http://hdl.handle.net/11434/18 2026-05-23T02:08:55Z 2026-05-23T02:08:55Z Singer, Yvonne http://hdl.handle.net/11434/2402 2025-10-29T23:38:55Z 2025-05-13T00:00:00Z

Title: Burn violence against women in Australia: The tip of the iceberg from Australian burn centers. Epworth Authors: Singer, Yvonne Abstract: Violence against women is pervasive. An estimated 25% of Australian women (≥15 years) have experienced intimate partner violence. Recent cases of homicidal burn violence perpetrated against Australian women have shocked the nation. However, little evidence exists about the burden of burn violence against Australian women. This study describes and compares the frequency, sociodemographic profile, injuries, and outcomes of women admitted to Australian burn centers with burns from suspected violence with women with unintentional burns. Data were extracted from the Burns Registry of Australia and New Zealand for women (≥18 years) admitted to Australian burn centers between 2009 and 2022, with burns from suspected violence or unintentional burns. Sociodemographic profiles, injury, and in-hospital outcomes were compared. To further explore group differences, 155 women from each group were propensity score matched (one-to-one basis), with subsequent group comparisons made. Of 6262 women meeting inclusion criteria, few reported burns from suspected violence (2.5% vs 97.5%). Women with burns from suspected violence were younger (median 36 vs 43 years), greater proportions sustained flame burns (38.1% vs 25.3%) involving petrol (80.0% vs 38.0%), their injuries more likely involved their head (42.3% vs 16.4%), and a greater proportion died (4.5% vs 1.5%). Perpetrators were most often intimate partners. Our study contributes to emerging international literature demonstrating the confronting nature and consequences of burn violence against women. Building capacity among burn center teams to identify and respond to suspected burn violence will better protect Australian women and align with national plans to end violence against women.

2025-05-13T00:00:00Z Ades, Alex Mor, Omer http://hdl.handle.net/11434/2397 2025-10-06T02:53:17Z 2025-10-01T00:00:00Z

Title: Pregnancy outcomes of 512 laparoscopic transabdominal cerclages: The Australian cohort. Epworth Authors: Ades, Alex; Mor, Omer Abstract: Study objective: Cervical insufficiency is recognized as an important cause of obstetric morbidity and mortality, leading to midtrimester loss and preterm birth. Laparoscopic transabdominal cerclage is one of the proposed interventions to manage this condition. The study reports on a large series of pregnancies with laparoscopic transabdominal cerclage to assess its effectiveness. Design: This study evaluates laparoscopic transabdominal cerclage as a procedure to improve obstetric outcomes in patients diagnosed with cervical insufficiency. It is a retrospective observational study of consecutive patients who underwent laparoscopic transabdominal cerclage between August 2007 and July 2024. Setting: The research was conducted in Melbourne, Australia, in several public and private healthcare facilities. Patients: Eligible patients had a diagnosis of cervical insufficiency based on previous obstetric history and were referred for a laparoscopic transabdominal cerclage. The indications for a transabdominal cerclage were a previous failed vaginal procedure, previous oncologic surgery that removed large portions of the cervix, and multiple midtrimester pregnancy losses because of cervical insufficiency. All patients were entered on a database and were prospectively followed up during subsequent pregnancies. The primary outcome was neonatal survival, and the secondary outcome was delivery of an infant at ≥34 weeks' gestation. Interventions: Surgical laparoscopic transabdominal cerclage. Measurement and main results: During the period of the study, 512 patients underwent a laparoscopic transabdominal cerclage following a clinical diagnosis or concerns of cervical insufficiency. We present the outcomes of 524 pregnancy reports among 414 patients to date. Neonatal survival was 96.4%, with 85.7% of neonates delivered at >34 weeks gestation. Less than 0.5% of the laparoscopic transabdominal cerclage surgeries had surgical complications or documented morbidity. Conclusions: Laparoscopic transabdominal cerclage is a successful management option for patients with concerns of cervical insufficiency and complex obstetric and gynecological histories. This large cohort study shows positive neonatal outcomes and low surgical morbidity.

2025-10-01T00:00:00Z Brownfoot, Fiona http://hdl.handle.net/11434/2344 2025-07-21T11:02:41Z 2025-05-01T00:00:00Z

Title: Impact of missing electronic fetal monitoring signals on perinatal asphyxia: a multicohort analysis. Epworth Authors: Brownfoot, Fiona Abstract: Cardiotocography (CTG) is essential for monitoring high-risk pregnancies, yet perinatal asphyxia prediction accuracy remains limited to 50-55%. Regions of artifacts (missing valid signals)-including signal processing aberrations-possibly contribute to this limitation, highlighted by 40% of FDA reports on intrapartum stillbirths. This cohort study applied causal inference to two digitized CTG databases, analyzing 36,792 labor episodes (>36 weeks) at a tertiary Australian hospital (2010-2021) and externally validating on a Czech dataset (n = 552).High rates of missing valid signals (>30% fetal heart rate signal dropout or >1% maternal-fetal heart rate coincidence) was independently associated with asphyxia (aOR 1.47, 95% CI 1.19-1.81); dropout >30% showing stronger link (aOR 1.58, 95% CI 1.13-2.20 Australian dataset; aOR 2.30, 95% CI 1.08-4.91 Czech dataset). Risk of asphyxia increased with higher dropout (>37.45%, aOR 2.21 Australian dataset; >34.01%, aOR 4.08 Czech dataset). Integrating measures of missing valid signals into fetal monitoring algorithms may improve decision-making and neonatal outcomes.

2025-05-01T00:00:00Z Holdsworth-Carson, Sarah http://hdl.handle.net/11434/2272 2023-11-13T10:02:36Z 2023-10-01T00:00:00Z

Title: A molecular staging model for accurately dating the endometrial biopsy. Epworth Authors: Holdsworth-Carson, Sarah Abstract: Natural variability in menstrual cycle length, coupled with rapid changes in endometrial gene expression, makes it difficult to accurately define and compare different stages of the endometrial cycle. Here we develop and validate a method for precisely determining endometrial cycle stage based on global gene expression. Our 'molecular staging model' reveals significant and remarkably synchronised daily changes in expression for over 3400 endometrial genes throughout the cycle, with the most dramatic changes occurring during the secretory phase. Our study significantly extends existing data on the endometrial transcriptome, and for the first time enables identification of differentially expressed endometrial genes with increasing age and different ethnicities. It also allows reinterpretation of all endometrial RNA-seq and array data that has been published to date. Our molecular staging model will significantly advance understanding of endometrial-related disorders that affect nearly all women at some stage of their lives, such as heavy menstrual bleeding, endometriosis, adenomyosis, and recurrent implantation failure.

2023-10-01T00:00:00Z