WEBVTT - Stealing Sand, Communicating via Poop, and Clinical Trial Participation

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<v Speaker 1>Welcome to How Stuff Works Now. I'm your host, Lauren Vogelbaum,

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<v Speaker 1>a researcher and writer. Here at How Stuff Works. Every week,

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<v Speaker 1>I'm bringing you three stories from our team about the

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<v Speaker 1>weird and wondrous advances we've seen in science, technology, and culture.

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<v Speaker 1>This week, sand is in such high demand and construction

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<v Speaker 1>markets around the world that people are stealing tons of it.

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<v Speaker 1>And unrelated, it turns out that white rhinos communicate via

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<v Speaker 1>massive communal poop piles. But First, Senior editor Katherine Whitborren

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<v Speaker 1>and our freelance writer Alia Hoyt take us behind the

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<v Speaker 1>scenes of medical research. Clinical trials make amazing new treatments

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<v Speaker 1>possible and safe, but here in the United States, they

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<v Speaker 1>struggle to find participants. Here's why and what you can

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<v Speaker 1>do to help. Dave Bexfield of Albuquerque, New Mexico, was

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<v Speaker 1>diagnosed with multiple sclerosis in two thousand and six. Three

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<v Speaker 1>years later, he applied for a clinical trial sponsored by

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<v Speaker 1>the National Institutes of Health that involved a stem cell transplant.

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<v Speaker 1>Bexfield says the trial saved his life. Within a few

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<v Speaker 1>months of completion, in twenty ten, he could walk again

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<v Speaker 1>without a cane or a walker. Participation levels in clinical

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<v Speaker 1>trials are often very low, even for patients with terminal diseases.

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<v Speaker 1>Doctor Julie M. Vos, immediate past president of the American

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<v Speaker 1>Society of Clinical Oncology, told us that only about three

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<v Speaker 1>percent of adopt patients with cancer participate in clinical trials.

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<v Speaker 1>This low rate limits patient access to new interventions that

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<v Speaker 1>could treat or even cure their cancer. In fact, analysis

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<v Speaker 1>of cancer trials found that a whopping forty of them

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<v Speaker 1>were unable to enroll the minimum number of participants. Another

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<v Speaker 1>survey showed only thirty five percent of Americans said they

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<v Speaker 1>were likely to enroll in a clinical trial. So why

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<v Speaker 1>don't more people participate in trials, even if it might

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<v Speaker 1>save their lives? Here are some reasons. Number one, they

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<v Speaker 1>don't know what's available. People diagnosed with diseases often mistakenly

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<v Speaker 1>assumed that their doctor will suggest appropriate clinical trials if

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<v Speaker 1>they're out there. Although some physicians are very dialed into

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<v Speaker 1>ongoing research, many aren't or simply don't have time to

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<v Speaker 1>sit through all the opportunities for their patients. So in

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<v Speaker 1>addition to asking your doctor directly about clinical studies, you

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<v Speaker 1>can also check a number of online resources that can

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<v Speaker 1>help you find them. The National Institute of Health website

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<v Speaker 1>lists several databases, including clinical Trials dot gov, which allows

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<v Speaker 1>users to search by condition or location. Breast Cancer Trials

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<v Speaker 1>dot org is another disease specific option where you can

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<v Speaker 1>be matched with an appropriate study. Search for finding clinical

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<v Speaker 1>trials to learn more. Number two, the trial locations are inconvenient.

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<v Speaker 1>Geography is a major problem with clinical trials because they

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<v Speaker 1>tend to be in specific locations that are often not

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<v Speaker 1>convenient to patients. Vicky Carr is our breast cancer survivor

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<v Speaker 1>and patient advocate for Susan G. Coleman, who lives outside Washington,

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<v Speaker 1>d C. For four years, she's taken a bus trip

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<v Speaker 1>every four weeks for a trial that will hopefully prevent

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<v Speaker 1>her cancer from returning and spreading. Another example, the multiple

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<v Speaker 1>scross a study that Dave Bexfield participated in, required ten

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<v Speaker 1>round trip flights from Albuquerque to Houston, including initial treatment

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<v Speaker 1>and follow up trips. His cost eventually were covered by

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<v Speaker 1>insurance company after a big fight. But not everyone has

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<v Speaker 1>the luxury of taking so much time off work. But

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<v Speaker 1>before you ride off a possibly life saving study, it's

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<v Speaker 1>important to know the terms because some trials will pay

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<v Speaker 1>for travel and hotel expenses. Number three, Patients worry about

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<v Speaker 1>getting the placebo. A lot of people are afraid of

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<v Speaker 1>going through all that trouble of participating in a trial

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<v Speaker 1>to only wind up in the group that gets the

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<v Speaker 1>sugar pill instead of the drug. But nowadays trials are

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<v Speaker 1>designed to be more patient friendly. For instance, there might

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<v Speaker 1>be several treatment groups and a single placebo group, so

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<v Speaker 1>the chances of receiving the placebo may only be twenty

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<v Speaker 1>five to thirty three percent. Crossover designs also allow every

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<v Speaker 1>participant to receive the drug at some point during the trial.

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<v Speaker 1>Another incentive is the open label extension trial. This is

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<v Speaker 1>a special trial that allows participants who complete the main

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<v Speaker 1>trial to have guaranteed access to the drug at the

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<v Speaker 1>end of it. Also, in the case of cancer trials,

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<v Speaker 1>people in either group will get at least the current

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<v Speaker 1>standard of care for their condition. No one goes without treatment.

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<v Speaker 1>Number four reason Patients also worry about safety. They hear

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<v Speaker 1>the word clinical trial and figure that the drug being

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<v Speaker 1>tested could really harm them, But by the time it

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<v Speaker 1>gets to the stage of being tested on humans, the

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<v Speaker 1>researchers have already tested this out on cells grown in

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<v Speaker 1>a lab, as well as on animals. These are called

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<v Speaker 1>preclinical studies. Clinical trials are done only after preclinical studies

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<v Speaker 1>suggest that the treatment is likely to be safe and

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<v Speaker 1>will work in people. The research must also be approved

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<v Speaker 1>by the u S Food and Drug Administration. The researchers

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<v Speaker 1>and doctors we spoke with for this story emphasize the

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<v Speaker 1>need to have a wider pool of study subjects. Clinical

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<v Speaker 1>trials need both men and women of all races and

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<v Speaker 1>ages to be sure that a treatment will work on everyone.

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<v Speaker 1>And by the way, you don't have to be sick

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<v Speaker 1>to participate in a clinical trial. Lots of them are

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<v Speaker 1>looking for healthy volunteers. Next up, staff writer Joe McCormick,

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<v Speaker 1>who's also the co host of a podcast you might

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<v Speaker 1>have heard of called Stuff to Blow Your Mind, presents

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<v Speaker 1>a story from our freelancer Dave Ruse about the strange

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<v Speaker 1>and very serious world of the sand mafia. As strange

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<v Speaker 1>as it may sound, sand is one of the world's

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<v Speaker 1>hottest commodities. The global construction boom has created an insatiable

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<v Speaker 1>appetite for sand, the chief ingredient in making concrete. The

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<v Speaker 1>problem is that sand isn't as abundant as it used

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<v Speaker 1>to be, and when high demand and high value. Meet scarcity,

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<v Speaker 1>you open the doors to smuggling. Meet the sand mafia.

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<v Speaker 1>In India, illegal sand mining is the country's largest organized

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<v Speaker 1>criminal activity. In inland villages, armed sand mafia's steel land

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<v Speaker 1>in order to strip its top soil and extract the

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<v Speaker 1>layers of valuable sand beneath along the posts. Pirate dredging

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<v Speaker 1>vessels siphon sand from the seafloor in broad daylight, with

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<v Speaker 1>bribed officials turning a blind eye. The Pilford sand fetches

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<v Speaker 1>a good price on the black market, where it is

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<v Speaker 1>sold to construction companies building high rises in mega cities

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<v Speaker 1>like Mumbai. According to journalist Vince Bisser, who wrote about

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<v Speaker 1>sand theft for Wired and The New York Times, people

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<v Speaker 1>who resist the mafia are beaten or killed, including police officers.

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<v Speaker 1>Filmmaker Dennis Dellastroc witnessed similar tactics in Morocco while shooting

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<v Speaker 1>Sand Wars, a documentary about the global sand trade and

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<v Speaker 1>its environmental impact. According to Dellastrac, quote, the sand of

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<v Speaker 1>mafia in Morocco is the second most powerful criminal organization

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<v Speaker 1>in the country. We saw people with shovels taking every

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<v Speaker 1>last grain of sand from the beach where a few

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<v Speaker 1>years ago you used to have a very thick and

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<v Speaker 1>white beach. Now you have this lunar landscape. It's devastating.

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<v Speaker 1>Environmental officials estimate that half of Morocco's construction sector is

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<v Speaker 1>built with stolen sand. The irony, says Dellastroc, is that

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<v Speaker 1>much of the stolen sand is used to build housing

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<v Speaker 1>for foreign tourists who are flocking to Morocco precisely because

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<v Speaker 1>of its beaches. If both legal and illegal sand mining

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<v Speaker 1>persists at its current rate in places like Morocco, India,

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<v Speaker 1>and across Asia, there may be few beaches left. The

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<v Speaker 1>United Nations Environment Program reported in that quote, sand and

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<v Speaker 1>gravel represent the highest volume of raw material used on

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<v Speaker 1>Earth after water. Their use greatly exceeds natural renewal rates.

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<v Speaker 1>Dellastrac claims that eight of everything built on our planet

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<v Speaker 1>is built out of concrete, and concrete uses a whole

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<v Speaker 1>lot of sand. It takes thirty thousand tons or more

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<v Speaker 1>than twenty seven thousand metric tons of sand to construct

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<v Speaker 1>one kilometer of highway. It takes about two hundred tons

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<v Speaker 1>or about a hundred and eighty men trick tons to

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<v Speaker 1>build the average concrete house. Reports Coastal Care, a nonprofit

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<v Speaker 1>foundation dedicated to beach conservation. According to a report from

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<v Speaker 1>the International Monetary Fund, the Birj Khalifa Tower in Dubai,

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<v Speaker 1>the world's tallest building, required more than a hundred and

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<v Speaker 1>twenty one thousand tons or about a hundred and ten

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<v Speaker 1>thousand metric tons of concrete and over one point six

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<v Speaker 1>million square meters of glass. Another industrial commodity that's a

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<v Speaker 1>massive consumer of sand, Dubai represents another of the great

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<v Speaker 1>tragic ironies of the global sand trade. This booming desert

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<v Speaker 1>outposts surrounded by endless seas of sand dunes, must import

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<v Speaker 1>most of its construction sand from Australia. That's because desert

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<v Speaker 1>sand is too smooth and fine. The rough angular sand

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<v Speaker 1>required to make concrete can only be found in or

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<v Speaker 1>near water or an ancient seabed deposits underground. Of course,

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<v Speaker 1>Dubai isn't alone in its hunger for concrete. According to

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<v Speaker 1>a twenty fourteen UN report on global urbanization, fifty four

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<v Speaker 1>percent of the world's population now lives in urban areas,

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<v Speaker 1>including twenty eight mega cities, Sprawling urban areas with more

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<v Speaker 1>than ten million people. The global sand trade generates seventy

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<v Speaker 1>billion dollars a year to mine, dredge, extract, and ship

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<v Speaker 1>enough raw material to meet the explosive demand for urban housing.

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<v Speaker 1>How long though, until we run out of sand? It

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<v Speaker 1>takes twenty thousand years for the natural process of sand

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<v Speaker 1>formations as dellastrak. Ocean sand begins its journey high in

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<v Speaker 1>the mountains, where erosive forces slowly break rocks into smaller

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<v Speaker 1>and smaller pieces that are eventually carried by streams and

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<v Speaker 1>rivers into the sea. The ocean floor contains a surprisingly

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<v Speaker 1>thin layer of sand. Most large deposits are found on beaches.

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<v Speaker 1>The scarcity of natural sand makes beaches and shorelines the

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<v Speaker 1>ripest targets for both legal and illegal sand mining. The

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<v Speaker 1>environmental impact of large scale sand excavation can be disastrous.

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<v Speaker 1>More than two dozen small islands in Indonesia have disappeared

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<v Speaker 1>due to runaway erosion caused by offshore dredging operations. In

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<v Speaker 1>the United States, a sim x sand mining California's Monterey

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<v Speaker 1>Bay is blamed by environmentalists for rapid coastal erosion. John

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<v Speaker 1>gillis a retired history professor from Rutger's University and author

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<v Speaker 1>of The Human Shore Sea coasts in history, says the

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<v Speaker 1>most immediate human victims of sand mining and sand theft

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<v Speaker 1>are poor fishing communities in the Third World. Quote as

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<v Speaker 1>sand gains value in scarcity and becomes a commodity, you

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<v Speaker 1>see what happens. It disrupts not just the biological systems

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<v Speaker 1>of these places, but also the social systems, driving people

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<v Speaker 1>away from their very tenuous hold on the shore. But

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<v Speaker 1>if sand mining is left unchecked, the damage to coastal

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<v Speaker 1>ecosystems could start swallowing up beaches closer to home. One

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<v Speaker 1>more thing, documentary filmmaker Deleastra says that large scale recycling

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<v Speaker 1>of industrial materials, especially glass and concrete, is one way

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<v Speaker 1>to curb the appetite for natural sand. In Denmark, attacks

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<v Speaker 1>on extracting raw materials has created an incentive for companies

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<v Speaker 1>to recycle. In nineteen five, only twelve percent of construction

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<v Speaker 1>and demolition waste was recycled. By two thousand four, that

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<v Speaker 1>number was finally. This week, staff editor Christopher Hasiotis and

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<v Speaker 1>our freelancer Justcelin Shields have a piece for us about

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<v Speaker 1>one of the fascinating ways that non human animals lacking

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<v Speaker 1>a verbal language communicate with one another. Via poop. Most

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<v Speaker 1>of us agree it's nice to have a special, separate

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<v Speaker 1>area where everyone can relieve themselves. It's objectively great that,

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<v Speaker 1>instead of finding piles of human feces all over the

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<v Speaker 1>airport or grocery store, we extend to one another the

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<v Speaker 1>curb to see if crapping and mutually agreed upon spaces

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<v Speaker 1>so civilized. The very humanness of this act might be

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<v Speaker 1>why when a group of animals all use a shared

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<v Speaker 1>public toilet where all now, isn't that interesting? But let's

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<v Speaker 1>not fool ourselves. Plenty of animal species poop in latrines

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<v Speaker 1>or middens, and it's not just us fancy pants primates,

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<v Speaker 1>nor even just vertebrates. While the act of defecating in

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<v Speaker 1>shared communal dung heaps is common in all manner of mammals,

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<v Speaker 1>from molds to otters to elephants, some species of ants,

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<v Speaker 1>for instance, make refuse chambers in their own nests. Un

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<v Speaker 1>Lest we assume the public toilet is a modern invention,

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<v Speaker 1>The oldest animal latrine ever discovered was created two hundred

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<v Speaker 1>and forty million years ago by a herd of Dinodontosaurus,

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<v Speaker 1>giant herbivorous reptiles that kind of resembled a modern rhino.

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<v Speaker 1>This prehistoric pile of pooh was gargantuan, covering an area

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<v Speaker 1>of almost ten thousand square feet or nine hundred square meters,

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<v Speaker 1>with a poop density of around ninety four tirds per

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<v Speaker 1>square meter. And speaking of the modern rhinoceros, the critically

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<v Speaker 1>endangered white rhino can tell us a lot about what's

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<v Speaker 1>probably going on when animals poop in huge communal piles.

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<v Speaker 1>Why because white rhinos are seriously into smelling each other's crap.

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<v Speaker 1>But let's back up a step. In the past, researchers

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<v Speaker 1>have come up with lots of different reasons why a

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<v Speaker 1>population of animals would want to create a communal midden

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<v Speaker 1>rather than just go behind the nearest tree or wherever.

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<v Speaker 1>Since we humans mostly confine our droppings to a specific

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<v Speaker 1>area for sanitary reasons, some biologists have assumed that other

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<v Speaker 1>animals might be doing the same. And sure, social insects

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<v Speaker 1>like ants and spider mites probably do keep their biological

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<v Speaker 1>waste and uneaten food separate from their communal living spaces

0:13:49.000 --> 0:13:52.120
<v Speaker 1>with the intention of keeping harmful bacteria at bay. But

0:13:52.240 --> 0:13:55.080
<v Speaker 1>many other animals, like the white rhino we're talking about,

0:13:55.400 --> 0:13:58.120
<v Speaker 1>will regularly just stroll up to a giant pile of

0:13:58.120 --> 0:14:02.640
<v Speaker 1>poop and give it a good, thorough investigatory snuffle. They're

0:14:02.640 --> 0:14:06.640
<v Speaker 1>probably not all that worried about germs. So communal latrines

0:14:06.679 --> 0:14:10.080
<v Speaker 1>have also been thought to mark borders of territories or

0:14:10.120 --> 0:14:13.280
<v Speaker 1>even communicate to predators that this heart is large enough

0:14:13.320 --> 0:14:15.120
<v Speaker 1>that lunch isn't going to serve itself to them on

0:14:15.200 --> 0:14:19.480
<v Speaker 1>golden platters. But for some species, scientists think the purpose

0:14:19.480 --> 0:14:24.640
<v Speaker 1>of communal latrines is for intraspecies communication. Period. Take Courtney

0:14:24.680 --> 0:14:28.040
<v Speaker 1>Marnoik for example. She is an ecologist and doctoral student

0:14:28.040 --> 0:14:31.600
<v Speaker 1>at the University of Quasulu Natal in South Africa, and

0:14:31.640 --> 0:14:34.080
<v Speaker 1>she's the lead author of recent study investigating the role

0:14:34.120 --> 0:14:37.840
<v Speaker 1>of dung in white rhino communication. White rhinos use communal

0:14:37.840 --> 0:14:40.680
<v Speaker 1>defecation sites to communicate. She tells, how stuff works and

0:14:40.760 --> 0:14:43.600
<v Speaker 1>this is the only reason they do this. They can

0:14:43.640 --> 0:14:48.560
<v Speaker 1>identify age, sex, territorial state, estra state of the depositor,

0:14:48.800 --> 0:14:51.520
<v Speaker 1>and even how long ago they were there. And although

0:14:51.560 --> 0:14:53.960
<v Speaker 1>Marnoick didn't test for this in her recent study, she

0:14:54.080 --> 0:14:58.720
<v Speaker 1>believes rhinos can recognize specific individuals through fecal scent. One

0:14:58.760 --> 0:15:01.600
<v Speaker 1>interesting thing about white rhine no midden making behavior is

0:15:01.640 --> 0:15:04.360
<v Speaker 1>that every rhino of every age in the area will

0:15:04.440 --> 0:15:07.440
<v Speaker 1>all use the same dung heap, but the only one

0:15:07.440 --> 0:15:09.360
<v Speaker 1>allowed to poop right in the very center of the

0:15:09.360 --> 0:15:13.560
<v Speaker 1>pile is the resident dominant male. He's also the only

0:15:13.600 --> 0:15:16.600
<v Speaker 1>one who kicks his dunge around afterwards, spreading his smell

0:15:16.640 --> 0:15:19.000
<v Speaker 1>around the midden, but also carrying the smell of his

0:15:19.040 --> 0:15:22.760
<v Speaker 1>own poop with him everywhere he walks. According to Marnock,

0:15:23.080 --> 0:15:27.080
<v Speaker 1>lots of other animals, both herbivores and carnivores, used communal

0:15:27.120 --> 0:15:30.760
<v Speaker 1>defecation sites for communication, sometimes only to mark territory and

0:15:30.800 --> 0:15:34.000
<v Speaker 1>pick up signals from other animals, sometimes just for keeping

0:15:34.000 --> 0:15:38.920
<v Speaker 1>track of estrus females, and often both, particularly for herbivores species.

0:15:38.920 --> 0:15:42.280
<v Speaker 1>She says, there's this hypothesis that communal defecation sites could

0:15:42.280 --> 0:15:46.680
<v Speaker 1>potentially be for parasite avoidance, basically, don't crap where you eat.

0:15:47.680 --> 0:15:50.160
<v Speaker 1>She highly doubts that this is the case, though, and

0:15:50.240 --> 0:15:54.520
<v Speaker 1>thanks communication is the reason for all species. So next

0:15:54.560 --> 0:15:56.440
<v Speaker 1>time you're in a public bathroom, you might want to

0:15:56.440 --> 0:15:59.560
<v Speaker 1>look around or take a sniff and see what the

0:15:59.600 --> 0:16:03.640
<v Speaker 1>world's telling you. Oh and one more thing, completely unrelated

0:16:03.640 --> 0:16:07.520
<v Speaker 1>to Rhino's but fascinating. Nonetheless, since we're talking about animal

0:16:07.560 --> 0:16:11.080
<v Speaker 1>bathroom habits here, let's talk about sloths. Though they don't

0:16:11.160 --> 0:16:14.640
<v Speaker 1>use shared latrines, they do only poop about once a week.

0:16:15.240 --> 0:16:17.480
<v Speaker 1>In fact, it's the only reason they climb out of

0:16:17.480 --> 0:16:19.760
<v Speaker 1>the tree. And because it takes up to a month

0:16:19.880 --> 0:16:24.800
<v Speaker 1>for a sloth to digest its food, they're always very constipated.

0:16:25.480 --> 0:16:29.240
<v Speaker 1>That's why each week, defecating sloths undergo what biologists describe

0:16:29.280 --> 0:16:39.320
<v Speaker 1>as an ordeal akin to Chipper. Now, that's our show

0:16:39.320 --> 0:16:41.440
<v Speaker 1>for this week. Thank you so much for tuning in.

0:16:41.760 --> 0:16:44.840
<v Speaker 1>Further thanks for audio producer Dylan Fagin and our orial

0:16:44.920 --> 0:16:48.680
<v Speaker 1>liaison Alison Laddermilk. Subscribe to now Now for more of

0:16:48.680 --> 0:16:50.920
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0:16:53.440 --> 0:16:56.160
<v Speaker 1>you're reading right now. I'm reading Grant Morrison's comic The

0:16:56.160 --> 0:16:59.160
<v Speaker 1>Invisibles for the first time. Uh and it's very not

0:16:59.280 --> 0:17:02.400
<v Speaker 1>safe for work. It very excellent. You can send us

0:17:02.400 --> 0:17:05.560
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0:17:05.600 --> 0:17:08.600
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