Stealing Sand, Communicating via Poop, and Clinical Trial Participation

massive communal poop piles. But First, Senior editor Katherine Whitborren and our freelance writer Alia Hoyt take us behind the scenes of medical research. Clinical trials make amazing new treatments possible and safe, but here in the United States, they struggle to find participants. Here's why and what you can do to help. Dave Bexfield of Albuquerque, New Mexico, was

diagnosed with multiple sclerosis in two thousand and six. Three years later, he applied for a clinical trial sponsored by the National Institutes of Health that involved a stem cell transplant. Bexfield says the trial saved his life. Within a few months of completion, in twenty ten, he could walk again without a cane or a walker. Participation levels in clinical trials are often very low, even for patients with terminal diseases.

Doctor Julie M. Vos, immediate past president of the American Society of Clinical Oncology, told us that only about three percent of adopt patients with cancer participate in clinical trials. This low rate limits patient access to new interventions that could treat or even cure their cancer. In fact, analysis of cancer trials found that a whopping forty of them were unable to enroll the minimum number of participants. Another survey showed only thirty five percent of Americans said they

were likely to enroll in a clinical trial. So why don't more people participate in trials, even if it might save their lives? Here are some reasons. Number one, they don't know what's available. People diagnosed with diseases often mistakenly assumed that their doctor will suggest appropriate clinical trials if they're out there. Although some physicians are very dialed into ongoing research, many aren't or simply don't have time to

sit through all the opportunities for their patients. So in addition to asking your doctor directly about clinical studies, you can also check a number of online resources that can help you find them. The National Institute of Health website lists several databases, including clinical Trials dot gov, which allows users to search by condition or location. Breast Cancer Trials dot org is another disease specific option where you can be matched with an appropriate study. Search for finding clinical

trials to learn more. Number two, the trial locations are inconvenient. Geography is a major problem with clinical trials because they tend to be in specific locations that are often not convenient to patients. Vicky Carr is our breast cancer survivor and patient advocate for Susan G. Coleman, who lives outside Washington, d C. For four years, she's taken a bus trip every four weeks for a trial that will hopefully prevent

her cancer from returning and spreading. Another example, the multiple scross a study that Dave Bexfield participated in, required ten round trip flights from Albuquerque to Houston, including initial treatment and follow up trips. His cost eventually were covered by insurance company after a big fight. But not everyone has the luxury of taking so much time off work. But before you ride off a possibly life saving study, it's important to know the terms because some trials will pay

for travel and hotel expenses. Number three, Patients worry about getting the placebo. A lot of people are afraid of going through all that trouble of participating in a trial to only wind up in the group that gets the sugar pill instead of the drug. But nowadays trials are designed to be more patient friendly. For instance, there might be several treatment groups and a single placebo group, so the chances of receiving the placebo may only be twenty

five to thirty three percent. Crossover designs also allow every participant to receive the drug at some point during the trial. Another incentive is the open label extension trial. This is a special trial that allows participants who complete the main trial to have guaranteed access to the drug at the end of it. Also, in the case of cancer trials, people in either group will get at least the current standard of care for their condition. No one goes without treatment.

Number four reason Patients also worry about safety. They hear the word clinical trial and figure that the drug being tested could really harm them, But by the time it gets to the stage of being tested on humans, the researchers have already tested this out on cells grown in a lab, as well as on animals. These are called preclinical studies. Clinical trials are done only after preclinical studies suggest that the treatment is likely to be safe and

will work in people. The research must also be approved by the u S Food and Drug Administration. The researchers and doctors we spoke with for this story emphasize the need to have a wider pool of study subjects. Clinical trials need both men and women of all races and ages to be sure that a treatment will work on everyone. And by the way, you don't have to be sick to participate in a clinical trial. Lots of them are

looking for healthy volunteers. Next up, staff writer Joe McCormick, who's also the co host of a podcast you might have heard of called Stuff to Blow Your Mind, presents a story from our freelancer Dave Ruse about the strange and very serious world of the sand mafia. As strange as it may sound, sand is one of the world's hottest commodities. The global construction boom has created an insatiable

appetite for sand, the chief ingredient in making concrete. The problem is that sand isn't as abundant as it used to be, and when high demand and high value. Meet scarcity, you open the doors to smuggling. Meet the sand mafia. In India, illegal sand mining is the country's largest organized criminal activity. In inland villages, armed sand mafia's steel land in order to strip its top soil and extract the

layers of valuable sand beneath along the posts. Pirate dredging vessels siphon sand from the seafloor in broad daylight, with bribed officials turning a blind eye. The Pilford sand fetches a good price on the black market, where it is sold to construction companies building high rises in mega cities like Mumbai. According to journalist Vince Bisser, who wrote about sand theft for Wired and The New York Times, people who resist the mafia are beaten or killed, including police officers.

Filmmaker Dennis Dellastroc witnessed similar tactics in Morocco while shooting Sand Wars, a documentary about the global sand trade and its environmental impact. According to Dellastrac, quote, the sand of mafia in Morocco is the second most powerful criminal organization in the country. We saw people with shovels taking every last grain of sand from the beach where a few years ago you used to have a very thick and white beach. Now you have this lunar landscape. It's devastating.

Environmental officials estimate that half of Morocco's construction sector is built with stolen sand. The irony, says Dellastroc, is that much of the stolen sand is used to build housing for foreign tourists who are flocking to Morocco precisely because of its beaches. If both legal and illegal sand mining persists at its current rate in places like Morocco, India,

and across Asia, there may be few beaches left. The United Nations Environment Program reported in that quote, sand and gravel represent the highest volume of raw material used on Earth after water. Their use greatly exceeds natural renewal rates. Dellastrac claims that eight of everything built on our planet is built out of concrete, and concrete uses a whole lot of sand. It takes thirty thousand tons or more than twenty seven thousand metric tons of sand to construct

one kilometer of highway. It takes about two hundred tons or about a hundred and eighty men trick tons to build the average concrete house. Reports Coastal Care, a nonprofit foundation dedicated to beach conservation. According to a report from the International Monetary Fund, the Birj Khalifa Tower in Dubai, the world's tallest building, required more than a hundred and twenty one thousand tons or about a hundred and ten thousand metric tons of concrete and over one point six

million square meters of glass. Another industrial commodity that's a massive consumer of sand, Dubai represents another of the great tragic ironies of the global sand trade. This booming desert outposts surrounded by endless seas of sand dunes, must import most of its construction sand from Australia. That's because desert sand is too smooth and fine. The rough angular sand required to make concrete can only be found in or near water or an ancient seabed deposits underground. Of course,

Dubai isn't alone in its hunger for concrete. According to a twenty fourteen UN report on global urbanization, fifty four percent of the world's population now lives in urban areas, including twenty eight mega cities, Sprawling urban areas with more than ten million people. The global sand trade generates seventy billion dollars a year to mine, dredge, extract, and ship enough raw material to meet the explosive demand for urban housing.

How long though, until we run out of sand? It takes twenty thousand years for the natural process of sand formations as dellastrak. Ocean sand begins its journey high in the mountains, where erosive forces slowly break rocks into smaller and smaller pieces that are eventually carried by streams and rivers into the sea. The ocean floor contains a surprisingly thin layer of sand. Most large deposits are found on beaches. The scarcity of natural sand makes beaches and shorelines the

ripest targets for both legal and illegal sand mining. The environmental impact of large scale sand excavation can be disastrous. More than two dozen small islands in Indonesia have disappeared due to runaway erosion caused by offshore dredging operations. In the United States, a sim x sand mining California's Monterey

Bay is blamed by environmentalists for rapid coastal erosion. John gillis a retired history professor from Rutger's University and author of The Human Shore Sea coasts in history, says the most immediate human victims of sand mining and sand theft are poor fishing communities in the Third World. Quote as sand gains value in scarcity and becomes a commodity, you see what happens. It disrupts not just the biological systems of these places, but also the social systems, driving people

away from their very tenuous hold on the shore. But if sand mining is left unchecked, the damage to coastal ecosystems could start swallowing up beaches closer to home. One more thing, documentary filmmaker Deleastra says that large scale recycling of industrial materials, especially glass and concrete, is one way to curb the appetite for natural sand. In Denmark, attacks on extracting raw materials has created an incentive for companies

to recycle. In nineteen five, only twelve percent of construction and demolition waste was recycled. By two thousand four, that number was finally. This week, staff editor Christopher Hasiotis and our freelancer Justcelin Shields have a piece for us about one of the fascinating ways that non human animals lacking a verbal language communicate with one another. Via poop. Most of us agree it's nice to have a special, separate

area where everyone can relieve themselves. It's objectively great that, instead of finding piles of human feces all over the airport or grocery store, we extend to one another the curb to see if crapping and mutually agreed upon spaces so civilized. The very humanness of this act might be why when a group of animals all use a shared public toilet where all now, isn't that interesting? But let's

not fool ourselves. Plenty of animal species poop in latrines or middens, and it's not just us fancy pants primates, nor even just vertebrates. While the act of defecating in shared communal dung heaps is common in all manner of mammals, from molds to otters to elephants, some species of ants,

for instance, make refuse chambers in their own nests. Un Lest we assume the public toilet is a modern invention, The oldest animal latrine ever discovered was created two hundred and forty million years ago by a herd of Dinodontosaurus, giant herbivorous reptiles that kind of resembled a modern rhino. This prehistoric pile of pooh was gargantuan, covering an area of almost ten thousand square feet or nine hundred square meters, with a poop density of around ninety four tirds per

square meter. And speaking of the modern rhinoceros, the critically endangered white rhino can tell us a lot about what's probably going on when animals poop in huge communal piles. Why because white rhinos are seriously into smelling each other's crap. But let's back up a step. In the past, researchers have come up with lots of different reasons why a population of animals would want to create a communal midden rather than just go behind the nearest tree or wherever.

Since we humans mostly confine our droppings to a specific area for sanitary reasons, some biologists have assumed that other animals might be doing the same. And sure, social insects like ants and spider mites probably do keep their biological waste and uneaten food separate from their communal living spaces with the intention of keeping harmful bacteria at bay. But many other animals, like the white rhino we're talking about, will regularly just stroll up to a giant pile of

poop and give it a good, thorough investigatory snuffle. They're probably not all that worried about germs. So communal latrines have also been thought to mark borders of territories or even communicate to predators that this heart is large enough that lunch isn't going to serve itself to them on golden platters. But for some species, scientists think the purpose of communal latrines is for intraspecies communication. Period. Take Courtney

Marnoik for example. She is an ecologist and doctoral student at the University of Quasulu Natal in South Africa, and she's the lead author of recent study investigating the role of dung in white rhino communication. White rhinos use communal defecation sites to communicate. She tells, how stuff works and this is the only reason they do this. They can identify age, sex, territorial state, estra state of the depositor,

and even how long ago they were there. And although Marnoick didn't test for this in her recent study, she believes rhinos can recognize specific individuals through fecal scent. One interesting thing about white rhine no midden making behavior is that every rhino of every age in the area will all use the same dung heap, but the only one allowed to poop right in the very center of the

pile is the resident dominant male. He's also the only one who kicks his dunge around afterwards, spreading his smell around the midden, but also carrying the smell of his

own poop with him everywhere he walks. According to Marnock, lots of other animals, both herbivores and carnivores, used communal defecation sites for communication, sometimes only to mark territory and pick up signals from other animals, sometimes just for keeping track of estrus females, and often both, particularly for herbivores species. She says, there's this hypothesis that communal defecation sites could potentially be for parasite avoidance, basically, don't crap where you eat.

She highly doubts that this is the case, though, and thanks communication is the reason for all species. So next time you're in a public bathroom, you might want to look around or take a sniff and see what the world's telling you. Oh and one more thing, completely unrelated to Rhino's but fascinating. Nonetheless, since we're talking about animal bathroom habits here, let's talk about sloths. Though they don't use shared latrines, they do only poop about once a week.

In fact, it's the only reason they climb out of the tree. And because it takes up to a month for a sloth to digest its food, they're always very constipated. That's why each week, defecating sloths undergo what biologists describe as an ordeal akin to Chipper. Now, that's our show for this week. Thank you so much for tuning in. Further thanks for audio producer Dylan Fagin and our orial

liaison Alison Laddermilk. Subscribe to now Now for more of the latest science news, and send this links to anything you'd like to hear his cover. Plus tell me what you're reading right now. I'm reading Grant Morrison's comic The Invisibles for the first time. Uh and it's very not safe for work. It very excellent. You can send us an email at now Podcast at how stuff works dot com, and of course, for lots more stories like these, head on over to our home planet now dot how stuff works dot com.