![]() After the murder of the Comedian, his former teammate Rorschach dedicates himself to solving the crime, unitentionally uncovering a vast and terrifying conspiracy that reconnects the old team and will ultimately end up changing the face of the world as they know it forever. Though in this universe masked crime-fighters were once a part of everyday life with the heroic Minutemen living as both vigilantes and celebrities, they have been banned by the time the book begins, leaving the former heroes in disarray. The Watchmen’s StoryWatchmen is set in an alt-universe version of America where the country won the Vietnam War with the help of Doctor Manhattan, and Richard Nixon is still President after the repeal of the 22nd Amendment. And last but certainly not least is the super-smart Adrian Veidt, who worked under the historically ominous name Ozymandias. Next on the slate is inventor Daniel Dreiberg, who took on the legacy title of Nite Owl from one of the Minutemen (the previous generation of masked heroes). Laurie's romantic partner is the naked, blue, and omnipotent Doctor Manhattan, who began life as a nuclear physicist called Jonathan Osterman. The only woman on the team is Laurie Juspeczyk, also known as the Silk Spectre, who took on that costumed-adventurer mantle from her mother. Edward Blake is better known as the Comedian, a Vietnam vet, mass murderer, and rapist whose suspicious death sparks the story. Our "in" character is Walter Kovacs' Rorschach, a desperate and deranged vigilante who will stop at nothing to find the truth. Who Are the Watchmen?The titular team is made up of six costumed heroes (although they’re never really called Watchmen in the comic). So here's everything you need to know about the original Watchmen series, the men who made it, and the massive impact it's had on pop culture history. (The movie, of course, had a different ending than the comic.) Read our first impressions of the Watchmen pilot. Additionally, the HBO Watchmen TV series is a continuation of the book, not the movie, set some 34 years after that story. That seminal book was of course turned into a movie directed by Zack Snyder in 2009, though by its very nature the film had to drop or alter several elements from the comic. ![]()
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![]() ![]() Ever since its launch in 2013, the tool has only grown more in popularity. I recommend this tool to all my SEO Clients and will continue to do so for the rest of the years because it is backed by one of the most trusted names in the Digital Industry, Neil Patel. How to Track Your Black Friday and Cyber Monday Sales.5 Most Common On-Page SEO Issues and How To Fix Them.And, if you want to increase your website’s visibility and want an all-in-one solution for your marketing campaigns, then Raven tools is worth a try! If you are a newbie in the SEO world, nothing beats the excitement to measure the performance of your SEO campaign. Raven tools provide you following platforms to help you in your campaign: Their interface is entirely web-based, so it is convenient to use this platform from anywhere you want and monitor your campaign metrics. Raven tools offer you a full set of SEO toolkit to research, track, and optimize your SEO campaign. 5 Most Important SEO Strategies For 2017.5 Ways To Amplify SEO Juice From Existing Backlinks.The report is easy to understand, and with this report, you can easily understand your website issues and fix them in real time. ![]() When you put a website’s URL, it does an in-depth analysis of the website and gives you a brief report. With Woorank, you get a variety of features as mentioned below: The answer is simple – Woorank provides analysis of On-Page SEO, Off-Page SEO with tracking traffic, backlinks and find out issues that need to be fixed boosting your online visibility. Without further ado, let me share the 21 web-based tools that I promised. 21 most powerful top SEO tools in 2018 that can boost your search engine strategy.īefore I spill the beans about the Top 21 Web-based SEO Solutions that you should try, I would like to give a worthy mention to my post – 101 Social Media Management Tools, which will help you up to your social game and 25 Social Media Influencers to Follow in 2017, which will help you stay on the zenith of Social Media News and Discoveries. ![]() Fortunately, there are plenty of great web-based SEO platforms out there that would make your life easier. No campaign is complete without effective SEO tools. And, it’s high time to evaluate the effectiveness of the tactics and measure the good or bad over the previous 11months. Running an SEO campaign is crucial for you to get found in SERPs. However, managing campaigns, building an audience, and implementing the right SEO strategy is not so easy task. Starting a Digital Marketing Campaign is easy anyone can do it. How do you feel about the result of your SEO techniques through 2016? ![]() ![]() Quantum teleportation is essentially the transmission of qubits between two different locations, but it cannot facilitate faster-than-light transportation of information. Thus, you can think of an organism not as a whole entity, but rather as the aggregation of different quantum bits, or qubits. ![]() In the quantum world, the exact state of an atom or a photon can be considered a kind of bit of information. To understand quantum teleportation, you first need to understand the concept of quantum information. ![]() The simple reason for this? Real-world physics is crazy complicated. The concept that books, shows, and movies (with the notable exception of Michael Crichton’s 2003 novel Timeline) seem to actively avoid is actual teleportation: quantum teleportation. When the soldiers in the Stargate universe travel to different worlds, it’s through an artificial wormhole created between two ancient Egyptian gates - as one does. But Warp Speed and TK (why would they need both?) aren’t portrayed as similar technologies and it only gets more complicated in other franchises. The company is raising a new round of money now.Teleportation technologies are common in science fiction because no one wants to watch Star Trek IV: The Literal Voyage Home. The company has raised more than 3 million euros in three rounds from investors including T-Venture Holding, one of Germany’s big venture capital firms, Mountain Partners, and High-Tech Grunderfonds. Andreson joined as chief executive in 2007. Weblin was founded in 2006 by Christine Stumpf and Heiner Wolf, who first used a preliminary version of Weblin in a virtual classroom application. So far, the company has premium ad revenue from Adidas and 20th Century Fox. The rationale is that, while almost nobody clicks on banner ads, Weblin users are almost certain to click on ads that are built into web treasure hunts. Weblin hopes that users will pay real money for certain services and that marketers will pay to stage Weblin promotions on real web sites. Starting in February, it will generate virtual goods revenues via virtual gift exchanges. On average, Weblin users interact with each other more than 30 hours each month. The most popular hotspots where the Weblin avatars - dubbed weblins - gather are social networking sites such as Facebook, Friendster, hi5, Orkut, Yahoo and YouTube. Weblin itself has more than 1 million registered users, and its social browsing application is being downloaded more than 10,000 times a day. The Second Life avatar is capable of performing all of the actions of a Weblin avatar, such as walking left and right, dancing, laughing or waving. Linden Lab actively supports the teleportation application. They walk around at the bottom of a screen so they don’t obscure the user’s view of the web page. The Weblin characters are smaller than actual Second Life characters. It’s essentially like exporting a character from one game to another. The avatars are then captured using Weblin’s software and recreated in the Weblin universe. Users enter the photo booth with their avatars. But now Weblin has a “photo booth” within the Weblin House space within Second Life. Normally, you’d create your own Weblin avatar. “We think of ourselves as a social browsing experience,” said Jan Andreson, chief executive of Weblin. With RocketOn or Weblin, you can chat with friends, create doors from one web site to another, and go on virtual treasure hunts across the web. Both Weblin and RocketOn put a virtual layer over your web browser so that you can move your own characters around on any web site. The cool thing about Weblin is that it’s one of a number of “parallel web” applications, much like RocketOn, which launched its own virtual characters that can walk and scrawl all over other sites on the web. ![]() It’s kind of like a mass jail break for virtual characters. Those users become attached to their avatars, but they can only use them in one world. ![]() Second Life has more than 16.4 million registered users. ![]() ![]() ![]() ![]() The earliest known occurrence of the spells included in the Book of the Dead is from the coffin of Queen Mentuhotep, of the 16th Dynasty, where the new spells were included amongst older texts known from the Pyramid Texts and Coffin Texts. The Book of the Dead first developed in Thebes toward the beginning of the Second Intermediate Period, around 1700 BC. The Coffin Texts were available to wealthy private individuals, vastly increasing the number of people who could expect to participate in the afterlife a process which has been described as the "democratization of the afterlife". The Coffin Texts were most commonly written on the inner surfaces of coffins, though they are occasionally found on tomb walls or on papyri. The Coffin Texts used a newer version of the language, new spells, and included illustrations for the first time. In the Middle Kingdom, a new funerary text emerged, the Coffin Texts. Towards the end of the Old Kingdom, the Pyramid Texts ceased to be an exclusively royal privilege, and were adopted by regional governors and other high-ranking officials. The purpose of the Pyramid Texts was to help the dead king take his place amongst the gods, in particular to reunite him with his divine father Ra at this period the afterlife was seen as being in the sky, rather than the underworld described in the Book of the Dead. The Pyramid Texts were written in an unusual hieroglyphic style many of the hieroglyphs representing humans or animals were left incomplete or drawn mutilated, most likely to prevent them causing any harm to the dead pharaoh. These texts were written on the walls of the burial chambers within pyramids, and were exclusively for the use of the pharaoh (and, from the 6th Dynasty, the queen). ![]() The first funerary texts were the Pyramid Texts, first used in the Pyramid of King Unas of the 5th Dynasty, around 2400 BC. The Book of the Dead developed from a tradition of funerary manuscripts dating back to the Egyptian Old Kingdom. Part of the Pyramid Texts, a precursor of the Book of the Dead, inscribed on the tomb of Teti Wallis Budge in 1888 and was taken to the British Museum, where it currently resides. The finest extant example of the Egyptian Book of the Dead in antiquity is the Papyrus of Ani. The Book of the Dead was most commonly written in hieroglyphic or hieratic script on a papyrus scroll, and often illustrated with vignettes depicting the deceased and their journey into the afterlife. Some people seem to have commissioned their own copies of the Book of the Dead, perhaps choosing the spells they thought most vital in their own progression to the afterlife. The surviving papyri contain a varying selection of religious and magical texts and vary considerably in their illustration. There was no single or canonical Book of the Dead. A number of the spells which make up the Book continued to be separately inscribed on tomb walls and sarcophagi, as the spells from which they originated always had been. Other spells were composed later in Egyptian history, dating to the Third Intermediate Period (11th to 7th centuries BC). ![]() Some of the spells included in the book were drawn from these older works and date to the 3rd millennium BC. The Book of the Dead, which was placed in the coffin or burial chamber of the deceased, was part of a tradition of funerary texts which includes the earlier Pyramid Texts and Coffin Texts, which were painted onto objects, not written on papyrus. Karl Richard Lepsius introduced for these texts the German name Todtenbuch (modern spelling Totenbuch), translated to English as Book of the Dead. "Book" is the closest term to describe the loose collection of texts consisting of a number of magic spells intended to assist a dead person's journey through the Duat, or underworld, and into the afterlife and written by many priests over a period of about 1,000 years. The original Egyptian name for the text, transliterated r(ꜣ)w n(y)w prt m hrw(w), is translated as Book of Coming Forth by Day or Book of Emerging Forth into the Light. The Book of the Dead ( Ancient Egyptian: □□□□□□□□□□□□□□□□□, r(ꜣ)w n(y)w prt m hrw(w)) is an ancient Egyptian funerary text generally written on papyrus and used from the beginning of the New Kingdom (around 1550 BC) to around 50 BC. ![]() ![]() One limitation is the learning curve associated with mastering the tool's advanced functionalities. While Microsoft Power BI offers numerous advantages, it does have a few drawbacks that users should be aware of. This enables business analysts to seamlessly integrate and consolidate data from various platforms, facilitating a holistic view of business operations. One of the key strengths of Power BI is its ability to connect to a wide range of data sources, including popular databases, cloud services, and Excel spreadsheets. Its intuitive user interface and comprehensive set of functionalities make it an excellent choice for professionals in the field. Microsoft Power BI is a powerful tool that offers an array of features designed to streamline data analysis and visualization for business analysts. With continuous updates and improvements from Microsoft, Power BI is a dependable and evolving tool that can support business analysts in their pursuit of actionable intelligence. ![]() Its extensive data connectivity options, robust visualization capabilities, and seamless integration with the Microsoft ecosystem make it a valuable asset for professionals in the field.Despite a learning curve associated with mastering advanced features, Power BI provides users with the ability to uncover valuable insights, enabling data-driven decision-making. Microsoft Power BI is a highly recommended tool for business analysts seeking efficient data analysis and visualization solutions. It seems like it would be a great addition to allow limited sharing to everyone - even those without a Pro account, as most of my internal team does not have an account. However, the requirement that all users must have a Pro Account to view dashboards created in Pro is a bit of a hindrance in a global organization where it does not make economical sense for every employee to have a Pro account. Sharing dashboards and reports in Power BI is easy and it has a lot of options for doing so. In this way, Power BI is extremely powerful because it can be used for so many different types of projects the data-analysis intensive to the more visual 'data-presentation' dashboards. Everything about the program is made with the full spectrum of analysis in mind - from the designer to the data 'wrangler' to the end consumer (ie. Nothing has seemed to compare to the functionality that Power BI offers. I have used Tableau and Google Data Studio - among other alternatives. ![]() Power BI allows me to manipulate data and present it in visually appealing and flexible formats. ![]() ![]() No support questions outside of the Daily Advice Thread.No posts that aren’t directly related to Apple or the Apple eco-system.No rude, offensive, or hateful comments.No editorialized link titles (use the original source's title if applicable).Posts must foster reasonable discussion.No memes, direct images or contextless image/video posts.If you have a tech or buying/selling-related question, please check out our Daily Advice Thread or r/AppleHelp! CommunityĪ more in-depth version of the rules can be found here Fifth, and finally, the stylus no longer has an "eraser" on its butt.Welcome to r/Apple, the unofficial community for Apple news, rumors, and discussions. They're almost strong enough to suspend the tablet from the stylus. Fourth, the magnets holding the stylus in place are significantly stronger than the original Note Air. Third, there's a textured plastic cover on the screen that makes writing feel more organic and paper-like. Second, it has a lighter and more durable Mobius E Ink panel instead of a glass-based Carta screen. ![]() First, the Note Air 2 uses a faster, more advanced processor. However, the few differences are important. The Onyx Boox Note Air 2 is almost identical to the Note Air 1. Q: How does the Note Air 2 compare to the Note Air 1? While Qualcomm has a patent on wireless charging through a metal chassis, it doesn't appear to have been implemented in a consumer product yet. Almost all metal chassis devices do not implement wireless charging because metal can interfere with wireless frequencies. The Note Air 2 doesn't have wireless charging. Q: Does the Onyx Boox Note Air 2 have wireless charging? ![]() FAQ Q: Does the Onyx Boox Note Air 2 have Bluetooth? However, if you're looking for a note-taking platform or a more disposable device, a Remarkable 2 (our Remarkable 2 review) or Boyue P10 series might better suit your needs. Most students heading back to school or office staff heading back to the office will probably prefer an Onyx device over its competitors. The higher price is justified if you use its complex suite of eReader and note-taking software. But there's one big catch: it's expensive. The Onyx Boox Note Air 2 is the best eReader-digital notebook around. For this reason, it’s better to take notes using split screen mode. Currently, I know of no way to access your raw data. There is an option to use Dropbox instead of Onyx’s cloud storage but the data is backed up in an encrypted state and only decrypted or made readable when you use Onyx’s software. So you can’t transfer data from your Note Air 2 to another device. The big problem is that Onyx doesn’t allow users to use third-party software to access backed-up notes. On-page annotation isn’t perfect, though. The plastic layer is textured to feel like paper when brushed with the stylus. There’s a plastic layer covering the glass screen of the Note Air 2. You can then copy and paste the converted characters into apps. Users can also use Optical Character Recognition in their notes, which converts handwriting into digital text. Onyx’s app then stores the notes in its cloud app or through DropBox. Annotating eBooks is easy: you can just run Onyx’s NeoReader app by opening an eBook. But it has a trick that its competitors aren’t particularly good at: it can take notes directly onto eBooks. The big 10-inch screen makes the Note Air 2 great for both reading and taking notes. ![]() ![]() The weight difference between the Note Air 2 and the original Note Air is negligible thanks to the Note Air 2’s additional textured plastic layer on top of the glass. But the differences are nearly unnoticeable. However, in this case, the plastic substrate weighs less and is more durable, compared to a glass substrate in an E Ink Carta panel. Normally, Mobius screens get used in flexible displays. The substrate runs behind the glass screen. While its competitors use a similar panel, the difference is that the Mobius screen uses a plastic substrate. As such, the Note Air 2's midrange Snapdragon 662 is one of the fastest eReaders on today’s market.įurthermore, the 1872 x 1404 resolution E Ink Mobius panel has one of the best “pixel” densities of 227 pixels-per-inch (PPI). Android eReaders, however, need more processing power, particularly when multitasking between apps. EReader hardware isn't comparable to smartphone processors because eBooks aren’t resource-intensive. ![]() ![]() ![]() While life rarely can tell us so cleanly which of the uncertain paths we’re exploring will be fruitful, there’s still a lesson here. ![]() Then my wife will come along and find ‘udon’ or ‘iconic’ or ‘epee’ or ‘naan,’ or we’ll click on the hints to look at the skeleton key for that day’s puzzle, and a new door opens. Having played Spelling Bee for a few months, I’ve become familiar with the ‘stuck’ feeling: staring at that honeycomb of letters and being fully, completely convinced that there’s nothing left there for me to find. Hence, the (previously credible) voice telling me I’m at a dead end is silenced. That I’m on the path to success: there are four more words that start with G.To narrow my field of vision: looking for words that start with G will be fruitful.The new information-in this case about the number of words that start with the letter G-is telling me two things: This is a version of looking when know something is there (in the pantry, in your organization). Then, after a glance at the first table of ‘hints,’ and armed with the information that there are 7 words that start with the letter ‘G’ when I’ve only found three…it practically makes more ‘G’ words appear as if by magic. I can be absolutely stuck, having stared at the same seven letters for 5 minutes straight, sure that there are no words left that I can find. It is difficult to overstate how helpful the first table is. But when we do check out the hints, I try to look first at the top table and then, if I’m really at a dead end, I’ll look at the bottom list as well. Of these, per the next section of hints, 9 of the C words start with ‘CO’ and 2 start with ‘CU.’Īs a family, whenever we play, we try not to click on the hints. So, for example, for last Sunday’s puzzle there were (per the grid above) 11 words that started with C: one with four letters, two with five, two with six, three with seven, two with 9, and one with 10. and beneath that, (2) A list that tells you the first two letters of the words listed in the above table. It has hints for each day’s puzzle, and is divided into two sections: (1) A grid that shows the number of possible words and their length, listed by letter… Recently, the Times added a something called the Spelling Bee Forum. Also, there’s a Pangram every day, a word that uses all 7 letters. The rules are simple: make as many words as possible with the 7 available letters all words must be four or more letters long and all must use the middle letter at least once. The game refreshes daily and we’ll typically spend 10-20 minutes playing it across all devices. Someone in our family does it nearly every day. Recently, my family and I have gotten obsessed with Spelling Bee on the NYTimes Crossword. ![]() ![]() ![]() ![]() I won’t pretend to understand much of what it does-I’m not an audio guy-but combining multiple audio output devices into a single destination is relatively straightforward, albeit with several gotchas. The trick to performing this combinatorial audio magic is the Audio MIDI Setup app, which you’ll find in the Utilities folder inside the Applications folder. Sadly, you can’t include AirPlay speakers like a HomePod in that mix more on that later. You could use this capability to play the same audio through your Mac and a set of connected speakers or to configure a 5:1 or 7:1 surround-sound system. By combining the speakers in my iMac and Thunderbolt Display, I can again have sound emanating equally from both sides of my desk. With thoughts of HomePod stereo pairs running through my head, I did a little research and discovered that Apple has long provided a way to combine multiple audio output devices into a single destination. I wanted to find a way to balance the signal between both pairs of speakers for more accurate stereo sound. I stand pretty much right between them, so routing audio through the iMac (which sits on the right side of my desk) made it seem to come from my right, whereas sending it through the Thunderbolt Display moved the sound to my left. When I tried using either one, however, the sound felt unbalanced. ![]() I work on a 27-inch iMac with a 27-inch Thunderbolt Display, and both have decent stereo speakers. However, I still want to listen to music while I’m working through all the suggestions. After some troubleshooting, I determined that replacement was probably the better part of valor and asked for (and received) recommendations on TidBITS Talk. Alas, something in the controller failed recently, rendering the controls inoperable and causing the sound to cut out or disappear entirely. The sound has been excellent, and I have appreciated having a dedicated controller for power and volume-it makes turning the sound off or adjusting the volume easier than using keyboard shortcuts or a graphical interface. Since 2005 or so, I’ve been listening to music on my Mac through an Altec Lansing FX6021 speaker system with two stereo speakers and a subwoofer. Improve Your Mac’s Audio by Combining Speakers #1662: New Macs, 12 top OS features for 2023, vertical tabs in Web browsers, watchOS 9.5.1.#1663: Exploring the Apple Vision Pro, 12 more OS features coming in 2023, new Apple service features, Apollo shuts down.#1664: Real system requirements for OS 2023, beware Siri creating alarms instead of timers.#1665: Important OS security updates, abusive Web notifications, solve myopia with an iPhone, Self Service Repair.#1666: Air quality websites and apps, The Password Game. ![]() ![]() ![]() Supported OS: Windows 11 / Windows 10 / Windows 8.Technical Details and System Requirements Windows 11 X64 Pro Activated + Office 2021 en-US APRIL TPM BYPASSED 2022 - CzOS. Click here to Magnet Download the torrent. Microsoft Office 2016-2019 Professional Plus / Standard v7. Torrent: Microsoft Office LTSC 2023 Pro Plus v2301 (圆4) + Patch (1.8 GB) Has total of 5 files and has 15034 Seeders and 10036 Peers. Following the release of the preview version in the first half of this year, the product has been refined and is now available to users. Microsoft has officially announced the availability of the final version of its Office 2021 release for Windows and Mac users. Microsoft OneDrive for business in 2016 Download Microsoft Office 2019 with Crack Torrent magnet link. Microsoft Office Pro Plus 2021 v2112 Build 9.20194 (圆4) Pre-Cracked. Microsoft Office 2016 Suite Installer Volume License Version 16.16.27 Minimum 10.10.x (Yosemite) DOWNLOAD LINK INSTALLER.(Legal) - GitHub - 21Z/Microsoft-Office-2021: Download and Activate Microsoft Office 2021. Uptobox: Se recomienda crear una cuenta gratuita en uptobox para poder descargar sin límites y archivos de más de 1GB. Download and Activate Microsoft Office 2021 (Latest) for free. Microsoft Office Professional Plus 2016 Microsoft Office 2021 Pro - Plus (x86/圆4) - ESPAÑOL - MULTI9 + ACTIVADOR.The download package contains the following: Features of Microsoft Office 2016 Pro Plus It will offer new security, compliance, and deployment features, giving organizations more control over sensitive data and IT more flexibility in deployment and management. Get the installed applications you know and trust – Word, Excel, PowerPoint, OneNote, Outlook, Publisher, Access.Īlways have the latest, full installed versions of Word, Excel, PowerPoint, OneNote, Outlook, Publisher, and Access and capture your ideas however you work best – using a keyboard, pen, or touchscreen. It can open your applications, documents anywhere across multiple devices. This is the complete, cross-platform, cross-device solution for the modern workplace, with innovative tools for individuals, teams, and businesses. ![]() Overview of Microsoft Office 2016 Pro Plus It is a complete, cross-device solution for the modern workplace. Free Download Microsoft Office 2016 Professional Plus full version pre-activated for Windows. : 3 11:13: 36.3K: : 3 11:13: 1.7K: : 3 18:53: 20.0K: microsoft-office-2021. ![]() ![]() While seemingly rare, it is an important clinical consideration given theĬorrect circumstances and should not be overlooked in the emergency department. Prolonged QT is perceived as a clinical specter that is transiently considered on an academicīasis when we approach a patient with syncope or order one of the many medications that canĮlongate the interval. Identification of differences in the pediatric and adult ECG aid in distinguishing potentially life-threatening abnormalities from a normal ECG, with one of the most notable and vastly overlooked conditions being prolonged QT interval. This percentage was shown to be higher when a group of teenagers in intensive physical training were analyzed. Around 10% can develop transient, asymptomatic Mobitz Type I 2nd degree AV block at rest. Additionally, these adolescents can have a prolonged PR interval at rest - some to the extent they have ongoing 1st degree block while sleeping. Bradycardia at rest is often seen in young, healthy and mostly athletic teenagers. Of note, healthy teenagers can have significant abnormalities on ECG that are normal variants. Age-based charts are available and should be referenced when determining appropriate PR interval and QRS complex duration. 2 Both P wave and QRS slowly widen to adult ranges as the child ages. The PR interval initially shortens in the first year of life before gradually widening to the adult range through childhood. It is important to remember that what may be a normal PR interval in an adult can be a manifestation of 1st degree block in a young child.Īdditionally, a normal adult QRS could be a bundle branch block in a young child. This is often overlooked because most of us have committed normal adult wavelength ranges to memory. 1,3Ĭhildren have shortened PR intervals and QRS complexes compared with adults. ![]() These Q waves are expected, so much so that their absence in the lateral leads can be an indication of congenital heart disease. Other characteristics that would raise concern would be right precordial Q waves, wide Q waves, abnormally deep Q waves. They can be as deep as 8 mm in lead III during childhood. Young children can have a significant Q wave in the inferior and lateral leads from birth until age 3-5 years, when they recede. ![]() 2 The T waves in V5 and V6 should always be positive after the first 3 days of life. Presence of a positive T wave in V1-V3 past the first week of life is pathologic and warrants further investigation. Occasionally, this pattern can last later into adolescence and young adulthood. 1,2,3Ī pediatric norm that can initially seem alarming to an adult practitioner is the “juvenile T-wave pattern.” The precordial leads have T-wave inversions that normally persists until age 10-12 years. Similarly, as the left ventricle grows during the first years of life, a decrease in the amplitude of the R waves and corresponding increase in the amplitude of S waves is seen in the right precordial leads. A persistent rightward axis can be indicative of congenital heart disease. ![]() The normal adult ratio of right-to-left ventricle mass - and thus a normal axis - is expected to be seen by age 6 months. ![]() Most pronounced at 1-2 months of age, the axis slowly migrates from right to left as the left ventricular myocardium hypertrophies to account for the postnatal increase in systemic vascular resistance and a concomitant decrease in pulmonary vasculature pressures. 4Īt birth, all neonates have a rightward axis because of relative right ventricular hypertrophy. Up to 50% of infants can have sudden prolongation of the P-P interval with no symptomatic or long-term effects. This phenomenon is termed sinus arrhythmia. The resting heart rate does not coincide with adult range until at least age 5 years.Ĭhildren can also have wider variation in heart rate associated with the respiratory cycle and changes in P-P interval. Unlike adults, children not only tolerate a much higher heart rate but depend on an increase in heart rate alone to increase cardiac output. This review will focus on the key differences in rate, axis, and intervals. Detecting these differences can focus your differential, impact your treatment, and most importantly provide you with solid footing in making a relevant consultation to pediatric cardiology. The pediatric ECG has numerous subtle and not-so-subtle differences when compared to the average adult ECG. ![]() |
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