Stakeholder perceptions of event attribution in the loss and damage debate

In 2013 the Warsaw International Mechanism (WIM) for loss and damage (L&D) associated with climate change impacts was established under the United Nations Framework Convention on Climate Change (UNFCCC). For scientists, L&D raises ques- tions around the extent that such impacts can be attributed to anthropogenic climate change, which may generate complex results and be controversial in the policy arena. This is particularly true in the case of probabilistic event attribution (PEA) science, a new and rapidly evolving field that assesses whether changes in the probabilities of extreme events are attributable to GHG emissions. If the potential applications of PEA are to be considered responsibly, dialogue between scientists and policy makers is fundamental. Two key questions are considered here through a literature review and key stakeholder interviews with representatives from the science and policy sectors underpinning L&D. These provided the opportunity for in-depth insights into stakeholders’ views on firstly, how much is known and understood about PEA by those associated with the L&D debate? Secondly, how might PEA inform L&D and wider climate policy? Results show debate within the climate science community, and limited understanding among other stakeholders, around the sense in which extreme events can be attributed to climate change. However, stake- holders do identify and discuss potential uses for PEA in the WIM and wider policy, but it remains difficult to explore precise applications given the ambiguity surrounding L&D. This implies a need for stakeholders to develop greater understandings of alternative conceptions of L&D and the role of science, and also identify how PEA can best be used to support policy, and address associated challenges.

Media damage following detergent sclerotherapy appears to be secondary to the induction of inflammation and apoptosis: an immunohistochemical study elucidating previous histological observations

Objective/Background: Traditionally, sclerotherapy has been thought to work by the cytotoxic effect of the sclerosant upon the endothelium alone. However, studies have shown that sclerotherapy is more successful in smaller veins than in larger veins. This could be explained by the penetration of the sclerosant, or its effect, into the media. This study aimed to investigate intimal and medial damage profiles after sclerosant treatment. Methods: Fresh human varicose veins were treated ex vivo with either 1% or 3% sodium tetradecyl sulphate (STS) for 1 or 10 minutes. The effect of the sclerosant on the vein wall was investigated by immunofluorescent labelling of transverse vein sections using markers for endothelium (CD31), smooth muscle (a-actin), apoptosis (p53) and inflammation (intercellular adhesion molecule-1 [ICAM-1]). Polidocanol (POL; 3%) treatment at 10 minutes was similarly investigated. Results: Endothelial cell death was concentration- and time-dependent for STS but incomplete for both sclerosants. Time, but not concentration, significantly affected cell death (p > .001). A 40% and 30% maximum reduction was observed for STS and POL, respectively. Destruction of 20e30% of smooth muscle cells was found up to 250 mm from the lumen after 3% STS treatment for 10 minutes. POL treatment for 10 minutes showed inferior destruction of medial cells. Following STS treatment and 24-hour tissue culture, p53 and ICAM-1 were upregulated to a depth of around 300 mm. This effect was not observed with POL. Conclusion: Inflammatory and apoptotic markers show the same distribution as medial cell death, implying that sclerotherapy with STS works by inducing apoptosis in the vein wall rather than having an effect restricted to the endothelium. Incomplete loss of endothelial cells and penetration of the sclerosant effect up to 250 mm into the media suggest that medial damage is crucial to the success of sclerotherapy and may explain why it is less effective in larger veins.