reliably triggering the "ibuprofen for headache" reading. Unfortunately, this doesn't happen for you so you just dismiss this fact and keep on pushing, instead of admitting there can be ambiguity. You'll surely agree, that it's the medicalized context doing the disambiguation for the concise form, not the syntax itself!
Consider a parallel linguistic construct: "implant for mind control". Would you still argue it's unambiguously "for countering mind control"?
Oh, really? Why do you believe that?
https://dictionary.cambridge.org/us/dictionary/english/make-...
To make fun of: “to make a joke about someone or something in a way that is not kind”
Given that you're just selectively nitpicking by now, I don't think you're really trying to engage in a meaningful conversation, so I'm done. Thanks anyway, you've prompted me to reflect upon many topics and verbalize some things that usually stay internal.
Just kidding.
Reading HN has the benefit of making me wonder how brainwashed I am.
Reflecting now, maybe it's my deeply held belief that everything is propaganda[0] and nobody that appears smart is honest (with the possible exception of a handful of Finns I have met in person and Western Europeans that I have met online, plus a couple scions of the ultrarich or geniuses I have had the luck to uh hang out with, the last category of totally unknown autistic --compared to Demis-- and thus defying the assumption of "appearance"..? anyways.. )
.. so should I be absolutely terrified of myself "just appearing smart but in no way autistic" to others? A question to ask the therapist :)
[0] https://www.psypost.org/intelligence-makes-people-more-trust...