Battle Royale: Remastered by Koushun Takami – Koushun Takami’s notorious high-octane thriller envisions a nightmare scenario: a class of junior high school.. . The Paperback of the Battle Royale by Koushun Takami at Barnes & Noble The book’s scenes of torture, implied rape and killing combine the. Buy Battle Royale: The Novel by Koushun Takami from Waterstones today! Click and Collect from your local Waterstones or get FREE UK delivery on orders.

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Koushun Takami’s notorious high-octane thriller is based on an irresistible premise: If they are in the wrong part of the island at the wrong time, their collars will explode. If they band together to save themselves a collar will explode at random.

If they try to escape from the island, they will be blown up. Goyale only chance for survival lies in killing their classmates. Koushun Takami is best-known as the author of the novel Battle Royale, originally published in Japanese, and later translated into English by Yuji Oniki.

Battle Royale was rejected in the final round of the literary competition for which it was written owing to its controversial content. It become a bestseller when finally released in and, a year later, became a manga series and a feature film. The cult Japanese bestselling phenomenon! Battle Royale Volume 1: Spring Snow The Sea of Fertility. Death Note All-in-One Edition. Ver todas las apps de lectura gratuitas de Kindle. Detalles del producto Tapa blanda: Mostrando de 2 opiniones.

Ha surgido un problema al filtrar las opiniones justo en este momento. Vuelva a intentarlo en otro momento.

Battle Royale: The Novel

Tapa blanda Compra verificada. After reading the battle royale book and the mangas, i’ve heard about this “expansion”. Art, stories, even the final speech of the autor. Only for big fans. I have to say that I had already read the hunger games before I started reading this book, so the originality was kind of lost for me. Having said that, I was expecting much more coming from this book. There are way too many characters with Asian names, so it was difficult for me too keep track of who they were and what they were doing.

Furthermore, some of them are introduced in one chapter and given a background story just to die in the end I felt that was a total loss of time. Just to conclude, I didn’t connect with any of them at all. The beginning of the book is really good and the main reason I rated it 3 stars. From page on, I did not feel the need to keep reading, I just didn’t care about what happened to these characters.

There were though some plot twists towards the end that made the story a little more interesting. After I read the hunger games I decided I wanted to read this book, after all it did come out before the hunger games. I absolutely loved this book for a few reasons. First I loved the fact that it not only focused on a large group of kids, but it also gave inside to their stories and their perspective while in the game. It not only gives you an understanding of the kids, but it gives the book character.

I was intrigued by Shogo the most, and he was definitely my favorite character until the very end. We have this guy who is mysterious and a transfer student. I became intrigued when Shuya said Shogo was a loner and just sat by himself. That scene of him attempting to open a window in the bus really caught my attention.

Seriously, this book is so brutal, as many of the killings are merciless, especially those performed by Kazuo and Mitsuko. To see that these two kids were troubled on their own and then to have no heart to just kill their classmates and then have Kazuo kill Mitsuko just wow.

Shinji was another of my favorite characters, to have this one kid who is absolutely smart enough to hack into the government system and create a plan to blow up the school and those running the program, incredible. His death was just heartbreaking, as his plan was so close to being completed.

What I love about the author is that he does a great job at reminding you that these are ordinary kids. And nonchalantly he reminds you of their age as he occasionally throws it in the text.

It just makes this book much more brutal, you have these 42 kids whose class was randomly selected to kill each other off because the government said so as it is in their best interest.

Imagine not being able to trust your best friends, or most of all, imagine having to kill them to save yourself. To see how these kids kill each other and how the author describes, in detail, the death of each child, definitely left me speechless. I definitely recommend this book, especially to those who love dystopian books; it is definitely hard to put down once you start.

My downsides to this book: Without this, the author could have definitely made it much more difficult for the reader to guess who would win. I think one thing needs to be made clear because a lot of reviews seem to be looking at this as following the dystopian trend set by The Hunger Games: So any comments about a lack of originality do not belong here. Okay, this is a dark dystopian society in which teenagers are forced to fight to the death.

This is a premise that had been used before by The Running Man and others. But Battle Royale brings something new to the table by having the fight ring participants be children and by having them face off against their friends. Despite the similar premise, Battle Royale and The Hunger Games focus on very different aspects of the competition, and I think which book you prefer will depend largely on your personal taste. Battle Royale focuses much more on the morality of the game, and many students didn’t want to kill anyone.

Many students tried to find a way to beat the system. In THG, the tributes pretty much accept that they have to kill to survive. Battle Royale also focuses very effectively and poignantly on the prisoner’s dilemma.

Many students didn’t want to fight, but killed because they were afraid of the others or else didn’t reach out to the others because they were afraid. Like the prisoner’s dilemma, the students didn’t get the chance to talk to one another before being armed, so they couldn’t safely get together and try to cooperate to get out of the game.

This is used very well, with some very sad deaths. Also, in Battle Royale, more of the characters fighting in the contest are fully developed. This makes their deaths more poignant. If you’re interested in a story that looks at the competing bonds of friendship and survival, I think you might prefer Battle Royale.

In The Hunger Games, there is more emphasis on the romantic aspect as well as a theme about what is “real” on reality tv. Gana dinero con nosotros. Todos los derechos reservados.

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The term ‘trainer’ refers to trainers, teachers; lecturers or instructors from your training organization. Provide one response to each item on the form. You are required to use the Learner Questionnaire (PDF) and the Employer for download); ASQA’s Quality Indicator annual summary report template (DOC). Do I have to use the Australian Quality Training Framework (AQTF) survey form. AQTF Learner Questionnaire If you are a Learner please complete this Learner Questionnaire. organisation. Provide one response to each item on the form.

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Learner Questionnaire

In most cases, RTOs already had very genuine and meaningful learner and employer feedback arrangements and this new requirement forced them to either discard their current arrangements or continue to apply them ldarner to the new mandatory system. In my opinion, this was a very sad day for the VET sector.

This was a welcome decision as the SMART database had huge deficiencies, particularly in the way it retained data from year to year and in its reporting structure which was difficult to interpret. In my audits over this period, I have seen the majority of RTOs collecting the survey data for compliance purposes only.

The completed survey forms often pile up in a draw until May each year when they are entered into SMART for the 30 June reporting requirement. It is extremely rare to see an RTO make the connection between the reporting of satisfaction trends and their continuous improvement approach.

Reporting on quality indicators

ASQA has issued a general direction on this click here to see and provided a simple form called the Quality Indicator Annual Summary Report which allows an RTO to report the outcomes relating to response rates, trends, feedback and improvements actions, nice! Finally we are moving to a position where we are linking the collection and analysis of data with our continuous improvement actions.

We have RTOs contact us regularly looking for a solution to this problem. To provide a solution to this problem, Newbery Consulting has developed a nice simple database that will allow you to progressively enter your survey results and produce reports over any date range. It will produce a summary report and a detailed report for both the learner and employer satisfaction trends.

It uses the traffic light system to guide management decisions about how to respond when your satisfaction levels lezrner low. At Newbery Consulting we are serious about supporting the VET sector with practical, common sense products that support quality and strengthen your compliance. Satisfaction Data will complement the continuous improvement arrangements of those using our RTO System.

TAC – Quality Indicators

Satisfaction Data is a split Microsoft Access database file. Microsoft Office Professional is the version that has Microsoft Learne which is a database program. There is more information on system requirements on the request page. Satisfaction Data is not a supported software and is not eligible for technical support from Newbery Consulting or updates.

If you meet these requirements and need to improve your use of survey data to identify opportunities for improvement, please proceed to the request page:. Supporting the VET Sector.

So, where are we today? If you meet these requirements and need to improve your use of survey data to identify opportunities for improvement, please proceed to questionnaide request page:


Misc. Notes, This edition contains an interpolated number (№8-bis, act 2), composed by V.P. Valentinov, the author of the Russian text. In all other respects it. Franz LEHÁR ( – ) Zigeunerliebe (Gipsy Love) – Romantic operetta in three acts, First version () Johanna Stojkovic (soprano) – Zorika; Dagmar. Franz Lehár. Zigeunerliebe (Gypsy Love), operetta in 3 acts. Composition Information ↓; Description ↓; Parts/Movements ↓; Appears On ↓. Share on.

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A romantic operetta in 3 acts. Book and lyrics by A. Willner and Robert Bodanzky. Then, as the storm dies away, the skies brighten, and the sound of a violin is heard.

The gipsy boy is deferential to the daughter of the local landowner, but Zorika is a democratic girl, and she is happy lehad let a conversation develop. Jonel arrives for the engagement party, decked out in a splendid Boyar costume and accompanied by army officers and other guests, to be welcomed happily by the elderly widower Dragotin. Being an outdoor girl, Zorika has insisted on holding her engagement party out-of-doors and, when she appears with her maids of honour, Jonel offers her a bunch of wild roses.

Zorika, her mind in a turmoil, refuses the flowers and insists that Jonel has yet to prove that he is the right man for her.

A woman has zigeunerliebbe right to put men in their place and she herself does it frequently. He does so, counting his success with Zorika and, when Jonel comes in search of his engagement kiss, Zorika, her mind and heart in a whirl, refuses him. In her confusion, she remembers a superstition told her by her nurse, telling that anyone drinking from the River Czerna on Annunciation Eve will see into the future. Zigeunedliebe bends down and drinks from the water.

She falls asleep as the glow-worms and fireflies dance around about and mysterious voices call to her in the darkness. After all, Ilona herself has always shown an interest in him, and there are plenty of other gipsy girls to welcome him back zigeunfrliebe practical expressions of delight. Now Ilona appears in hunting costume, accompanied by Dragotin, who has come to join the party.

Zigeunerliebe (Lehár, Franz)

Old Dragotin is trying to impress the free-living lady with his potential as a lover and overcome her doubts about his virility, but Ilona reckons that she knows the only recipe for eternal youth.

His violin begins to play, as the voice of Jonel is heard calling romantically through the night. Seeing her father, Zorika goes to him, but he denies her. zigeunerliehe

He does not have a gipsy daughter. Ilona tells her that she must dance and sing for them, but Zorika makes a poor effort at being a gipsy. A gipsy wedding is good enough for him, he says, and he produces a red scarf that zigeunsrliebe says will bind them together.

Zorika, knowing that she can never love in gipsy style, turns on her heels and flees. While Zorika has been looking into the future, the party for her engagement zigdunerliebe Jonel lehaar continued at Dragotin’s hunting lodge. Jonel looks out and sees the figure of Zorika, lying asleep by the river, and longs for her pledge of love.

His reputation is a little dusty now and Ilona continues to keep him at bay without too much trouble, viewing the whole proceedings with an air of cynicism until the champagne brings out all her wild gipsy instincts.

The men clamour round her, longing to know if she will reward one of them with her favours. These zigeunerlieve are not his people and he wants only to return to the gipsy world he knows. As he leaves, Zorika rouses from her sleep, and Jonel hurries to her side. Zigeuherliebe he opens his arms to her, she declares that she is his and will devote her entire life to him. Not for her the vagabond life and vagabond love of the gipsy folk.

The name Zorika was given to a subsidiary role.

In the latest version of the world-famous operetta, the setting is Victorian England. She elopes with Zigeunerilebe, but her romantic dreams are soon shattered and reprisals are threatened against the whole Romany tribe.

Zigeunerliebe | Lehar, Franz | Opera & Operetta | Josef Weinberger

He sacrifices his hopes of happiness for the sake of his people – and Miranda. Another gloriously melodious score from the pen of the world’s best-loved operetta composer. Boyars, Hungarian soldiers, Romanian and Hungarian countryfolk, gipsies, gipsy musicians, waitresses, village children. Gipsy Love Zigeunerliebe A romantic operetta in 3 acts.

The MGM film Rogue Songallegedly based on Zigeunerliebeused a different story and only a little of the score. ACT 3 While Zorika has been looking into the future, the party for her engagement to Jonel has continued at Dragotin’s hunting lodge.


Concertpiece For Trumpet sheet music – Concert Band, Trumpet sheet music by James Curnow: Curnow Music. Shop the World’s Largest Sheet Music Selection . Check out Concertpiece for Clarinet, Winds, and Percussion by Howard Klug & James Curnow The University of Illinois Symphonic Band on Amazon Music. Concertpiece for Cornet is a valuable and tremendous addition to the solo repertoire of the instrument. Full of fireworks and technicalities the.

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Composed by James Curnow. Curnow Music Concert Band.

Published by Curnow Music HL. Trumpet Solo with Concert Band From the dynamic, driving introduction to the expressively lyric Andante cantabileConcertpiece for Trumpet was created to showcase both the technical and lyrical qualities of the trumpet.

Whether cascading down difficult runs, negotiating its way through exciting double-tonguing passages, or soaring above the ensemble during the most expressive ja,es, the trumpet soloist is challenged to perform at an extremely high standard of excellence.

After an expressive concertpiede section, the brilliance and energy of the opening allegro returns, then the coda focuses on the interplay between the soloist and the ensemble. A dramatic flourish of ascending runs brings this work to a fitting conclusion.

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Concertpiece for Cornet

Make a wish list for gifts, suggest standard repertoire, let students know which books to buy, boast about pieces you’ve mastered: Music Lists are as unique as the musician! Easily share your music lists with friends, students, and the world. This site uses cookies to analyze your use of our products, to assist with promotional and marketing efforts, to analyze our traffic and to provide content from third parties.

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Concertpiece for Trumpet, Curnow Music Concert Band – Hal Leonard Online

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La Clave​ de Salomón (en latín: Clavícula Salomonis, Pequeña llave de Salomón; en hebreo: Mafteaḥ Shelomoh [מפתח שלמה]) es un grimorio atribuido al Rey. Esta antigua recopilación de textos es un antiguo grimorio que ofrece al lector el El rey Salomón poseía un conocimiento inspirado en las. EL GRAN GRIMORIO DEL PAPA HONORIO, LAS CLAVICULAS DEL REY SALOMON. 2 likes. Book.

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The Key of Solomon Latin: Clavicula SalomonisHebrew: It probably dates back to the 14th- or 15th-century Italian Renaissance. It presents a typical example of Renaissance magic.

It is possible that the Key of Solomon inspired later works, particularly the 17th-century grimoire also known as Clavicula Salomonis RegisLesser Key of Solomon or Lemegetonalthough there are many differences between the books.

Many such grimoires attributed to King Solomon were written during the Renaissance, ultimately being influenced by earlier works of Jewish kabbalists and Arab alchemists. These, in turn, incorporated aspects of the Greco-Roman magic of Late Antiquity. Several versions of the Key of Solomon exist, in various translations, with minor to significant differences.

The archetype was probably a Latin or Italian text dating to the 14th or 15th century.

There is also an early Greek manuscript dating to the 15th century Harleian MS. Its contents are very similar to the Clavicula. An early Latin text survives in printed form, dated to ca. There are a number of later 17th century Latin manuscripts. One of the oldest existing manuscripts besides Harleian is a text in English translation, entitled The Clavicle of Solomon, revealed by Ptolomy the Grecian and dated grimkrio Sloane There are a number of French manuscripts, all dated to the 18th century, with the exception of one dated to P, ed.

The BL manuscript was dated to the 16th century by its first editor Greenupbut is now thought to be somewhat younger, dating to the 17th or 18th century.

Gollancz was published by his son Hermann Gollancz inwho also published a facsimile edition in The Hebrew text is not considered the original. It is rather a late Jewish adaptation of a Latin or Italian Clavicula text. An edition of the Latin manuscripts saalomon the British Library was published by S.

Clave de Salomón – Wikipedia, la enciclopedia libre

MacGregor Mathers in The Key of Solomon is divided into two books. It describes not the appearance or work of any spirit but only the necessary drawings to prepare each “experiment” or, in more modern language, magical operations. Unlike later grimoires such as the Pseudomonarchia Daemonum 16th century sakomon the Lemegeton 17th centurythe Key of Solomon grimodio not mention the signature of the 72 spirits constrained by King Solomon in a bronze vessel.

As in most medieval grimoires, all magical operations are ostensibly performed through the power of Godto whom reu the invocations are addressed. Before any of these operations termed “experiments” are performed, the operator must confess his sins and purge himself of evilinvoking the protection of God.

Elaborate preparations are necessary, and each of the numerous items used in the operator’s “experiments” must be constructed of the appropriate materials obtained in the prescribed manner, at the appropriate astrological dle, marked with de, specific set of magical symbols, and blessed with its own specific words. All substances needed for the magic drawings and amulets are detailed, as well as the means to purify and prepare them.

Many of the symbols incorporate the Transitus Fluvii occult alphabet. According to grimoro mythical history of the document, as recorded in its introduction, Solomon wrote the book for his son Rehoboamand commanded him to hide the book in his sepulchre upon his death. After many years the book was discovered by a group of Babylonian philosophers repairing Solomon’s tomb. The Angel of the Lord appeared to him and extracted a promise that he would keep the text hidden from the unworthy and the wicked, after which he was able to read it plainly.

Tratado Mágico de Salomón: Textos antiguos de magia y poder de otro mundo – CODIGO OCULTO

Book I contains conjurationsinvocations and curses to summon de constrain spirits of the dead and demons in order to compel them to do the operator’s will. It also describes how to find stolen items, become invisible, gain favour and love, and so on.

Book II describes various purifications which the operator termed “exorcist” should undergo, how they should clothe themselves, how the magical implements used in their operations should be constructed, and what animal sacrifices should be made to the spirits. From Wikipedia, the free encyclopedia. For other uses, see Key of Solomon disambiguation.

Tratado Mágico de Salomón: Textos antiguos de magia y poder de otro mundo

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Download drivers, software, firmware and manuals for your Canon product and get access to online technical support resources Canon PowerShot A IS. Camera manuals and free digital camera pdf instructions. Find the user manual you need for your camera and more at ManualsOnline. Canon PowerShot A IS equipped with a MP CCD sensor and advanced DIGIC 4 Image Processor drives responsive operation.

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Make sure you read this guide before using the camera. Store this guide safely so that you can use it in the future, Canon Customer Support Help Desk. For Canon Customer Support contacts, please see the customer support list supplied with your camera.

Canon PowerShot A1100 IS manual and software kit

Shoot, leaving it to the camera to make settings Easy Shooting Easy Mode Shoot to match special conditions Easy Playback Easy Mode Automatically play back pictures slideshow Look at my pictures on a TV Chapters 1 – 3 explain the basic operations and frequently used functions this camera.

Chapters 4 onward explain the advanced functions, letting you learn more as you read each chapter. Checking the Package Contents. Table of Contents Adjusting the W hite Balance Shooting Using aTV Monitor. Before using the c amera, please ensure that you r ead the s afety precautions described below. Always ensure that the c amera isoperated correctly. The s afety precautions noted on the f ollowing pages are i ntended toprevent injuries to yourself and o ther persons, or damage Safety Precautions Battery Use only recommended batteries.

Do not place the batteries near or in direct flame. Do not let the batteries come into contact with water e. Do not attempt to disassemble, alter or apply heat to the batteries.

Canon Digital Camera A IS User Guide |

Safety Precautions Do not use the flash with dirt, dust or other items stuck to the surface, or if it is covered by your fingers or clothing. This may cause the camera to malfunction. Remove and store the batteries when are not using the camera. Getting Started This chapter explains preparations before shooting, how to shoot in mode, and then how to view, erase and print the images you take.

The latter part of this chapter explains how to shoot and view images in Easy Mode, how to shoot and view movies and how to transfer images to a computer. Insert the included batteries and memory card into the camera. Check the card’s write-protect tab.

If the memory card has a write-protect tab, you will not be able to record images if the tab is in the locked position. Slide the tab up until you hear a click. Removing the Memory Card Push the memory card in until you hear a click, then slowly manua, The memory card will pop up. The values for NiMH batteries are based on fully charged batteries.

We cannot recommend the use of any other batteries than those listed above The number of shots that can be taken wil! Since the dates and times recorded into your images are s1100is on these settings, be sure to set them Turn on the camera.

MENU Amnual the button. Press the Av buttons to select You can change the language displayed in the LCD monitor menus and messages. Press the [] button. Display the settings screen. The shutter button has two stops. To take images that are in focus, be sure to first press the shutter button lightly halfway to focus, then take the shot.

The camera automatically makes the necessary Since the camera can determine the subject and shooting conditions, majual let it automatically select the best settings for the scene and just shoot. The camera can also detect and focus on faces, setting the color and brightness to optimal levels.

Canon PowerShot A1100 IS Camera User Manual, Instruction Manual, User Guide (PDF)

Green AF frames appear where subject is in focus. The image comes out dark mnaual if the flash fired when shooting? The subject is too far away for the flash to reach. Shoot within the effective flash range of approximately 30 cm – 4. You can view your images on the screen. You can select and erase images one at a time. Please note that erased images cannot be recovered. Exercise adequate caution before erasing image. Select the playback mode. The last image you took will appear.

You can easily print the images you have taken if you connect the camera to a PictBridge compliant printer sold separately. Compact Photo Printers Inkjet Printers The explanations of camera operations and behavior below are basically same mabual in ‘! This prevents incorrect operation The camera can automatically select all settings so that you can manuual movies just by pressing the shutter button.

Press the shutter button fully. The camera will start shooting the movie, and manuap Rec. Once shooting begins, take your finger off the shutter button. If you change the composition of your shot during shooting, the focus will stay the You can view your movies on the screen.


Transferring images to a Computer Macintosh CameraWindow will appear when a connection between the camera computer is established.

If CameraWindow does not appear, click the [CameraWindow] icon on the Dock the bar which appears at the bottom the desktop. The following camera accessories are sold separately. Some accessories are not sold in manuql regions, or may no longer available.

Learning More This chapter explains the parts of the camera and what displays the screen, as well as, the basic operating instructions. Conventions Used in this Guide Icons are used in the text nanual represent the camera buttons and switches. Language that displays on the screen appears Recordable White Balance p. However, brightness of the image on the mnual, and the brightness of the actual image recorded may be different.

Commonly used shooting functions can be set with the FUNC. Select a shooting mode. Set the mode dial to the desired shooting mode. Various functions can be set from the menus. The menu items differ depending on the mode pp. Press the MENU button.

You can silence or adjust the volume of camera sounds. MENU Press the button. When you have mistakenly changed a setting, you can reset the camera the default settings. Before you use a new memory card or one that has been used in other devices, you should format a1100iss card with this camera. Formatting initializing a a1100js card erases all data on the memory card. As you cannot retrieve the erased data, exercise adequate Formatting MemoryCards The supplied memory card has already been formatted.

When the [Memory card error] message appears, or when the camera does not work correctly, formatting the memory card may solve the problem.

Copy the images from the memory card to a computer or other device before formatting. The camera will select the necessary settings for the conditions in which you wish to shoot when you select the matching mode. Set the mode dial to the scene you wish to shoot The camera will select the necessary settings for the a1100si in which you wish to shoot when you select the matching mode. Set the mode dial to and press the button.

Take nightscapes Night Scene Lets you a1100s beautifully lit city nightscapes or night backgrounds. You can shoot with the flash turned off.

When you press the shutter button halfway in low light conditions where camera shake is likely, the indicator will blink orange and a flashing will appear. A1100os can insert the shooting date and time in the lower right corner of an image. Once inserted, however, they cannot be deleted.


Bga Breakouts And Routing: Effective Design Methods For Very Large Bgas [ Charles Pfeil] on *FREE* shipping on qualifying offers. There are. results, fast performance. Holder of 11 patents. Wrote a design book titled, “BGA Breakouts and Routing”. Inducted into the. PCB Design Hall of Fame by the UP. Call it a “vanity” publishing project if you will, but Charles Pfeil’s book, BGA Breakouts & Routing, published by his employer, Mentor Graphics.

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That’s right, you can learn the principles for successful BGA routing in just 30 minutes! Even if you can read words per minute, Charles’ webcast will be hard to beat. That’s smart because layers affect both fabrication costs and product reliability.

But these same designers struggle when routing the high-pin-count ball grid arrays BGAs that are becoming increasingly popular with electronics manufacturers. The reason is simple. Without a breakout strategy for getting traces out of the BGA, the layer count will be excessive, causing cost and reliability to suffer. Knowing how to create an effective fanout pattern can save space and minimize layer count.

What the presentation is about Charles’ presentation is the best, quickest way to learn the principles behind effective BGA fanouts. In it, he’ll show you how designers create unique and effective fanout patterns for:.

Is it possible to find a tutorial of BGA fanout? | Mentor Graphics Communities

The presentation also explores a variety of theoretical approaches, exposes their inadequacies, considers the impact of different via models, and provides via patterns that work in each context.

Quickly learn the principles behind effective BGA fanouts: Electronic System level Design. Sign me up for the newsletter. When Less is More! In it, he’ll show you how designers create unique and effective fanout patterns for: A New Online Support Experience.

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Ann Cardiol Angeiol (Paris). Nov;28(6) [Angor pectoris with ST segment elevation “Prinzmetal variant form” and its relationship with angor pectoris. Angina, also known as angina pectoris, is chest pain or pressure, usually due to not enough blood flow to the heart muscle. Angina is usually due to obstruction. The Canadian Cardiovascular Society grading of angina pectoris is a classification system used to grade the severity of exertional angina. Contents. 1 Medical.

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Anginaalso known as angina pectorisis chest pain or pressure, usually due to not enough blood flow pectiris the heart muscle. Angina is usually due to obstruction or spasm of the coronary arteries.

The main mechanism of coronary artery obstruction is an atherosclerosis as part of coronary artery disease. The term derives from the Latin angere “to strangle” and pectus “chest”and can therefore be translated as “a strangling feeling in the chest”.

There is a weak relationship between severity of pain and degree of oxygen deprivation in the heart muscle i.

In some cases, angina can be quite severe, and anbor the early pecttoris century this was a known sign of impending death. Worsening angina attacks, sudden-onset angina at rest, and angina lasting more than 15 minutes are symptoms of unstable angina usually grouped with similar conditions as the acute coronary syndrome. As these may precede a pecotris attack, they require urgent medical attention and are, in general, treated in similar fashion to myocardial infarction. Also known as ‘effort angina’, this refers to the classic type of angina related to myocardial ischemia.

A typical presentation of stable angina is that of chest discomfort and associated symptoms precipitated by some activity running, qngor, etc. In anfor way, stable angina may be thought of as being similar to intermittent claudication symptoms. Other recognized precipitants of stable angina include cold weather, heavy meals, and emotional stress. Unstable angina UA also ” crescendo angina “; this is a form of acute coronary syndrome is defined as angina pectoris that changes or worsens.

UA may occur unpredictably at rest, which may be epctoris serious indicator of an impending heart attack. What differentiates stable angina from unstable angina other than symptoms is the pathophysiology of the atherosclerosis. The pathophysiology of unstable angina is the reduction of coronary flow due to transient platelet aggregation on apparently normal endothelium, coronary artery spasms, or coronary thrombosis.

In stable angina, the developing atheroma qngor protected with a fibrous cap. This cap may rupture in unstable angina, allowing blood clots to precipitate and further decrease the area of the coronary vessel’s lumen.

This explains why, in many cases, unstable angina develops independently of activity. Cardiac syndrome X, sometimes known as pectogis angina is characterized by angina-like chest pain, in the context of normal epicardial coronary arteries the largest vessels on the surface of the heart, prior to significant branching on angiography.

The original definition of cardiac syndrome X also mandated that ischemic changes on exercise despite normal coronary arteries were displayed, as shown on cardiac stress tests. Studies, including the Women’s Ischemia Syndrome Evaluation WISEsuggest that microvascular angina is part of the pathophysiology of ischemic heart disease, perhaps explaining the higher rates of angina in women than in men, as well as their predilection towards ischemia and acute coronary syndromes in the absence of obstructive coronary artery disease.

Angina pectoris can be quite painful, but many patients with anvor complain of chest discomfort rather than actual pain: Apart from chest discomfort, anginal pains may also be experienced in the epigastrium upper central abdomenagor, neck area, jaw, or shoulders. This is explained by ahgor concept of referred painand is due to the fact that the spinal level that receives visceral sensation from the heart simultaneously receives cutaneous sensation from parts of the skin specified by that spinal nerve’s dermatomewithout an ability to discriminate the two.

Typical locations for referred pain are arms often inner left armshoulders, and neck into the jaw. Angina is typically precipitated by exertion pecyoris emotional stress. It is exacerbated by having a full stomach and by cold temperatures. Pain may be accompanied by breathlessness, sweating, and nausea in some cases.

angor pectoris

In this case, the pulse rate and the blood pressure increases. Chest pain lasting only a few seconds is normally not angina such as precordial catch syndrome. Myocardial ischemia comes about when the myocardium the heart muscle receives insufficient blood and oxygen to function normally either because of increased oxygen demand by the myocardium or because of decreased supply to the myocardium.

This inadequate perfusion of blood and the resulting reduced delivery of oxygen and nutrients are directly correlated to blocked or narrowed blood vessels. Some experience pectorris symptoms” related to increased activity of the autonomic nervous system such as nauseavomitingand pallor. Major risk factors for angina include cigarette smokingdiabeteshigh cholesterolhigh blood pressuresedentary lifestyleand family history of premature heart disease.

A variant form of angina— Prinzmetal’s angina anor in patients with normal coronary arteries or insignificant atherosclerosis. Qngor is believed caused by spasms of the artery. It occurs more in younger women. Coital angina, also known as angina d’amouris angina subsequent to sexual intercourse.

Routine counselling of adults to advise them to improve their diet and increase their physical activity has not been found to significantly alter behaviour, and thus is not recommended. One study found that smokers with coronary artery disease had a significantly increased level of sympathetic nerve activity when compared to those without. This is in addition to increases in blood pressure, heart rate, and peripheral vascular resistance associated with nicotine, which may lead to recurrent angina attacks.

Studies have found that there are short-term and long-term benefits to smoking cessation.

Myocardial ischemia can result from:. Atherosclerosis is the most common cause of stenosis narrowing of the blood vessels of the heart’s arteries and, hence, angina pectoris. Some people with chest pain have normal or minimal narrowing of heart arteries; in these patients, vasospasm is a more likely cause for the pain, sometimes in the context of Prinzmetal’s angina and syndrome X.

Myocardial ischemia also can be the result of factors affecting blood composition, such as reduced oxygen-carrying capacity of bloodas seen with severe anemia low number of red blood cellsor long-term smoking. Angina results when there is an imbalance between the heart’s oxygen demand and supply.

This imbalance can result from an increase in demand e. However, the pathophysiology of angina in females varies significantly as compared to males.

Angina should be suspected in people presenting tight, dull, or heavy chest discomfort that is: Some pectogis present with atypical symptoms, including breathlessness, nausea, or epigastric discomfort or burning. These atypical symptoms are particularly likely in older people, women, and those with diabetes.

Anginal pain pectiris not usually sharp or stabbing or influenced by respiration. Antacids and simple analgesics do not usually relieve the pain. If chest discomfort of whatever site is precipitated by exertion, relieved by rest, and relieved by glyceryl trinitrate, the likelihood of angina is increased.

In angina patients momentarily not feeling any chest pain, an electrocardiogram ECG is typically normal unless there have been other cardiac problems in the past. During periods of pain, depression, or elevation of the ST segment may be observed. Even constant monitoring of the blood pressure and the pulse rate pectoriw lead to some conclusion regarding angina. The exercise test is also useful pectori looking for other markers of myocardial ischemia: Other pectpris to a standard exercise test include a thallium scintigram or sestamibi scintigram in patients unable to exercise enough for the purposes of the treadmill tests, e.

In patients in whom such noninvasive testing is diagnostic, a coronary angiogram is typically performed to identify the nature of the coronary lesion, nagor whether this would be a candidate for angioplastycoronary artery bypass graft CABGtreatment only with medication, or other treatments. In hospitalized patients with unstable angina or the newer term of “high-risk acute coronary syndromes”those with resting ischaemic ECG changes or those with raised cardiac enzymes such as troponin may undergo coronary angiography directly.

The most specific medicine to treat angina is nitroglycerin. It is a potent vasodilator that decreases myocardial oxygen demand by decreasing the heart’s workload. Beta blockers and calcium channel blockers act to decrease the heart’s workload, and thus its requirement qngor oxygen.

Nitroglycerin should not be given if certain inhibitors such as sildenafiltadalafilor vardenafil have been taken within the previous 12 hours as the combination of the two could cause a serious drop in blood pressure. Treatments for angina are balloon angioplastyin which the balloon is inserted at the end of a catheter and inflated to widen the arterial lumen.

Stents to maintain the arterial widening wngor often used at the same time.

Angina – Wikipedia

Coronary bypass surgery involves bypassing constricted arteries with venous grafts. This pectiris much more invasive than angioplasty. The main goals of treatment in angina pectoris are relief of symptoms, slowing progression of the disease, and reduction of future events, especially heart attacks and death.

Ivabradine provides pure heart rate reduction [35] leading to major anti-ischemic and antianginal efficacy. ACE inhibitors are also vasodilators with both symptomatic and prognostic benefit. However, in patients without established cardiovascular disease, the increase in hemorrhagic stroke and gastrointestinal bleeding offsets any benefits and it is no longer advised unless the risk of myocardial infarction is very high.

Exercise is also a very good long-term treatment for the angina but only particular regimens – gentle and sustained exercise rather than intense short bursts[38] pectoriz working by complex mechanisms such as improving blood pressure and promoting coronary artery collateralisation. Identifying and pectodis risk factors for further coronary heart disease is a priority in patients with angina. This means testing for elevated cholesterol and other fats in the blood, diabetes and hypertension high blood pressureand encouraging smoking cessation and weight optimization.

The calcium channel blocker nifedipine prolongs cardiovascular event- and procedure-free survival in patients with coronary artery disease. Women with myocardial ischemia often have either no or atypical symptoms, such as palpitations, anxiety, weakness, and fatigue. Additionally, many women with angina are found to have cardiac ischemia, yet no evidence of obstructive coronary artery disease on cardiac catheterization. Evidence is accumulating that nearly half of women with myocardial ischemia suffer from coronary microvascular disease, a condition often called microvascular angina MVA.

Small intramyocardial arterioles constrict in MVA causing ischemic pain that is less predictable than with typical epicardial coronary artery disease CAD. The pathophysiology is complex and still being elucidated, but there is stong evidence that endothelial dysfunction, decreased endogenous vasodilators, inflammation, changes in adipokines, and platelet activation are contributing factors. The diagnosis of MVA may require catheterization during which there is assessment of the microcirculatory response to adenoside or acetylcholine and measurement of coronary and fractional flow reserve.

New techniques include positron emission tomography PET scanning, cardiac magnetic resonance imaging Angoand transthoracic Doppler echocardiography. Managing MVA can be challenging, for example, women with this condition have less coronary microvascular dilation in response to nitrates than do those without MVA.

Aggressive interventions to reduce modifiable risk factors are sngor important component of management, especially smoking cessation, exercise, and diabetes management. The combination of nonnitrate vasodilators, such as calcium channel blockers and angiotensin converting enzyme ACE inhibitors along with HMG-CoA reductase inhibitors statinsalso has been shown to be effective in many women, and new drugs, such as Ranolazine and Ivabradine, have shown promise in the treatment of MVA.

Other approaches include spinal cord stimulators, adenosine receptor blockade, and psychiatric intervention. Hospital admission for people with the following symptoms is recommended, as they may abgor unstable angina: All people with suspected angina should be urgently referred to a chest pain evaluation service, for confirmation of the diagnosis and assessment of the severity of coronary heart disease.

In the United States, The prevalence of angina rises with increasing age, with a mean age of onset of Men with angina were found to have an increased risk of subsequent acute myocardial infarction and coronary heart disease related death than women.

Similar figures apply in the remainder of the Western world. All forms of coronary heart disease are much less-common in the Third Worldas its risk factors are much more common in Western and Westernized countries; it could, therefore, be termed a disease of affluence. The adoption of a rich, Westernized diet and subsequent increase of smokingobesityand other ppectoris factors has led to an increase in angina and related diseases in countries such as China.

The condition was named “hritshoola” in ancient India and was described by Sushruta 6th century BC.


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Ivo Banac. The National Question in Yugoslavia: Origins, History, Politics. Ithaca, N.Y. and London: Cornell University Press, pp. Loading data.. Open Bottom Panel. Go to previous Content Download this Content Share this Content Add This Content to Favorites Go to next Content. ← →. The National Question in Yugoslavia: Origins, History, Politics. By Ivo Banac. ( Ithaca, N.Y.: Cornell University Press, Pp. $) – Volume 79 Issue 1.

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