Not sure if it was intended but this item can be usefull, and gamebreaking if you are patient enough. (Spoilers??) When you use D20 on pickups there is like a small moment where you can pick up pickups and reroll it right after, giving you the pickup AND a random pickup on the floor. This works with D0 too, so you can basically duplicate any pickup. In addition to this, you can repair broken slot machines and chests, making new machines you can play and new chests with new pickups inside. It doesnt have much use on items. Only use I found is that you can pick up and use an spacebar item, put it back down, use D0 on it and you have a new charge. This means every item could become a 1 room charge item but means you have to do backtracking and you cant take both with you too another floor. (Unless you have Moving Box, no idea how this works on Moving Box or Void tough).