The delta of the Mekong River in Vietnam has been heavily impacted by anthropogenic stresses in recent years, such as upstream dam construction and sand mining within the main and distributary channels, leading to riverbank and coastal erosion. Intensive bathymetric surveys, conducted within the Tien River branch during the dry and wet season 2018, reveal a high magnitude of sand mining activities. For the year 2018, an analysis of bathymetric maps and the local refilling processes leads to an estimated sand extraction volume of 4.64  0.31 Mm/yr in the study area, which covered around 20 km. Reported statistics of sand mining for all of the Mekong’s channels within the delta, which have a cumulative length of several hundred kilometres, are 17.77 Mm/yr for this period. Results from this study highlight that these statistics are likely too conservative. It is also shown that natural sediment supplies from upper reaches of the Mekong are insufficient to compensate for the loss of extracted bed aggregates, illustrating the non-sustainable nature of the local sand mining practices.

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Context.—During the last 50 years, the incidence and mortality of gastric cancer has declined in many countries. This decline has primarily included the intestinal type (Lauren classification). However, there is an impression among pathologists that the diffuse type, especially the signet ring cell subtype, has become more prevalent. Objectives.—Using data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute, we analyzed the trends of the 2 primary types (intestinal and diffuse) of gastric carcinomas from 1973 through 2000. Design.—Trends in age-adjusted rates were determined for gastric carcinomas through the SEER statistical program (SEER*Stat), which is available on the Internet to the public. Results.—During the period studied, the intestinal type continued to decline in males, females, African Americans, and whites. The intestinal type was more common in males than in females and more common in African Americans than in whites. In contrast, a consistent increase in the rate of the diffuse type of gastric carcinoma was seen during this period. The rate increased from 0.3 cases per 100 000 persons in 1973 to 1.8 cases per 100 000 persons in 2000. This increase was seen in males, females, African Americans, and whites. The predominant increase occurred in the signet ring type. Conclusions.—The results indicate a progressive decrease in the incidence of the intestinal type of gastric cancer and an increase in the diffuse type of gastric carcinoma, especially the signet ring cell type. The clinical implications of the increase are considered.

Risk management has reduced vulnerability to floods and droughts globally1,2, yet their impacts are still increasing3. An improved understanding of the causes of changing impacts is therefore needed, but has been hampered by a lack of empirical data4,5. On the basis of a global dataset of 45 pairs of events that occurred within the same area, we show that risk management generally reduces the impacts of floods and droughts but faces difficulties in reducing the impacts of unprecedented events of a magnitude not previously experienced. If the second event was much more hazardous than the first, its impact was almost always higher. This is because management was not designed to deal with such extreme events: for example, they exceeded the design levels of levees and reservoirs. In two success stories, the impact of the second, more hazardous, event was lower, as a result of improved risk management governance and high investment in integrated management. The observed difficulty of managing unprecedented events is alarming, given that more extreme hydrological events are projected owing to climate change3.

Sustainable livelihood development is an ongoing challenge worldwide, and has regained importance due to threats of water shortages and climate change. To cope with changing climatic, demographic and market conditions in Vietnam's Mekong Delta (VMD) an agricultural transformation process has been suggested in the recent Mekong Delta Plan. This agricultural transformation process requires the implementation of alternative livelihood models. The majority of current agricultural livelihood models in the VMD have been introduced by the government in a top-down manner. In this study, we applied a bottom-up approach to understand the motivations and abilities of local farmers to adopt alternative livelihood models. It is based on the MOTA methodological framework, which is further tested with the use of multivariate analyses. The study was conducted in Ben Tre coastal province. Results showed that farmers' motivations and abilities to apply alternative models vary substantially among different groups, driven by their perceptions on triggers and opportunities. Acknowledging this diversity is essential to the development of agricultural transformation plans. Furthermore, based on the analysis, a projection of the precise support that communities need to supplement their knowledge, skills and financial capacities, as well as interventions to reduce the risks of new livelihood models, is given.

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o Piperacillin-tazobactam (PTZ) is known to cause false-positive results in the Platelia Aspergillus enzyme-linked immunoassay (EIA), due to contamination with galactomannan (GM). We tested 32 lots of PTZ and 27 serum specimens from patients receiving PTZ. GM was not detected in the lots of PTZ; one serum specimen (3.7%) was positive. PTZ formulations commonly used in the United States today appear to be a rare cause for false-positive GM results.

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