title: Petri dish

text: The culture medium is often an agar plate, a layer a few mm thick of agar or agarose gel containing whatever nutrients the organism requires (such as blood, salts, carbohydrates, amino acids) and other desired ingredients (such as dyes, indicators, and medicinal drugs). The agar and other ingredients are dissolved in warm water and poured into the dish and left to cool down. Once the medium solidifies, a sample of the organism is inoculated ("plated").


title: Petri dish

text: The dishes are then left undisturbed for hours or days while the organism grows, possibly in an incubator. They are usually covered, or placed upside-down, to lessen the risk of contamination from airborne spores.


title: Petri dish

text: Virus or phage cultures require that a population of bacteria be grown in the dish first, which then becomes the culture medium for the viral inoculum.


title: Petri dish

text: While Petri dishes are widespread in microbiological research, smaller dishes tend to be used for large-scale studies in which growing cells in Petri dishes can be relatively expensive and labor-intensive.


title: Petri dish

text: Petri dishes can be used to visualize the location of contamination on surfaces, such as kitchen counters and utensils, clothing, food preparation equipment, or animal and human skin.


title: Petri dish

text: For this application, the Petri dishes may be filled so that the culture medium protrudes slightly above the edges of the dish to make it easier to take samples on hard objects. Shallow Petri dishes prepared in this way are called Replicate Organism Detection And Counting (RODAC) plates and are available commercially.


title: Petri dish

text: Petri dishes are also used for cell cultivation of isolated cells from eukaryotic organisms, such as in immunodiffusion studies, on solid agar or in a liquid medium.


title: Petri dish

text: Petri dishes may be used to observe the early stages of plant germination, and to grow plants asexually from isolated cells.


title: Petri dish

text: Due to their large open surface, Petri dishes are effective containers to evaporate solvents and dry out precipitates, either at room temperature or in ovens and desiccators.


title: Petri dish

text: Petri dishes also make convenient temporary storage for samples, especially liquid, granular, or powdered ones, and small objects such as insects or seeds. Their transparency and flat profile allows the contents to be inspected with the naked eye, magnifying glass, or low-power microscope without removing the lid.


title: Petri dish

text: The Petri dish is one of a small number of laboratory equipment items whose name entered popular culture. It is often used metaphorically, e.g. for a contained community that is being studied as if they were microorganisms in a biology experiment, or an environment where original ideas and enterprises may flourish.<ref name="merriam-webster.com/dictionary/petridish"></ref>


title: Petri dish

text: Unicode has a Petri dish emoji, "🧫", which has the code point U+1F9EB (HTML entity "🧫" or "🧫", UTF-8 "0xF0 0x9F 0xA7 0xAB").


title: Bebeto

text: José Roberto Gama de Oliveira (born 16 February 1964), known as Bebeto (), is a Brazilian former professional football player who played as a forward. He entered politics in the 2010 Brazilian General Elections and was elected to the Legislative Assembly of Rio de Janeiro representing the Democratic Labour Party.


title: Bebeto

text: With 39 goals in 75 appearances for Brazil, Bebeto is the sixth highest goalscorer for his national team. He was the top scorer for Brazil at the 1989 Copa América when they won the tournament. At the 1994 FIFA World Cup, he formed a formidable strike partnership with Romário to lead Brazil to a record fourth World Cup title. He also generated headlines at the tournament for his goal celebration where he began rocking an imaginary baby after scoring against the Netherlands; his wife had given birth to their third child just days before. He was also a member of the Brazilian team that won the 1997 FIFA Confederations Cup, while he won Olympic silver and bronze medals with Brazil at the 1988 and 1996 Summer Olympic Games respectively. In 1989, Bebeto was named South American Footballer of the Year.


title: Bebeto

text: In January 2013 and August 2014, Bebeto was named as one of the six Ambassadors of the 2014 FIFA World Cup and Rio 2016 in Brazil, others being Ronaldo, Amarildo, Marta, Carlos Alberto Torres, Mário Zagallo.


title: Bebeto

text: He played for Flamengo, Vasco da Gama, Cruzeiro and Botafogo in Brazil, Deportivo La Coruña and Sevilla in Spain, Toros Neza in Mexico, Kashima Antlers in Japan, and Al Ittihad in Saudi Arabia, finally retiring in 2002.


title: Bebeto

text: Bebeto spent four years in Spain at Deportivo La Coruña, scoring an impressive 86 goals in 131 games. Bebeto became the top scorer in La Liga in his first season at Deportivo, scoring 29 goals in the 1992–93 season. In the next season, 1993–94 season, Deportivo had the chance to win their first ever La Liga title by beating Valencia in the last match of the season. In a very evenly matched contest Deportivo had a golden opportunity to seal the victory and thus the league title. They were given a penalty kick just minutes from the end. The official penalty taker all season had been Bebeto (after Donato, who wasn't in the field), who this time, refused to take the penalty. Eventually, Miroslav Đukić took the penalty and failed to score; hence, the match ended with a 0–0 draw, effectively handing Barcelona the title.


title: Bebeto

text: In 1996 Bebeto returned to play for native club Flamengo, but after just 15 games, Bebeto returned to Spain to play for Sevilla, for whom he never scored. In 1997, Bebeto joined Cruzeiro for just one match, the 1997 Intercontinental Cup final against Borussia Dortmund. Despite his presence, the Belo Horizonte side lost the match 2–0. Bebeto returned to goalscoring form at native clubs Vitória in late 1997 and Botafogo in early 1998, which saw him being picked for Brazil's World Cup defence in 1998.


title: Bebeto

text: In 2001, he was rejected by Scottish side St Mirren, who were willing to pay his wages but had reservations about his fitness. On 5 September 2002, he joined his final club at the age of 38, Al-Ittihad of Saudi Arabia, after pledging to join Vasco da Gama on 28 August.


title: Bebeto

text: For Brazil, Bebeto scored 39 goals in 75 caps after making his debut in 1985. He played in three World Cups: 1990, 1994, and 1998. In 1994, he was one of the best players of the tournament, scoring three goals and providing two assists for the eventual champions, and then repeated the feat four years later as Brazil finished second to hosts France.


title: Bebeto

text: During the 1994 World Cup, Bebeto formed a formidable partnership with Romário, after they succeeded in putting their personal differences aside. Bebeto and Romário were fierce rivals in the Spanish League. Bebeto led the Spanish first division with 29 goals in 1992–93 and Romário led it with 30 goals in 1993–94. It was Romário who gave Bebeto the nickname Chorao, or Crybaby, for his habit of pouting to referees. It was also Romário who called a news conference before the World Cup to announce that he would not sit next to Bebeto on the team's flight to the United States. Today, however, Bebeto and Romario are friends, with Bebeto claiming that they talk often. In an interview in 2018, Bebeto praised his partnership with Romario: "I played with Romario only in the national team. We played only one game together at Flamengo before he left for Europe. Do you know that Brazil have never lost a game when Bebeto and Romario played together? Not a single game! Besides, every time we played together at least one of us scored."


title: Bebeto

text: Bebeto became a household name for his goal celebration in the 1994 World Cup in the United States. His wife had delivered their third child just days before a quarter-final match against the Netherlands in the scorching heat of Dallas. After scoring, Bebeto ran to the sideline, brought his arms together and began rocking an imaginary baby. Teammates Romário and Mazinho quickly joined in. That child, a boy who was named Mattheus, started his football career with the youth side of Brazilian club Flamengo.


title: Bebeto

text: He won a silver medal for Brazil in the 1988 Summer Olympics. He was later chosen to be an over-23 player at the 1996 Summer Olympics, scoring a hat-trick in the Bronze medal match against Portugal.


title: Bebeto

text: On 8 December 2012 a friendly match was played by Brazil Masters vs IFA All Stars at Salt Lake Stadium, Kolkata, India. Bebeto scored a goal for Brazil Masters as they defeated All Stars by 3–1.


title: Bebeto

text: Regarded one of Brazil's greatest strikers, Bebeto was a prolific goalscorer and an excellent finisher, who was known for his consistency and determination throughout his career, although he was also injury-prone and was criticised for his character. Despite not being imposing physically due to his lack of height and slender physique, he was a fast and opportunistic player, who used his agility, offensive movement, and intelligence to lose his markers in tight spaces. Due to his vision, outstanding technical skills, close control on the ball, and his ability to play off other strikers and provide them with assists, he was often employed as a playmaking attacking midfielder or as a supporting striker early on in his career, drawing influence from Zico's playing style. He was later deployed as a striker or as a centre-forward, however, where he excelled, due to his eye for goal, and remained in this position for the rest of his career.


title: Bebeto

text: Bebeto was hired on 16 December 2009 as the América Football Club's head coach. After an average performance at the Taça Guanabara, he was sacked on 13 February 2010. He had a record of three wins, one draw and four losses.


title: Bebeto

text: Bebeto is married to Denise Oliveira, who played volleyball for Flamengo in 1988, with whom he has two sons and one daughter, Stéphannie who is married to Carlos Eduardo. His son, Mattheus, is a professional footballer. Bebeto's brother-in-law, Luiz Fernando Petra, was murdered in 2002, during a federal deputy election in Rio de Janeiro.


title: Bebeto

text: Bebeto features in EA Sports' "FIFA" video game series; he was on the cover of certain editions of "FIFA 97".


title: Dali and Cocky Prince

text: Dali and Cocky Prince () is a 2021 South Korean television series starring Kim Min-jae, Park Gyu-young, Kwon Yul, Hwang Hee, and Yeonwoo. It is about the romance between a parvenu who lacks education, and the daughter of a prestigious family who tries to save a collapsed art museum. It aired on KBS2 from September 22 to November 11, 2021.


title: Dali and Cocky Prince

text: Visiting researcher Kim Dali meets restaurateur Jin Moo-hak in a case of mistaken identity in the Netherlands. When her father dies, Dali returns home to take over management of her family's struggling art museum. Moo-hak is a major creditor to the art museum, and they meet again unexpectedly when he arrives to collect on his debts. Gradually, Moo-hak realizes that he wants to turn the museum's fortunes around to help Dali rather than solely get his money back.


title: 17th Lok Sabha

text: The 17th Lok Sabha was formed by the members elected in the 2019 Indian general election. Elections, all across India, were conducted in seven phases from 11 April 2019 to 19 May 2019 by the Election Commission of India. Counting started officially on the morning of 23 May 2019 and the results were declared on the same day.


title: 17th Lok Sabha

text: Om Birla was elected as speaker of the house. As no party holds 10% of the seats to secure the position of Leader of Opposition, currently, there is no leader of opposition. However, Adhir Ranjan Chowdhury is the leader of the Congress in the Lok Sabha, which is the second largest party.


title: 17th Lok Sabha

text: The 17th Lok Sabha has the most women representatives, at 14 percent. 267 members are first-time MPs. 233 members (43 percent) have had criminal charges against them. 475 members have their declared assets to be more than ; average assets were . Around 39 percent of members are professionally noted to be politicians or involved in social work.


title: 17th Lok Sabha

text: The 17th Lok Sabha has the highest ever number of women politicians with a total of 78 which is nearly 14%. The earlier Lok Sabha had 62 women MPs. The average age of 17th Lok Sabha is noted to be 54 years and 12% of MPs are below the age of 40. Chandrani Murmu of BJD from Keonjhar constituency became the youngest member at the age of 25 years, 11 months and nine days and Shafiqur Rahman Barq of SP from Sambhal constituency became the oldest member at the age of 89. Education-wise, 43% MPs have graduate-level education, 25% are post-graduates and 4% of members have doctorates in various subjects. Of the total strength, 300 members have been elected as member for the first time and 197 members have been elected second time consecutively i.e. they were a member in the 16th Lok Sabha as well. BJP members Maneka Gandhi from Sultanpur constituency and Santosh Gangwar from Bareilly constituency has been elected to Lok Sabha for the eighth time. Religion-wise, 90.4% members are Hindus and 5.2% are Muslims, with the rest, nearly 4%, being Sikhs, Christians and other minorities.


title: 17th Lok Sabha

text: According to the NGO Association for Democratic Reforms (ADR), 233 members (i.e. 43%) have criminal charges against them. Of these, nearly 29% of the cases are rape, murder, attempted murder, or crime against women. Congress MP Dean Kuriakose, of the Idukki constituency in Kerala, has 204 criminal cases.


title: 17th Lok Sabha

text: Financially, the number of members who are crorepati (i.e. with declared assets more than ) are 475. Members with more than assets are 266. The average assets of the whole Lok Sabha was and Nakul Nath of Congress from Chhindwara constituency has the highest declared assets of nearly . Nath is followed by H. Vasanthakumar from Kanyakumari constituency, with and D. K. Suresh from Bangalore Rural constituency with ; both being of Congress party.


title: 17th Lok Sabha

text: Professionally, around 39% noted to be politicians or involved in social work. This is followed by 38% of members declaring as agriculturists and 23% as businessmen.


title: 17th Lok Sabha

text: As of November 2021, during the tenure of the 17th Lok Sabha, 12% of bills were referred to Parliamentary committees for examination.


title: Sleepwalking

text: Sleepwalking, also known as somnambulism or noctambulism, is a phenomenon of combined sleep and wakefulness. It is classified as a sleep disorder belonging to the parasomnia family. It occurs during slow wave stage of sleep, in a state of low consciousness, with performance of activities that are usually performed during a state of full consciousness. These activities can be as benign as talking, sitting up in bed, walking to a bathroom, consuming food, and cleaning, or as hazardous as cooking, driving a motor vehicle, violent gestures and grabbing at hallucinated objects.


title: Sleepwalking

text: Although sleepwalking cases generally consist of simple, repeated behaviors, there are occasionally reports of people performing complex behaviors while asleep, although their legitimacy is often disputed. Sleepwalkers often have little or no memory of the incident, as their consciousness has altered into a state in which memories are difficult to recall. Although their eyes are open, their expression is dim and glazed over. This may last from 30 seconds to 30 minutes.


title: Sleepwalking

text: Sleepwalking occurs during slow-wave sleep (N3) of non-rapid eye movement sleep (NREM sleep) cycles. It typically occurs within the first third of the night when slow-wave sleep is most prominent. Usually, it will occur once in a night, if at all.


title: Sleepwalking

text: Despite how it is portrayed in many cultures (eyes closed and walking with arms outstretched), the sleepwalker's eyes are open but may appear as a glassy-eyed stare or blank expression and pupils are dilated. They are often disoriented, consequent to awakening: the sleepwalker may be confused and perplexed, and might not know why or how they got out of bed; however, the disorientation will fade within minutes. They may talk while sleepwalking, but the talk typically does not make sense to the observer. There are varying degrees of amnesia associated with sleepwalking, ranging from no memory at all, vague memories or a narrative.


title: Sleepwalking

text: In the study "Sleepwalking and Sleep Terrors in Prepubertal Children" it was found that, if a child had another sleep disordersuch as restless leg syndrome (RLS) or sleep-disorder breathing (SDB)there was a greater chance of sleepwalking. The study found that children with chronic parasomnias may often also present SDB or, to a lesser extent, RLS. Furthermore, the disappearance of the parasomnias after the treatment of the SDB or RLS periodic limb movement syndrome suggests that the latter may trigger the former. The high frequency of SDB in family members of children with parasomnia provided additional evidence that SDB may manifest as parasomnias in children. Children with parasomnias are not systematically monitored during sleep, although past studies have suggested that patients with sleep terrors or sleepwalking have an elevated level of brief EEG arousals. When children receive polysomnographies, discrete patterns (e.g., nasal flow limitation, abnormal respiratory effort, bursts of high or slow EEG frequencies) should be sought; apneas are rarely found in children. Children's respiration during sleep should be monitored with nasal cannula or pressure transducer system or esophageal manometry, which are more sensitive than the thermistors or thermocouples currently used in many laboratories. The clear, prompt improvement of severe parasomnia in children who are treated for SDB, as defined here, provides important evidence that subtle SDB can have substantial health-related significance. Also noteworthy is the report of familial presence of parasomnia. Studies of twin cohorts and families with sleep terror and sleepwalking suggest genetic involvement of parasomnias. RLS and SDB have been shown to have familial recurrence. RLS has been shown to have genetic involvement.


title: Sleepwalking

text: Sleepwalking may also accompany the related phenomenon of night terrors, especially in children. In the midst of a night terror, the affected person may wander in a distressed state while still asleep, and examples of sufferers attempting to run or aggressively defend themselves during these incidents have been reported in medical literature.


title: Sleepwalking

text: In some cases, sleepwalking in adults may be a symptom of a psychological disorder. One study suggests higher levels of dissociation in adult sleepwalkers, since test subjects scored unusually high on the hysteria portion of the "Crown-Crisp Experiential Index". Another suggested that "A higher incidence [of sleepwalking events] has been reported in patients with schizophrenia, hysteria and anxiety neuroses". Also, patients with migraine headaches or Tourette syndrome are 4–6 times more likely to sleepwalk.


title: Sleepwalking

text: Most sleepwalkers get injuries at some point during sleepwalking, often minor injuries such as cuts or bruises. In rare occasions, however, sleepwalkers have fractured bones and died as the result of a fall. Sleepwalkers may also face embarrassment of being found naked in public.


title: Sleepwalking

text: The cause of sleepwalking is unknown. A number of, as yet unproven, hypotheses are suggested for why it might occur, including: delay in the maturity of the central nervous system, increased slow wave sleep, sleep deprivation, fever, and excessive tiredness. There may be a genetic component to sleepwalking. One study found that sleepwalking occurred in 45% of children who have one parent who sleepwalked, and in 60% of children if both parents sleepwalked. Thus, heritable factors may predispose an individual to sleepwalking, but expression of the behavior may also be influenced by environmental factors. Genetic studies using common fruit flies as experimental models reveal a link between night sleep and brain development mediated by evolutionary conserved transcription factors such as AP-2 Sleepwalking may be inherited as an autosomal dominant disorder with reduced penetrance. Genome-wide multipoint parametric linkage analysis for sleepwalking revealed a maximum logarithm of the odds score of 3.14 at chromosome 20q12-q13.12 between 55.6 and 61.4 cM.


title: Sleepwalking

text: Sleepwalking has been hypothesized to be linked to the neurotransmitter serotonin, which also appears to be metabolized differently in migraine patients and people with Tourette syndrome, both populations being four to nine times more likely to experience an episode of sleepwalking. Hormonal fluctuations have been found to contribute to sleepwalking episodes in women, with the likeliness to sleepwalk being higher before the onset of menstruation. It also appears that hormonal changes during pregnancy decrease the likelihood of engaging in sleepwalking


title: Sleepwalking

text: Medications, primarily in four classes—benzodiazepine receptor agonists and other GABA modulators, antidepressants and other serotonergic agents, antipsychotics, and β-blockers— have been associated with sleepwalking. The best evidence of medications causing sleepwalking is for Zolpidem and sodium oxybate; all other reports are based on associations noted in case reports.


title: Sleepwalking

text: A number of conditions, such as Parkinson's disease, are thought to trigger sleepwalking in people without a previous history of sleepwalking.


title: Sleepwalking

text: Polysomnography is the only accurate assessment of a sleepwalking episode. Because this is costly and sleepwalking episodes are usually infrequent, other measures commonly used include self-, parent-, or partner-report. Three common diagnostic systems that are generally used for sleepwalking disorders are International Classification of Diseases (ICD-10), the International Classification of Sleep Disorders (ICSD-3), and the Diagnostic and Statistical Manual.


title: Sleepwalking

text: The Diagnostic and Statistical Manual defines two subcategories of sleepwalking, although sleepwalking does not need to involve either behaviours:


title: Sleepwalking

text: Sleep eating involves consuming food while asleep. These sleep eating disorders are more often than not induced for stress related reasons. Another major cause of this sleep eating subtype of sleepwalking is sleep medication, such as Ambien for example (Mayo Clinic). There are a few others, but Ambien is a more widely used sleep aid. Because many sleep eaters prepare the food they consume, there are risks involving burns and such with ovens and other appliances. As expected, weight gain is also a common outcome of this disorder, because food that is frequently consumed contains high carbohydrates. As with sleepwalking, there are ways that sleep eating disorders can be maintained. There are some medications that calm the sleeper so they can get longer and better-quality rest, but activities such as yoga can also be introduced to reduce the stress and anxiety causing the action.


title: Sleepwalking

text: Sleepwalking should not be confused with alcohol- or drug-induced blackouts, which can result in amnesia for events similar to sleepwalking. During an alcohol-induced blackout (drug-related amnesia), a person is able to actively engage and respond to their environment (e.g. having conversations or driving a vehicle), however the brain does not create memories for the events. Alcohol-induced blackouts can occur with blood alcohol levels higher than 0.06g/dl. A systematic review of the literature found that approximately 50% of drinkers have experienced memory loss during a drinking episode and have had associated negative consequences similar to sleepwalkers, including injury and death.


title: Sleepwalking

text: Other differential diagnoses include Rapid eye movement sleep behavior disorder, confusional arousals, and night terrors.


title: Sleepwalking

text: An assessment of sleepwalking via polysomnography poses the problem that sleepwalking is less likely to occur in the sleep laboratory, and if an episode occurs, it is usually less complex than what the patient experiences at home. Therefore, the diagnosis can often be made by assessment of sleep history, time-course and content of the sleep related behaviors. Sometimes, home videos can provide additional information and should be considered in the diagnostic process.


title: Sleepwalking

text: There have been no clinical trials to show that any psychological or pharmacological intervention is effective in preventing sleepwalking episodes. Despite this, a wide range of treatments have been used with sleepwalkers. Psychological interventions have included psychoanalysis, hypnosis, scheduled or anticipatory waking, assertion training, relaxation training, managing aggressive feelings, sleep hygiene, classical conditioning (including electric shock), and play therapy. Pharmacological treatments have included tricyclic antidepressants (imipramine), an anticholinergic (biperiden), antiepileptics (carbamazepine, valproate), an antipsychotic (quetiapine), benzodiazepines (clonazepam, diazepam, flurazepam and triazolam), melatonin, a selective serotonin reuptake inhibitor (paroxetine), a barbiturate (sodium amytal) and herbs.


title: Sleepwalking

text: There is no evidence to show that waking sleepwalkers is harmful or not, though the sleepwalker is likely to be disoriented if awakened as sleepwalking occurs during the deepest stage of sleep.


title: Sleepwalking

text: Unlike other sleep disorders, sleepwalking is not associated with daytime behavioral or emotional problems. This may be because the sleepwalker's sleep is not disturbed—unless they are woken, they are still in a sleep state while sleepwalking.


title: Sleepwalking

text: Maintaining the safety of the sleepwalker and others and seeking treatment for other sleep problems is recommended. Reassurance is recommended if sleepwalking is not causing any problems. However, if it causes distress or there is risk of harm, hypnosis and scheduled waking are recommended as treatments.


title: Sleepwalking

text: For those whose sleepwalking episodes are hazardous, a door alarm may offer a measure of protection. There are various kinds of door alarms that can attach to a bedroom door and when the door is opened, the alarm sounds. The intention is that the sound will fully awaken the person and interrupt the sleepwalking episode, or if the sleepwalker lives with others, the sound will prompt them to check on the person.


title: Sleepwalking

text: Sleepwalkers should aim to have their bedrooms on the ground floor of a home, apartment, dorm, hotel, etc.


title: Sleepwalking

text: Sleepwalkers should not have easily accessible weapons (loaded guns, knives) in the bedroom or any room of the house for that matter. If there are weapons, they should be locked away with keys secluded from the sleepwalker.


title: Sleepwalking

text: For partners of sleepwalkers who are violent or disturb their sleep, sleeping in another room may lead to better sleep quality and quantity.


title: Sleepwalking

text: The lifetime prevalence of sleepwalking is estimated to be 4.6%–10.3%. A meta-analysis of 51 studies, that included more than 100,000 children and adults, found that sleepwalking is more common in children with an estimated 5%, compared with 1.5% of adults, sleepwalking at least once in the previous 12 months. The rate of sleepwalking has not been found to vary across ages during childhood.


title: Sleepwalking

text: Sleepwalking has attracted a sense of mystery, but was not seriously investigated and diagnosed until the 19th century. The German chemist and parapsychologist Baron Karl Ludwig von Reichenbach (1788–1869) made extensive studies of sleepwalkers and used his discoveries to formulate his theory of the Odic force.


title: Sleepwalking

text: Sleepwalking was initially thought to be a dreamer acting out a dream. For example, in one study published by the Society for Science & the Public in 1954, this was the conclusion: "Repression of hostile feelings against the father caused the patients to react by acting out in a dream world with sleepwalking, the distorted fantasies they had about all authoritarian figures, such as fathers, officers and stern superiors." This same group published an article twelve years later with a new conclusion: "Sleepwalking, contrary to most belief, apparently has little to do with dreaming. In fact, it occurs when the sleeper is enjoying his most oblivious, deepest sleep—a stage in which dreams are not usually reported." More recent research has discovered that sleepwalking is actually a disorder of NREM (non-rapid eye movement) arousal. Acting out a dream is the basis for a REM (rapid eye movement) sleep disorder called REM Behavior Disorder (or REM Sleep Behavior Disorder). More accurate data about sleep is due to the invention of technologies, such as the electroencephalogram (EEG) by Hans Berger in 1924 and BEAM by Frank Duffy in the early 1980s.


title: Sleepwalking

text: In 1907, Sigmund Freud spoke about sleepwalking to the Vienna Psychoanalytic Society (Nunberg and Federn). He believed that sleepwalking was connected to fulfilling sexual wishes and was surprised that a person could move without interrupting their dream. At that time, Freud suggested that the essence of this phenomenon was the desire to go to sleep in the same area as the individual had slept in childhood. Ten years later, he speculated about somnambulism in the article "A Metapsychological Supplement to the Theory of Dreams" (1916–17 [1915]). In this essay, he clarified and expanded his hypothetical ideas on dreams. He described the dream as a fragile equilibrium that is destabilized by the repressed unconscious impulses of the unconscious system, which does not obey the wishes of the ego. Certain preconscious daytime thoughts can be resistant and these can retain a part of their cathexis as well. Unconscious impulses and day residues can come together and result in a conflict. Freud then wondered about the outcome of this wishful impulse: an unconscious instinctual demand that becomes a dream wish in the preconscious. Freud stated that this unconscious impulse could be expressed as mobility during sleep. This would be what is observed in somnambulism, though what actually makes it possible remains unknown.


title: Sleepwalking

text: It is unclear whether it simply hasn't been observed yet, or whether sleepwalking is a uniquely human phenomenon.


title: Sleepwalking

text: Vincenzo Bellini's 1831 Italian opera semiseria, La sonnambula, the plot of which is centered on the question of the innocence of the betrothed and soon-to-be married Amina, who, upon having been discovered in the bedchamber of a stranger, and despite the assurances of that stranger that Amina was entirely innocent, has been rejected by her enraged fiancé, Elvino — who, then, decides to marry another. In fact, when stressed, Amina was susceptible to somnambulism; and had come to be in the stranger's bedchamber by sleep-walking along a high parapet (in full view of the opera's audience). Elvino, who later observes the (exhausted by all the fuss) Amina, sleep-walking across a very high, very unstable, and very rickety bridge at the local mill, realizes his mistake, abandons his plans of marriage to the other woman, and re-unites with Amina.


title: Sleepwalking

text: In August 1847, the famous soprano Jenny Lind visited Manchester, and gave two performances as Amina. The outstanding difference between Lind and her contemporaries was that, "whilst the beauty of her voice was far greater than any other in living memory (thus, the "Swedish Nightingale"), what really set her apart was her outstanding ability to act"; and, moreover, in performing as Amina, rather than walking along a wide and well-protected walkway (as the others did), she routinely acrobatically balanced her way along narrow planks.


title: Sleepwalking

text: While she was in Manchester—on the basis that, at the time, many characterized ""hypnotism"" as ""artificial somnambulism"", and that, from a rather different perspective, her stage performance could also be described as one of "artificial" (rather than spontaneous) somnambulism—her friends arranged for her to visit the local surgeon James Braid, who had discovered hypnotism in 1841:


title: Sleepwalking

text: As sleepwalking behaviours occur without volition, sleepwalking can be used as a legal defense, as a form of legal automatism. An individual can be accused of non-insane or insane automatism. The first is used as a defense for temporary insanity or involuntary conduct, resulting in acquittal. The latter results in a "special verdict of not guilty by reason of insanity." This verdict of insanity can result in a court order to attend a mental institution.


title: Sleepwalking

text: In the 1963 case "Bratty v A-G for Northern Ireland", Lord Morris stated, "Each set of facts must require a careful examination of its own circumstances, but if by way of taking an illustration it were considered possible for a person to walk in his sleep and to commit a violent crime while genuinely unconscious, then such a person would not be criminally liable for that act." While the veracity of the cases are disputed, there have been acts of homicide where the prime suspect may have committed the act while sleepwalking.


title: Sleepwalking

text: Alternative explanations to homicidal or violent sleepwalking include malingering, drug-induced amnesia, and other disorders in which sleep-related violence may occur, such as REM Sleep Behavior Disorder, fugue states, and episodic wandering.


title: Phase transition

text: In chemistry, thermodynamics, and other related fields, a phase transition (or phase change) is the physical process of transition between one state of a medium and another. Commonly the term is used to refer to changes among the basic states of matter: solid, liquid, and gas, and in rare cases, plasma. A phase of a thermodynamic system and the states of matter have uniform physical properties. During a phase transition of a given medium, certain properties of the medium change as a result of the change of external conditions, such as temperature or pressure. This can be a discontinuous change; for example, a liquid may become gas upon heating to its boiling point, resulting in an abrupt change in volume. The identification of the external conditions at which a transformation occurs defines the phase transition point.


title: Phase transition

text: At the phase transition point for a substance, for instance the boiling point, the two phases involved - liquid and vapor, have identical free energies and therefore are equally likely to exist. Below the boiling point, the liquid is the more stable state of the two, whereas above the boiling point the gaseous form is the more stable.


title: Phase transition

text: It is sometimes possible to change the state of a system diabatically (as opposed to adiabatically) in such a way that it can be brought past a phase transition point without undergoing a phase transition. The resulting state is metastable, i.e., less stable than the phase to which the transition would have occurred, but not unstable either. This occurs in superheating, supercooling, and supersaturation, for example.


title: Phase transition

text: Common transitions between the solid, liquid, and gaseous phases of a single component, due to the effects of temperature and/or pressure are identified in the following table:


title: Phase transition

text: Phase transitions occur when the thermodynamic free energy of a system is non-analytic for some choice of thermodynamic variables (cf. phases). This condition generally stems from the interactions of a large number of particles in a system, and does not appear in systems that are small. Phase transitions can occur for non-thermodynamic systems, where temperature is not a parameter. Examples include: quantum phase transitions, dynamic phase transitions, and topological (structural) phase transitions. In these types of systems other parameters take the place of temperature. For instance, connection probability replaces temperature for percolating networks.


title: Phase transition

text: Paul Ehrenfest classified phase transitions based on the behavior of the thermodynamic free energy as a function of other thermodynamic variables. Under this scheme, phase transitions were labeled by the lowest derivative of the free energy that is discontinuous at the transition. "First-order phase transitions" exhibit a discontinuity in the first derivative of the free energy with respect to some thermodynamic variable. The various solid/liquid/gas transitions are classified as first-order transitions because they involve a discontinuous change in density, which is the (inverse of the) first derivative of the free energy with respect to pressure. "Second-order phase transitions" are continuous in the first derivative (the order parameter, which is the first derivative of the free energy with respect to the external field, is continuous across the transition) but exhibit discontinuity in a second derivative of the free energy. These include the ferromagnetic phase transition in materials such as iron, where the magnetization, which is the first derivative of the free energy with respect to the applied magnetic field strength, increases continuously from zero as the temperature is lowered below the Curie temperature. The magnetic susceptibility, the second derivative of the free energy with the field, changes discontinuously. Under the Ehrenfest classification scheme, there could in principle be third, fourth, and higher-order phase transitions.


title: Phase transition

text: The Ehrenfest classification implicitly allows for continuous phase transformations, where the bonding character of a material changes, but there is no discontinuity in any free energy derivative. An example of this occurs at the supercritical liquid–gas boundaries.


title: Phase transition

text: The first example of a phase transition which did not fit into the Ehrenfest classification was the exact solution of the Ising model, discovered in 1944 by Lars Onsager. The exact specific heat differed from the earlier mean-field approximations, which had predicted that it has a simple discontinuity at critical temperature. Instead, the exact specific heat had a logarithmic divergence at the critical temperature. In the following decades, the Ehrenfest classification was replaced by a simplified classification scheme that is able to incorporate such transitions.


title: Phase transition

text: In the modern classification scheme, phase transitions are divided into two broad categories, named similarly to the Ehrenfest classes:


title: Phase transition

text: First-order phase transitions are those that involve a latent heat. During such a transition, a system either absorbs or releases a fixed (and typically large) amount of energy per volume. During this process, the temperature of the system will stay constant as heat is added: the system is in a "mixed-phase regime" in which some parts of the system have completed the transition and others have not.


title: Phase transition

text: Familiar examples are the melting of ice or the boiling of water (the water does not instantly turn into vapor, but forms a turbulent mixture of liquid water and vapor bubbles). Yoseph Imry and Michael Wortis showed that quenched disorder can broaden a first-order transition. That is, the transformation is completed over a finite range of temperatures, but phenomena like supercooling and superheating survive and hysteresis is observed on thermal cycling.


title: Phase transition

text: Second-order phase transitions are also called ""continuous phase transitions"". They are characterized by a divergent susceptibility, an infinite correlation length, and a power law decay of correlations near criticality. Examples of second-order phase transitions are the ferromagnetic transition, superconducting transition (for a Type-I superconductor the phase transition is second-order at zero external field and for a Type-II superconductor the phase transition is second-order for both normal-state–mixed-state and mixed-state–superconducting-state transitions) and the superfluid transition. In contrast to viscosity, thermal expansion and heat capacity of amorphous materials show a relatively sudden change at the glass transition temperature which enables accurate detection using differential scanning calorimetry measurements. Lev Landau gave a phenomenological theory of second-order phase transitions.


title: Phase transition

text: Apart from isolated, simple phase transitions, there exist transition lines as well as multicritical points, when varying external parameters like the magnetic field or composition.


title: Phase transition

text: They are continuous but break no symmetries. The most famous example is the Kosterlitz–Thouless transition in the two-dimensional XY model. Many quantum phase transitions, e.g., in two-dimensional electron gases, belong to this class.


title: Phase transition

text: The liquid–glass transition is observed in many polymers and other liquids that can be supercooled far below the melting point of the crystalline phase. This is atypical in several respects. It is not a transition between thermodynamic ground states: it is widely believed that the true ground state is always crystalline. Glass is a "quenched disorder" state, and its entropy, density, and so on, depend on the thermal history. Therefore, the glass transition is primarily a dynamic phenomenon: on cooling a liquid, internal degrees of freedom successively fall out of equilibrium. Some theoretical methods predict an underlying phase transition in the hypothetical limit of infinitely long relaxation times. No direct experimental evidence supports the existence of these transitions.


title: Phase transition

text: The gelation transition of colloidal particles has been shown to be a second-order phase transition under nonequilibrium conditions.


title: Phase transition

text: A disorder-broadened first-order transition occurs over a finite range of temperatures where the fraction of the low-temperature equilibrium phase grows from zero to one (100%) as the temperature is lowered. This continuous variation of the coexisting fractions with temperature raised interesting possibilities. On cooling, some liquids vitrify into a glass rather than transform to the equilibrium crystal phase. This happens if the cooling rate is faster than a critical cooling rate, and is attributed to the molecular motions becoming so slow that the molecules cannot rearrange into the crystal positions. This slowing down happens below a glass-formation temperature "T", which may depend on the applied pressure. If the first-order freezing transition occurs over a range of temperatures, and "T" falls within this range, then there is an interesting possibility that the transition is arrested when it is partial and incomplete. Extending these ideas to first-order magnetic transitions being arrested at low temperatures, resulted in the observation of incomplete magnetic transitions, with two magnetic phases coexisting, down to the lowest temperature. First reported in the case of a ferromagnetic to anti-ferromagnetic transition, such persistent phase coexistence has now been reported across a variety of first-order magnetic transitions. These include colossal-magnetoresistance manganite materials, magnetocaloric materials, magnetic shape memory materials, and other materials.


title: Phase transition

text: The interesting feature of these observations of "T" falling within the temperature range over which the transition occurs is that the first-order magnetic transition is influenced by magnetic field, just like the structural transition is influenced by pressure. The relative ease with which magnetic fields can be controlled, in contrast to pressure, raises the possibility that one can study the interplay between "T" and "T" in an exhaustive way. Phase coexistence across first-order magnetic transitions will then enable the resolution of outstanding issues in understanding glasses.


title: Phase transition

text: In any system containing liquid and gaseous phases, there exists a special combination of pressure and temperature, known as the critical point, at which the transition between liquid and gas becomes a second-order transition. Near the critical point, the fluid is sufficiently hot and compressed that the distinction between the liquid and gaseous phases is almost non-existent. This is associated with the phenomenon of critical opalescence, a milky appearance of the liquid due to density fluctuations at all possible wavelengths (including those of visible light).


title: Phase transition

text: Phase transitions often involve a symmetry breaking process. For instance, the cooling of a fluid into a crystalline solid breaks continuous translation symmetry: each point in the fluid has the same properties, but each point in a crystal does not have the same properties (unless the points are chosen from the lattice points of the crystal lattice). Typically, the high-temperature phase contains more symmetries than the low-temperature phase due to spontaneous symmetry breaking, with the exception of certain accidental symmetries (e.g. the formation of heavy virtual particles, which only occurs at low temperatures).


title: Phase transition

text: An order parameter is a measure of the degree of order across the boundaries in a phase transition system; it normally ranges between zero in one phase (usually above the critical point) and nonzero in the other. At the critical point, the order parameter susceptibility will usually diverge.


title: Phase transition

text: An example of an order parameter is the net magnetization in a ferromagnetic system undergoing a phase transition. For liquid/gas transitions, the order parameter is the difference of the densities.


title: Phase transition

text: From a theoretical perspective, order parameters arise from symmetry breaking. When this happens, one needs to introduce one or more extra variables to describe the state of the system. For example, in the ferromagnetic phase, one must provide the net magnetization, whose direction was spontaneously chosen when the system cooled below the Curie point. However, note that order parameters can also be defined for non-symmetry-breaking transitions.


title: Phase transition

text: Some phase transitions, such as superconducting and ferromagnetic, can have order parameters for more than one degree of freedom. In such phases, the order parameter may take the form of a complex number, a vector, or even a tensor, the magnitude of which goes to zero at the phase transition.


title: Phase transition

text: There also exist dual descriptions of phase transitions in terms of disorder parameters. These indicate the presence of line-like excitations such as vortex- or defect lines.


title: Phase transition

text: Symmetry-breaking phase transitions play an important role in cosmology. As the universe expanded and cooled, the vacuum underwent a series of symmetry-breaking phase transitions. For example, the electroweak transition broke the SU(2)×U(1) symmetry of the electroweak field into the U(1) symmetry of the present-day electromagnetic field. This transition is important to explain the asymmetry between the amount of matter and antimatter in the present-day universe, according to electroweak baryogenesis theory.


title: Phase transition

text: Progressive phase transitions in an expanding universe are implicated in the development of order in the universe, as is illustrated by the work of Eric Chaisson and David Layzer.


title: Phase transition

text: Continuous phase transitions are easier to study than first-order transitions due to the absence of latent heat, and they have been discovered to have many interesting properties. The phenomena associated with continuous phase transitions are called critical phenomena, due to their association with critical points.


title: Phase transition

text: It turns out that continuous phase transitions can be characterized by parameters known as critical exponents. The most important one is perhaps the exponent describing the divergence of the thermal correlation length by approaching the transition. For instance, let us examine the behavior of the heat capacity near such a transition. We vary the temperature "T" of the system while keeping all the other thermodynamic variables fixed and find that the transition occurs at some critical temperature "T". When "T" is near "T", the heat capacity "C" typically has a power law behavior:


title: Phase transition

text: The heat capacity of amorphous materials has such a behaviour near the glass transition temperature where the universal critical exponent "α" = 0.59 A similar behavior, but with the exponent "ν" instead of "α", applies for the correlation length.


title: Phase transition

text: The exponent "ν" is positive. This is different with "α". Its actual value depends on the type of phase transition we are considering.


title: Phase transition

text: It is widely believed that the critical exponents are the same above and below the critical temperature. It has now been shown that this is not necessarily true: When a continuous symmetry is explicitly broken down to a discrete symmetry by irrelevant (in the renormalization group sense) anisotropies, then some exponents (such as formula_2, the exponent of the susceptibility) are not identical.


title: Phase transition

text: For −1 < "α" < 0, the heat capacity has a "kink" at the transition temperature. This is the behavior of liquid helium at the lambda transition from a normal state to the superfluid state, for which experiments have found "α" = −0.013 ± 0.003.


title: Phase transition

text: At least one experiment was performed in the zero-gravity conditions of an orbiting satellite to minimize pressure differences in the sample. This experimental value of α agrees with theoretical predictions based on variational perturbation theory.


title: Phase transition

text: For 0 < "α" < 1, the heat capacity diverges at the transition temperature (though, since "α" < 1, the enthalpy stays finite). An example of such behavior is the 3D ferromagnetic phase transition. In the three-dimensional Ising model for uniaxial magnets, detailed theoretical studies have yielded the exponent "α" ≈ +0.110.


title: Phase transition

text: Some model systems do not obey a power-law behavior. For example, mean field theory predicts a finite discontinuity of the heat capacity at the transition temperature, and the two-dimensional Ising model has a logarithmic divergence. However, these systems are limiting cases and an exception to the rule. Real phase transitions exhibit power-law behavior.


title: Phase transition

text: Several other critical exponents, "β", "γ", "δ", "ν", and "η", are defined, examining the power law behavior of a measurable physical quantity near the phase transition. Exponents are related by scaling relations, such as


title: Phase transition

text: It is a remarkable fact that phase transitions arising in different systems often possess the same set of critical exponents. This phenomenon is known as "universality". For example, the critical exponents at the liquid–gas critical point have been found to be independent of the chemical composition of the fluid.


title: Phase transition

text: More impressively, but understandably from above, they are an exact match for the critical exponents of the ferromagnetic phase transition in uniaxial magnets. Such systems are said to be in the same universality class. Universality is a prediction of the renormalization group theory of phase transitions, which states that the thermodynamic properties of a system near a phase transition depend only on a small number of features, such as dimensionality and symmetry, and are insensitive to the underlying microscopic properties of the system. Again, the divergence of the correlation length is the essential point.


title: Phase transition

text: There are also other critical phenomena; e.g., besides "static functions" there is also "critical dynamics". As a consequence, at a phase transition one may observe "critical slowing down" or "speeding up". Connected to the previous phenomenon is also the phenomenon of "enhanced fluctuations" before the phase transition, as a consequence of lower degree of stability of the initial phase of the system. The large "static universality classes" of a continuous phase transition split into smaller "dynamic universality" classes. In addition to the critical exponents, there are also universal relations for certain static or dynamic functions of the magnetic fields and temperature differences from the critical value.


title: Phase transition

text: Phase transitions play many important roles in biological systems. Examples include the lipid bilayer formation, the coil-globule transition in the process of protein folding and DNA melting, liquid crystal-like transitions in the process of DNA condensation, and cooperative ligand binding to DNA and proteins with the character of phase transition.


title: Phase transition

text: In "biological membranes", gel to liquid crystalline phase transitions play a critical role in physiological functioning of biomembranes. In gel phase, due to low fluidity of membrane lipid fatty-acyl chains, membrane proteins have restricted movement and thus are restrained in exercise of their physiological role. Plants depend critically on photosynthesis by chloroplast thylakoid membranes which are exposed cold environmental temperatures. Thylakoid membranes retain innate fluidity even at relatively low temperatures because of high degree of fatty-acyl disorder allowed by their high content of linolenic acid, 18-carbon chain with 3-double bonds. Gel-to-liquid crystalline phase transition temperature of biological membranes can be determined by many techniques including calorimetry, fluorescence, spin label electron paramagnetic resonance and NMR by recording measurements of the concerned parameter by at series of sample temperatures. A simple method for its determination from 13-C NMR line intensities has also been proposed.


title: Phase transition

text: It has been proposed that some biological systems might lie near critical points. Examples include neural networks in the salamander retina, bird flocks


title: Phase transition

text: gene expression networks in Drosophila, and protein folding. However, it is not clear whether or not alternative reasons could explain some of the phenomena supporting arguments for criticality. It has also been suggested that biological organisms share two key properties of phase transitions: the change of macroscopic behavior and the coherence of a system at a critical point. Phase transitions are prominent feature of motor behavior in biological systems. Spontaneous gait transitions, as well as fatigue-induced motor task disengagements, show typical critical behavior as an intimation of the sudden qualitative change of the previously stable motor behavioral pattern.


title: Phase transition

text: The characteristic feature of second order phase transitions is the appearance of fractals in some scale-free properties. It has long been known that protein globules are shaped by interactions with water. There are 20 amino acids that form side groups on protein peptide chains range from hydrophilic to hydrophobic, causing the former to lie near the globular surface, while the latter lie closer to the globular center. Twenty fractals were discovered in solvent associated surface areas of > 5000 protein segments. The existence of these fractals proves that proteins function near critical points of second-order phase transitions.


title: Phase transition

text: In groups of organisms in stress (when approaching critical transitions), correlations tend to increase, while at the same time, fluctuations also increase. This effect is supported by many experiments and observations of groups of people, mice, trees, and grassy plants.


title: Palpitations

text: Palpitations are perceived abnormalities of the heartbeat characterized by awareness of cardiac muscle contractions in the chest, which is further characterized by the hard, fast and/or irregular beatings of the heart.


title: Palpitations

text: Symptoms include a rapid pulsation, an abnormally rapid or irregular beating of the heart. Palpitations are a sensory symptom and are often described as a skipped beat, rapid fluttering in the chest, pounding sensation in the chest or neck, or a flip-flopping in the chest.


title: Palpitations

text: Palpitation can be associated with anxiety and does not necessarily indicate a structural or functional abnormality of the heart, but it can be a symptom arising from an objectively rapid or irregular heartbeat. Palpitation can be intermittent and of variable frequency and duration, or continuous. Associated symptoms include dizziness, shortness of breath, sweating, headaches and chest pain.


title: Palpitations

text: Palpitation may be associated with coronary heart disease, hyperthyroidism, diseases affecting cardiac muscle such as hypertrophic cardiomyopathy, diseases causing low blood oxygen such as asthma and emphysema; previous chest surgery; kidney disease; blood loss and pain; anemia; drugs such as antidepressants, statins, alcohol, nicotine, caffeine, cocaine and amphetamines; electrolyte imbalances of magnesium, potassium and calcium; and deficiencies of nutrients such as taurine, arginine, iron, vitamin B.


title: Palpitations

text: Three common descriptions of "palpitation" are "flip-flopping" (or "stop and start"), often caused by premature contraction of the atrium or ventricle, with the perceived "stop" from the pause following the contraction, and the "start" from the subsequent forceful contraction; rapid "fluttering in the chest", with regular "fluttering" suggesting supraventricular or ventricular arrhythmias (including sinus tachycardia) and irregular "fluttering" suggesting atrial fibrillation, atrial flutter, or tachycardia with variable block; and "pounding in the neck" or neck pulsations, often due to cannon A waves in the jugular venous, pulsations that occur when the right atrium contracts against a closed tricuspid valve.


title: Palpitations

text: Palpitation associated with chest pain suggests coronary artery disease, or if the chest pain is relieved by leaning forward, pericardial disease is suspected. Palpitation associated with light-headedness, fainting or near fainting suggest low blood pressure and may signify a life-threatening abnormal heart rhythm. Palpitation that occurs regularly with exertion suggests a rate-dependent bypass tract or hypertrophic cardiomyopathy. If a benign cause for these concerning symptoms cannot be found at the initial visit, then ambulatory monitoring or prolonged heart monitoring in the hospital might be warranted. Noncardiac symptoms should also be elicited since the palpitations may be caused by a normal heart responding to a metabolic or inflammatory condition. Weight loss suggests hyperthyroidism. Palpitation can be precipitated by vomiting or diarrhea that leads to electrolyte disorders and hypovolemia. Hyperventilation, hand tingling, and nervousness are common when anxiety or panic disorder is the cause of the palpitations.


title: Palpitations

text: The current knowledge of the neural pathways responsible for the perception of the heartbeat is not clearly elucidated. It has been hypothesized that these pathways include different structures located both at the intra-cardiac and extra-cardiac level. Palpitations are a widely diffused complaint and particularly in subjects affected by structural heart disease. The list of etiologies of palpitations is long, and in some cases, the etiology is unable to be determined. In one study reporting the etiology of palpitations, 43% were found to be of cardiac etiology, 31% of psychiatric etiology and approximately 10% were classified as miscellaneous (medication induced, thyrotoxicosis, caffeine, cocaine, anemia, amphetamine, mastocytosis).


title: Palpitations

text: The cardiac etiologies of palpitations are the most life-threatening and include ventricular sources (premature ventricular contractions (PVC), ventricular tachycardia and ventricular fibrillation), atrial sources (atrial fibrillation, atrial flutter) high output states (anemia, AV fistula, Paget's disease of bone or pregnancy), structural abnormalities (congenital heart disease, cardiomegaly, aortic aneurysm, or acute left ventricular failure), and miscellaneous sources (postural orthostatic tachycardia syndrome abbreviated as POTS, Brugada syndrome, and sinus tachycardia).


title: Palpitations

text: Palpitations can occur during times of catecholamine excess, such as during exercise or at times of stress. The cause of the palpitations during these conditions is often a sustained supraventricular tachycardia or ventricular tachyarrhythmia. Supraventricular tachycardias can also be induced at the termination of exercise when the withdrawal of catecholamines is coupled with a surge in the vagal tone. Palpitations secondary to catecholamine excess may also occur during emotionally startling experiences, especially in patients with a long QT syndrome.


title: Palpitations

text: Anxiety and stress elevate the body's level of cortisol and adrenaline, which in turn can interfere with the normal functioning of the parasympathetic nervous system resulting in overstimulation of the vagus nerve. Vagus nerve induced palpitation is felt as a thud, a hollow fluttery sensation, or a skipped beat, depending on at what point during the heart's normal rhythm the vagus nerve fires. In many cases, the anxiety and panic of experiencing palpitations cause a patient to experience further anxiety and increased vagus nerve stimulation. The link between anxiety and palpitation may also explain why many panic attacks involve an impending sense of cardiac arrest. Similarly, physical and mental stress may contribute to the occurrence of palpitation, possibly due to the depletion of certain micronutrients involved in maintaining healthy psychological and physiological function. Gastrointestinal bloating, indigestion and hiccups have also been associated with overstimulation of the vagus nerve causing palpitations, due to branches of the vagus nerve innervating the GI tract, diaphragm, and lungs.


title: Palpitations

text: Many psychiatric conditions can result in palpitations including depression, generalized anxiety disorder, panic attacks, and somatization. However one study noted that up to 67% of patients diagnosed with a mental health condition had an underlying arrhythmia. There are many metabolic conditions that can result in palpitations including, hyperthyroidism, hypoglycemia, hypocalcemia, hyperkalemia, hypokalemia, hypermagnesemia, hypomagnesemia, and pheochromocytoma.


title: Palpitations

text: The medications most likely to result in palpitations include sympathomimetic agents, anticholinergic drugs, vasodilators and withdrawal from beta blockers.


title: Palpitations

text: Common etiologies also include excess caffeine, or marijuana. Cocaine, amphetamines, 3-4 methylenedioxymethamphetamine (Ecstasy or MDMA) can also cause palpitations.


title: Palpitations

text: The sensation of palpitations can arise from extra-systoles or tachyarrhythmia. It is very rarely noted due to bradycardia. Palpitations can be described in many ways. The most common descriptions include a flip-flopping in the chest, a rapid fluttering in the chest, or pounding in the neck. The description of the symptoms may provide a clue regarding the etiology of the palpitations, and the pathophysiology of each of these descriptions is thought to be different. In patients who describe the palpitations as a brief flip-flopping in the chest, the palpitations are thought to be caused by extra- systoles such as supraventricular or ventricular premature contractions. The flip-flop sensation is thought to result from the "forceful" contraction following the pause, and the sensation that the heart is stopped results from the pause. The sensation of rapid fluttering in the chest is thought to result from a sustained ventricular or supraventricular arrhythmia. Furthermore, the sudden cessation of this arrythmia can suggest paroxysmal supraventricular tachycardia. This is further supported if the patient can stop the palpitations by using Valsalva maneuvers. The rhythm of the palpitations may indicate the etiology of the palpitations (irregular palpitations indicate atrial fibrillation as a source of the palpitations). An irregular pounding sensation in the neck can be caused by the dissociation of mitral valve and tricuspid valve, and the subsequent atria are contracting against a closed tricuspid and mitral valves, thereby producing cannon A waves. Palpitations induced by exercise could be suggestive of cardiomyopathy, ischemia or channelopathies.


title: Palpitations

text: The most important initial clue to the diagnosis is one's description of palpitation. The approximate age of the person when first noticed and the circumstances under which they occur are important, as is information about caffeine intake (tea or coffee drinking), and whether continual palpitations can be stopped by deep breathing or changing body positions. It is also very helpful to know how they start and stop (abruptly or not), whether or not they are regular, and approximately how fast the pulse rate is during an attack. If the person has discovered a way of stopping the palpitations, that is also helpful information.


title: Palpitations

text: A complete and detailed history and physical examination are two essential elements of the evaluation of a patient with palpitations. The key components of a detailed history include age of onset, description of the symptoms including rhythm, situations that commonly result in the symptoms, mode of onset (rapid or gradual), duration of symptoms, factors that relieve symptoms (rest, Valsalva), positions and other associated symptoms such as chest pain, lightheadedness or syncope. A patient can tap out the rhythm to help demonstrate if they are not currently experiencing the symptoms. The patient should be questioned regarding all medications, including over-the-counter medications. Social history, including exercise habits, caffeine consumption, alcohol and illicit drug use, should also be determined. Also, past medical history and family history may provide indications to the etiology of the palpitations.


title: Palpitations

text: Palpitations that have been a condition since childhood are most likely caused by a supraventricular tachycardia, whereas palpitations that first occur later in life are more likely to be secondary to structural heart disease. A rapid regular rhythm is more likely to be secondary to paroxysmal supraventricular tachycardia or ventricular tachycardia, and a rapid and irregular rhythm is more likely to be an indication of atrial fibrillation, atrial flutter, or tachycardia with variable block. Supraventricular and ventricular tachycardia is thought to result in palpitations with abrupt onset and abrupt termination. In patients who can terminate their palpitations with a Valsalva maneuver, this is thought to indicate possibly a supraventricular tachycardia. Palpitations associated with chest pain may suggest myocardial ischemia. Lastly, when lightheadedness or syncope accompanies the palpitations, ventricular tachycardia, supraventricular tachycardia, or other arrhythmias should be considered.


title: Palpitations

text: The diagnosis is usually not made by a routine medical examination and scheduled electrical tracing of the heart's activity (ECG) because most people cannot arrange to have their symptoms be present while visiting the hospital. Nevertheless, findings such as a heart murmur or an abnormality of the ECG might be indicative of probable diagnosis. In particular, ECG changes that are associated with specific disturbances of the heart rhythm may be noticed; thus physical examination and ECG remain important in the assessment of palpitation. Moreover, a complete physical exam should be performed including vital signs (with orthostatic vital signs), cardiac auscultation, lung auscultation, and examination of extremities. A patient can tap out the rhythm to help demonstrate what they felt previously, if they are not currently experiencing the symptoms.


title: Palpitations

text: Positive orthostatic vital signs may indicate dehydration or an electrolyte abnormality. A mid-systolic click and heart murmur may indicate mitral valve prolapse. A harsh holo-systolic murmur best heard at the left sternal border which increases with Valsalva may indicate hypertrophic obstructive cardiomyopathy. An irregular rhythm indicates atrial fibrillation or atrial flutter. Evidence of cardiomegaly and peripheral edema may indicate heart failure and ischemia or a valvular abnormality.


title: Palpitations

text: Blood tests, particularly tests of thyroid gland function, are also important baseline investigations (an overactive thyroid gland is a potential cause for palpitations; the treatment, in that case, is to treat the thyroid gland over-activity).


title: Palpitations

text: The next level of diagnostic testing is usually 24-hour (or longer) ECG monitoring, using a recorder called a Holter monitor, which can record the ECG continuously during a 24-hour or 48-hour period. If symptoms occur during monitoring it is a simple matter to examine the ECG recording and see what the cardiac rhythm was at the time. For this type of monitoring to be helpful, the symptoms must be occurring at least once a day. If they are less frequent, the chances of detecting anything with continuous 24- or even 48-hour monitoring are substantially lowered. More recent technology such as the Zio Patch allows continuous recording for up to 14 days; the patient indicates when symptoms occur by pushing a button on the device and keeps a log of the events.


title: Palpitations

text: Other forms of monitoring are available, and these can be useful when symptoms are infrequent. A continuous-loop event recorder monitors the ECG continuously, but only saves the data when the wearer activates it. Once activated, it will save the ECG data for a period of time before the activation and for a period of time afterwards – the cardiologist who is investigating the palpitations can program the length of these periods. An implantable loop recorder may be helpful in people with very infrequent but disabling symptoms. This recorder is implanted under the skin on the front of the chest, like a pacemaker. It can be programmed and the data examined using an external device that communicates with it by means of a radio signal.


title: Palpitations

text: Investigation of heart structure can also be important. The heart in most people with palpitation is completely normal in its physical structure, but occasionally abnormalities such as valve problems may be present. Usually, but not always, the cardiologist will be able to detect a murmur in such cases, and an ultrasound scan of the heart (echocardiogram) will often be performed to document the heart's structure. This is a painless test performed using sound waves and is virtually identical to the scanning done in pregnancy to look at the fetus.


title: Palpitations

text: A 12-lead electrocardiogram must be performed on every patient complaining of palpitations. The presence of a short PR interval and a delta wave (Wolff-Parkinson-White syndrome) is an indication of the existence of ventricular pre-excitation. Significant left ventricular hypertrophy with deep septal Q waves in I, L, and V4 through V6 may indicate hypertrophic obstructive cardiomyopathy. The presence of Q waves may indicate a prior myocardial infarction as the etiology of the palpitations, and a prolonged QT interval may indicate the presence of the long QT syndrome.


title: Palpitations

text: Laboratory studies should be limited initially. Complete blood count can assess for anemia and infection. Serum urea, creatinine and electrolytes to assess for electrolyte imbalances and renal dysfunction. Thyroid function tests may demonstrate a hyperthyroid state.


title: Palpitations

text: Most patients have benign conditions as the etiology for their palpitations. The goal of further evaluation is to identify those patients who are at high risk for an arrhythmia. Recommended laboratory studies include an investigation for anemia, hyperthyroidism and electrolyte abnormalities. Echocardiograms are indicated for patients in whom structural heart disease is a concern.


title: Palpitations

text: Further diagnostic testing is recommended for those in whom the initial diagnostic evaluation (history, physical examination, and EKG) suggest an arrhythmia, those who are at high risk for an arrhythmia, and those who remain anxious to have a specific explanation of their symptoms. People considered to be at high risk for an arrhythmia include those with organic heart disease or any myocardial abnormality that may lead to serious arrhythmias. These conditions include a scar from myocardial infarction, idiopathic dilated cardiomyopathy, clinically significant valvular regurgitant, or stenotic lesions and hypertrophic cardiomyopathies.


title: Palpitations

text: An aggressive diagnostic approach is recommended for those at high risk and can include ambulatory monitoring or electrophysiologic studies. There are three types of ambulatory EKG monitoring devices: Holter monitor, continuous-loop event recorder, and an implantable loop recorder.


title: Palpitations

text: People who are going to have these devices checked should be made aware of the properties of the devices and the accompanying course of the examination for each device. The Holter monitor is a 24-hour monitoring system that is worn by exam takers themselves and records and continuously saves data. Holter monitors are typically worn for a few days. The continuous-loop event recorders are also worn by the exam taker and continuously record data, but the data is saved only when someone manually activates the monitor. The continuous-loop recorders can be long worn for longer periods of time than the Holter monitors and therefore have been proven to be more cost-effective and efficacious than Holter monitors. Also, because the person triggers the device when he/she feel the symptoms, they are more likely to record data during palpitations. An implantable loop recorder is a device that is placed subcutaneously and continuously monitors for cardiac arrhythmias. These are most often used in those with unexplained syncope and can be used for longer periods of time than the continuous loop event recorders. An implantable loop recorder is a device that is placed subcutaneously and continuously monitors for the detection of cardiac arrhythmias. These are most often used in those with unexplained syncope and are a used for longer periods of time than the continuous loop event recorders. Electrophysiology testing enables a detailed analysis of the underlying mechanism of the cardiac arrhythmia as well as the site of origin. EPS studies are usually indicated in those with a high pretest likelihood of a serious arrhythmia. The level of evidence for evaluation techniques is based upon consensus expert opinion.


title: Palpitations

text: Treating palpitation will depend on the severity and cause of the condition. Radiofrequency ablation can cure most types of supraventricular and many types of ventricular tachycardias. While catheter ablation is currently a common treatment approach, there have been advances in stereotactic radioablation for certain arrythmias. This technique is commonly used for solid tumors and has been applied with success in management of difficult to treat Ventricular Tachycardia and Atrial Fibrillation.


title: Palpitations

text: The most challenging cases involve palpitations that are secondary to supraventricular or ventricular ectopy or associated with normal sinus rhythm. These conditions are thought to be benign, and the management involves reassurance of the patient that these arrhythmias are not life-threatening. In these situations when the symptoms are unbearable or incapacitating, treatment with beta-blocking medications could be considered, and may provide a protective effect for otherwise healthy individuals.


title: Palpitations

text: People who present to the emergency department who are asymptomatic, with unremarkable physical exams, have non-diagnostic EKGs and normal laboratory studies, can safely be sent home and instructed to follow up with their primary care provider or cardiologist. Patients whose palpitations are associated with syncope, uncontrolled arrhythmias, hemodynamic compromise, or angina should be admitted for further evaluation.


title: Palpitations

text: Palpitation that is caused by heart muscle defects will require specialist examination and assessment. Palpitation that is caused by vagus nerve stimulation rarely involves physical defects of the heart. Such palpitations are extra-cardiac in nature, that is, palpitation originating from outside the heart itself. Accordingly, vagus nerve induced palpitation is not evidence of an unhealthy heart muscle.


title: Palpitations

text: Treatment of vagus nerve induced palpitation will need to address the cause of irritation to the vagus nerve or the parasympathetic nervous system generally. It is of significance that anxiety and stress are strongly associated with increased frequency and severity of vagus nerve induced palpitation. Anxiety and stress reduction techniques such as meditation and massage may prove extremely beneficial to reduce or eliminate symptoms temporarily. Changing body position (e.g. sitting upright rather than lying down) may also help reduce symptoms due to the vagus nerve's innervation of several structures within the body such as the GI tract, diaphragm and lungs.


title: Palpitations

text: Direct-to-consumer options for monitoring heart rate and heart rate variability have become increasingly prevalent using smartphones and smartwatches. These monitoring systems have become increasingly validated and may help provide early identification for those at risk for a serious arrhythmia such as atrial fibrillation.


title: Palpitations

text: Palpitations can be a very concerning symptom for people. The etiology of the palpitations in most patients is benign. Therefore, comprehensive workups are not indicated. However appropriate follow up with the primary care provider can provide the ability to monitor symptoms over time and determine if consultation with cardiologist is required. People who are determined to be at high risk for palpitations of serious or life-threatening etiologies require a more extensive workup and comprehensive management.


title: Palpitations

text: Once a cause is determined, the recommendations for treatment are quite strong with moderate to high quality therapies studied. Partnership with the people who have the chief complaint of palpitation, using a shared decision-making model and involving an interprofessional team including a nurse, nurse practitioner, physician assistant, and physician can help best direct therapy and provide good followup.


title: Palpitations

text: Palpitations are a common complaint in the general population, particularly in those affected by structural heart disease. Clinical presentation is divided into four groups: extra-systolic, tachycardic, anxiety-related, and intense. Anxiety-related is the most common.


title: Hampton Roads

text: Hampton Roads is the name of both a body of water in the United States that serves as a wide channel for the James, Nansemond and Elizabeth rivers between Old Point Comfort and Sewell's Point where the Chesapeake Bay flows into the Atlantic Ocean, and the surrounding metropolitan region located in the southeastern Virginia and northeastern North Carolina portions of the Tidewater Region.


title: Hampton Roads

text: Comprising the Virginia Beach–Norfolk–Newport News, VA–NC, metropolitan area and an extended combined statistical area that includes the Elizabeth City, North Carolina, micropolitan statistical area and Kill Devil Hills, North Carolina, micropolitan statistical area, Hampton Roads is known for its large military presence, ice-free harbor, shipyards, coal piers, and miles of waterfront property and beaches, all of which contribute to the diversity and stability of the region's economy.


title: Hampton Roads

text: The body of water known as Hampton Roads is one of the world's largest natural harbors (more accurately a roadstead or "roads"). It incorporates the mouths of the Elizabeth, Nansemond, and James rivers, together with several smaller rivers, and empties into the Chesapeake Bay near its mouth leading to the Atlantic Ocean.


title: Hampton Roads

text: The land area includes a collection of cities, counties, and towns on the Virginia Peninsula and in South Hampton Roads. Some of the outlying areas further from the harbor may or may not be included as part of "Hampton Roads", depending upon the organization or usage. For example, as defined for federal economic purposes, the Hampton Roads metropolitan statistical area (MSA) includes two counties in northeastern North Carolina and two counties in Virginia's Middle Peninsula. The Virginia Beach–Norfolk–Newport News, VA–NC, MSA has a population of 1,799,674, making it the 37th-largest metropolitan area in the United States. The Combined Statistical Area includes four additional counties in North Carolina, pushing the regional population to nearly 1.9 million residents, the 32nd-largest CSA in the country.


title: Hampton Roads

text: The area is home to hundreds of historical sites and attractions. The harbor was the key to Hampton Roads' growth, both on land and in water-related activities and events. While the harbor and its tributaries were (and still are) important transportation conduits, at the same time they presented obstacles to land-based commerce and travel.


title: Hampton Roads

text: Creating and maintaining adequate infrastructure has long been a major challenge. The Hampton Roads Bridge–Tunnel (HRBT) and the Monitor–Merrimac Memorial Bridge–Tunnel (MMMBT) are major harbor crossings of the Hampton Roads Beltway interstate, which links the large population centers of Hampton Roads. In 2009, the Hampton Roads Transportation Authority (HRTA) was abolished by the Virginia General Assembly less than two years after its creation. In 2014, the Hampton Roads Transportation Accountability Commission was established to oversee the Hampton Roads Transportation Fund.


title: Hampton Roads

text: The term "Hampton Roads" is a centuries-old designation that originated when the region was a struggling English outpost nearly four hundred years ago.


title: Hampton Roads

text: The word "Hampton" honors one of the founders of the Virginia Company of London and a great supporter of the colonization of Virginia, Henry Wriothesley, 3rd Earl of Southampton. The early administrative center of the new colony was known as Elizabeth Cittie, named for Princess Elizabeth, the daughter of King James I, and formally designated by the Virginia Company in 1619. The town at the center of Elizabeth Cittie became known as "Hampton", and a nearby waterway was designated Hampton Creek (also known as Hampton River).


title: Hampton Roads

text: Other references to the Earl include the area to the north across the bay (in what is now the Eastern Shore) which became known as Northampton, and an area south of the James River which became Southampton. As with Hampton, both of these names remain in use today.


title: Hampton Roads

text: The term "Roads" (short for roadstead) indicates the safety of a port; as applied to a body of water, it is "a partly sheltered area of water near a shore in which vessels may ride at anchor". Examples of other roadsteads are Castle Roads, in another of the Virginia Company's settlements, Bermuda, and Lahaina Roads, in Hawaii.


title: Hampton Roads

text: In 1755, the Virginia General Assembly recorded the name "Hampton Roads" as the channel linking the James, Elizabeth, and Nansemond rivers with the Chesapeake Bay.


title: Hampton Roads

text: Hampton Roads is among the world's largest natural harbors. It is the northernmost major East Coast port of the United States which is ice-free year round. (This status is claimed with the notable exception of the extraordinarily cold winter of 1917, which was the entire U.S.'s coldest year on record.)


title: Hampton Roads

text: Over time, the entire region has come to be known as "Hampton Roads", a label more specific than its other moniker, "Tidewater Virginia", which includes the whole coastal region of the state. The U.S. Postal Service changed the area's postmark from "Tidewater Virginia" to "Hampton Roads, Virginia" beginning in 1983.


title: Hampton Roads

text: In January 2019, ABC News affiliate WVEC reported that the area was considering a rebranding under the Greater Norfolk Area banner according to a post from an Instagram page Oceanfront9.


title: Hampton Roads

text: The U.S. Census Bureau defines the "Virginia Beach–Norfolk–Newport News, VA–NC, MSA" as 19 county-level jurisdictions—six counties and ten independent cities in Virginia, and three counties in North Carolina. While the borders of what locals call "Hampton Roads" may not perfectly align with the definition of the MSA, Hampton Roads is most often the name used for the metropolitan area.


title: Hampton Roads

text: "Virginia Beach–Norfolk–Newport News, VA–NC, MSA" is a U.S. Metropolitan Statistical Area (MSA). According to the 2010 Census, its population is 1,676,822 and the 2014 estimated population is 1,716,624.


title: Hampton Roads

text: "Since a state constitutional change in 1871, all cities in Virginia are independent cities and they are not legally located in a county. The OMB considers these independent cities to be county-equivalents for the purpose of defining MSAs in Virginia. Each MSA is listed by its counties, then cities, in alphabetical order and not by size."


title: Hampton Roads

text: The Hampton Roads metropolitan area was first defined in 1950 as the "Norfolk–Portsmouth Metropolitan Statistical Area". It comprised the independent cities of Norfolk, Portsmouth and South Norfolk and the counties of Norfolk and Princess Anne. In 1952, Virginia Beach separated from Princess Anne County.


title: Hampton Roads

text: In 1963, Virginia Beach and Princess Anne County merged, retaining the name Virginia Beach. The city was added to the MSA that year, while South Norfolk lost its metropolitan status. Also in 1963, Norfolk County and the City of South Norfolk merged to create the city of Chesapeake.


title: Hampton Roads

text: In 1983, the "Newport News–Hampton Metropolitan Statistical Area", comprising the cities of Newport News, Hampton, Poquoson and Williamsburg, and the counties of Gloucester, James City and York, was combined with the Norfolk–Virginia Beach–Portsmouth MSA and renamed the "Norfolk–Virginia Beach–Newport News MSA".


title: Hampton Roads

text: In 1993, Isle of Wight, Mathews and Surry counties were added. Although Virginia Beach had passed Norfolk as the state's largest city by 1990, it was not made the first primary city of the MSA until 2010.


title: Hampton Roads

text: As a result of the 2010 Census, Gates County, North Carolina was added to the MSA, while Surry County, Virginia was removed.


title: Hampton Roads

text: The Virginia Beach–Norfolk, VA–NC, Combined Statistical Area additionally includes the Elizabeth City, NC, Micropolitan Statistical Area, comprising:


title: Hampton Roads

text: As of the 2010 census, the total population of this Combined Statistical Area was 1,779,243, with a 2013 estimate of 1,810,266, a growth of 1.74%. It is currently the 32nd largest in the country and the largest based in Virginia. Among all metropolitan areas in Virginia, only the Northern Virginia portion of the Washington–Arlington–Alexandria, DC–VA–MD–WV, MSA is larger.


title: Hampton Roads

text: The metropolitan area and water area is in the Tidewater region, a low-lying plains region composed of southeastern portions of Virginia and northeastern portions of North Carolina.


title: Hampton Roads

text: The water area known as Hampton Roads is a wide channel through which the waters of the James River, Nansemond River, and Elizabeth River pass (between Old Point Comfort to the north and Sewell's Point to the south) into the Chesapeake Bay and the Atlantic Ocean.


title: Hampton Roads

text: Norfolk and Hampton Roads are among the worst-hit parts of the United States by the effects of global warming. As of 2016, the region is a few decades ahead in feeling the effects of sea-level rise compared to many American coastal areas.


title: Hampton Roads

text: The geology and topography of the Hampton Roads region is influenced by the Chesapeake Bay impact crater, one of three factors contributing to the sinking of Hampton Roads at a rate between per century.


title: Hampton Roads

text: The region has extensive natural areas, including of Atlantic Ocean and Chesapeake Bay beaches, the Great Dismal Swamp, picturesque rivers, state parks, wildlife refuges, and botanical gardens. Inland from the bay, the region includes Lake Drummond, one of only two natural lakes in Virginia, and miles of waterfront property along the various rivers and waterways. The region's native flora is consistent with that of the Southeast Coastal Plain and the lower Southeast Maritime Forest.


title: Hampton Roads

text: The land area that constitutes Hampton Roads varies depending upon perspective and purpose. Most of Hampton Roads' land is geographically divided into 2 smaller regions: the eastern portion of the Virginia Peninsula (the Peninsula) and South Hampton Roads (locally known as "the Southside"), which are separated by the harbor. When speaking of communities of Hampton Roads, virtually all sources include the seven major cities, two smaller ones, and three counties within those two subregions.


title: Hampton Roads

text: In addition, the Middle Peninsula counties of Gloucester and Mathews, while not part of the geographical Hampton Roads area, are included in the metropolitan region's population, as is a small portion of northeastern North Carolina (Currituck County). Due to a peculiarity in the drawing of the Virginia-North Carolina border, Knott's Island in that county is connected to Virginia by land, but is only accessible to other parts of North Carolina by water via a ferry system.


title: Hampton Roads

text: Each of the following current cities, counties and towns is included by at least one of the three organizations that define Hampton Roads:


title: Hampton Roads

text: The Hampton Roads area consists of nine independent cities (which are not part of any county). Chesapeake, Norfolk, Portsmouth, Suffolk, and Virginia Beach cover the Southside of Hampton Roads while Hampton, Newport News, Poquoson, and Williamsburg are on the Peninsula. Franklin borders Suffolk but the Census Bureau does not consider it part of the metro area.


title: Hampton Roads

text: The metro area has one county in North Carolina, Currituck. The remaining counties, in Virginia, include Isle of Wight and Surry on the Southside, James City and York on the Virginia Peninsula, and Gloucester and Mathews on the Middle Peninsula. While Southampton is adjacent to Surry, Isle of Wight, and the City of Suffolk, the Census Bureau does not consider it part of the metro area.


title: Hampton Roads

text: Five incorporated towns are in the metro area, including Claremont in Surry County, Dendron in Surry County, Smithfield in Isle of Wight County, Surry, Surry County's seat, and Windsor in Isle of Wight County. (Two other incorporated towns, Boykins and Courtland, are in Southampton County, and therefore, like the county within which they are located, are not part of the federally defined metropolitan area).


title: Hampton Roads

text: Other unincorporated towns and communities in the metropolitan area that are not within its cities include Gloucester Courthouse and Gloucester Point in Gloucester County, Isle of Wight Courthouse, Rushmere, Rescue, Carrollton, Benns Church, and Walters in Isle of Wight County, Yorktown, Grafton, Seaford, and Tabb in York County, Jamestown, Ford's Colony, Grove, Lightfoot, Toano, and Norge in James City County, Moyock, Knotts Island, and Currituck in Currituck County, North Carolina.


title: Hampton Roads

text: The Hampton Roads MSA, with a population of about 1.7 million, is the seventh-largest metropolitan area in the Southeastern United States, after the Washington metropolitan area; Miami–Fort Lauderdale–Pompano Beach, FL, MSA; Atlanta–Sandy Springs–Marietta, GA, MSA, Tampa–St. Petersburg–Clearwater, FL, MSA; Orlando–Kissimmee, FL, MSA; and Charlotte–Gastonia-Rock Hill, NC–SC, MSA.


title: Hampton Roads

text: The first colonists arrived in 1607 when English Captain Christopher Newport landed at Cape Henry, today's City of Virginia Beach, an event now called the "First Landing." However, his party moved on, in search of a more defensible area upriver, mindful of competitors such as the Spanish, who had built a failed settlement on the Virginia Peninsula known as the Ajacán Mission.


title: Hampton Roads

text: After exploring the James River, they established the first successful English colony in the New World on Jamestown Island on May 14, 1607. But the low, marshy site proved unhealthy and most of the colonists died, before a new Governor, Lord De La Warr (Delaware) arrived with John Rolfe, who would establish the Virginia tobacco industry.


title: Hampton Roads

text: The harbor and rivers of Hampton Roads were immediately recognized as prime locations for commerce, shipbuilding and military installations, with the fortifications at Old Point Comfort established as early as 1610, and Gosport Navy Yard (later Norfolk Naval Shipyard) in 1767. The decisive battle of the Revolution was won at Yorktown in 1781, and the first naval action of the War of 1812 took place in Hampton Roads, when a Royal Naval vessel was seized by the American privateer "Dash". Later the entrance from Chesapeake Bay was equipped with new fortifications (Fort Monroe and Fort Wool), much of the building work being supervised by a young military engineer Robert E. Lee.


title: Hampton Roads

text: During the American Civil War (1861–1865), the historic Battle of Hampton Roads between the first American ironclad warships, the and the CSS "Virginia", took place off Sewell's Point in 1862. The battle was inconclusive, but Union forces later took control of Hampton Roads, Norfolk, and the lower James River, though they were thwarted from venturing further upstream by a strong Confederate battery at Drewry's Bluff. Also in 1862, Fort Monroe was the launching place for Union General George McClellan's massive advance up the Virginia Peninsula, which almost reached the Confederate capital Richmond, before the Seven Days Battles forced him back. In 1865, as the Confederacy was near collapse, President Abraham Lincoln met with three senior Confederates at Hampton Roads in an unsuccessful bid for a negotiated peace.


title: Hampton Roads

text: Some former slaves had been camped near Fort Monroe, where they were declared to be Contraband of war, instead of being returned to their former owners. Booker T. Washington was among the freedmen who attended the local school, which evolved into the present-day Hampton University.


title: Hampton Roads

text: The Jamestown Exposition for the 300th anniversary of the 1607 founding of Jamestown was held at Sewell's Point in a rural section of Norfolk County in 1907.


title: Hampton Roads

text: President Theodore Roosevelt arrived by water in the harbor of Hampton Roads, as did other notable persons such as Mark Twain and Henry Huttleston Rogers, who both arrived aboard the latter's steam yacht "Kanawha". A major naval display was featured, and the U.S. Great White Fleet made an appearance. The leaders of the U.S. Navy apparently did not fail to note the ideal harbor conditions, as was later proved.


title: Hampton Roads

text: Beginning in 1917, as the United States became involved in World War I under President Woodrow Wilson, formerly rural Sewell's Point became the site of what grew to become the largest Naval Base in the world which was established by the United States Navy and is now known as the Naval Station Norfolk.


title: Hampton Roads

text: Twice in the 20th century, inhabitants mostly African American were displaced when land along the northern side of the Peninsula primarily in York County west of Yorktown was taken in large tracts for military use during World War I and World War II, creating the present-day U.S. Naval Weapons Station Yorktown, which includes Cheatham Annex, and a former Seabee base which became Camp Peary.


title: Hampton Roads

text: Communities including "the Reservation", Halstead's Point, Penniman, Bigler's Mill, and Magruder were all lost and absorbed into the large military bases.


title: Hampton Roads

text: Although some left the area entirely, many of the displaced families chose to relocate nearby to Grove, an unincorporated town in southeastern James City County where many generations of some of those families now reside. From a population estimated at only 37 in 1895, Grove had grown to an estimated 1,100 families by the end of the 20th century. (To its north, Grove actually borders the Naval Weapons Station property and on its extreme east, a portion of the U.S. Army's land at Fort Eustis extends across Skiffe's Creek, although there is no direct access to either base).