• Climate change impact assessment on mild and extreme drought events using copulas over Ankara, Turkey

      Afshar, Mehdi H.; orcid: 0000-0002-4411-3299; email: mehdi.afshar@manchester.ac.uk; Şorman, Ali Ünal; orcid: 0000-0002-7383-6496; Tosunoğlu, Fatih; orcid: 0000-0002-8423-1089; Bulut, Burak; orcid: 0000-0003-4567-5258; Yilmaz, M. Tugrul; orcid: 0000-0001-5094-1878; Danandeh Mehr, Ali; orcid: 0000-0003-2769-106X (Springer Vienna, 2020-05-22)
      Abstract: Climate change, one of the major environmental challenges facing mankind, has caused intermittent droughts in many regions resulting in reduced water resources. This study investigated the impact of climate change on the characteristics (occurrence, duration, and severity) of meteorological drought across Ankara, Turkey. To this end, the observed monthly rainfall series from five meteorology stations scattered across Ankara Province as well as dynamically downscaled outputs of three global climate models that run under RCP 4.5 and RCP 8.5 scenarios was used to attain the well-known SPI series during the reference period of 1986–2018 and the future period of 2018–2050, respectively. Analyzing drought features in two time periods generally indicated the higher probability of occurrence of drought in the future period. The results showed that the duration of mild droughts may increase, and extreme droughts will occur with longer durations and larger severities. Moreover, joint return period analysis through different copula functions revealed that the return period of mild droughts will remain the same in the near future, while it declines by 12% over extreme droughts in the near future.
    • Pre- and postoperative need for pituitary hormone replacement in non-adenomatous sellar and parasellar lesions: importance of the sellar encroachment score

      Waqar, Mueez; orcid: 0000-0002-7848-6237; email: mueez.waqar@manchester.ac.uk; Rampersad, Shiva; Bennett, David; Kearney, Tara; Gnanalingham, Kanna K.; email: kanna.gnanalingham@srft.nhs.uk (Springer Vienna, 2020-06-06)
      Abstract: Background: Pre-/postoperative pituitary endocrine deficiencies in patients with sellar/parasellar non-adenomatous lesions are poorly described and studies have not considered the effect of sellar invasion on endocrine outcome. The aim of this study was to relate the need for pituitary hormone replacement pre-/postoperatively, with sellar invasion, in non-adenomatous sellar/parasellar lesions. Methods: Single-centre review of adults with histologically confirmed non-adenomatous sellar/parasellar lesion and follow-up ≥ 3 months or until postop radiotherapy. Pituitary dysfunction was defined by hormone replacement. The sellar encroachment score (0–6) was calculated as the sum of the thirds of radiological encroachment into the sellar region in the coronal and sagittal planes. Multivariate analysis with binary logistic regression was used to determine factors associated with pituitary hormone replacement. Results: One hundred and seventeen patients were included with a median age of 49 years (range 16–84 years) and median follow-up of 13 months. Surgery was trans-sphenoidal (53%), trans-cranial (36%) or a combination (11%). The commonest histology types were meningioma (n = 33, 28%) and craniopharyngioma (n = 20, 17%). The median sellar encroachment score was 6 (range 0–6). Most (n = 86, 74%) did not require pituitary hormone replacement preoperatively. The need for pituitary hormones increased after surgery in 41 (35%) patients. In multivariate analysis, the sellar encroachment score was the only factor predictive of pre- (OR = 2.6, 95% CI = 1.2–5.5; p = 0.01) and postoperative risk of new pituitary hormone replacement (OR = 4.1, 95% CI = 1.7–10.1, p = 0.002). Conclusion: A significant proportion of these patients present with need for pituitary hormone replacement that may worsen postoperatively. The degree of sellar encroachment is predictive of pituitary hormone replacement status pre-/postoperatively.
    • Suicidality in women with Premenstrual Dysphoric Disorder: a systematic literature review

      Osborn, E.; Brooks, J.; O’Brien, P. M. S.; Wittkowski, A.; email: anja.wittkowski@manchester.ac.uk (Springer Vienna, 2020-09-16)
      Abstract: Previous research has identified how menstruation is an important factor in both attempted and completed suicides for women. The purpose of this review was to outline (a) the risk profile for suicidality in women who were identified to experience Premenstrual Dysphoric Disorder (PMDD), a condition characterized by severe physical and psychological changes that occur during the luteal menstrual phase, and (b) the implications of these findings for clinical practice. A systematic literature review was conducted using five databases to identify any peer-reviewed articles published between 1989 and 2019. Ten papers eligible for inclusion were identified: three pertaining to suicide cognitions, five to suicide attempts and two to both cognitions and attempts. Findings showed that suicidal thoughts, ideation, plans and attempts were strongly associated with experiences of PMDD and that these findings were independent of psychiatric co-morbidities. However, women with PMDD did not present with more severe risk profiles for suicide attempts (in terms of frequency, impulsivity and lethality) or make more frequent attempts during the luteal menstrual phase compared with suicide attempters without PMDD. Women with PMDD should be considered a high risk group for suicidality; thus, identifying and treating symptoms are vital in reducing suicide attempts. Implications for clinical practice are outlined in the discussion.