In this multicenter, randomized trial, we assigned patients with shock to receive either dopamine or norepinephrine as first-line vasopressor therapy to restore and maintain blood pressure. When blood pressure could not be maintained with a dose of 20 μg per kilogram of body weight per minute for dopamine or a dose of 0.19 μg per kilogram per minute for norepinephrine, open-label norepinephrine, epinephrine, or vasopressin could be added. The primary outcome was the rate of death at 28 days after randomization; secondary end points included the number of days without need for organ support and the occurrence of adverse events.


In this multicenter, randomized, blinded trial comparing dopamine and norepinephrine as the initial vasopressor therapy in the treatment of shock, there was no significant difference in the rate of death at 28 days between patients who received dopamine and those who received norepinephrine. Dopamine was associated with more arrhythmic events than was norepinephrine, and arrhythmic events that were severe enough to require withdrawal from the study were more frequent in the dopamine group. In addition, dopamine was associated with a significant increase in the rate of death in the predefined subgroup of patients with cardiogenic shock.
I have to admit...I bought this for my 5 year old son, but I found it to be just as enjoyable! Setup took a matter of minutes before he was launching his first rocket in the air. he was impressed with the THUMP followed by a dissapearing act as it launched into the sky. After he had a few tries it was my turn, I assumed it would not handle my 200lb frame very well so I started light and worked my way up to an all out double foot stomp that left craters where I landed. The SQUEEEEEL from my son as the rocket nearly "went to the moon" was priceless. We lost a few rockets that day to rooftops, damage from landing on pavement, and one down a difficult to repeat sewer drain. I advise to have the little ones wear safety ... full review
For taxonomic purposes it is an important distinction, but the modifiers discussed below are often considered dunk types in common parlance. This misconception is perhaps attributable to the modifier being the most salient component of the dunk from the perspective of the observer. However, each dunk modifier requires a dunk type to be a successful dunk—albeit the most-basic dunk type.
A predefined subgroup analysis was conducted according to the type of shock — septic shock, which occurred in 1044 patients (542 in the dopamine group and 502 in the norepinephrine group); cardiogenic shock, which occurred in 280 patients (135 in the dopamine group and 145 in the norepinephrine group); or hypovolemic shock, which occurred in 263 patients (138 in the dopamine group and 125 in the norepinephrine group). The overall effect of treatment did not differ significantly among these subgroups (P=0.87 for interaction), although the rate of death at 28 days was significantly higher among patients with cardiogenic shock who were treated with dopamine than among those with cardiogenic shock who were treated with norepinephrine (P=0.03) (Figure 3). The Kaplan–Meier curves for the subgroup analysis according to type of shock are shown in Figure 7 in the Supplementary Appendix.
You can assist in recording your score by holding a piece of chalk in your had and using it to mark the wall. If the wall already has horizontal lines, such as a brick wall, it will be easier to mark your jump height. Have as many attempts as you need to get the best possible score. Practice your technique, as the jump height can be affected by how much you bend your knees before jumping, and the effective use of the arms.
By emphasizing certain muscles in your legs, you can train your body for the force needed to leap high. Increasing your vertical jump will improve your rebounding, blocking, dunking, and make you an all-around better basketball player. Here are a few of CoachUp’s favorite exercises for improving your leg strength and vertical jump. If you ever need extra motivation to get through these exercises on a daily basis, just re-watch these gifs and focus up!

All data were analyzed according to the intention-to-treat principle. Differences in the primary outcome were analyzed with the use of an unadjusted chi-square test. Results are presented as absolute and relative risks and 95% confidence intervals. Kaplan–Meier curves for estimated survival were compared with the use of a log-rank test. A Cox proportional-hazards regression model was used to evaluate the influence of potential confounding factors on the outcome (factors were selected if the P value in the univariate analysis was <0.20).


The first thing they have to do is improve their flexibility, for a couple of reasons. They need to be flexible to undertake the kind of exercises they need to be able to jump higher. They also just need to be able to increase their flexibility, because in the short sprints you take when you try to dunk a basketball, if you can imagine yourself running up to try to dunk on the rim, the higher you can bring your knees in a sprint, just like a sprinter running the hundred meters, the greater force you’ll be able to exert on the ground, especially with your leaping step.

My quest to dunk started poorly. The main problem was that I could only do about half of the very long list of ercises the Jump Manual instructed at the crowded and inadequate YMCA near my place. The basketball court—the only space big enough to do some of the drills—was always occupied with classes. The Strength Shoes, meanwhile, were so absurd that I was too embarrassed to wear them in front of other gym-goers. I used them only a handful of times, in an empty stairwell on the top floor of the gym.

I learned that insects are fucking awesome. There was an insect in particular that I was interested in called the froghopper, or spittlebug, that is basically one of the world’s top jumpers. It’s a survival mechanism. It can jump far, far higher than we can as a function of its weight, basically. So I learned that humans are quite modest in the jumping scheme of things.
“There aren’t many people in the world who can [dunk], that’s why it has this allure, I guess,” Carter told me last fall, during his first training camp with the Grizzlies. “As far as trying to do it, there are so many ways people can go about it. The approach you’re taking is the right approach. When I was younger, that’s how I started. Tennis ball, to the point that it became easy. Then a volleyball. Then a girls’ ball. Finally I took—it was like a dodgeball. I dunked that and said, ‘You know what, I’m gonna try it.’ Next thing you know. . . .” He shrugged and smiled, the gray whiskers on his jaw sinking into a dimple.
In the 2008 Sprite Rising Star's Slam Dunk Contest Dwight Howard performed the "Superman" dunk. He donned a Superman outfit as Orlando Magic guard Jameer Nelson tied a cape around his shoulders. Nelson alley-ooped the basketball as Howard jumped from within the key side of the free throw circle line, caught the ball, and threw it through the rim. This dunk is somewhat controversial, as his hand was not over as well as on a vertical plane to the rim. Some insist that it should in fact be considered a dunk because the ball was thrust downward into the basket, meeting the basic definition of the dunk.

Because jumping ability is a combination of leg strength and explosive power, jumping can be developed in the same fashion as any other muscular activity. The ultimate limit to how high any athlete can jump will be determined to a significant degree by the distribution of fast-twitch versus slow-twitch fibers present in the muscles of the legs. This distribution is a genetic determination. Fast-twitch fibers are those whose governing neurons, the component of the nervous system that receives the impulses generated by the brain to direct muscular movement, fires more rapidly, which in turn creates the more rapid muscle contractions required for speed. As a general proposition, an athlete with a greater distribution of fast-twitch fibers will be able jump higher than one with a preponderance of slow-twitch fibers.
The player approaches the basket and obstruction, and then leaps. During flight, some portion of the player's body is elevated above the obstruction. This may entail raising the legs or some portion thereof in-air to soar over the obstruction. In other instances, the trunk-moves over an obstruction as the legs pass around it. Common obstructions include: motor vehicles; crouched, seated or standing person(s); ball rack; or other available objects.
The vertical jump involves coordinated spine, hip, knee, and ankle extension to produce force in a vertical direction very quickly, while the muscles are shortening through to a very short muscle length. Since the time available for producing force is long compared to other athletic movements, this reduces the importance of rate of force development. Yet, the force-velocity relationship is the primary determinant of the amount of force that can be exerted at a given movement speed. Therefore, maximum force, velocity, and the force-velocity gradient all affect vertical jump height.

Overall, 309 patients (18.4%) had an arrhythmia; the most common type of arrhythmia was atrial fibrillation, which occurred in 266 patients (86.1%). More patients had an arrhythmia, especially atrial fibrillation, in the dopamine group than in the norepinephrine group (Table 3). The study drug was discontinued in 65 patients owing to severe arrhythmias — 52 patients (6.1%) in the dopamine group and 13 patients (1.6%) in the norepinephrine group (P<0.001). These patients were included in the intention-to-treat analysis. There were no significant differences between the groups in the incidences of other adverse events.

Finally, to make things even more complicated, it is likely that the roles of the lower body muscles may differ according to if: (1) the jump is maximal or sub-maximal, (2) long-term training has occurred, and (3) the individual has a “hip-dominant” or a “knee-dominant” technique. Indeed, the vertical jump is more dependent upon the hip extensors in maximal jumps, compared to in sub-maximal ones. And after long-term jumping training, the increase in the amount of work done in the jump by the hip extensors is related to the increase in height, while the increase in the amount of work done by the knee extensors is not.

I just turned 14 year old 5''''10-5''''11 8th grade 165 pounds and i''''m wondering what stretching exercises and weight lifting exercises i can do to increase my vertical its already at like 30-32 inches but i want maybe a 40 by high school and a 48 or more by the time i''m out of high school i''ve dunked over 15 times ( in practice and alone with one hand its effortless to touch rim with both feet and easier with one but i''m also wondering how to take off when i dunk because i stutter step and i want to get my explosiveness up. And i want to be able to dunk with two hands. Can anyone help me?


Other obstruction-dunks are worth noting: Haneef Munir performed a Dubble-Up, dunking with his right-hand and then caught and dunked a second ball with his left hand—a yet to be duplicated dunk pioneered by Jordan Kilganon on a lower, non-regulation rim. Jordan Kilganon, a Canadian athlete, approached from the baseline a person standing, holding the ball above their head. Kilganon leaped, controlled the ball in front of his torso and raised it above the horizontal plane of the rim before bringing the ball downward into the hoop and hooking both elbows on and hanging from the rim.
Increase your vertical leap. You will need the lifting power of your legs to get you in the air and up to the basket. Building a regimen of leg workouts that will increase the fast-twitch strength and the flexibility of your leg muscles can help you add inches to your vertical leap, getting you that much closer to the rim.[2] A good regimen to get started with might include:
The phrase "slam dunk" has entered popular usage in American English outside of its basketball meaning, to refer to a "sure thing": an action with a guaranteed outcome, or a similarly impressive achievement. This is related to the high probability of success for a slam dunk versus other types of shots. Additionally, to "be dunked on" is sometimes popularly used to indicate that a person has been easily embarrassed by another, in reference to the embarrassment associated with unsuccessfully trying to prevent an opponent from making a dunk. This ascension to popular usage is reminiscent of, for example, the way that the baseball-inspired phrases "step up to the plate" and "he hit it out of the park," or American football-inspired phrases such as "victory formation" or "hail Mary" have entered popular North American vernacular.
Stand on your right leg and lift your left knee up as high as you can. Keeping your knee bent and your left leg out of the way, jump and land eight to ten times on your right leg. Focus on the landing. Your body should be ready to spring back up again the second you hit the ground. Try to jump higher with every repetition. Use your left hip and raised leg to build leverage.
You can assist in recording your score by holding a piece of chalk in your had and using it to mark the wall. If the wall already has horizontal lines, such as a brick wall, it will be easier to mark your jump height. Have as many attempts as you need to get the best possible score. Practice your technique, as the jump height can be affected by how much you bend your knees before jumping, and the effective use of the arms.

John Willman del Financial Times lo describe como "una obra profundamente errónea donde se mezclan fenómenos juntos y dispares para crear algo seductor, pero que en última instancia, posee un argumento deshonesto."14​ Tom Redburn de New York Times dice que "lo que ella más oculta, es el papel necesario del capitalismo emprendedor en la superación de la tendencia inherente de cualquier sistema social establecido a caducar en el estancamiento".15​
During the 2009 NBA dunk contest, Howard had a separate goal brought onto the court, and the rim was noticeably significantly higher than a standard goal. Howard, after going into a 1950s-era telephone booth and again fashioning the Superman attire, caught a pass from Nelson and easily completed a two-handed dunk on the higher goal. While this was not performed for record-setting purposes, the dunk received a perfect score and a warm response from the crowd, in part because of its theatrics. Also in this contest, 5'9" guard Nate Robinson wore a green New York Knicks jersey and green sneakers to represent Kryptonite, playing on Howard's Superman theme. He used a green "Kryptonite" ball, and jumped over the 6'11" Howard prior to dunking. This dunk and the theatrics could have won the competition for Robinson, who was voted the winner by the NBA fans. Robinson then thanked Howard for graciously allowing him to dunk over him, asking the crowd to also give Howard a round of applause.
En la introducción del comienzo y final se muestra la historia de los últimos treinta años de la doctrina de choque económico que se ha aplicado alrededor del mundo, desde América del Sur en la década de los setenta hasta Nueva Orleans después del huracán Katrina. Klein introduce dos de sus temas principales. 1) En donde los profesionales de la doctrina de choque tienden a buscar una pizarra en blanco en el cual plasmar su ideal de crear economías de libre mercado, en el que inevitablemente requiere normalmente una violenta destrucción del orden económico preexistente. 2) Las similitudes entre la crisis económica y la doctrina original de la terapia de choque, una técnica psiquiátrica donde se aplicaron choques eléctricos a los pacientes con enfermedades mentales.
My wife of 11 years, who isn’t a sports fan, knit her brow in confusion and nodded when I raised this idea for the first time. She wanted to care but could not muster the attention span, for she had given birth just three weeks earlier to our third daughter. I would be needed at home in the coming weeks—a reasonable expectation. Although I look back today with pride at how I balanced that responsibility with the time-consuming­ and far less important dedication to dunking, I knew at the time that I would miss a lot of family dinners, bath times and diaper changes so that I could ride my bike to the gym or to local playgrounds, with no guarantee that I would reach my goal, or even come close.
“Put in the work. It’s muscle memory, first and foremost. Training­wise, people say, ‘You gotta do this, you gotta do that.’ I didn’t believe in that. I never worked on my legs in high school or middle school. I would just go through this routine over and over and over, visualizing that day when you dunk on the court. And then you live in that moment.”
The way Arthur J. Daley and the other spectators at the Y felt when Fortenberry dunked—that’s how fans at the Oakland Arena felt on Feb. 12, 2000, when Vince Carter shoved his forearm into the rim and swung there by his elbow. What only the initiated noticed about Carter’s dunk was that if you froze him during his approach, he looked like Bob Beamon. Carter long-jumped some 12 feet, right foot leading the way, before landing for a nanosecond and blasting off into his two-footed ascent.
Still, by the late 1950s and early 1960s players such as Bill Russell and Wilt Chamberlain had incorporated the move into their offensive arsenal. The dunk became a fan-favorite, as offensive players began to aggressively intimidate defenders with the threat of vicious slams. Through the 1970s, the slam dunk was standard fare; David Thompson, Julius Erving, Darryl Dawkins, and others wowed crowds with high-flying moves.
Not so long ago, I played the worst basketball game of my life. I missed layups, turned over the ball, allowed my opponent free reign to the hoop. It was dark. As I slumped on the sidelines after the game, I realized how far I’d fallen from my prime a decade ago. Back then, I could dunk; now, at 33, I could barely curl my fingers over the rim. My game had regressed to hovering around the arc jacking threes. The last time I dunked a basketball, Michael Jordan was a Washington Wizard and people still listened to Coldplay.
Also, using the lifting (concentric) phase of these exercises only, rather than both lowering and lifting phases, *might* further improve results. This is partly because lifting phases involve faster rate coding, and partly because this strategy might potentially help avoid optimizing stretch-shortening cycle function for lifting heavy weights, rather than for jumping.
Of course, these forces increase linearly with increasing body weight. Therefore Olympic high-jumpers are usually build more like marathon runners and less like football players. Every unnecessary pound adds to the forces during take-off, and at some point the muscles and tendons of the jumping leg are just not strong enough any more to support all the weight.
i am 6 foot 2 inches tall, i am in the 8th grade, and i am 13 years old going on 14 in september. I discovered on May 15th that I could hang on the rim at my school with two hands by jogging about 3 steps very very slowly and jumping off both of my feet. I have dunked about 3 times before, but the last couple times I tried, I got "hung" and sent backwards but I managed to keep balance on the way down due to my height. What is my problem? Also after I attempt to dunk about 4 times in a day my shin begins to hurt. Why does this keep happening?
For women's basketball, to dunk or not to dunk has long been the question. It’s the ‘wow factor’ that WNBA haters often point to as proof that the women's game doesn't deserve the fandom, fame and fortune that the guys get. Cristen and Caroline talk to two dunking superstars of past and present to sort through the courtside gender politics and controversy of stuffing the net and find out whether more women bringing the slams could settle the score.
The two-hand backscratcher finish can exert tremendous force on the basket. In 1979, Darryl Dawkins twice shattered NBA backboards with tomahawk dunks leading to a quickly-enacted rule making it an offence to break the backboard.[citation needed] Technology has evolved to adapt to the increased strength and weight of players to withstand the force of such dunks, such as the breakaway rim (introduced to the NBA in 1981) changes to the material used for the backboards, and strengthening of the goal standards themselves.
High pulls can also be done using a dumbbell or kettlebell,. When doing so, position the weight between your feet and pull with one arm at a time (switching arms halfway through the set). A trap bar (aka, hex bar) is also an option, particularly for individuals who have a hard time keeping the lower back flat; the trap bar allows the hands to be positioned behind the shins to help pull the shoulders back.
Single leg jumping with it's high impact forces and dependence on the elasticity of muscles and tendons works best for young athletes. With increasing age, the tendons and muscles lose their elasticity and springiness and the risk of injury gets higher and higher. That's why a lot of basketball players start to rely more and more on their two-foot jump as they get older. And the winner of the Olympic high jumping contest are almost always below 30.
I'm 5"11 and 12 years old, and i'm able to touch the rim, but it's very inconsistent. like 50% of the time I can wrap my 3 biggest fingers around it, or i dont touch it the other 50% of the time. I've been training for about 4 months, doing calf raises every day until they cramp, and everyday i try to touch the rim at my gym or school or at any court. I found out i could touch the rim 2 days ago, but is there any way to add 7 inches to my vertical instead of doing thousands of calf raises again, because i really want to be able to dunk by 8th gradr
7. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction). Circulation 2004;110:e82-e292[Erratum, Circulation 2005;111:2013-4, 2007;115(15):e411.]
In this multicenter, randomized, blinded trial comparing dopamine and norepinephrine as the initial vasopressor therapy in the treatment of shock, there was no significant difference in the rate of death at 28 days between patients who received dopamine and those who received norepinephrine. Dopamine was associated with more arrhythmic events than was norepinephrine, and arrhythmic events that were severe enough to require withdrawal from the study were more frequent in the dopamine group. In addition, dopamine was associated with a significant increase in the rate of death in the predefined subgroup of patients with cardiogenic shock.
This list of movements was compiled by a pair of trainers who know a thing or two about making athletes more explosive: Jason Benguche, assistant strength and conditioning coach for the Carolina Panthers (@movement_mogul on Instagram), works one-one-one during the season with the NFL’s most explosive quarterback, Cam Newton. And Firdose Khan (@dose_9), head trainer at Nine Innovations athlete training facility in Houston, has worked with such athletes as former NBA MVP Derrick Rose and NFLers Arian Foster, Braxton Miller, and Brian Cushing.

Another aspect to look at for any potential dunkers is flexibility. I'm about 6'4 and 21. In high school, I, like many of you on here, worked on jumping and lifting to gain power. I had some decent strength, but the flexibility of a toothpick. Once I got out of high school and got more interested in fitness, I saw how much that affected me. If you can't touch your toes or only squat 8 inches down, this is a great place to start working on your flexibility.


Each time you land, spring immediately back up. Don’t hesitate. The single beat that typically happens after we hit the ground is a natural reflex, and we may not even realize we’re doing it. But that extra pause has to go if we’re looking for a way to jump higher. Check the mirror or watch videos of yourself as you hit the ground. The momentary pause you may see between one vertical jump and the next may be holding you back. For more detail on how this works, visit the plyometrics section of our website.
James Naismith, I learned, was a bit different. “I was only three when he passed away [in 1939],” said his grandson, James Naismith, 78, of Corpus Christi, Texas. “He was known as a tenderhearted man, but he also had”—the doctor’s namesake pauses—“the polite term is ‘firmness of mind.’ It’s kind of a family trait. He devoted his life to improving the lives of others through physical activity, through games. That took time.
The dose was determined according to the patient's body weight. Doses of dopamine could be increased or decreased by 2 μg per kilogram per minute and doses of norepinephrine by 0.02 μg per kilogram per minute (or more in emergency cases) (see Figure 1 and Figure 2 in the Supplementary Appendix, available with the full text of this article at NEJM.org). An example of the dose-escalation table is provided in Table 1 in the Supplementary Appendix. The target blood pressure was determined by the doctor in charge for each individual patient. If the patient was still hypotensive after the maximum dose of either agent had been administered (20 μg per kilogram per minute for dopamine or 0.19 μg per kilogram per minute for norepinephrine — doses that have been shown to have similar effects on mean arterial blood pressure12,13), open-label norepinephrine was added. The dose of 20 μg per kilogram per minute for dopamine was selected as the maximal dose because this upper limit was the standard of care in the participating ICUs, in line with expert recommendations14 and international guidelines.15
By emphasizing certain muscles in your legs, you can train your body for the force needed to leap high. Increasing your vertical jump will improve your rebounding, blocking, dunking, and make you an all-around better basketball player. Here are a few of CoachUp’s favorite exercises for improving your leg strength and vertical jump. If you ever need extra motivation to get through these exercises on a daily basis, just re-watch these gifs and focus up!
For one-footed jumpers, the ball is generally transferred to the non-dominant hand just before or upon take-off; for two-footers, this transfer is often delayed for milliseconds as both hands control the ball to prevent dropping it. Once airborne, the dunker generally transfers the ball from non-dominant to dominant hand beneath a raised leg. Finally, the ball is brought upwards by the dominant hand and slammed through the rim.
The dose was determined according to the patient's body weight. Doses of dopamine could be increased or decreased by 2 μg per kilogram per minute and doses of norepinephrine by 0.02 μg per kilogram per minute (or more in emergency cases) (see Figure 1 and Figure 2 in the Supplementary Appendix, available with the full text of this article at NEJM.org). An example of the dose-escalation table is provided in Table 1 in the Supplementary Appendix. The target blood pressure was determined by the doctor in charge for each individual patient. If the patient was still hypotensive after the maximum dose of either agent had been administered (20 μg per kilogram per minute for dopamine or 0.19 μg per kilogram per minute for norepinephrine — doses that have been shown to have similar effects on mean arterial blood pressure12,13), open-label norepinephrine was added. The dose of 20 μg per kilogram per minute for dopamine was selected as the maximal dose because this upper limit was the standard of care in the participating ICUs, in line with expert recommendations14 and international guidelines.15

Other binary end points were analyzed with the use of chi-square tests, and continuous variables were compared by means of an unpaired Student's t-test or a Wilcoxon rank-sum test, as appropriate, with the use of SPSS software, version 13.0 (SPSS). All reported P values are two-sided and have not been adjusted for multiple testing. The study statistician and investigators remained unaware of the patients' treatment assignments while they performed the final analyses.

The player approaches the basket and leaps as they would for a generic dunk. Instead of simply dunking the ball with one or two hands, the player allows their forearm(s) to pass through the basket, hooking their elbow pit on the rim before hanging for a short period of time. Although the dunk was introduced by Vince Carter in the 2000 NBA Slam Dunk contest, Kobe Bryant was filmed performing the dunk two years earlier at an exhibition in the Philippines.[22] Colloquially, the dunk has a variety of names including 'honey dip', 'cookie jar', and 'elbow hook'.
But you know what? Because these help with your jumping, you will become an amazing rebounder, blocker, and, well, dunker! In 2016, according to MaxPreps, I was 14 in the country in average blocks per game (National Basketball (2016-17) Blocks Stat Leaders, I’m 14th ;P). I had two triple-doubles. No, not points, rebounds, and assists, but points, rebounds, and BLOCKS.
Go between the legs. While he wasn't the first player to complete it, Vince Carter wowed crowds at the 2000 NBA dunk contest by passing the ball under one leg while in the air and slamming it with authority. It didn't hurt that his forehead was almost touching the rim. If you've worked your ups to that height, try passing it under one leg and dunking it.
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But you know what? Because these help with your jumping, you will become an amazing rebounder, blocker, and, well, dunker! In 2016, according to MaxPreps, I was 14 in the country in average blocks per game (National Basketball (2016-17) Blocks Stat Leaders, I’m 14th ;P). I had two triple-doubles. No, not points, rebounds, and assists, but points, rebounds, and BLOCKS.
Yet, rate of force development is likely less important for vertical jumping than for faster athletic movements, such as sprinting. This is because the time that is available for force production is *ten times* longer in the vertical jump than in sprinting. Sprinters often take their foot off the ground before their lower body muscles have achieved maximum force (which takes approximately 150ms), but this early period of rising force production plays only a very small role during vertical jumping.
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