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Normative data for the squat, bench press and deadlift exercises in powerlifting: Data from 809,986 competition entries
Strength assessment and comparison to normative values are an important benchmarking tool in human health and performance. However, population specific normative data are several decades old, lack information about adolescent and adult strength levels and are not representative of the strength levels of strength trained individuals. The purpose of this study was to develop contemporary strength norms for the squat, bench press, and deadlift using powerlifters competing in un-equipped, drug-tested competitions.
Retrospective cross-sectional analysis.
Retrospective data from global drug-tested, unequipped powerlifting competitions were collated with 809,986 samples (571,650 males, 238,336 females) included. Strength was assessed according to sex, United Nations age classifications, and competitive powerlifting weight class. Strength was expressed relatively (ratio of weight lifted/bodyweight) and computed for the 10th–90th percentile for each of the above categories.
Relative strength was greatest for young adults (18–35 years; 90th percentile for squat [male: 2.83 × bodyweight, female: 2.26], bench press [male: 1.95, female: 1.35], deadlift [male: 3.25, female: 2.66]) before declining thereafter for all three exercises. Although lower than their younger counterparts, very old adults (>80 years) had 90th percentile data for the squat of male: 1.72 and female: 1.01, bench press: male: 1.31 and female: 0.92, and deadlift: male: 2.30 and female: 1.68.
These findings provide a comprehensive, accurate and precise representation of strength for drug-tested, unequipped powerlifters in each category and serve as a point of reference for other trained population groups. To facilitate uptake and ease of comparison, we have developed a freely available online tool (www.thestrengthinitiative.com).
•Strength norms reported in practitioner textbooks are unsuitable for strength trained athletes.•Current strength norms do not account for adolescent and very old population groups.•Powerlifting athletes demonstrate relative strength values that substantially exceed previously published norms.•The norms established by this research are easily accessed and compared using the tool at www.thestrengthinitiative.com.
Journal Article
Cerebrospinal Fluid Total Protein Reference Intervals Derived from 20 Years of Patient Data
Reference intervals are vital for interpretation of laboratory results. Many existing reference intervals for cerebrospinal fluid total protein (CSF-TP) are derived from old literature because of the invasive nature of sampling. The objective of this study was to determine reference intervals for CSF-TP using available patient data.
Twenty years of hospital database information was mined for previously reported CSF-TP results. Associated demographic, laboratory, and clinical diagnosis (International Classification of Diseases 9/10 codes) details were extracted. CSF-TP results included 3 different analytical platforms: the Siemens Vista 1500, Beckman Lx20, and Roche Hitachi 917. From an initial data set of 19591 samples, the following exclusion criteria were applied: incomplete data, white blood cells (WBCs) >5 × 10
/L, red blood cells (RBCs) >50 × 10
/L, and glucose <2.5 mmol/L. Patient charts were reviewed in detail to exclude 60 different conditions for which increases in CSF-TP would be expected. A total of 6068 samples were included; 63% of the samples were from females. Continuous reference intervals were determined using quantile regression. Age- and sex-partitioned intervals were established using the quantile regression equation and splitting age-groups into 5-year bins.
CSF-TP showed a marked age dependence, and males had significantly higher CSF-TP than females across all ages. CSF-TP results from the 3 different instruments and manufacturers showed small (approximately 0.04 g/L), but statistically significant, differences. CSF-TP showed weak, but again statistically significant, correlation with WBC and RBC but was independent of serum total protein and creatinine.
The age dependence of CSF-TP supports that age-partitioned reference intervals will be more accurate than a single cutoff, particularly in patients with advancing age.
Journal Article
Is there a difference in textbook outcomes of emergency cholecystectomy in older patients compared with younger patients?
Background
Textbook outcome (TO) is a concept that describes achieving an uneventful course for a patient undergoing surgery. It was first described for colorectal surgery and is now increasingly linked to various topics of surgical literature. After the S.P.Ri.M.A.C.C. Study, the authors applied the concept to emergency cholecystectomies. In this study, we aimed to question whether being an older patient commands a difference in textbook outcome rates.
Methods
All patients undergoing emergency cholecystectomy in a single tertiary hospital between 2020 and 2024 were included in this study. The TO criteria included no 30-day mortality, no 30-day postoperative complications, no readmission within 30 days, a hospital stay of ≤ 7 days and complete laparoscopic surgery. Group A included patients younger than 65 years and the others comprised group B.
Results
The study was conducted with 212 patients, of whom 123 (58%) were female. Conversion to open and subtotal cholecystectomy were similar between groups. The textbook outcome rate was 88% in the younger group and 72% in the elderly patients (
p
= 0.040). However, multivariate logistic regression analyses did not support age as a significant factor in textbook outcome. Length of hospital stay (> 7 days) and postoperative complications were determined to be reasons for not achieving the textbook outcome.
Conclusions
The textbook outcome rate in older patients was not similar to that in younger patients. Surgical and non-surgical causes should be highlighted. Risk stratification remains important in the management of acute cholecystitis. Larger studies with patient-centred data are needed to improve the concept.
Journal Article
Back to the Future - Part 1. The medico-legal autopsy from ancient civilization to the post-genomic era
Part 1 of the review “
Back to the Future
” examines the historical evolution of the medico-legal autopsy and microscopy techniques, from Ancient Civilization to the Post-Genomic Era. In the section focusing on “
The Past
”, the study of historical sources concerning the origins and development of the medico-legal autopsy, from the Bronze Age until the Middle Ages, shows how, as early as 2000 BC, the performance of autopsies for medico-legal purposes was a known and widespread practice in some ancient civilizations in Egypt, the Far East and later in Europe. In the section focusing on “
The Present
”, the improvement of autopsy techniques by Friedrich Albert Zenker and Rudolf Virchow and the contemporary development of optical microscopy techniques for forensic purposes during the 19th and 20th centuries are reported, emphasizing, the regulation of medico-legal autopsies in diverse nations around the world and the publication of international guidelines or best practices elaborated by International Scientific Societies. Finally, in “The Future” section, innovative robotized and advanced microscopy systems and techniques, including their possible use in the bio-medicolegal field, are reported, which should lead to the improvement and standardization of the autopsy methodology, thereby achieving a more precise identification of natural and traumatic pathologies.
Journal Article
The church as sacred space in Middle English literature and culture
This book presents an exciting new approach to the medieval church by examining the role of literary texts, visual decorations, ritual performance and lived experience in the production of sanctity. The meaning of the church was intensely debated in the fourteenth and fifteenth centuries. This book explores what was at stake not only for the church’s sanctity but for the identity of the parish community as a result. Focusing on pastoral material used to teach the laity, it shows how the church’s status as a sacred space at the heart of the congregation was dangerously – but profitably – dependent on lay practice. The sacred and profane were inextricably linked and, paradoxically, the church is shown to thrive on the sacrilegious challenge of lay misbehaviour and sin.
eBook
Textbook outcome and nomogram-guided approaches for enhancing surgical success in elderly HCC patients: Deciphering the influence of sarcopenia
Sarcopenia, serving as a surrogate for frailty, is clinically significant in liver resection (LR) for elderly hepatocellular carcinoma (HCC) patients. Our study aims to assess sarcopenia’s impact, measured by Psoas Muscle Index (PMI), on postoperative outcomes. We retrospectively studied patients aged ≥ 60 years who underwent LR for HCC between 2014 and 2018. PMI, derived from preoperative CT scans, and Textbook Outcome (TO) for LR were assessed. A nomogram predicting overall survival (OS) was developed via multivariable analysis. Of the 149 eligible HCC patients, the median PMI was 7.225 cm
2
/m
2
in males and 4.882 cm
2
/m
2
in females, with 37 (24.8%) patients identified as sarcopenic. Mortality was significantly associated with sarcopenia (HR 2.15;
p
= 0.032), MELD ≥ 10 (HR 3.13;
p
= 0.001), > 3 HCC nodules (HR 4.97;
p
= 0.001), and Clavien–Dindo ≥ 3 complications (HR 3.38;
p
< 0.001). Sarcopenic patients had a 5-year OS of 38.8% compared to 61% for non-sarcopenic individuals (
p
= 0.085). Achieving TO correlated with higher OS (
p
= 0.01). In sarcopenic cases, the absence of postoperative complications emerged as a limiting factor. Sarcopenic patients failing to achieve TO had worse OS compared to non-sarcopenic and TO-achieving counterparts (5-year OS 18.5%;
p
= 0.00039). Sarcopenia emerges as a prognostic factor for LR outcomes in elderly HCC patients. Postoperative complications in sarcopenic patients may compromise oncological outcomes.
Journal Article
The Effect of LyricsTraining on Listening Achievement and Listening Anxiety in Foreign Language Education 1
The aim of this study is to examine the effect of LyricsTraining on the English listening achievement and listening anxiety of 7th grade middle school students. The research was conducted during the first semester of the 2023-2024 academic year at a public middle school located in a mid-sized city in Türkiye. A quasi-experimental design involving pre-test, posttest, and retention test was employed. In the experimental group, listening activities designed using LyricsTraining were implemented, while the control group followed the activities included in the 7th grade English textbook provided by the Ministry of National Education. The data were collected through a Listening Achievement Test and a Listening Anxiety Scale, and analyzed using Mixed Design ANOVA and ANCOVA. According to the results, there was no statistically significant difference between the post-test scores of the experimental and control groups. However, the results of the retention test revealed that the experimental group using Lyrics Training demonstrated more effective retention of listening skills compared to the control group. In addition, a statistically significant decrease was observed in the post-test listening anxiety scores of the experimental group. This indicates that Lyrics Training is an effective tool in reducing students' listening anxiety. The findings suggest that LyricsTraining enhances the long-term retention of listening skills and reduces anxiety levels among students. In this regard, it is recommended that LyricsTraining be used more frequently and at regular intervals to increase its effectiveness.
Journal Article
Tang ‘cosmopolitanism': Towards a critical and holistic approach
The Tang dynasty is the only period of Chinese history to which the word ‘cosmopolitan’ is now routinely applied in Western-language historical writing. This article traces the origins of this glamorous image of the Tang to the 1950s and 1960s, but also links its current popularity to a more recent increase in the appeal of the concept of cosmopolitanism, as well as the idea of a ‘cosmopolitan empire’ among Western intellectuals since the end of the Cold War. The article then proposes a less presentist and more critical and holistic reading of Tang ‘cosmopolitanism’ as part of a larger, interconnected, multi-centred, and changing medieval world of numerous coexisting cosmopolitanisms, and argues for recognizing the existence of a different but equally important mode of ‘cosmopolitanism’ in the Song.
Journal Article
Agency, Growth, and Ownership on African Soil: an SFL Analysis of a World History Textbook
The persistent narratives favoring dominant groups make it necessary to investigate the way these groups are portrayed in textbooks, which though they are meant to provide neutral information, often have an agenda that disempowers individuals from marginalized groups. This systemic functional linguistics text analysis of 362 passages of a world history textbook’s sections on African participants asks the following question: How, if at all, does the use of different verb processes position individuals of different ethnic and racial identities? The findings indicate that different processes are used to legitimize European control and other Western involvement in African nations and remove their culpability in the exploitation of African resources. Meanwhile, the textbook authors remove African agency in the time periods following medieval and ancient Africa.
Journal Article