what's a good follow up to this opening?
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Yeah, exchanging the knights on d4 isnt good at all for black.
I would probably say e6... but im no expert
As someone who plays the Old Sicilian a lot you definitely do not want to play 4... Nxd4 . Instead you should play either 4... Nf6, 4...e6,or 4... g6 (accelerated dragon). All of these are good moves (I beleive they are the top three in games explorer at this position) and all are far superior to Nxd4.