Better Biome Podcast

Join us as we discuss Kambo Medicine Therapy with Todd Shipman. 

So what is Kambo and why are we talking about it? Kambo is a non-psychoactive traditional amazonian medicine and is legal in the United States. Kambo’s secretions, while used as a defense mechanism, and deadly to most animals, provide many health benefits for humans. The secretion is then applied through superficial burns that are made into the skin. Our interest in Kambo, aside from its wide ranging applications, lies in the positive effects on the microbiome.  

While more studies are needed in this area of Kambo research, many people with gut issues, Lyme, parasites, constipation, SIBO, stress etc. find immense relief in their symptoms when they do Kambo. Some find relief after one session and some do it a couple of times a year.

Episode Takeaways:

What is Kambo? 

• The sweat that comes from a large tree frog in the amazon
• It’s a defense mechanism to them, but to humans it has several healing properties
• The sweat contains bioactive peptides
• It is considered non-psychoactive

• It is applied fresh off of the frog on to the person's skin

Historical use

• Tribes in the amazon use Kambo to 
• Magnify their senses prior to hunting
• Correctional behavior of children
• Attract a mate
• Fertility

How is Kambo sourced?   

• From tribes in the amazon
• Kambo samples can be good for a couple of years

What are the benefits? 

• Beneficial Peptides like
• Dermorphin - stronger than morphine 
• Dermaseptin - strongest natural antiviral, antimicrobial, antibacterial, antifungal 
• And many more Deltorphin, Phyllokinin, Phyllomedusin, Adenoregulein, Phyllokinin, Phyllocarulein, Caerulein and Sauvagine and more…
• Many people with health challenges like lyme, parasites, addiction, depression, anxiety, fertility, fatigue, and stress experience improvements after using Kambo 
• Some people use it to increase athletic endurance and to enhance their energy and performance 
• Early research shows benefits are sustained up to 3 months out

Dosing

• First, find a seasoned practitioner who is familiar with the specific challenges you wish to improve
•  There are specific dosing considerations for different challenges, ailments,  goals 
• You should NEVER try Kambo on your own without guidance

What is the mechanism? 

• Several different peptides are at work in the …
• Central nervous system
• Digestive system
• Lymphatic system
• Endocrine system
• Microbiome benefits - there are 5 peptides that seem to benefit the microbiome
• Some help release trauma which helps gut performance almost immediately
• Some promote calmness which helps to release people from a state of constant fight or flight
• Some stimulate myoelectric activity 
• And some reset the liver

What is the ceremony or experience like?

• Focus on calming first 
• Starts with breath work
• A calming tobacco is offered
• Meditate on goals
• A small dot to burn to expose skin is applied to a designated area
• Fasting for 5-8 hours takes place prior
• Drink 2 liters of water within 5 minutes to start the Kambo
• 9 out of 10 people experience within the first minute elevated heart rate
• Then become flushed and hot, then you become pale 
• Then purging happens 2-3 times is pretty common 
• Once the Kambo is removed from the skin, recovery happens within minutes
• Many experience an emotional release 

How can someone find a safe Kambo practice  

• Look for practitioners who have been through extensive training
• Never do it by yourself
• Great resources - Kambofinder.com or  Kambointernational.com
• Safety - DO NOT DO IT IF YOU ARE 
• Pregnant
• Embolism
• Prone to seizures (some caveats here)
• Liver disease 
• The list goes on … speak to a professional before you try Kambo
  
  

Connect with Scott:

• Website
• Instagram: @Biohackertodd

Connect with Kiran Krishnan and Dr. Nicole Beurkens on...

• Instagram: better.biome
• Facebook: better biome 
• Instagram: Dr. Nicole
• Instagram: Kiran Krishnan
• Website: BetterBiome.com
• Website: DrBeurkens.com

Join us as we discuss the health benefits of a good quality Olive Oil with Tony Kasandrinos. The keywords here are “good quality.” Tony walks us through how to find a good quality olive oil and what makes it good quality to begin with. Olives are an amazing source of polyphenols. Polyphenols are reducing agents, and together with other dietary antioxidants, protect the body's tissues against oxidative stress and associated pathologies such as cancers, heart disease and inflammation.

For centuries, in places like Greece, Italy, Tunisia, and Spain, good quality olive oil has been regarded as a necessary staple in the diet if you want to live long, have good overall health and vitality and a healthy gut microbiome. 

So where do you find “good quality” olive oil? Tony explains that if you want to derive the health benefits from olive oil, it must be grown in places where the olive trees have produced for many decades without requiring any pesticides to hurry their growth. He tells us what to look for on the labels and explains what certain buzz words mean in the olive oil industry like “product of Italy.” 

So get yourself a good quality olive oil and pour it on everything you eat!

Episode Takeaways:

The health benefits of a good quality olive oil:

• Optimize Heart Function
•  Reduce Inflammation
• Increase Brain Function
• Help Maintain Healthy Weight
• Fight Disease
• Lift Mood And Lower Anxiety
• Smooth Digestion and Gut Microbiome
• Lengthen Your Life

The down side to mass produced olive trees (and olive oil): 

• Olive Trees planted in mass production are sprayed with pesticides, allowing them to grow and produce more olives at a faster pace. 
• Pesticides are getting sprayed on the majority of olives 
• Fruit gets bruised by machinery vs hand picked in orchids 
• It’s difficult getting it to the consumer before it’s too old - look at the harvest date
• Most bottles won’t say how old the oil is, it’s typically edible but past the point of deriving any health benefits from it

The much older trees remain fruitful without having to invade with pesticides 

• Handpicked olives
• They are pressed (cleaned)

Olive is a fruit 

• All the polyphenols and antioxidants will start to dissipate over time 

Stick to organic if you can 

• Generic olive oil has likely had many different pesticides sprayed on it
• Look for USDA organic labels
• Look for batch testing on their website

What does Extra virgin mean?

• Extra virgin refers to the acidity level of the oil

Health benefits of olive oil 

• Polyphenols and antioxidants 
• Brain health
• Heart health
• Bone health
• Hair and Skin health
• Increases life expectancy

Will it oxidize?

• Olive oil will oxidize over time, with air, and light - doesn’t oxidize as fast as other oils like vegetable oils

Fat is good despite what you’ve heard

• Your brain and body need the right kinds of fat

What about cooking with olive oil, is it safe?

• In greece they use it often for cooking
• Different olive oils have different smoke points
• Smoke point - if it’s smoking, you are cooking it too hot

What about flavored oil?

• Don’t buy flavored olive oil, make it at home
• The bottles of flavored olive oil in the stores almost always use synthetic flavoring

Non-consumption uses for olive oil

• Skin - soaps, body butter, hair care 

Microbiome connection

• Polyphenols are excellent for the microbiome
• Increase the growth of acromansia which is very important for metabolic health 
• Polyphenol count is tested in the Kasandrinos on a regular basis
• About 1000 milligrams of polyphenols per kilogram 
• However polyphenols do degrade in oil over time, after about 2 years polyphenols drop off considerably

Can you give olive oil to kids? Babies?

• Yes, ideally it’s organic olive oil that is less than two years old so they can benefit from the healthy compounds in it

Connect with Tony:

• Website 
• Instagram: @kasandrinos 
• Facebook 
• YouTube

Connect with Kiran Krishnan and Dr. Nicole Beurkens on...

• Instagram: better.biome
• Facebook: better biome 
• Instagram: Dr. Nicole
• Instagram: Kiran Krishnan
• Website: BetterBiome.com
• Website: DrBeurkens.com

Join us as we discuss the microbiome and hormone connection for women as they age. No, women do NOT have to suffer greatly through perimenopause and menopause. That’s not “normal” or  “just how it is” and that’s not how it has to be. Dr. Anna Cabeca shares how she came to understand how much of the suffering in perimenopause and menopause can be eliminated with the right protocols to support your hormones and overall health. 

On today’s episode, we discuss the inner workings of the vaginal microbiome and the gut microbiome and how they are directly related to hormones.  Dr. Cabeca tells us that if we can better support our hormones when they are going through changes, we will feel much better. You’ll learn several ways in which you can support your own journey through these stages of change. In some cases, you can even reverse early onset perimenopause or menopause. 

GUEST INFO:

Dr. Anna Cabeca, a triple board-certified, Emory University trained physician and hormone expert was diagnosed with early menopause at age 38. Devastated, she set out on a personal wellness journey to reverse her menopause side effects, which resulted in her delivery of a healthy baby girl at the age of 41.  

After experiencing her own health successes, Dr. Cabeca began counseling others, ultimately changing the lives of thousands of women across the globe. Her new book “The Hormone Fix” and other empowering transformation programs have helped women of all ages become their best selves again. Her successful line of all-natural products features the alkaline superfoods drink Mighty Maca® PLUS and the rejuvenating vulva cream Julva®.

EPISODE TAKEAWAYS

Reversing early Perimenopause and Menopause

• If you notice brain fog, hot flashes, limited sleep a night, irritability, weight gain, mood swings you might be experiencing early perimenopause
• In many cases, this can be reversed. But your doctor likely won’t tell you that, they might not even know this is possible. 
• In order to do this, the body needs specific support from you
• Nutrition, Dr. Cabecas talks about KetoGreen and intermittent fasting in the book
• Supplementation  (see Dr. Cabecas KetoGreen and The Hormone Fix book) 
• Lowering stress as much as you can is helpful too

Importance of the gut microbiome in perimenopause and menopause

• When patients come in with perimenopausal symptoms: PMS, irregular bleeding, irritability, sleeplessness, however many of these symptoms can be reversed once they improve their gut health. 
• A nutritional detox supporting liver function, a plant-based alkalizing diet (which supports the microbiome) helps balance the hormones, patients say “I’m 90% better” after 6 weeks or so
• The KetoGreen Way is a protocol that is very helpful for women in this stage of life. 
• Intermittent fasting is also an excellent strategy for improving these symptoms and hormone function 
• No Snacking please! Snacking can really throw off proper hormone function and digestion as well
• Do not drink while you eat, let your stomach acid do its thing! 
• So the biggest takeaways are intermittent fasting, healthy fats, healthy protein, lots of greens

Importance of the vaginal microbiome in perimenopause and menopause

• The vaginal microbiome is directly related to perimenopause and menopause symptoms
• The number one thing that is common that women do and have been told to do is douching, and that is absolutely the most devastating thing for the vaginal microbiome
• A lot of the products that are marketed to women, particularly as they get older, when they are dealing with vaginal dryness, painful intercourse, etc. are products that are filled with chemicals and microbiome-disrupting things that actually seem to make the problem worse
• Tampon trauma, using dehydrating soaps, sprays, and feminine washes all disrupt our vaginal microbiome

• Many of the products will dehydrate, will cause further irritation, and can have chemical sensitivities or endocrine disruptors as they are, and we have to remember the vagina is an amazing organ that has such vascularity to it. Huge blood flow, great muscle and collagen potential.
• Anything we put near the vagina, the vulva, can be absorbed into the bloodstream

• A product like Julva can help restore balance in the vagina as well as DHEA

Can you reverse incontinence?

• The number one reason caregivers put their loved ones in a nursing home is incontinence
• In many cases, incontinence can be improved or even reversed with the right strategies 
• Using bioidentical hormone therapy, vaginal probiotics, Julva, and working with a practitioner who understands how to strengthen this area, can help reverse incontinence.

EPISODE TIMESTAMPS:

00:02:04 Anna’s experience with early perimenopause

00:07:00 Importance of gut & vaginal microbiome in perimenopause and menopause

00:12:42 Don’t use products that disrupt the vaginal microbiome

00:20:38 Fasting for a better microbiome

00:23:50 Why the microbiome thrives on greens

CONNECT:
Connect with Anna:

• Website: https://drannacabeca.com/
• Books: https://drannacabeca.com/collections/books
• Instagram: @drannacabeca
• Facebook: https://www.facebook.com/Drannac/
• Twitter: @AnnaCabeca
  
  

Connect with Kiran and Dr. Beurkens:

• Website: BetterBiome.com
• Dr. Nicole Website: DrBeurkens.com
• Instagram: better.biome
• Facebook: better biome
• Instagram: Dr. Nicole
• Instagram: Kiran Krishnan

These small but mighty creatures do really important work and won’t harm you in the slightest. They remove dead tissue from infected wounds, they even help in the case of antibiotic resistant organisms and they do so in a matter of a couple of days. They get a bad rap for being gross but actually they are quite the opposite. They are helping humans heal where modern medicine cannot. For instance, they have the potential to save someone from having their foot amputated due to diabetic foot ulcers. There are many use cases for them.

They only get a bad rap because of their association. You typically find these little creatures in the trash, scavenging on a dead animal, etc. These powerful and healing creatures  are maggots.  

Learn more about maggot therapy click here.

Episode Takeaways: 

What is a maggot? 00:05:40

• Larval stage of the fly
• Blow flies feed on dead tissue and are instinctively motivated to get as far away from the host as possible after a couple of day so they don’t get eaten by the next scavenger

How do maggots help us heal?  00:09:00

• They dissolve the dead enzymes by secreting digestive enzymes and suck the juices up 
• Some species can only dissolve dead tissue not live tissue
• They remove dead tissue
• Feed for two days and leave the host 
• They kill microbes (bacteria, fungus, virus’)
• They create growth stimulating activity - clinical observations, lab evidence, studies show proof of this

Historical use 00:10:00

• There is some historical literature that suggests the Mayans and Native australians used maggots in their medical care
• Europe - military doctor observations - soldiers whose wounds had maggots had a better chance of survival 
• A practitioner - Johns Hopkins - intentionally placed maggots on children with bone infections

Why is maggot therapy not more widely used 00:14:30

• In europe maggot therapy is much more popular and widely used
• In North America - this therapy is not widely used enough
• Much of it is due to the way insurance works in north america 
• There are over 100,000 limb amputations per year due to diabetes, where maggot therapy could be useful
• Less than 2% are given a trial of maggot therapy 
• The research shows that 50% or more of patients with diabetic foot ulcers who are given maggot therapy as a last resort, are able to heal their wounds and do not have to get their limbs amputated. .
• In a Kaiser Permanente study, 74% of their patients given maggot therapy as a last resort avoided amputation or ended up with a more conservative amputation.

How do maggots control bacteria 00:20:00

• When they feed on the dead tissue, they are sucking up a lot of bacteria as well. 
• Clinically, several researchers have been able to describe a decrease in the number of pathogens on the wound as well as a decrease in the population size of those organisms.
• Some researchers have looked at antibiotic resistant organisms such as MRSA and seen success with maggot therapy killing those organisms. 

How does Maggot therapy work? 00:35:38

• They feed for 3-4 days depending on temperature and abundance of food
• Once they finish feeding, they leave the host 
• The maggot crawls like a worm away from the host
• For treatment purposes, in order to keep the maggots on the wound, they cover them with a porous net fabric that allows air to get through, or they contain them in a bag 

Is it painful? 00:42:00

• No direct pain-reducing affect 
• Most people have no wound pain and don’t feel the maggots 
• For those who can feel their wounds - the maggots could cause pain after 24 hours so practitioners are encouraged to help the patient with an analgesic  

Interested in learning more about maggot therapy? 00:45:00

• Visit Bterfoundation.org for lots of information on how and where to get this therapy 

Where to learn more about

• PBHealthcenter.com
• Instagram: better.biome
• Instagram: Microbiome Keynotes
• Facebook: Microbiome Keynotes
• Instagram: Dr. Nicole
• Instagram: Kiran Krishnan

Join us as we discuss the vaginal microbiome. Jacques explains what it is, how to support it, and what to stop doing so that you can continue to have a healthy vaginal microbiota. This is a fascinating conversation that reveals so much about what we know so far and what we have yet to learn in this unique microbiome. 

Some background on Dr. Jacques Ravel, he is a professor in the Department of Microbiology and Immunology, and the Associate Director for Genomics at The Institute for Genome Sciences, University of Maryland, School of Medicine in Baltimore Maryland. Over the past 15 years, he has developed a research program focused on applying modern genomic technologies and ecological principles to characterize the role and dynamics of the microbial communities inhabiting the human body in health and disease and better define the interactions between the host, the microbes and the environment that drives these ecological systems. Specifically, he is interested in the role of the vaginal microbiome in women’s health in order to develop improved strategies to manage gynecological and obstetrics conditions.

He has published over 225 peer-reviewed publications and has attracted grant income of more than $30 million. His work is currently being translated by developing novel live microbiome-based biotherapeutic formulations targeted to restore vaginal health, treat conditions such as bacterial vaginosis, urinary tract infections and improved fertility. His work earned him to be elected to the fellowship of the American Academy of Microbiology, and in

2015, he was awarded the Blaise Pascal international research chair. He is the founder and editor-in-chief of the journal Microbiome. He joined the Institute for Genome Sciences at The University of Maryland Medical School in 2007 as an associate professor.

To learn more about  Dr. Jacques Ravel click here.

Episode Takeaways:

What is the vaginal microbiome?

• The vaginal microbiome is just like the gut, it’s a collection of bacteria that live together to perform a function that is beneficial. If it lives in the body, it’s often beneficial to the host.
• When it comes to the vaginal microbiota, there are five types of women, four of these types are dominated by lactobacillus, one of the four species (lactobacillus crispatus, lactobacillus iners, lactobacillus gasseri, lactobacillus jensenii). And one of them is not and it’s represented, it’s more like the gut, this type is very diverse. So you can see it’s diverse and very even, a lot more even than what you see in the others.
• Those bacteria, they acidify the vagina, the pH of the vagina is about 3.6-4, so it’s very acidic
• Those that have an acidified environment are those that you would call very well-protected
• 25-30% of women that don’t have lactobacillus

How does the composition of the vaginal microbiome impact a woman’s overall health?

• Without a healthy vaginal microbiome, women are subject to many different risks
• Sexually transmitted infections
• A woman being able to get pregnant - the implantation of the egg
• Chronic yeast infections
• Vaginal dryness which can make intercourse very painful

Can lubricants affect the vaginal microbiome negatively?

• They are very hypertonic, that’s a big problem because what happens is it dries the cells
• Most lubricants, especially in medicine, contain antimicrobial agents, so it kills even the good bacteria
• Not every woman is affected by the application of lubricant

What are some of the things that people are doing in day to day life that seem to be hurting the vaginal microbiome?

• Douching - you’re basically washing your vagina with chemicals
• Smoking has a major impact on the vaginal microbiota
• Poor diet
• A really heavy dose of azithromycin has a really detrimental effect on the vaginal microbiota

What can women start doing right now to help support a healthy vaginal microbiome?

• Eat healthy - whole foods, less packaged food
• No smoking
• Some studies show that exercise helps support a healthy vagina as well

Where to learn more about Dr. Jacques Ravel, 

• Website: http://ravel-lab.org
• Youtube: https://www.youtube.com/watch?v=UEQ5hVUYOtg

Connect with Kiran and Dr. Nicole:

• Website: BetterBiome.com
• Instagram: better.biome
• Instagram: Microbiome Keynotes
• Facebook: Microbiome Keynotes
• Instagram: Dr. Nicole
• Instagram: Kiran Krishnan

Join us as we discuss how exposure to dirt and time in nature are essential to supporting a healthy microbiome while learning the practices behind Terrain Medicine with Dr. Maya Shetreat. Dr. Maya goes into the history and stigmas that have followed ‘germs’ over time and breaks down simple ways we can support our health by introducing our microbiomes to more diverse environments inside and outside the home. 

Dr. Maya Shetreat is a neurologist, herbalist, urban farmer and author of ‘The Dirt Cure: Healthy Food, Healthy Gut, Happy Child’, which has been translated into 10 languages. She's been featured in The New York Times, The Telegraph, NPR, Sky News, The Dr. Oz Show and more. Dr. Maya is the founder of the Terrain Institute where she teaches terrain medicine, earth-based programs for transformational healing. She works and studies with indigenous communities and healers in Ecuador, and is a lifelong student of ethnobotany, plant healing, and the sacred.

To learn more about Dr. Maya Shetreat click here.

Show Notes:

What is Terrain Medicine?

• Terrain medicine is the practice of aligning our bio terrain with our eco terrain resulting in a healthy and beautiful environment for both the body and the world
• • We all have ‘bio-terrain’ - our organ systems, DNA, epigenetics, our microbiome
  • We are surrounded by our ‘eco-terrain’ - water, soil, sun, wind, food 

Practicing Gratitude and Awe

• Gratitude practice has been shown to positively influence our physiology
• • Examples of benefits:
  • • Reduced anxiety, lower blood pressure, minimized depression, lower cortisol levels, improved sleep and more
• Getting back outside in nature
• • Try earthing/grounding - time outdoors is essential 
  • Examples of outdoor benefits:
  • • Lower cortisol levels, higher anti-cancer proteins, increased executive function, creativity, happiness and more

Dirt is Not Dirty

• We have been raised in a world that teaches us that perfect hygiene is to remove bacterias and stay far away from getting “dirty” - that being sterile is important
• • A study in Europe showed that in home or schools that use more bleach the exposed children to those environments were more likely to have chronic respiratory infections
• We were intended to come in contact with dirt and to get dirty
• • Germ diversity is essential for a healthy and happy life

Steps You Can Take Right Now 

• The simplest thing is to start by going outside
• • Take your lunch outside on a picnic blanket, sit on a rock, hug a tree
  • Take your computer outside and get some sun and breathe fresh air while you work
• Home cleaning 
• • Replace chemical cleaning products with natural cleaners - many of these you can make with just a few simple ingredients

• Look for easy swaps and be aware of what you are ingesting (diet) and the environmental factors around you (products)

Timestamps:

Episode Intro … 00:00:30
Dr. Shetreat’s Story … 00:01:30
What is Terrain Medicine? … 00:05:34
Practicing Gratitude and Awe … 00:13:00
Dirt is Not Dirty … 00:20:51
Steps You Can Take Right Now … 00:34:10
Episode Wrap-Up … 00:45:10

Connect with us:

Instagram: Better Biome

Facebook: Better Biome 

Website: Better Biome

Join us as we discuss an integrative approach to dermatology and the skin microbiome with board-certified dermatologist and researcher, Dr. Raja Sivamani. In this episode, Dr. Sivamani shares how addressing key lifestyle components like diet, environment, and stress can affect our skin microbiome’s health. Learn what steps you can take to start supporting your skin’s unique microbiome and where to access key resources for skin health.

About the guest:

Dr. Raja Sivamani is a board-certified dermatologist and practices as an integrative dermatologist at Pacific Skin Institute. He is an Adjunct Associate Professor of Clinical Dermatology at the University of California, Davis, and Director of Clinical Research and the Clinical Trials Unit. He is also an Adjunct Assistant Professor in the Department of Biological Sciences at the California State University, Sacramento, and an Associate Professor of Dermatology at California Northstate University, College of Medicine. He engages in clinical practice, as well as, both clinical and translational research that integrates bioengineering, nutrition, cosmetics, and skin biology. With training in both Allopathic and Ayurvedic medicine, he takes an integrative approach to his patients and in his research. He has published over 100 peer-reviewed research manuscripts, 10 textbook chapters, and a textbook entitled Cosmeceuticals and Active Cosmetics, 3rd Edition with a passion for expanding the evidence and boundaries of integrative medicine for skincare.

To learn more about Dr. Raja Sivamani click here.

Episode Highlights

Acne

• Environment
• • Ex: a dry environment versus a humid environment can make a great difference for someone who has dry skin or eczema 
• Diet
• • It is important to take note at the kinds of foods your skin reacts negatively to
  • We all have different sensitivities and predispositions. This is not a one size fits all problem with a simple solution
  • Focus on whole foods that are good for you - avoid excessive sugars and processed foods as much as you can
  • Keep an eye on your reaction to dairy products so you can make informed decisions for yourself

Dermveda

• Dermveda seeks to direct its users to optimize their skin health
• Visit dermveda.com 
• • Dermveda will step you through a quiz to analyze specific function for specific areas

• Ex: lactobacillus rhamnosus gg has been shown to have an effect for eczema

• When looking for probiotics you really have to spend the time educating yourself
• • How were they made? What are the ingredients? What is the research behind their creation? 
  • There are many false advertisement labels in this field 
• “You can't fast-forward science” - Dr. Sivamani

Key Takeaway

• Dr. Sivamani says, “Your skin is dependent on so many biomes, that a holistic has to be a part of a full package.”
• The internal, external, and existential all matter - from what you consume, to what you use, and to the relationships you hold
  
  

Where to learn more about Dr. Raja Sivamani...

• Dermveda.com
• LearnSkin.com
• Pacific Skin Institute
• Pacific Skin Institute Instagram

Timestamps

Episode Intro … 00:00:30
Dr. Sivamani’s Story … 00:02:40
Ayurveda … 00:04:20
Skin and The Microbiome … 00:09:00
Acne … 00:17:30
Environment … 00:25:30
Dermveda Skin Profile … 00:27:50
Probiotic Use for Skin … 00:33:15
Key Takeaway … 00:47:15
Episode Wrap Up … 00:48:50