Thus, dopamine and norepinephrine may have different effects on the kidney, the splanchnic region, and the pituitary axis, but the clinical implications of these differences are still uncertain. Consensus guidelines and expert recommendations suggest that either agent may be used as a first-choice vasopressor in patients with shock.6-8 However, observational studies have shown that the administration of dopamine may be associated with rates of death that are higher than those associated with the administration of norepinephrine.3,9,10 The Sepsis Occurrence in Acutely Ill Patients (SOAP) study,3 which involved 1058 patients who were in shock, showed that administration of dopamine was an independent risk factor for death in the intensive care unit (ICU). In a meta-analysis,11 only three randomized studies, with a total of just 62 patients, were identified that compared the effects of dopamine and norepinephrine in patients with septic shock. The lack of data from clinical trials in the face of growing observational evidence that norepinephrine may be associated with better outcomes called for a randomized, controlled trial. Our study was designed to evaluate whether the choice of norepinephrine over dopamine as the first-line vasopressor agent could reduce the rate of death among patients in shock.
This study has several limitations. First, dopamine is a less potent vasopressor than norepinephrine; however, we used infusion rates that were roughly equipotent with respect to systemic arterial pressure, and there were only minor differences in the use of open-label norepinephrine, most of which were related to early termination of the study drug and a shift to open-label norepinephrine because of the occurrence of arrhythmias that were difficult to control. Doses of open-label norepinephrine and the use of open-label epinephrine and vasopressin were similar between the two groups. Second, we used a sequential design, which potentially allowed us to stop the study early if an effect larger than that expected from observational trials occurred; however, the trial was eventually stopped after inclusion of more patients than we had expected to be included on the basis of our estimates of the sample size. Accordingly, all conclusions related to the primary outcome reached the predefined power.
Dunking exposes you to some extra risk of injury. First of all, you can get low-bridged or get your legs tangled up with defenders near the hoop, causing you to fall awkwardly from a significant height. You can also throw yourself off balance by trying to hang on the rim and slipping off, resulting in awkward falls. If you are in heavy traffic on the dunk, then being able to grab and hang on the rim until the clutter beneath you clears is a safety technique. If you are in the clear on a dunk, then avoiding hanging on the rim at all is the recommended safety technique (It's also a technical foul to hang on the rim in that situation). Whatever the situation, you need to come down with control and balance. Ankle, knee, neck, and head injuries await those who fail to control their momentum after a dunk.
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.
Since the magnitude of the effect derived from observational studies can be misleading, we opted for a sequential trial design with two-sided alternatives20; the trial design called for analyses to be performed after inclusion of the first 50 and 100 patients, and then after inclusion of each additional 100 patients, and allowed for the discontinuation of the trial according to the following predefined boundaries: superiority of norepinephrine over dopamine, superiority of dopamine over norepinephrine, or no difference between the two. An independent statistician who is also a physician monitored the efficacy analyses and the adverse events; on October 6, 2007, after analysis of the outcome in the first 1600 patients showed that one of the three predefined boundaries had been crossed, the statistician advised that the trial be stopped.
Randomization was performed in computer-generated, permuted blocks of 6 to 10, stratified according to the participating ICU. Treatment assignments and a five-digit reference number were placed in sealed, opaque envelopes, which were opened by the person responsible for the preparation of the trial-drug solutions. The solutions of norepinephrine or dopamine were prepared in vials or syringes according to the preference of the local ICU. Each vial or syringe was then labeled with its randomly allocated number. The doctors and nurses administering the drugs, as well as the local investigators and research personnel who collected data, were unaware of the treatment assignments. The trial was approved by the ethics committee at each participating center. Written informed consent was obtained from all patients or next of kin.
Which is why, on April 1, 2014, I dedicated myself to dunking a basketball for the first time. So that I could live it, breathe it, perhaps take a crack at it with my pen. I had tossed this idea around for years, realizing with each passing birthday that my chances of success were dimming. However, on that April Fool’s Day (a coincidence) I spent three hours on the court and at the gym, with a promise to myself to return several times each week until I threw one down like Gerald Green. Or at least like Litterial Green, who played in 148 NBA games between 1992 and ’99, and who, like me, was born in the early ’70s, stands 6'1", 185 pounds and is at no risk of having dunker carved into his epitaph.
The vertical jump is defined as the highest point that the athlete can touch from a standing jump, less the height that the athlete can touch from a standing position. The measurement of the jump is flawed if the athlete is permitted to take one or more steps before jumping, as the athlete will convert some of the energy developed in the step taken into the force of propulsion that generates upward lift. Basketball has numerous legends and other urban myths concerning the seemingly superhuman leaping ability attributed to certain players; one such player, former University of Louisville star Darrell "Dr. Dunkenstein" Griffith, was reputed to possess a 42 in (1 m) vertical leap. It is likely that the average National Basketball Association player 6 ft 6 in (1.97 m) or shorter has a vertical leap of between 25 and 30 in (0.63 and 0.75 m); taller and heavier players will usually not be able to jump as high.
Generally, a player can reach their highest when jumping off one foot and reaching up with one hand. For a player that is right-handed, the most common way is approaching from the left and jumping off the left foot with the ball in the right hand. Obviously, for a left-handed player, it’s coming from the right and jumping off the right with the ball in your left hand.
I went through this progression, too. I went from touching the middle of the net at 12 years old, to dunking a basketball at 14 years old, to doing serious acrobatic 360-degree dunks at 17 years old. In college, my personal record for the vertical leap was 40 inches. At my peak, I was able to touch the top of the square on a regulation backboard, about 11.5 feet from the ground. Even now, in my thirties, I can dunk a basketball while standing underneath the basket—no run up required. I owe it all to the power of the vertical jump.
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.
Thank you very much for your sharing this information. I am excited to start working on your recommendations immediately. The information seems very clear and easy to follow. I like the available links, and the fact that I can use this product on my Kindle, although I am used my PC to view. The book is brief and not full of wordy marketing fluffy verbiage.
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.
Rope skipping is also a very basic form of a type of exercise called plyometrics. Plyometric exercises involve repetitive explosive movements, such as jumping up and down or catching and throwing a medicine ball. The idea is to execute the movement with as little downtime as possible between repetitions. This, in effect, trains muscles to be powerful and explosive, and utilize the kinetic energy inherent in athletic movements in the most efficient way.
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.
Athletes often do depth jumps with two plyo boxes: one to step off of and another to jump onto. Essentially, it’s a depth jump into a box jump. When doing this variation, make sure to leave enough room between the boxes to allow you to land and jump safely (3–5 feet between boxes should work). To advance within this progression, increase the height of the second box gradually as you develop more strength and power.
Another high pull option is to shorten the range of motion to make it a hang high pull instead of a power high pull (“power” implying that the load starts on the floor). In this case, the start position is from standing, with the bar hanging in front of your thighs at arms’ length. The movement is initiated with a dip in the hips and knees, so that the bar lowers to just above knee level, followed immediately by an explosive pull.
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.
I cannot honestly say that the program absolutely works since I have yet to execute it. However, I believe that the principles and exercises absolutely work. They are honed into a system by Mr. Grover and Attack Athletics. I believe Mr. Grover to be at the top in athletic training. His list of clients and their success speaks for itself. As far as the book goes...it looks like it was written in the stone ages! But once you get past its appearance and the stars of yesteryear that appear in the book...it has quality and value. Although I believe it to be somewhat overpriced (what isn't these days???), it can help an athlete get to the next level in sports performance! Do it!
In the 2011 NBA contest, Los Angeles Clippers power-forward Blake Griffin completed a self-pass off of the backboard prior to elbow-hanging on the rim. A number of other variants of the elbow hang have been executed, including a lob self-pass, hanging by the arm pit, a windmill, and over a person. Most notable are two variations which as of July 2012, have yet to be duplicated. In 2008, Canadian athlete Justin Darlington introduced an iteration aptly entitled a 'double-elbow hang', in which the player inserts both forearms through the rim and subsequently hangs on both elbows pits. Circa 2009, French athlete Guy Dupuy demonstrated the ability to perform a between-the-legs elbow hang; however, Guy opted not to hang on the rim by his elbow, likely because the downward moment could have resulted in injury.
Resident Evil 2: DualShock Ver., known as Biohazard 2 DualShock Ver. (バイオハザード2：デュアルショックバージョン Baiohazādo Tsū: De~yuarushokkubājon?) in Japan, As the title suggests, is a second expanded version of Resident Evil 2 that became the base of other subsequent versions/ports of the game. The game was modified to incorporate support for the vibration function and analog control of the PlayStation DualShock controller.
The simplest method to measure an athlete's vertical jump is to get the athlete to reach up against a flat wall, with a flat surface under his/her feet (such as a gym floor or concrete) and record the highest point he/she can reach flat-footed (the height of this point from the ground is referred to as "standing reach"); fingertips powdered with chalk can facilitate the determination of points touched on the wall. The athlete then makes an effort to jump up with the goal of touching the highest point on the wall that he or she can reach; the athlete can perform these jumps as many times as needed. The height of the highest point the athlete touches is recorded. The difference between this height and the standing reach is the athlete's vertical jump.