document_title: Mackinac Bridge

question_text: what is the speed limit on the mackinaw bridge

text: Mackinac Bridge

text: Length[edit]

text: The bridge opened on November 1, 1957,[6] connecting two peninsulas linked for decades by ferries. A year later, the bridge was formally dedicated as the "world's longest suspension bridge between anchorages", allowing a superlative comparison to the Golden Gate Bridge, which had a longer center span between towers, and the San Francisco–Oakland Bay Bridge, which had an anchorage in the middle.

text: It remains the longest suspension bridge with two towers between anchorages in the Western Hemisphere.[5] Much longer anchorage-to-anchorage spans have been built in the Eastern Hemisphere, including the Akashi Kaikyō Bridge in Japan (12,826 ft or 3,909 m). But the long leadups to the anchorages on the Mackinac make its total shoreline-to-shoreline length of 5 miles (8 km) longer than the Akashi-Kaikyo (2.4 mi or 3.9 km).

text: The length of the bridge's main span is 3,800 feet (1,158 m), which makes it the third-longest suspension span in the United States and 19th longest suspension span worldwide. It is also one of the world's longest bridges overall.

text: History[edit]

text: Early history[edit]

text: The Algonquian peoples who lived in the straits area prior to the arrival of Europeans in the 17th century called this region Michilimackinac, which is widely understood to mean the Great Turtle. This is thought to refer to the shape of what is now called Mackinac Island. This interpretation of the word is debated by scholars. Trading posts at the Straits of Mackinac attracted peak populations during the summer trading season; they also developed as intertribal meeting places.[7]

text: As exploitation of the state's mineral and timber resources increased during the 19th century, the area became an important transport hub. In 1881 the three railroads that reached the Straits, the Michigan Central, Grand Rapids & Indiana, and the Detroit, Mackinac & Marquette, jointly established the Mackinac Transportation Company to operate a railroad car ferry service across the straits and connect the two peninsulas.[8]

text: Improved highways along the eastern shores of the Lower Peninsula brought increased automobile traffic to the Straits region starting in the 1910s. The state of Michigan initiated an automobile ferry service between Mackinaw City and St. Ignace in 1923; it eventually operated nine ferry boats that would carry as many as 9,000 vehicles per day. Traffic backups could stretch as long as 16 miles (26 km).[9]

text: Plans for the bridge[edit]

text: After the opening of the Brooklyn Bridge in 1883, local residents began to imagine that such a structure could span the straits. In 1884, a store owner in St. Ignace published a newspaper advertisement that included a reprint of an artist's conception of the Brooklyn Bridge with the caption "Proposed bridge across the Straits of Mackinac".[10]

text: The idea of the bridge was discussed in the Michigan Legislature as early as the 1880s. At the time, the Straits of Mackinac area was becoming a popular tourist destination, especially following the creation of Mackinac National Park on Mackinac Island in 1875.

text: At a July 1888 meeting of the board of directors of the Grand Hotel on Mackinac Island, Cornelius Vanderbilt II proposed that a bridge be built across the straits, of a design similar to the one then under construction across the Firth of Forth in Scotland. This would advance commerce in the region and help lengthen the resort season of the hotel.[10]

text: Decades went by with no formal action. In 1920, the Michigan state highway commissioner advocated construction of a floating tunnel across the Straits. At the invitation of the state legislature, C. E. Fowler of New York City put forth a plan for a long series of causeways and bridges across the straits from Cheboygan, 17 miles (27 km) southeast of Mackinaw City, to St. Ignace, using Bois Blanc, Round, and Mackinac islands as intermediate steps.

text: Formal planning[edit]

text: In 1923, the state legislature ordered the State Highway Department to establish ferry service across the strait. More and more people used ferries to cross the straits each year, and as they did, the movement to build a bridge increased. Chase Osborn, a former governor, wrote,

text: "Michigan is unifying itself, and a magnificent new route through Michigan to Lake Superior and the Northwest United States is developing, via the Straits of Mackinac. It cannot continue to grow as it ought with clumsy and inadequate ferries for any portion of the year."[11]

text: By 1928, the ferry service had become so popular and so expensive to operate that Michigan Governor Fred W. Green ordered the department to study the feasibility of building a bridge across the strait. The department deemed the idea feasible, estimating the cost at $30 million (equivalent to $2.11 billion in 2016[12]).

text: In 1934, the Michigan Legislature created the Mackinac Straits Bridge Authority to explore possible methods of constructing and funding the proposed bridge. The Legislature authorized the Authority to seek financing for the project. In the mid-1930s, during the Great Depression, when numerous infrastructure projects received federal aid, the Authority twice attempted to obtain federal funds for the project but was unsuccessful. The United States Army Corps of Engineers and President Franklin D. Roosevelt endorsed the project but Congress never appropriated funds. Between 1936 and 1940, the Authority selected a route for the bridge based on preliminary studies. Borings were made for a detailed geological study of the route.

text: The preliminary plans for the bridge featured a 3-lane roadway, a railroad crossing on the underdeck of the span, and a center-anchorage double-suspension bridge configuration similar to the design of the San Francisco – Oakland Bay Bridge. Because this would have required sinking an anchorage pier in the deepest area of the Straits, the practicality of this design may have been questionable.[citation needed] A concrete causeway, approximately 4,000 feet (1,219 m), extending from the northern shore, was constructed in shallow water from 1939 to 1941. However, a unique engineering challenge was created by the tremendous forces that operate against the base of the bridge, because the lakes freeze during the winter, causing large icebergs to place enormous stress on the bridge.

text: At that time, with funding for the project still uncertain, further work was put on hold because of the outbreak of World War II. The Mackinac Straits Bridge Authority was abolished by the state legislature in 1947, but the same body created a new Mackinac Bridge Authority three years later in 1950. In June 1950, engineers were retained for the project. By then, it was reported that cars queuing for the ferry at Mackinaw City did not reach St. Ignace until five hours later, and the typical capacity of 460 vehicles per hour could not match the estimated 1600 for a bridge.[13]

text: After a report by the engineers in January 1951,[14] the state legislature authorized the sale of $85 million (equivalent to $2.08 billion in 2016[12]) in bonds for bridge construction on April 30, 1952. However, a weak bond market in 1953 forced a delay of more than a year before the bonds could be issued.

text: Engineering and construction[edit]

text: David B. Steinman was appointed as the design engineer in January 1953 and by the end of 1953, estimates and contracts had been negotiated. A Civil Engineer at the firm, Abul Hasnat, did the preliminary plans for the bridge. Total cost estimate at that time was $95 million (equivalent to $2.23 billion in 2016[12]) with estimated completion by November 1, 1956. Tolls collected were to pay for the bridge in 20 years.[15] Construction began on May 7, 1954. The American Bridge Division of United States Steel Corporation was awarded a contract of more than $44 million (equivalent to $1.05 billion in 2016[12]) to build the steel superstructure.

text: Construction, staged using the 1939-41 causeway, took three and a half years (four summers, no winter construction) at a total cost of $100 million and the lives of five workers. Contrary to popular belief, none of them are entombed in the Bridge.[16] It opened to traffic on schedule on November 1, 1957, and the ferry service was discontinued on the same day. The Bridge was formally dedicated on June 25, 1958.

text: G. Mennen Williams was governor during the construction of the Mackinac Bridge. He began the tradition of the governor leading the Mackinac Bridge Walk across it every Labor Day.[17] U.S. Senator Prentiss M. Brown has been called the "father of the Mackinac Bridge,"[18] and was honored with a special memorial bridge token created by the Mackinac Bridge Authority.[19]

text: The bridge officially achieved its 100 millionth crossing exactly forty years after its dedication, on June 25, 1998.[2] The 50th anniversary of the bridge's opening was celebrated on November 1, 2007 in a ceremony hosted by the Mackinac Bridge Authority at the viewing park adjacent to the St. Ignace causeway.[2]

text: History of the bridge design[edit]

text: The design of the Mackinac Bridge was directly influenced by the lessons from the first Tacoma Narrows Bridge, which failed in 1940 because of its instability in high winds. Three years after that disaster, Steinman had published a theoretical analysis of suspension-bridge stability problems, which recommended that future bridge designs include deep stiffening trusses to support the bridge deck and an open-grid roadway to reduce its wind resistance. Both of these features were incorporated into the design of the Mackinac Bridge. The stiffening truss is open to reduce wind resistance. The road deck is shaped as an airfoil to provide lift in a cross wind, and the center two lanes are open grid to allow vertical (upward) air flow, which fairly precisely cancels the lift, making the roadway stable in design in winds of up to 150 miles per hour (240 km/h).

text: Facts and figures[edit]

text: The Mackinac Bridge is currently a toll bridge on Interstate 75 (I-75). Prior to the coming of I-75, the bridge carried US Highway 27 (US 27). It is one of only three segments of I-75 that are tolled, the others being the American half of the International Bridge near Sault Ste. Marie, Michigan, and Alligator Alley in Florida. The current toll is $4.00 for automobiles and $5.00 per axle for trucks.[3] The Mackinac Bridge Authority raised the toll in 2007 to fund a $300 million renovation program, which would include completely replacing the bridge deck.[20]

text: Every Labor Day, the bridge is open to walkers for the Mackinac Bridge Walk.

text: Painting of the bridge takes seven years,[21] and when painting of the bridge is complete, it begins again.

text: The bridge celebrated its 150 millionth vehicle crossing on September 6, 2009.[22]

text:
Length from cable bent pier to cable bent pier: 7,400 feet (2,256 m).[2]
Total width of the roadway: 54 feet (16.5 m)[2]

Two outside lanes: 12 feet (3.7 m) wide each[2]
Two inside lanes: 11 feet (3.4 m) wide each[2]
Center mall: 2 feet (0.61 m)
Catwalk, curb and rail width: 3 feet (0.91 m) on each side

Width of stiffening truss in the suspended span: 68 feet (20.7 m).[2]
Depth of stiffening truss: 38.1 feet (11.6 m)[1][2]
Height of the roadway at mid-span: approximately 200 feet (61 m) above water level.[2]
Vertical clearance at normal temperature:

155 feet (47 m) at the center of the main suspension span.[2]
135 feet (41 m) at the boundaries of the 3,000 feet (914 m) wide navigation channel.[2]

Construction cost: $99.8 million (equivalent to $2.07 billion in 2016[12])[2]
Height of towers above water: 552 feet (168 m)[2]
Max. depth of towers below water: 210 feet (64 m)[2]
Depth of water beneath the center of the bridge, 250 feet (76 m)[2]
Total length of wire in main cables: 42,000 miles (68,000 km).[2]
Total vehicle crossings, 2005: 4,236,491 (average 11,608 per day)
Speed limit: 45 miles per hour (72 km/h) for passenger cars, 20 miles per hour (32 km/h) for heavy trucks. Heavy trucks are also required to leave 500 feet (150 m) spacing ahead.

text: Work and major accident fatalities[edit]

text: Five workers died during the construction of the bridge.[23]

text:
Diver Frank Pepper ascended too quickly from a depth of 140 feet (43 m) on September 16, 1954. Despite being rushed to a decompression chamber, the forty-six-year-old died from the bends.[24]
Twenty-six-year-old James LeSarge lost his balance on October 10, 1954, and fell into a caisson. He fell 40 feet (12 m) and likely died of head injuries caused by impact with the criss-crossing steel beams inside the caisson.
Albert Abbott died on October 25, 1954. The forty-year-old fell four feet (1.2 m) into the water while working on an 18 inch (46 cm) wide beam. Witnesses speculate he suffered a heart attack.
Twenty-eight-year-old Jack Baker and Robert Koppen died in a catwalk collapse near the north tower on June 6, 1956. Koppen's body was never recovered. For both it was their first day on the job.

text: All five men are memorialized on a plaque near the bridge's southern end. Contrary to folklore, no bodies are embedded in the concrete.[25][26]

text: One worker has died since the bridge was completed. Daniel Doyle fell 60 to 70 feet (18 to 21 m) from scaffolding on August 7, 1997. He survived the fall but fell victim to the 50 °F (10 °C) water temperature. His body was recovered the next day in 95 feet (29 m) of water.

text: Two vehicles have fallen off the bridge.

text:
On September 22, 1989, Leslie Ann Pluhar died when her 1987 Yugo plunged over the 36-inch-high (91 cm) railing. A combination of high winds and excessive speed was initially blamed.[27] Later investigation showed the driver had stopped her car over the open steel grating on the bridge's span and that a gust of wind through the grating blew her vehicle off the bridge,[28] although this is not supported by recorded wind speed measurements taken on and around the bridge at the time of the accident.[29][30]
On March 2, 1997, Richard Alan Daraban drove a 1996 Ford Bronco over the edge. It was later determined to be a suicide.[31]

text: On September 10, 1978, a small private plane carrying United States Marine Corps Reserve officers Maj. Virgil Osborne, Capt. James Robbins, and Capt. Wayne W. Wisbrock smashed into one of the bridge's suspension cables while flying in a heavy fog. The impact tore the wings off the plane, which then plunged into the Straits of Mackinac. All three men were killed.[32]

text: Because the bridge is not accessible to pedestrians,[a] suicides by jumping from the bridge have been rare, with the most recent confirmed case taking place on December 31, 2012.[33] There have been roughly a dozen suicides by people jumping off the bridge.[34]

text: Crossing the bridge[edit]

text: Some individuals have difficulty crossing bridges, a phenomenon known as gephyrophobia. The Mackinac Bridge Authority has a Drivers Assistance Program that provides drivers for those with gephyrphobia, or anyone who is more comfortable having someone else drive them across. More than a thousand people use this service every year. Those interested can arrange, either by phone or with the toll collector, to have their cars or motorcycles driven to the other end. There is no additional fee for this service. Bicycles and pedestrians are not normally permitted on the bridge. An exception is allowed for riders of two annual bicycle tours. On an everyday basis, for a $5.00 fee, the Authority will transport bicyclists and their vehicles across the bridge.[3]

text: Travelers across the Mackinac Bridge can listen to an AM radio broadcast that recounts the history of the bridge and provides updates on driving conditions.[35]

text: Bridge Walk[edit]

text: The Mackinac Bridge Walk has been held each year since 1958, when it was led by Governor G. Mennen Williams. The first walk was held during the Bridge's Dedication Ceremony held in late June, and has been held on Labor Day since 1959. School buses from local districts transport walkers from Mackinaw City to St. Ignace to begin the walk. Thousands of people, traditionally led by the Governor of Michigan, cross the five-mile (8 km) span on foot from St. Ignace to Mackinaw City. Before 1964, people walked the Bridge from Mackinaw City to St. Ignace. Prior to 2017, two lanes of the bridge would remain open to public vehicle traffic; this policy was changed in 2017 to close the entire bridge to public vehicle traffic for the duration of the event.[36] The Bridge Walk is the only day of the year that hikers can hike this section of the North Country National Scenic Trail.[37]

text: Tourism[edit]

text: During summers, the Upper Peninsula and the Mackinac Bridge have become a major tourist destination.[38] In addition to visitors to Mackinac Island, the bridge has attracted interest from a diverse group of tourists including bridge enthusiasts, bird-watchers, and photographers.[39]

text: In media[edit]

text: On June 25, 1958, to coincide with the 1958 celebration of the November 1957 opening, the United States Postal Service (USPS) released a 3¢ commemorative stamp featuring the recently completed bridge. It was entitled "Connecting the Peninsulas of Michigan" and 107,195,200 copies were issued.[40] The USPS again honored the Mackinac Bridge as the subject of its 2010 priority mail $4.90 stamp, which went on sale February 3.[41] The bridge authority and MDOT unveiled the stamp, which featured a "seagull’s-eye view" of the landmark, with a passing freighter below.[42] Artist Dan Cosgrove worked from panoramic photographs to create the artwork. This is one of several designs that Cosgrove has produced for the USPS.[43]

text: A feature-length documentary entitled Building the Mighty Mac was produced by Hollywood filmmaker Mark Howell in 1997 and was shown on PBS. The program features numerous interviews with the key people who built the structure and includes restored 16mm color footage of the bridge's construction.[44]

text: The history and building of the bridge was featured in a 2003 episode of the History Channel TV show Modern Marvels.[45]

text: On July 19, 2007, the Detroit Science Center unveiled an 80-foot-long (24 m), 19-foot-tall (5.8 m) scale model of the Mackinac Bridge. The exhibit was part of the state’s 50th anniversary celebration of the bridge. Sherwin-Williams supplied authentic Mackinac Bridge-colored paint for the project.[46]

text: The bridge and its maintenance crew were featured in an episode of the Discovery Channel TV show Dirty Jobs on August 7, 2007. Host Mike Rowe and crew spent several days filming the episode in May 2007.[47][48]

text: MDOT also featured the bridge on the cover of the 2007 state highway map to celebrate its 50th anniversary.[49]


document_title: Smartphone

question_text: who came out with the first touch screen phone

question_tokens: who came out with the first touch screen phone

root

text: Smartphone

text: History

text: Forerunner

text: The first commercially available device that could be properly referred to as a "smartphone" began as a prototype called "Angler" developed by Frank Canova in 1992 while at IBM and demonstrated in November of that year at the COMDEX computer industry trade show.[4][5][6] A refined version was marketed to consumers in 1994 by BellSouth under the name Simon Personal Communicator. In addition to placing and receiving cellular calls, the touchscreen-equipped Simon could send and receive faxes and emails. It included an address book, calendar, appointment scheduler, calculator, world time clock, and notepad, as well as other visionary mobile applications such as maps, stock reports and news.[7] The term "smart phone" or "smartphone" was not coined until a year after the introduction of the Simon, appearing in print as early as 1995, describing AT&T's PhoneWriter Communicator.[8][non-primary source needed]

tag: p

text: Early integration of data signals with telephony

text: The first integration of data signals with telephony was conceptualized by Nikola Tesla in 1909 and pioneered by Theodore Paraskevakos beginning in 1968 with his work on transmission of electronic data through telephone lines. In 1971, while he was working with Boeing in Huntsville, Alabama, Paraskevakos demonstrated a transmitter and receiver that provided additional ways to communicate with remote equipment. This formed the original basis for what is now known as caller ID.[9] The first caller ID equipment was installed at Peoples' Telephone Company in Leesburg, Alabama and was demonstrated to several telephone companies. The original and historic working models are still in the possession of Paraskevakos.[10]

text: PDA/phone hybrids

text: In the mid-late 1990s, many people who had mobile phones carried a separate dedicated PDA device, running early versions of operating systems such as Palm OS, Newton OS, Symbian or Windows CE/Pocket PC. These operating systems would later evolve into early mobile operating systems. Most of the "smartphones" in this era were hybrid devices that combined these existing familiar PDA OSes with basic phone hardware. The results were devices that were bulkier than either dedicated mobile phones or PDAs, but allowed a limited amount of cellular Internet access. The trend at the time, however, that manufacturers competed on in both mobile phones and PDAs was to make devices smaller and slimmer. The bulk of these smartphones combined with their high cost and expensive data plans, plus other drawbacks such as expansion limitations and decreased battery life compared to separate standalone devices, generally limited their popularity to "early adopters" and business users who needed portable connectivity.

text: In March 1996, Hewlett-Packard released the OmniGo 700LX, a modified HP 200LX palmtop PC with a Nokia 2110 mobile phone  piggybacked onto it and ROM-based software to support it.  It had a 640×200 resolution CGA compatible four-shade gray-scale LCD screen and could be used to place and receive calls, and to create and receive text messages, emails and faxes.  It was also 100% DOS 5.0 compatible, allowing it to run thousands of existing software titles, including early versions of Windows.

text: In August 1996, Nokia released the Nokia 9000 Communicator, a digital cellular PDA based on the Nokia 2110 with an integrated system based on the PEN/GEOS 3.0 operating system from Geoworks. The two components were attached by a hinge in what became known as a clamshell design, with the display above and a physical QWERTY keyboard below. The PDA provided e-mail; calendar, address book, calculator and notebook applications; text-based Web browsing; and could send and receive faxes. When closed, the device could be used as a digital cellular telephone.

text: In June 1999 Qualcomm released the "pdQ Smartphone", a CDMA digital PCS smartphone with an integrated Palm PDA and Internet connectivity.[11]

text: Subsequent landmark devices included:

text:
The Ericsson R380 (2000) by Ericsson Mobile Communications.[12] The first device marketed as a "smartphone",[13] it was the first Symbian-based phone, with PDA functionality and limited Web browsing on a resistive touchscreen utilizing a stylus.[14] Users could not install their own software on the device, however.
The Kyocera 6035 (early 2001), a dual-nature device with a separate Palm OS PDA operating system and CDMA mobile phone firmware. It supported limited Web browsing with the PDA software treating the phone hardware as an attached modem.[15][16]
Handspring's Treo 180 (2002), the first smartphone that fully integrated the Palm OS on a GSM mobile phone having telephony, SMS messaging and Internet access built in to the OS. The 180 model had a thumb-type keyboard and the 180g version had a Graffiti handwriting recognition area, instead.[17]

tag: ul

text: Japanese cell phones

text: In 1999, Japanese wireless provider NTT DoCoMo launched i-mode, a new mobile internet platform which provided data transmission speeds up to 9.6 kilobits per second, and access web services available through the platform such as online shopping. NTT DoCoMo's i-mode used cHTML, a language which restricted some aspects of traditional HTML in favor of increasing data speed for the devices. Limited functionality, small screens and limited bandwidth allowed for phones to use the slower data speeds available. The rise of i-mode helped NTT DoCoMo accumulate an estimated 40 million subscribers by the end of 2001, and ranked first in market capitalization in Japan and second globally. This power would later wane in the face of the rise of 3G and new phones with advanced wireless network capabilities. Japanese cell phones increasingly diverged from global standards and trends to offer other forms of advanced services and functionality, such as mobile payments, near-field communication (NFC), and 1seg mobile television.[18][19][20][21][22]

text: Early smartphones

text: Smartphones were still rare outside Japan until the introduction of the Danger Hiptop in 2002, which saw moderate success among U.S. consumers as the T-Mobile Sidekick. Later, in the mid-2000s, business users in the U.S. started to adopt devices based on Microsoft's Windows Mobile, and then BlackBerry smartphones from Research In Motion. American users popularized the term "CrackBerry" in 2006 due to the BlackBerry's addictive nature.[23]

text: Outside the U.S. and Japan, Nokia was seeing success with its smartphones based on Symbian, originally developed by Psion for their personal organisers, and it was the most popular smartphone OS in Europe during the middle to late 2000s. Initially, Nokia's Symbian smartphones were focused on business with the Eseries,[24] similar to Windows Mobile and BlackBerry devices at the time. From 2006 onwards, Nokia started producing consumer-focused smartphones, popularized by the entertainment-focused Nseries. Until 2010, Symbian was the world's most widely used smartphone operating system.[25]

text: Form factor shift

text: In the 2000s, it was common for smartphones to have a physical T9 numeric keypad or QWERTY keyboard in either a candybar or sliding form factor. Some smartphones had resistive touchscreens, which allowed for virtual keyboards and handwriting input with a stylus or finger.[26]

text: In January 2007, Apple Computer unveiled the iPhone, the company's first smartphone. The iPhone was designed around a large capacitive touchscreen, which supported the use of multi-touch gestures for interactions (such as "pinching" to zoom in and out on photos and web pages), and offered features such as a web browser designed to render full web pages (as opposed to stripped down WAP services), multimedia functionality (including synchronization with its iTunes music software), and online services such as Google Maps. Although facing criticism for not supporting the latest 3G wireless network standards, or the installation of third-party software on-launch, the iPhone was praised for its hardware and software design, and its June 2007 release was met with heavy demand, with customers waiting in lines outside Apple Store locations to be among the first to purchase it.[27] The following year, Apple unveiled the iPhone 3G, and a service known as App Store—which would allow users to download and purchase new apps for their iPhone.[28][29][30][31][32]

text: The iPhone's pioneering design affected the development of another smartphone OS platform, Android, with a more BlackBerry-esque prototype device scrapped in favor of a touchscreen device with a slide-out physical keyboard.[33][34][35] The first Android device, the HTC Dream, was released in September 2008.[36]

text: Android and iPhone devices popularized the smartphone form factor based on a large capacitive touchscreen, and led to the decline of earlier, keyboard- and keypad-focused platforms. Microsoft, for instance, discontinued Windows Mobile and started a new touchscreen-oriented OS from scratch, called Windows Phone. Nokia abandoned Symbian and partnered with Microsoft to use Windows Phone on its smartphones. Windows Phone became the third-most-popular smartphone OS, before being replaced by Windows 10 Mobile, which declined in share to become "largely irrelevant" at less than 0.5% of the smartphone market.[37] Palm replaced their Palm OS with webOS, which was bought by Hewlett-Packard and later sold to LG Electronics for use on LG smart TVs. BlackBerry Limited, formerly known as Research In Motion, made a new platform based on QNX, BlackBerry 10, with which it was possible to control a device without having to press any physical buttons; this platform was later discontinued.

text: By the mid-2010s, almost all smartphones were touchscreen-only, and Android and iPhone smartphones dominated the market since smartphones started to grow in use by 2012 and 2013.

text: Developments in the 2010s

text: In 2013, Fairphone launched its first "socially ethical" smartphone at the London Design Festival to address concerns regarding the sourcing of materials in the manufacturing.[38] In late 2013, QSAlpha commenced production of a smartphone designed entirely around security, encryption and identity protection.[39] Some companies began to release smartphones incorporating flexible displays to create curved form factors, such as the Samsung Galaxy Round and LG G Flex.[40][41][42]

text: In October 2013, Motorola Mobility announced Project Ara, a concept for a modular smartphone platform that would allow users to customize and upgrade their phones with add-on modules that attached magnetically to a frame.[43][44] Ara was retained by Google following its sale of Motorola Mobility to Lenovo,[45] but was shelved in 2016.[46] That year, LG and Motorola both unveiled smartphones featuring a limited form of modularity for accessories; the LG G5 allowed accessories to be installed via the removal of its battery compartment,[47] while the Moto Z utilizes accessories attached magnetically to the rear of the device.[48]

text: The first smartphone with a fingerprint reader was the Motorola Atrix 4G in 2011.[49] In September 2013, the iPhone 5S was unveiled as the first smartphone on a major U.S. carrier since the Atrix to feature this technology.[50]

text: By 2014, 1440p displays began to appear on high-end smartphones.[51] In 2015, Sony released the Xperia Z5 Premium, featuring a 4K resolution display, although only images and videos could actually be rendered at that resolution (all other software is upscaled from 1080p).[52] Microsoft, expanding upon the concept of Motorola's short-lived "Webtop", unveiled functionality for its Windows 10 operating system for phones that allows supported devices to be docked for use with a PC-styled desktop environment.[53][54] Other major technologies began to trend in 2016, including a focus on virtual reality and augmented reality experiences catered towards smartphones, the newly introduced USB-C connector, and improving LTE technologies.[55]  As of 2015, the global median for smartphone ownership was 43%.[56] Statista forecast that 2.87 billion people would own smartphones in 2020.[57]

text: New trends for smartphone displays began to emerge in 2017, with both LG and Samsung releasing flagship smartphones utilizing displays with taller aspect ratios than the common 16:9 ratio. These designs allow the display to have a larger physical size, but with a slimmer width than 16:9 displays with an equivalent screen size.[58][59][60] Another trend popularized that year were designs—colloquially known as a "notch"—where the front-facing camera, and sometimes other sensors typically located along the top bezel of a device, are contained into a tab-like area at the top of the device that the display wraps around. These designs allow for "edge-to-edge" displays that take up nearly the entire height of the device, with little to no bezel along the top. This design characteristic was popularized by the Essential Phone (which featured a circular tab for its camera) and iPhone X (which used a wider tab to contain a camera and facial scanning system).[61][62][63][64] In 2018, the first smartphones featuring fingerprint readers embedded within OLED displays were announced.[65]

text: Future possible developments

text: This section needs to be updated. Please update this article to reflect recent events or newly available information. (April 2018)

tag: table

text: Foldable OLED smartphones have been anticipated for years but have failed to materialize because of the relatively high failure rate when producing these screens.[citation needed] Creating a battery that can be folded is another hurdle.[66] Samsung has attempted to make a smartphone with a flexible display. Samsung is still on some finishing touches which after then may become the first OLED or flexible smartphone made.[citation needed]

text: Hardware

text: Central processing unit

text: Smartphones have central processing units (CPUs), similar to those in computers, but optimised to operate in low power environments.

text: Mobile CPU performance depends not only on the clock rate (generally given in multiples of hertz)[67] but also the memory hierarchy also greatly affects overall performance. Because of these problems, the performance of mobile phone CPUs is often more appropriately given by scores derived from various standardized tests to measure the real effective performance in commonly used applications.

text: Display

text: One of the main characteristics of smartphones is the screen. Depending on the device's design, the screen fills most or nearly all of the space on a device's front surface. Many smartphone displays have an aspect ratio of 16:9, but taller aspect ratios became more common in 2017.

text: Screen sizes are measured in diagonal inches; phones with screens larger than 5.2 inches are often called "phablets." Smartphones with screens over 4.5 inches in size are commonly difficult to use with only a single hand, since most thumbs cannot reach the entire screen surface; they may need to be shifted around in the hand, held in one hand and manipulated by the other, or used in place with both hands.  Due to design advances, some modern smartphones with large screen sizes and "edge-to-edge" designs have compact builds that improve their ergonomics, while the shift to taller aspect ratios have resulted in phones that have larger screen sizes whilst maintaining the ergonomics associated with smaller 16:9 displays.[68][69][70]

text: Liquid-crystal displays are the most common; others are IPS, LED, OLED, and AMOLED displays. Some displays are integrated with pressure-sensitive digitizers, such as those developed by Wacom and Samsung,[71] and Apple's "3D Touch" system.

text: Sound

text: Some audio quality enhancing features, such as Voice over LTE and HD Voice, have appeared and are often available on newer smartphones. Sound quality can remain a problem due to the design of the phone, the quality of the cellular network and compression algorithms used in long distance calls.[72][73]  Audio quality can be improved using a VoIP application over WiFi.[74] Cellphones have small speakers so that the user can use a speakerphone feature and talk to a person on the phone without holding it to their ear. The small speakers can also be used to listen to digital audio files of music or speech or watch videos with an audio component, without holding the phone close to the ear.

text: Battery

text: By the end of 2017, smartphone battery life has become generally adequate;[75] however, earlier smartphone battery life was poor due to the weak batteries that could not handle the significant power requirements of the smartphones' computer systems and color screens.[76][77][78]

text: Smartphone users purchase additional chargers for use outside the home, at work, and in cars and by buying portable external "battery packs". External battery packs include generic models which are connected to the smartphone with a cable and custom-made models that "piggyback" onto a smartphone's case. In 2016, Samsung had to recall millions of the Galaxy Note 7 smartphones due to an explosive battery issue.[79]  For consumer convenience, wireless charging stations have been introduced in some hotels, bars, and other public spaces.[80]

text: Accessories

text: A wide range of accessories are sold for smartphones, including cases, screen protectors, power charging cables, wireless power stations, USB On-The-Go adapters (for connecting USB drives and or, in some cases, a HDMI cable to an external monitor), add-on batteries, headphones, combined headphone-microphones (which, for example, allow a person to privately conduct calls on the device without holding it to the ear), and Bluetooth-enabled powered speakers that enable users to listen to media from their smartphones wirelessly.

text: Cases range from relatively inexpensive rubber or soft plastic cases which provide moderate protection from bumps and good protection from scratches to more expensive, heavy-duty cases that combine a rubber padding with a hard outer shell. Some cases have a "book"-like form, with a cover that the user opens to use the device; when the cover is closed, it protects the screen. Some "book"-like cases have additional pockets for credit cards, thus enabling people to use them as wallets.

text: Accessories include products sold by the manufacturer of the smartphone and compatible products made by other manufacturers.

text: Software

text: Mobile operating systems

text: A mobile operating system (or mobile OS) is an operating system for phones, tablets, smartwatches, or other mobile devices.

text: Mobile operating systems combine features of a personal computer operating system with other features useful for mobile or handheld use; usually including, and most of the following considered essential in modern mobile systems; a touchscreen, cellular, Bluetooth, Wi-Fi Protected Access, Wi-Fi, Global Positioning System (GPS) mobile navigation, video- and single-frame picture cameras, speech recognition, voice recorder, music player, near field communication, and infrared blaster. By Q1 2018, over 383 million smartphones were sold with 85.9 percent running Android, 14.1 percent running iOS and other OSes negligible.[81] Android alone is more popular than the popular desktop operating system Windows, and in general smartphone use (even without tablets) outnumber desktop use.

text: Mobile devices with mobile communications abilities (e.g., smartphones) contain two mobile operating systems – the main user-facing software platform is supplemented by a second low-level proprietary real-time operating system which operates the radio and other hardware. Research has shown that these low-level systems may contain a range of security vulnerabilities permitting malicious base stations to gain high levels of control over the mobile device.[82]

text: Mobile app

text: A mobile app is a computer program designed to run on a mobile device, such as a smartphone. The term "app" is a shortening of the term "software application".

text: Application stores

text: The introduction of Apple's App Store for the iPhone and iPod Touch in July 2008 popularized manufacturer-hosted online distribution for third-party applications (software and computer programs) focused on a single platform. There are a huge variety of apps, including video games, music products and business tools. Up until that point, smartphone application distribution depended on third-party sources providing applications for multiple platforms, such as GetJar, Handango, Handmark, and PocketGear. Following the success of the App Store, other smartphone manufacturers launched application stores, such as Google's Android Market (later renamed to the Google Play Store) and RIM's BlackBerry App World and Android-related app stores like F-Droid. In February 2014, 93% of mobile developers were targeting smartphones first for mobile app development.[83]

text: Sales

text: Since 1996, smartphone shipments have had positive growth. In November 2011, 27% of all photographs created were taken with camera-equipped smartphones.[84] In September 2012, a study concluded that 4 out of 5 smartphone owners use the device to shop online.[85] Global smartphone sales surpassed the sales figures for feature phones in early 2013.[2] Worldwide shipments of smartphones topped 1 billion units in 2013, up 38% from 2012's 725 million, while comprising a 55% share of the mobile phone market in 2013, up from 42% in 2012.[86] In Q1 2016 for the first time the shipments dropped by 3 percent year on year. The situation was caused by the maturing China market.[87]

text: By manufacturer

text: This section needs to be updated. Please update this article to reflect recent events or newly available information. Last update: Statistics till mid 2018 is needed for this section. (August 2018)

text:
Worldwide Smartphones Vendors Market Share

Source

Date

Samsung

Apple Inc.

Huawei

Oppo

Vivo

Others

Reference

Gartner
Q1 2017
20.7%
13.7%
9.0%
8.1%
6.8%
41.7%
[88]

IDC
Q1 2017
23.3%
14.7%
10.0%
7.5%
5.5%
39.0%
[89]

text: In 2011, Samsung had the highest shipment market share worldwide, followed by Apple. In 2013, Samsung had 31.3% market share, a slight increase from 30.3% in 2012, while Apple was at 15.3%, a decrease from 18.7% in 2012. Huawei, LG and Lenovo were at about 5% each, significantly better than 2012 figures, while others had about 40%, the same as the previous years figure. Only Apple lost market share, although their shipment volume still increased by 12.9 percent; the rest had significant increases in shipment volumes of 36 to 92 percent.[90] In Q1 2014, Samsung had a 31% share and Apple had 16%.[91] In Q4 2014, Apple had a 20.4% share and Samsung had 19.9%.[92] In Q2 2016, Samsung had a 22.3% share and Apple had 12.9%.[88] In Q1 2017, IDC reported that Samsung was first placed, with 80 million units, followed by Apple with 50.8 million, Huawei with 34.6 million, Oppo with 25.5 million and Vivo with 22.7 million.[93]

text: Samsung's mobile business is half the size of Apple's, by revenue. Apple business has been increasing very rapidly over the past 4 years.[94]

text: By operating system

text: Use

text: Social

text: A 2012 University of Southern California study found that unprotected adolescent sexual activity was more common among owners of smartphones.[95] A study conducted by the Rensselaer Polytechnic Institute's (RPI) Lighting Research Center (LRC) concluded that smartphones, or any backlit devices, can seriously affect sleep cycles.[96] Some persons might become psychologically attached to smartphones resulting in anxiety when separated from the devices.[97] A "smombie" (a combination of "smartphone" and "zombie") is a walking person using a smartphone and not paying attention as they walk, possibly risking an accident in the process, an increasing social phenomenon.[98] The issue of slow-moving smartphone users led to the temporary creation of a "mobile lane" for walking in Chongqing, China.[99] The issue of distracted smartphone users led the city of Augsburg, Germany to embed pedestrian traffic lights in the pavement.[100]

text: Mobile banking and payment

text: In many countries, mobile phones are used to provide mobile banking services, which may include the ability to transfer cash payments by secure SMS text message. Kenya's M-PESA mobile banking service, for example, allows customers of the mobile phone operator Safaricom to hold cash balances which are recorded on their SIM cards. Cash can be deposited or withdrawn from M-PESA accounts at Safaricom retail outlets located throughout the country and can be transferred electronically from person to person and used to pay bills to companies.

text: Branchless banking has been successful in South Africa and the Philippines. A pilot project in Bali was launched in 2011 by the International Finance Corporation and an Indonesian bank, Bank Mandiri.[101]

text: Another application of mobile banking technology is Zidisha, a US-based nonprofit micro-lending platform that allows residents of developing countries to raise small business loans from Web users worldwide. Zidisha uses mobile banking for loan disbursements and repayments, transferring funds from lenders in the United States to borrowers in rural Africa who have mobile phones and can use the Internet.[102]

text: Mobile payments were first trialled in Finland in 1998 when two Coca-Cola vending machines in Espoo were enabled to work with SMS payments. Eventually, the idea spread and in 1999, the Philippines launched the country's first commercial mobile payments systems with mobile operators Globe and Smart.

text: Some mobile phones can make mobile payments via direct mobile billing schemes, or through contactless payments if the phone and the point of sale support near field communication (NFC).[103] Enabling contactless payments through NFC-equipped mobile phones requires the co-operation of manufacturers, network operators, and retail merchants.[104][105]

text: While driving

text: Mobile phone use while driving—including calling, text messaging, playing media, web browsing, gaming, using mapping apps or operating other phone features—is common but controversial, since it is widely considered dangerous due to what is known as distracted driving. Being distracted while operating a motor vehicle has been shown to increase the risk of accidents. In September 2010, the US National Highway Traffic Safety Administration (NHTSA) reported that 995 people were killed by drivers distracted by phones. In March 2011 a US insurance company, State Farm Insurance, announced the results of a study which showed 19% of drivers surveyed accessed the Internet on a smartphone while driving.[106] Many jurisdictions prohibit the use of mobile phones while driving. In Egypt, Israel, Japan, Portugal and Singapore, both handheld and hands-free calling on a mobile phone (which uses a speakerphone) is banned.  In other countries including the UK and France and in many US states, only the use of calling on handheld phones is banned, while hands-free use is permitted.

text:
A 2011 study reported that over 90% of college students surveyed text (initiate, reply or read) while driving.[107]
The scientific literature on the danger of driving while sending a text message from a mobile phone, or texting while driving, is limited. A simulation study at the University of Utah found a sixfold increase in distraction-related accidents when texting.[108] Due to the complexity of smartphones that began to grow more after, this has introduced additional difficulties for law enforcement officials when attempting to distinguish one usage from another in drivers using their devices. This is more apparent in countries which ban both handheld and hands-free usage, rather than those which ban handheld use only, as officials cannot easily tell which function of the phone is being used simply by looking at the driver. This can lead to drivers being stopped for using their device illegally for a call when, in fact, they were using the device legally, for example, when using the phone's incorporated controls for car stereo, GPS or satnav.

text: A 2010 study reviewed the incidence of phone use while cycling and its effects on behavior and safety.[109] In 2013 a national survey in the US reported the number of drivers who reported using their phones to access the Internet while driving had risen to nearly one of four.[110] A study conducted by the University of Vienna examined approaches for reducing inappropriate and problematic use of mobile phones, such as using phones while driving.[111]

text: Accidents involving a driver being distracted by being in a call on a phone have begun to be prosecuted as negligence similar to speeding. In the United Kingdom, from 27 February 2007, motorists who are caught using a handheld phone while driving will have three penalty points added to their license in addition to the fine of £60.[112] This increase was introduced to try to stem the increase in drivers ignoring the law.[113] Japan prohibits all use of phones while driving, including use of hands-free devices.  New Zealand has banned handheld phone use since 1 November 2009. Many states in the United States have banned text messaging on phones while driving. Illinois became the 17th American state to enforce this law.[114] As of July 2010, 30 states had banned texting while driving, with Kentucky becoming the most recent addition on July 15.[115]

text: Public Health Law Research maintains a list of distracted driving laws in the United States. This database of laws provides a comprehensive view of the provisions of laws that restrict the use of mobile devices while driving for all 50 states and the District of Columbia between 1992, when first law was passed through December 1, 2010. The dataset contains information on 22 dichotomous, continuous or categorical variables including, for example, activities regulated (e.g., texting versus talking, hands-free versus handheld calls, web browsing, gaming), targeted populations, and exemptions.[116]

text: Legal

text: A "patent war" between Samsung and Apple started when the latter claimed that the original Galaxy S Android phone copied the interface—and possibly the hardware—of Apple's iOS for the iPhone 3GS. There was also smartphone patents licensing and litigation involving Sony Mobile, Google, Apple Inc., Samsung, Microsoft, Nokia, Motorola, HTC, Huawei and ZTE, among others. The conflict is part of the wider "patent wars" between multinational technology and software corporations. To secure and increase market share, companies granted a patent can sue to prevent competitors from using the methods the patent covers. Since the 2010's the number of lawsuits, counter-suits, and trade complaints based on patents and designs in the market for smartphones, and devices based on smartphone OSes such as Android and iOS, has increased significantly. Initial suits, countersuits, rulings, license agreements, and other major events began in 2009 as the smartphone market stated to grow more rapidly by 2012.

text: Facsimile

text: Some apps allows for sending and receiving facsimile (Fax), over a smartphone, including facsimile data (composed of raster bi-level graphics) generated directly and digitally from document and image file formats.

text: Medical

text: With the rise in number of mobile medical apps in the market place, government regulatory agencies raised concerns on the safety of the use of such applications. These concerns were transformed into regulation initiatives worldwide with the aim of safeguarding users from untrusted medical advice.[117]

text: Security

text: Smartphone malware is easily distributed through an insecure app store.[118][119]  Often, malware is hidden in pirated versions of legitimate apps, which are then distributed through third-party app stores.[120][121] Malware risk also comes from what is known as an "update attack", where a legitimate application is later changed to include a malware component, which users then install when they are notified that the app has been updated.[122] As well, one out of three robberies in 2012 in the United States involved the theft of a mobile phone. An online petition has urged smartphone makers to install kill switches in their devices.[123] In 2014, Apple's "Find my iPhone" and Google's "Android Device Manager" can locate, disable, and wipe the data from phones that have been lost or stolen. With BlackBerry Protect in OS version 10.3.2, devices can be rendered unrecoverable to even BlackBerry's own Operating System recovery tools if incorrectly authenticated or dissociated from their account.[124]

text: Leaked documents published by WikiLeaks, codenamed Vault 7 and dated from 2013–2016, detail the capabilities of the United States Central Intelligence Agency (CIA) to perform electronic surveillance and cyber warfare, including the ability to compromise the operating systems of most smartphones (including iOS and Android).[125][126]

text: Sleep

text: Using smartphones late at night can disturb sleep, due to the blue light and brightly lit screen, which affects melatonin levels and sleep cycles. In an effort to alleviate these issues, several apps that change the color temperature of a screen to a warmer hue based on the time of day to reduce the amount of blue light generated have been developed for Android, while iOS 9.3 integrated similar, system-level functionality known as "Night Shift". Amazon released a feature known as "blue shade" in their Fire OS "Bellini" 5.0 and later. It has also been theorized that for some users, addicted use of their phones, especially before they go to bed, can result in "ego depletion". Many people also use their phones as alarm clocks, which can also lead to loss of sleep.[127][128][129][130][131]

text: Bokeh cameras

text: Pocket cameras have difficulty producing bokeh in images, but nowadays, some smartphones have dual-lens cameras that produce the bokeh effect easily, and can even rearrange the level of bokeh after shooting. The iPhone 7 Plus debuted with a dual-lens camera in the back of the smartphone.[132] More advanced smartphones may come with 'quad cameras', or two dual-lens cameras such as the Honor 9 Lite smartphone. The back and front of the smartphone each have a 13MP main lens and a 2MP lens for capturing depth information.[133] The Evercoss U50A Max smartphone has 4 cameras, and costs less than $100.[134]

text: Huawei P20 Pro smartphone with triple lenses in the back of the smartphone has been launched as bokeh camera smartphone with optical zoom. First lens has 40MP RGB, second lens has 20MP monochrome and third lens has 8MP RGB telephoto 3x. The zoom can be enhanced to 5x with combination of the optical zoom and megapixel lens 40MP RGB to produce undeteriorated (optical+digital) zoom or digital zoom without loss of quality.[135]


document_title: List of Australian Football League wooden spoons

question_text: when did hawthorn last win the wooden spoon

text: Criteria[edit]

text: The team which finishes on the bottom of the ladder wins the wooden spoon. This is determined by:

text:
Fewest premiership points (four points for a win, two points for a draw)
Lowest percentage (the ratio of points for to points against if on same numbers of points)

text: No countback exists if teams finish equal on points but with a different number of wins.

text: From 1901–1907, the VFL season was set up such that each team played fourteen regular season games: two games against each opponent. Based upon regular season ladder positions, teams were divided into pools A (1st, 3rd, 5th and 7th) and B (2nd, 4th, 6th and 8th), and each team played the opponents from its pool once each in the "sectional round."

text: Following the sectional round, the results of these matches were added to the ladder to give a final ladder based on seventeen matches per team. As such, the wooden spooner is considered to be the team which finishes last after all seventeen matches.

text: The three sectional games changed the outcome of the wooden spoon twice in the seven seasons of this format: in 1905, St Kilda beat Geelong in their last game, relegating Melbourne to last, and in 1907, Fitzroy won all three of their games, relegating Essendon to last.

text: In the war-time season of 1916, only four teams (Carlton, Collingwood, Fitzroy and Richmond) competed. Fitzroy finished last after the home-and-away season with a record of 2–9–1 (10 pts), and Richmond finished third with a record of 5–7–0 (20 pts).

text: All four teams competed in the finals under the amended Argus system in place at the time. Richmond lost their Semi-Final and finished in overall last place as the lowest placed Semi-Final loser, while Fitzroy won their Semi-Final, the Final and the Grand Final to claim the premiership.

text: There is hence some uncertainty regarding which team should lay claim to the wooden spoon in that season; by analogy with the minor and major premierships, it could be said that Fitzroy won the "minor wooden spoon" and Richmond won the "major wooden spoon".

text: The official AFL season guide recognises Richmond as the wooden spooners for the 1916 VFL season.

text: Records[edit]

text:
St Kilda has won the most wooden spoons of any existing AFL team, with 27; its most recent wooden spoon was in 2014.
Carlton has the longest wooden spoon drought in VFL/AFL history, and was the last of the foundation clubs to win a wooden spoon. Its first wooden spoon came in 2002, the club's 106th season of VFL/AFL competition. Despite this, they currently have the most wooden spoons in the 21st century with four.
Essendon and Collingwood are the only teams to follow up a wooden spoon with a Grand Final appearance, in 1907–08 and 1976–77 respectively. Neither was victorious.
Essendon hold the record for the swiftest rise from wooden spoon to premiership, two seasons: they finished last in 1921 and won back-to-back premierships in 1923-24.
Melbourne and Fitzroy hold the record for the swiftest descent from premiership to wooden spoon, three seasons: Melbourne finished last in 1951 after winning the premiership in 1948, and Fitzroy laid partial claim to the 1916 wooden spoon after winning the premiership in 1913.
St Kilda, Hawthorn, Gold Coast and Greater Western Sydney all won the wooden spoon in their inaugural season in the VFL/AFL.
Collingwood in 1976 holds the record for the most wins by a wooden spooner with six.
Thirteen wooden spooners failed to win a match during the season, the most recent being Fitzroy in 1964.
The highest percentage recorded by a wooden spoon team was by South Melbourne, with 91.3% in 1922.
The Adelaide Crows and Port Adelaide are the only teams to not have "won" a wooden spoon.

text: Wooden spoons by season[edit]

text:
Season
Wooden spoon
Wins
Losses
Draws
Percentage
Points

1897
St Kilda
0
14
0
29.1
0

1898
St Kilda
0
14
0
33.5
0

1899
St Kilda
0
14
0
28.0
0

1900
St Kilda
1
13
0
39.1
4

1901
St Kilda
1
16
0
–
4

1902
St Kilda
0
17
0
–
0

1903
South Melbourne
2
15
0
–
8

1904
St Kilda
3
14
0
–
12

1905
Melbourne
3
14
0
–
12

1906
Melbourne
1
16
0
–
4

1907
Essendon
5
12
0
–
20

1908
Geelong
2
16
0
–
8

1909
St Kilda
2
15
0
59.3
8

1910
St Kilda
1
17
0
62.3
4

1911
University
1
17
0
52.1
4

1912
University
1
17
0
57.0
4

1913
University
0
18
0
57.6
0

1914
University
0
18
0
47.0
0

1915
Geelong
3
13
0
68.0
12

1916 Minor
1916 Major
Fitzroy
Richmond
2
5
9
7
1
0
81.6
89.9
10
20

1917
Richmond
3
11
1
–
14

1918
Essendon
3
11
0
64.2
12

1919
Melbourne
0
16
0
43.0
0

1920
St Kilda
2
14
0
57.2
8

1921
Essendon
3
11
2
80.8
16

1922
South Melbourne
4
11
1
91.3
18

1923
Melbourne
3
13
0
80.4
12

1924
St Kilda
4
12
0
75.7
16

1925
Hawthorn
3
14
0
66.1
12

1926
North Melbourne
0
17
1
73.7
2

1927
Hawthorn
1
17
0
63.1
4

1928
Hawthorn
0
18
0
61.6
0

1929
North Melbourne
1
17
0
60.2
4

1930
North Melbourne
1
17
0
51.8
4

1931
North Melbourne
0
18
0
50.8
0

1932
Hawthorn
3
15
0
64.1
12

1933
Essendon
2
16
0
77.1
12

1934
North Melbourne
0
18
0
66.4
0

1935
North Melbourne
1
17
0
65.1
4

1936
Fitzroy
2
16
0
68.9
8

1937
North Melbourne
3
15
0
64.2
12

1938
South Melbourne
2
16
0
71.8
8

1939
South Melbourne
3
15
0
70.8
12

1940
North Melbourne
4
14
0
75.1
16

1941
Hawthorn
3
15
0
68.2
12

1942
Hawthorn
1
14
0
65.6
8

1943
St Kilda
1
8
1
73.9
10

1944
Geelong
1
17
0
58.6
4

1945
St Kilda
2
18
0
62.2
8

1946
Hawthorn
3
16
0
70.5
12

1947
St Kilda
1
17
1
58.7
6

1948
St Kilda
2
17
0
59.9
8

1949
Hawthorn
3
16
0
61.1
12

1950
Hawthorn
0
18
0
49.8
0

1951
Melbourne
1
17
0
70.5
4

1952
St Kilda
2
17
0
68.1
8

1953
Hawthorn
3
15
0
68.5
12

1954
St Kilda
4
13
1
72.7
18

1955
St Kilda
1
17
0
45.4
4

1956
North Melbourne
3
16
0
69.5
12

1957
Geelong
5
12
1
88.2
22

1958
Geelong
4
14
0
73.8
16

1959
Footscray
3
15
0
73.3
12

1960
Richmond
2
14
2
65.1
12

1961
North Melbourne
4
13
1
79.1
18

1962
South Melbourne
3
15
0
74.4
12

1963
Fitzroy
1
17
0
57.5
4

1964
Fitzroy
0
18
0
59.7
0

1965
Hawthorn
4
14
0
68.9
16

1966
Fitzroy
1
17
0
53.8
4

1967
Footscray
4
14
0
71.8
16

1968
North Melbourne
3
17
0
74.3
12

1969
Melbourne
3
17
0
83.1
12

1970
North Melbourne
4
18
0
79.1
16

1971
South Melbourne
3
19
0
69.9
12

1972
North Melbourne
1
21
0
62.9
4

1973
South Melbourne
4
18
0
79.0
16

1974
Melbourne
3
19
0
77.1
12

1975
South Melbourne
2
20
0
75.0
8

1976
Collingwood
6
16
0
86.4
24

1977
St Kilda
3
17
2
73.5
16

1978
Melbourne
5
17
0
69.1
20

1979
St Kilda
3
19
0
65.0
12

1980
Fitzroy
4
17
1
86.0
18

1981
Melbourne
1
21
0
63.5
4

1982
Footscray
3
19
0
68.1
12

1983
St Kilda
5
17
0
79
20

1984
St Kilda
5
17
0
76
20

1985
St Kilda
3
19
0
64.7
12

1986
St Kilda
2
20
0
71.9
8

1987
Richmond
5
17
0
83
20

1988
St Kilda
4
18
0
82
16

1989
Richmond
5
17
0
71
20

1990
Brisbane Bears
4
18
0
71
16

1991
Brisbane Bears
3
19
0
70
12

1992
Sydney
3
18
1
74
14

1993
Sydney
1
19
0
63
4

1994
Sydney
4
18
0
78
16

1995
Fitzroy
2
20
0
58.2
8

1996
Fitzroy
1
21
0
49.5
4

1997
Melbourne
4
18
0
60.8
16

1998
Brisbane Lions
5
16
1
75
22

1999
Collingwood
4
18
0
84.8
16

2000
St Kilda
2
19
1
70.5
10

2001
Fremantle
2
20
0
72.0
8

2002
Carlton
3
19
0
73.1
12

2003
Western Bulldogs
3
18
1
74.8
14

2004
Richmond
4
18
0
69.2
16

2005
Carlton
4
17
1
75.5
18

2006
Carlton
3
18
1
74.2
14

2007
Richmond
3
18
1
77.2
14

2008
Melbourne
3
19
0
62.6
12

2009
Melbourne
4
18
0
74.7
16

2010
West Coast
4
18
0
77.1
16

2011
Gold Coast
3
19
0
56.27
12

2012
Greater Western Sydney
2
20
0
46.17
8

2013
Greater Western Sydney
1
21
0
50.97
4

2014
St Kilda
4
18
0
60.8
16

2015
Carlton
4
18
0
64.8
16

2016
Essendon
3
19
0
61
12

2017
Brisbane Lions
5
17
0
74.3
20

text: Wooden spoon tally[edit]

text:
Club
Total
Wooden
Spoons
Years of Wooden Spoon

St Kilda

27

1897, 1898, 1899, 1900, 1901, 1902, 1904, 1909, 1910, 1920, 1924, 1943, 1945, 1947, 1948, 1952, 1954, 1955, 1977, 1979, 1983, 1984, 1985, 1986, 1988, 2000, 2014

North Melbourne

13

1926, 1929, 1930, 1931, 1934, 1935, 1937, 1940, 1956, 1961, 1968, 1970, 1972

Melbourne

12

1905, 1906, 1919, 1923, 1951, 1969, 1974, 1978, 1981, 1997, 2008, 2009

Hawthorn

11

1925, 1927, 1928, 1932, 1941, 1942, 1946, 1949, 1950, 1953, 1965

South Melbourne/Sydney

11

1903, 1922, 1938, 1939, 1962, 1971, 1973, 1975, 1992, 1993, 1994

Fitzroy

8*

1916*, 1936, 1963, 1964, 1966, 1980, 1995, 1996

Richmond

7*

1916*, 1917, 1960, 1987, 1989, 2004, 2007

Geelong

5

1908, 1915, 1944, 1957, 1958

Essendon

5

1907, 1918, 1921, 1933, 2016

University

4

1911, 1912, 1913, 1914

Footscray/Western Bulldogs

4

1959, 1967, 1982, 2003

Carlton

4

2002, 2005, 2006, 2015

Brisbane Bears

2

1990, 1991

Brisbane Lions

2

1998, 2017

Collingwood

2

1976, 1999

Greater Western Sydney

2

2012, 2013

Fremantle

1

2001

West Coast Eagles

1

2010

Gold Coast

1

2011

Port Adelaide

0

N/A

Adelaide

0

N/A

text: current clubs are shown in bold

text: * See 1916 explanation above

text: Longest wooden spoon droughts[edit]

text:
Club
Time period
Years

Carlton
1897–2002
105

Essendon
1933–2016
83

Collingwood
1897–1976
79

Geelong
1958–present
59

Hawthorn
1965–present
52

North Melbourne
1972–present
45

Richmond
1917–1960
43

Fitzroy
1897–19361
39

Footscray
1925–1959
34

text: 1 See discussion on 1916 wooden spoon.

text: AFL Women's[edit]

text:
Season
Wooden spoon
Wins
Losses
Draws
Percentage
Points

2017
Greater Western Sydney
1
5
1
51.8
6


document_title: List of Boston Red Sox seasons

question_text: whats the most games the red sox have won in a season

text: List of Boston Red Sox seasons

text: Year by year[edit]

text:
World Series champions(1903–present) †

American League champions(1901–present)[a] *

Division champions(1969–present) ^

Wild Card berth(1994–present) ¤

text:
Season

Level

League

Division

Finish

Wins

Losses

Pct.

GB

Postseason

Awards

Ref.

1901

MLB

AL

2nd

79

57

.580

4

Cy Young (TC)

[7]

1902

MLB

AL

3rd

77

60

.562

6½

[8]

1903

MLB †

AL *

1st

91

47

.659

 —

Won World Series (Pirates) 5–3 †

[9]

1904

MLB

AL *

1st

95

59

.616

 —

World Series canceled[b] *

[10]

1905

MLB

AL

4th

78

74

.513

16

[11]

1906

MLB

AL

8th

49

105

.318

45½

[12]

1907

MLB

AL

7th

59

90

.395

32½

[13]

1908

MLB

AL

5th

75

79

.487

15½

[14]

1909

MLB

AL

3rd

88

63

.582

9½

[15]

1910

MLB

AL

4th

81

72

.529

22½

[16]

1911

MLB

AL

4th

78

75

.509

24

[17]

1912

MLB †

AL *

1st

105

47

.690

 —

Won World Series (Giants) 4–3 †

Tris Speaker (MVP)

[18]

1913

MLB

AL

4th

79

71

.526

15½

[19]

1914

MLB

AL

2nd

91

62

.594

8½

[20]

1915

MLB †

AL *

1st

101

50

.668

 —

Won World Series (Phillies) 4–1 †

[21]

1916

MLB †

AL *

1st

91

63

.590

 —

Won World Series (Robins) 4–1 †

[22]

1917

MLB

AL

2nd

90

62

.592

9

[23]

1918

MLB †

AL *

1st

75

51

.595

 —

Won World Series (Cubs) 4–2 †

[24]

1919

MLB

AL

6th

66

71

.481

20½

[25]

1920

MLB

AL

5th

72

81

.470

25½

[26]

1921

MLB

AL

5th

75

79

.487

23½

[27]

1922

MLB

AL

8th

61

93

.396

33

[28]

1923

MLB

AL

8th

61

91

.401

37

[29]

1924

MLB

AL

7th

67

87

.435

25

[30]

1925

MLB

AL

8th

47

105

.309

49½

[31]

1926

MLB

AL

8th

46

107

.300

44½

[32]

1927

MLB

AL

8th

51

103

.331

59

[33]

1928

MLB

AL

8th

57

96

.372

43½

[34]

1929

MLB

AL

8th

58

96

.376

48

[35]

1930

MLB

AL

8th

52

102

.337

50

[36]

1931

MLB

AL

6th

62

90

.407

45

[37]

1932

MLB

AL

8th

43

111

.279

64

[38]

1933

MLB

AL

7th

63

86

.423

34½

[39]

1934

MLB

AL

4th

76

76

.500

24

[40]

1935

MLB

AL

4th

78

75

.510

16

[41]

1936

MLB

AL

6th

74

80

.481

28½

[42]

1937

MLB

AL

5th

80

72

.526

21

[43]

1938

MLB

AL

2nd

88

61

.591

9½

Jimmie Foxx (MVP)

[44]

1939

MLB

AL

2nd

89

62

.589

17

[45]

1940

MLB

AL

4th

82

72

.532

8

[46]

1941

MLB

AL

2nd

84

70

.545

17

[47]

1942

MLB

AL

2nd

93

59

.611

9

Ted Williams (TC)
[48]

1943

MLB

AL

7th

68

84

.447

29

[49]

1944

MLB

AL

4th

77

77

.500

12

[50]

1945

MLB

AL

7th

71

83

.461

17½

[51]

1946

MLB

AL *

1st

104

50

.675

 —

Lost World Series (Cardinals) 4–3 *

Ted Williams (MVP)

[52]

1947

MLB

AL

3rd

83

71

.538

14

Ted Williams (TC)

[53]

1948

MLB

AL

2nd

96

59

.619

1

[54]

1949

MLB

AL

2nd

96

58

.623

1

Ted Williams (MVP)

[55]

1950

MLB

AL

3rd

94

60

.610

4

Walt Dropo (ROY)

[56]

1951

MLB

AL

3rd

87

67

.564

11

[57]

1952

MLB

AL

6th

76

78

.493

19

[58]

1953

MLB

AL

4th

84

69

.549

16

[59]

1954

MLB

AL

4th

69

85

.448

42

[60]

1955

MLB

AL

4th

84

70

.545

12

[61]

1956

MLB

AL

4th

84

70

.545

13

[62]

1957

MLB

AL

3rd

82

72

.532

16

[63]

1958

MLB

AL

3rd

79

75

.512

13

Jackie Jensen (MVP)

[64]

1959

MLB

AL

5th

75

79

.487

19

[65]

1960

MLB

AL

7th

65

89

.422

32

[66]

1961

MLB

AL

6th

76

86

.469

33

Don Schwall (ROY)

[67]

1962

MLB

AL

8th

76

84

.475

19

[68]

1963

MLB

AL

7th

76

85

.472

28

[69]

1964

MLB

AL

7th

72

90

.444

27

[70]

1965

MLB

AL

9th

62

100

.382

40

[71]

1966

MLB

AL

9th

72

90

.444

26

[72]

1967

MLB

AL *

1st

92

70

.567

—

Lost World Series (Cardinals) 4–3 *

Carl Yastrzemski (MVP, TC) Jim Lonborg (CYA)

[73]

1968

MLB

AL

3rd

86

76

.530

17

[74]

1969

MLB

AL

East

3rd

87

75

.537

22

[75]

1970

MLB

AL

East

3rd

87

75

.537

21

[76]

1971

MLB

AL

East

3rd

85

77

.524

18

[77]

1972

MLB

AL

East

2nd

85

70

.548

½

Carlton Fisk (ROY)

[78]

1973

MLB

AL

East

2nd

89

73

.549

8

[79]

1974

MLB

AL

East

3rd

84

78

.518

7

[80]

1975

MLB

AL *

East ^

1st

95

65

.593

 —

Won ALCS (Athletics) 3–0 Lost World Series (Reds) 4–3 *

Fred Lynn (MVP, ROY)
[81]

1976

MLB

AL

East

3rd

83

79

.512

15½

[82]

1977

MLB

AL

East

2nd

97

64

.602

2½

[83]

1978

MLB

AL

East

2nd

99

64

.607

1

Jim Rice (MVP)

[84]

1979

MLB

AL

East

3rd

91

69

.568

11½

[85]

1980

MLB

AL

East

5th

83

77

.518

19

[86]

1981[c]

MLB

AL

East

5th

59

49

.535

2½

[87]

1982

MLB

AL

East

3rd

89

73

.549

6

[88]

1983

MLB

AL

East

6th

78

84

.481

20

[89]

1984

MLB

AL

East

4th

86

76

.530

18

[90]

1985

MLB

AL

East

6th

81

81

.500

18½

[91]

1986

MLB

AL *

East ^

1st

95

66

.590

 —

Won ALCS (Angels) 4–3Lost World Series (Mets) 4–3 *

Roger Clemens (MVP, CYA)John McNamara (MOY)

[92]

1987

MLB

AL

East

5th

78

84

.481

20

Roger Clemens (CYA)

[93]

1988

MLB

AL

East ^

1st

89

73

.549

 —

Lost ALCS (Athletics) 4–0

[94]

1989

MLB

AL

East

3rd

83

79

.512

6

[95]

1990

MLB

AL

East ^

1st

88

74

.543

 —

Lost ALCS (Athletics) 4–0

[96]

1991

MLB

AL

East

2nd

84

78

.518

7

Roger Clemens (CYA)

[97]

1992

MLB

AL

East

7th

73

89

.450

23

[98]

1993

MLB

AL

East

5th

80

82

.493

15

[99]

1994[d]

MLB

AL

East

5th

54

61

.469

17

Playoffs cancelled

[100]

1995

MLB

AL

East ^

1st

86

58

.597

 —

Lost ALDS (Indians) 3–0

Mo Vaughn (MVP)

[101]

1996

MLB

AL

East

3rd

85

77

.524

7

[102]

1997

MLB

AL

East

4th

78

84

.481

20

Nomar Garciaparra (ROY)

[103]

1998

MLB

AL

East

2nd ¤

92

70

.567

22

Lost ALDS (Indians) 3–1

[104]

1999

MLB

AL

East

2nd ¤

94

68

.580

4

Won ALDS (Indians) 3–2Lost ALCS (Yankees) 4–1

Pedro Martínez (CYA, TC)Jimy Williams (MOY)

[105]

2000

MLB

AL

East

2nd

85

77

.524

2½

Pedro Martínez (CYA)

[106]

2001

MLB

AL

East

2nd

82

79

.509

13½

[107]

2002

MLB

AL

East

2nd

93

69

.574

10½

[108]

2003

MLB

AL

East

2nd ¤

95

67

.586

6

Won ALDS (Athletics) 3–2Lost ALCS (Yankees) 4–3

[109]

2004

MLB †

AL *

East

2nd ¤

98

64

.605

3

Won ALDS (Angels) 3–0Won ALCS (Yankees) 4–3Won World Series (Cardinals) 4–0 †

Manny Ramirez (WS MVP)

[110]

2005

MLB

AL

East

2nd ¤

95

67

.586

—[e]

Lost ALDS (White Sox) 3–0

[111]

2006

MLB

AL

East

3rd

86

76

.530

11

[112]

2007

MLB †

AL *

East ^

1st

96

66

.592

—

Won ALDS (Angels) 3–0Won ALCS (Indians) 4–3 Won World Series (Rockies) 4–0 †

Dustin Pedroia (ROY)Mike Lowell (WS MVP)

[113]

2008

MLB

AL

East

2nd ¤

95

67

.586

2

Won ALDS (Angels) 3–1Lost ALCS (Rays) 4–3

Dustin Pedroia (MVP)

[114]

2009

MLB

AL

East

2nd ¤

95

67

.586

8

Lost ALDS (Angels) 3–0

[115]

2010

MLB

AL

East

3rd

89

73

.549

7

[116]

2011

MLB

AL

East

3rd

90

72

.556

7

[117]

2012

MLB

AL

East

5th

69

93

.426

26

[118]

2013

MLB †

AL *

East ^

1st

97

65

.599

—

Won ALDS (Rays) 3–1Won ALCS (Tigers) 4–2Won World Series (Cardinals) 4–2 †

David Ortiz (WS MVP)

[119]

2014

MLB

AL

East

5th

71

91

.438

25

[120]

2015

MLB

AL

East

5th

78

84

.481

15

[121]

2016

MLB

AL

East ^

1st

93

69

.574

—

Lost ALDS (Indians) 3–0

Rick Porcello (CYA)

[122]

2017

MLB

AL

East ^

1st

93

69

.574

—

Lost ALDS (Astros) 3–1

[123]

2018

MLB †

AL *

East ^

1st

108

54

.667

—

Won ALDS (Yankees) 3–1Won ALCS (Astros) 4–1Won World Series (Dodgers) 4–1 †

Steve Pearce (WS MVP)

[124]

text: Regular season record by decade[edit]

text: The following table describes the Red Sox's MLB win–loss record by decade.

text:
Decade
Wins
Losses
Pct

1900s
691
634
.522

1910s
857
624
.579

1920s
595
938
.388

1930s
705
815
.464

1940s
854
683
.556

1950s
814
725
.529

1960s
764
845
.475

1970s
895
714
.556

1980s
821
742
.525

1990s
814
741
.523

2000s
920
699
.568

2010s
788
670
.540

All-time
9425
8761
.518

text: These statistics are from Baseball-Reference.com's Boston Red Sox History & Encyclopedia,[125] and are current as of the end of the 2017 regular season.

text: All-time records[edit]

text:
Total Games

Wins

Losses

Win %

Boston Americans regular season record (1901–1907)

1,020

528

492

.518

Boston Red Sox regular season record (1907–present)

17,166

8,882

8,284

.517

All-time regular season record

18,186

9,410

8,776

.517

All-time post-season record[126]

174

91

83

.523

All-time regular and post-season record

18,360

9,501

8,859

.517

text: Note: These statistics are current as of the conclusion of the 2017 season.

text: Notes[edit]

text:
a For all American League pennant winners see List of American League pennant winners
b The World Series was canceled after the New York Giants refused to play.
c The season was partially canceled due to a player's strike that closed the MLB for 50 days.
d The season was partially canceled due to a player's strike that closed the MLB for 223 days.
e The Red Sox finished 95–67 and with the same record as the New York Yankees, but since the Yankees had won the season series between the two teams, they won the American League East and the Red Sox had to settle for the American League Wild Card.


document_title: Anaphylaxis

question_text: what happens to blood pressure in anaphylactic shock

text: Anaphylaxis

text: Signs and symptoms[edit]

text: Anaphylaxis typically presents many different symptoms over minutes or hours[7][11] with an average onset of 5 to 30 minutes if exposure is intravenous and 2 hours if from eating food.[12] The most common areas affected include: skin (80–90%), respiratory (70%), gastrointestinal (30–45%), heart and vasculature (10–45%), and central nervous system (10–15%)[13] with usually two or more being involved.[3]

text: Skin[edit]

text: Symptoms typically include generalized hives, itchiness, flushing, or swelling (angioedema) of the afflicted tissues.[4] Those with angioedema may describe a burning sensation of the skin rather than itchiness.[12] Swelling of the tongue or throat occurs in up to about 20% of cases.[14] Other features may include a runny nose and swelling of the conjunctiva.[15] The skin may also be blue tinged because of lack of oxygen.[15]

text: Respiratory[edit]

text: Respiratory symptoms and signs that may be present include shortness of breath, wheezes, or stridor.[4] The wheezing is typically caused by spasms of the bronchial muscles[16] while stridor is related to upper airway obstruction secondary to swelling.[15] Hoarseness, pain with swallowing, or a cough may also occur.[12]

text: Cardiovascular[edit]

text: Coronary artery spasm may occur with subsequent myocardial infarction, dysrhythmia, or cardiac arrest.[3][13] Those with underlying coronary disease are at greater risk of cardiac effects from anaphylaxis.[16] The coronary spasm is related to the presence of histamine-releasing cells in the heart.[16] While a fast heart rate caused by low blood pressure is more common,[15] a Bezold–Jarisch reflex has been described in 10% of cases where a slow heart rate is associated with low blood pressure.[8] A drop in blood pressure or shock (either distributive or cardiogenic) may cause the feeling of lightheadedness or loss of consciousness.[16] Rarely very low blood pressure may be the only sign of anaphylaxis.[14]

text: Other[edit]

text: Gastrointestinal symptoms may include crampy abdominal pain, diarrhea, and vomiting.[4] There may be confusion, a loss of bladder control or pelvic pain similar to that of uterine cramps.[4][15] Dilation of blood vessels around the brain may cause headaches.[12] A feeling of anxiety or of "impending doom" has also been described.[3]

text: Causes[edit]

text: Anaphylaxis can occur in response to almost any foreign substance.[17] Common triggers include venom from insect bites or stings, foods, and medication.[8][18] Foods are the most common trigger in children and young adults while medications and insect bites and stings are more common in older adults.[3] Less common causes include: physical factors, biological agents such as semen, latex, hormonal changes, food additives such as monosodium glutamate and food colors, and topical medications.[15] Physical factors such as exercise (known as exercise-induced anaphylaxis) or temperature (either hot or cold) may also act as triggers through their direct effects on mast cells.[3][19] Events caused by exercise are frequently associated with the ingestion of certain foods.[12] During anesthesia, neuromuscular blocking agents, antibiotics, and latex are the most common causes.[20] The cause remains unknown in 32–50% of cases, referred to as "idiopathic anaphylaxis."[21] Six vaccines (MMR, varicella, influenza, hepatitis B, tetanus, meningococcal) are recognized as a cause for anaphylaxis, and HPV may cause anaphylaxis as well.[22] Physical exercise is an uncommon cause of anaphylaxis;[23] in about a third of such cases there is a co-factor like taking an NSAID or eating a specific food prior to exercising.[24]

text: Food[edit]

text: Many foods can trigger anaphylaxis; this may occur upon the first known ingestion.[8] Common triggering foods vary around the world. In Western cultures, ingestion of or exposure to peanuts, wheat, nuts, certain types of seafood like shellfish, milk, and eggs are the most prevalent causes.[3][13] Sesame is common in the Middle East, while rice and chickpeas are frequently encountered as sources of anaphylaxis in Asia.[3] Severe cases are usually caused by ingesting the allergen,[8] but some people experience a severe reaction upon contact. Children can outgrow their allergies. By age 16, 80% of children with anaphylaxis to milk or eggs and 20% who experience isolated anaphylaxis to peanuts can tolerate these foods.[17]

text: Medication[edit]

text: Any medication may potentially trigger anaphylaxis. The most common are β-lactam antibiotics (such as penicillin) followed by aspirin and NSAIDs.[13][25] Other antibiotics are implicated less frequently, and the reactions to NSAIDs are agent specific meaning that those who are allergic to one NSAID can typically tolerate a different one.[25] Other relatively common causes include chemotherapy, vaccines, protamine and herbal preparations.[3] Some medications (vancomycin, morphine, x-ray contrast among others) cause anaphylaxis by directly triggering mast cell degranulation.[8]

text: The frequency of a reaction to an agent partly depends on the frequency of its use and partly on its intrinsic properties.[26] Anaphylaxis to penicillin or cephalosporins occurs only after it binds to proteins inside the body with some agents binding more easily than others.[12] Anaphylaxis to penicillin occurs once in every 2,000 to 10,000 courses of treatment, with death occurring in fewer than one in every 50,000 courses of treatment.[12] Anaphylaxis to aspirin and NSAIDs occurs in about one in every 50,000 persons.[12] If someone has a reaction to penicillins, his or her risk of a reaction to cephalosporins is greater but still less than one in 1,000.[12] The old radiocontrast agents caused reactions in 1% of cases, while the newer lower osmolar agents cause reactions in 0.04% of cases.[26]

text: Venom[edit]

text: Venom from stinging or biting insects such as Hymenoptera (ants, bees, and wasps) or Triatominae (kissing bugs) may cause anaphylaxis in susceptible people.[7][27][28] Previous systemic reactions, which are anything more than a local reaction around the site of the sting, are a risk factor for future anaphylaxis;[29][30] however, half of fatalities have had no previous systemic reaction.[31]

text: Risk factors[edit]

text: People with atopic diseases such as asthma, eczema, or allergic rhinitis are at high risk of anaphylaxis from food, latex, and radiocontrast agents but not from injectable medications or stings.[3][8] One study in children found that 60% had a history of previous atopic diseases, and of children who die from anaphylaxis, more than 90% have asthma.[8] Those with mastocytosis or of a higher socioeconomic status are at increased risk.[3][8] The longer the time since the last exposure to the agent in question, the lower the risk.[12]

text: Pathophysiology[edit]

text: Anaphylaxis is a severe allergic reaction of rapid onset affecting many body systems.[5][6] It is due to the release of inflammatory mediators and cytokines from mast cells and basophils, typically due to an immunologic reaction but sometimes non-immunologic mechanism.[6]

text: Immunologic[edit]

text: In the immunologic mechanism, immunoglobulin E (IgE) binds to the antigen (the foreign material that provokes the allergic reaction). Antigen-bound IgE then activates FcεRI receptors on mast cells and basophils. This leads to the release of inflammatory mediators such as histamine. These mediators subsequently increase the contraction of bronchial smooth muscles, trigger vasodilation, increase the leakage of fluid from blood vessels, and cause heart muscle depression.[6][12] There is also an immunologic mechanism that does not rely on IgE, but it is not known if this occurs in humans.[6]

text: Non-immunologic[edit]

text: Non-immunologic mechanisms involve substances that directly cause the degranulation of mast cells and basophils. These include agents such as contrast medium, opioids, temperature (hot or cold), and vibration.[6][19] Sulfites may cause reactions by both immunologic and non-immunologic mechanisms.[32]

text: Diagnosis[edit]

text: Anaphylaxis is diagnosed on the basis of a person's signs and symptoms.[3] When any one of the following three occurs within minutes or hours of exposure to an allergen there is a high likelihood of anaphylaxis:[3]

text:
Involvement of the skin or mucosal tissue plus either respiratory difficulty or a low blood pressure causing symptoms
Two or more of the following symptoms after a likely contact with an allergen:

a. Involvement of the skin or mucosa
b. Respiratory difficulties
c. Low blood pressure
d. Gastrointestinal symptoms

Low blood pressure after exposure to a known allergen

tag: ol

text: Skin involvement may include: hives, itchiness or a swollen tongue among others. Respiratory difficulties may include: shortness of breath, stridor, or low oxygen levels among others. Low blood pressure is defined as a greater than 30% decrease from a person's usual blood pressure. In adults a systolic blood pressure of less than 90 mmHg is often used.[3]

text: During an attack, blood tests for tryptase or histamine (released from mast cells) might be useful in diagnosing anaphylaxis due to insect stings or medications. However these tests are of limited use if the cause is food or if the person has a normal blood pressure,[3] and they are not specific for the diagnosis.[17]

text: Classification[edit]

text: There are three main classifications of anaphylaxis. Anaphylactic shock is associated with systemic vasodilation that causes low blood pressure which is by definition 30% lower than the person's baseline or below standard values.[14] Biphasic anaphylaxis is the recurrence of symptoms within 1–72 hours with no further exposure to the allergen.[3] Reports of incidence vary, with some studies claiming as many as 20% of cases.[33] The recurrence typically occurs within 8 hours.[8] It is managed in the same manner as anaphylaxis.[7] Pseudoanaphylaxis or anaphylactoid reactions are a type of anaphylaxis that does not involve an allergic reaction but is due to direct mast cell degranulation.[8][34] Non-immune anaphylaxis is the current term used by the World Allergy Organization[34] with some recommending that the old terminology no longer be used.[8]

text: Allergy testing[edit]

text: Allergy testing may help in determining the trigger. Skin allergy testing is available for certain foods and venoms.[17] Blood testing for specific IgE can be useful to confirm milk, egg, peanut, tree nut and fish allergies.[17]

text: Skin testing is available to confirm penicillin allergies, but is not available for other medications.[17] Non-immune forms of anaphylaxis can only be determined by history or exposure to the allergen in question, and not by skin or blood testing.[34]

text: Differential diagnosis[edit]

text: It can sometimes be difficult to distinguish anaphylaxis from asthma, syncope, and panic attacks.[3] Asthma however typically does not entail itching or gastrointestinal symptoms, syncope presents with pallor rather than a rash, and a panic attack may have flushing but does not have hives.[3] Other conditions that may present similarly include: scrombroidosis and anisakiasis.[8]

text: Post-mortem findings[edit]

text: In a person who died from anaphylaxis, autopsy may show an "empty heart" attributed to reduced venous return from vasodilation and redistribution of intravascular volume from the central to the peripheral compartment.[35] Other signs are laryngeal edema, eosinophilia in lungs, heart and tissues, and evidence of myocardial hypoperfusion.[36] Laboratory findings could detect increased levels of serum tryptase, increase in total and specific IgE serum levels.[36]

text: Prevention[edit]

text: Avoidance of the trigger of anaphylaxis is recommended. In cases where this may not be possible, desensitization may be an option. Immunotherapy with Hymenoptera venoms is effective at desensitizing 80–90% of adults and 98% of children against allergies to bees, wasps, hornets, yellowjackets, and fire ants. Oral immunotherapy may be effective at desensitizing some people to certain food including milk, eggs, nuts and peanuts; however, adverse effects are common.[3] For example, many people develop an itchy throat, cough, or lip swelling during immunotherapy.[37] Desensitization is also possible for many medications, however it is advised that most people simply avoid the agent in question. In those who react to latex it may be important to avoid cross-reactive foods such as avocados, bananas, and potatoes among others.[3]

text: Management[edit]

text: Anaphylaxis is a medical emergency that may require resuscitation measures such as airway management, supplemental oxygen, large volumes of intravenous fluids, and close monitoring.[7] Administration of epinephrine is the treatment of choice with antihistamines and steroids (for example, dexamethasone) often used as adjuncts.[7] A period of in-hospital observation for between 2 and 24 hours is recommended for people once they have returned to normal due to concerns of biphasic anaphylaxis.[8][12][33][38]

text: Epinephrine[edit]

text: Epinephrine (adrenaline) is the primary treatment for anaphylaxis with no absolute contraindication to its use.[7] It is recommended that an epinephrine solution be given intramuscularly into the mid anterolateral thigh as soon as the diagnosis is suspected. The injection may be repeated every 5 to 15 minutes if there is insufficient response.[7] A second dose is needed in 16-35% of episodes with more than two doses rarely required.[7] The intramuscular route is preferred over subcutaneous administration because the latter may have delayed absorption.[7][39] Minor adverse effects from epinephrine include tremors, anxiety, headaches, and palpitations.[3]

text: People on β-blockers may be resistant to the effects of epinephrine.[8] In this situation if epinephrine is not effective intravenous glucagon can be administered which has a mechanism of action independent of β-receptors.[8]

text: If necessary, it can also be given intravenously using a dilute epinephrine solution. Intravenous epinephrine, however, has been associated both with dysrhythmia and myocardial infarction.[7] Epinephrine autoinjectors used for self-administration typically come in two doses, one for adults or children who weigh more than 25 kg and one for children who weigh 10 to 25 kg.[40]

text: Adjuncts[edit]

text: Antihistamines (both H1 and H2), while commonly used and assumed effective based on theoretical reasoning, are poorly supported by evidence.[41][42] A 2007 Cochrane review did not find any good-quality studies upon which to base recommendations[42] and they are not believed to have an effect on airway edema or spasm.[8] Corticosteroids are unlikely to make a difference in the current episode of anaphylaxis, but may be used in the hope of decreasing the risk of biphasic anaphylaxis. Their prophylactic effectiveness in these situations is uncertain.[33] Nebulized salbutamol may be effective for bronchospasm that does not resolve with epinephrine.[8] Methylene blue has been used in those not responsive to other measures due to its presumed effect of relaxing smooth muscle.[8]

text: Preparedness[edit]

text: People prone to anaphylaxis are advised to have an "allergy action plan." Parents are advised to inform schools of their children's allergies and what to do in case of an anaphylactic emergency. The action plan usually includes use of epinephrine autoinjectors, the recommendation to wear a medical alert bracelet, and counseling on avoidance of triggers.[43] Immunotherapy is available for certain triggers to prevent future episodes of anaphylaxis. A multi-year course of subcutaneous desensitization has been found effective against stinging insects, while oral desensitization is effective for many foods.[13]

text: Prognosis[edit]

text: In those in whom the cause is known and prompt treatment is available, the prognosis is good.[44] Even if the cause is unknown, if appropriate preventative medication is available, the prognosis is generally good.[12] If death occurs, it is usually due to either respiratory (typically asphyxia) or cardiovascular causes (shock),[6][8] with 0.7–20% of cases causing death.[12][16] There have been cases of death occurring within minutes.[3] Outcomes in those with exercise-induced anaphylaxis are typically good, with fewer and less severe episodes as people get older.[21]

text: Epidemiology[edit]

text: The number of people who get anaphylaxis is 4–100 per 100,000 persons per year,[8][45] with a lifetime risk of 0.05–2%.[46] About 30% of people get more than one attack.[45] Exercise-induced anaphylaxis affects about 1 in 2000 young people.[24]

text: Rates appear to be increasing: with the numbers in the 1980s being approximately 20 per 100,000 per year, while in the 1990s it was 50 per 100,000 per year.[13] The increase appears to be primarily for food-induced anaphylaxis.[47] The risk is greatest in young people and females.[7][8]

text: Anaphylaxis leads to as many as 500–1,000 deaths per year (2.7 per million) in the United States, 20 deaths per year in the United Kingdom (0.33 per million), and 15 deaths per year in Australia (0.64 per million).[8] Another estimate from the United States puts the death rate at 0.7 per million.[48] Mortality rates have decreased between the 1970s and 2000s.[49] In Australia, death from food-induced anaphylaxis occur primarily in women while deaths due to insect bites primarily occur in males.[8] Death from anaphylaxis is most commonly triggered by medications.[8]

text: History[edit]

text: The term aphylaxis was coined by Charles Richet in 1902 and later changed to anaphylaxis due to its nicer quality of speech.[17] In his experiments, Richet injected a dog with sea anemone (Actinia) toxin in an attempt to protect it. Although the dog had previously tolerated the toxin, on re-exposure, three weeks later with the same dose, it developed fatal anaphylaxis. Thus instead of inducing tolerance (prophylaxis), when lethal responses resulted from previously tolerated doses, he coined the word a (without) phylaxis (protection). He was subsequently awarded the Nobel Prize in Physiology or Medicine for his work on anaphylaxis in 1913.[12] The phenomenon itself, however, has been described since ancient times.[34] The term comes from the Greek words ἀνά, ana, "against", and φύλαξις, phylaxis, "protection".[50]

text: Research[edit]

text: There are ongoing efforts to develop sublingual epinephrine to treat anaphylaxis.[8] Subcutaneous injection of the anti-IgE antibody omalizumab is being studied as a method of preventing recurrence, but it is not yet recommended.[3][51]