document_title: Blood transfusion

question_text: where did the first blood transfusion take place

question_tokens: where did the first blood transfusion take place

text: Blood transfusion

text: Medical uses[edit]

text: Historically, red blood cell transfusion was considered when the hemoglobin level fell below 100 g/L or hematocrit falls below 30%.[1][2] Because each unit of blood given carries risks, a trigger level lower than that at 70 to 80 g/L is now usually used as it has been shown to have better patient outcomes.[3][4] The administration of a single unit of blood is the standard for hospitalized people who are not bleeding, with this treatment then followed with re-assessment and consideration of symptoms and hemoglobin concentration.[3] Patients with poor oxygen saturation may need more blood.[3] The advisory caution to use blood transfusion only with more severe anemia is in part due to evidence that outcomes are worsened if larger amounts are given.[5] One may consider transfusion for people with symptoms of cardiovascular disease such as chest pain or shortness of breath.[2] In cases where patients have low levels of hemoglobin but are cardiovascularly stable, parenteral iron is a preferred option based on both efficacy and safety.[6] Other blood products are given where appropriate, such as clotting deficiencies.

text: Procedure[edit]

text: Before a blood transfusion is given, there are many steps taken to ensure quality of the blood products, compatibility, and safety to the recipient. In 2012, a national blood policy was in place in 70% of countries and 62% of countries had specific legislation that covers the safety and quality of blood transfusion.[7]

text: Blood donation[edit]

text: Blood transfusions typically use sources of blood: one's own (autologous transfusion), or someone else's (allogeneic or homologous transfusion). The latter is much more common than the former. Using another's blood must first start with donation of blood. Blood is most commonly donated as whole blood intravenously and collecting it with an anticoagulant. In developed countries, donations are usually anonymous to the recipient, but products in a blood bank are always individually traceable through the whole cycle of donation, testing, separation into components, storage, and administration to the recipient. This enables management and investigation of any suspected transfusion related disease transmission or transfusion reaction. In developing countries the donor is sometimes specifically recruited by or for the recipient, typically a family member, and the donation occurs immediately before the transfusion.

text: Processing and testing[edit]

text: Donated blood is usually subjected to processing after it is collected, to make it suitable for use in specific patient populations. Collected blood is then separated into blood components by centrifugation: red blood cells, plasma, platelets, albumin protein, clotting factor concentrates, cryoprecipitate, fibrinogen concentrate, and immunoglobulins (antibodies). Red cells, plasma and platelets can also be donated individually via a more complex process called apheresis.

text:
The World Health Organization (WHO) recommends that all donated blood be tested for transfusion transmissible infections. These include HIV, Hepatitis B, Hepatitis C, Treponema pallidum (syphilis) and, where relevant, other infections that pose a risk to the safety of the blood supply, such as Trypanosoma cruzi (Chagas disease) and Plasmodium species (malaria).[8] According to the WHO, 25 countries are not able to screen all donated blood for one or more of: HIV; Hepatitis B; Hepatitis C; or syphilis.[9] One of the main reasons for this is because testing kits are not always available.[9] However the prevalence of transfusion-transmitted infections is much higher in low income countries compared to middle and high income countries.[9]
All donated blood should also be tested for the ABO blood group system and Rh blood group system to ensure that the patient is receiving compatible blood.[10]
In addition, in some countries platelet products are also tested for bacterial infections due to its higher inclination for contamination due to storage at room temperature.[11][12] Presence of Cytomegalovirus (CMV) may also be tested because of the risk to certain immunocompromised recipients if given, such as those with organ transplant or HIV. However, not all blood is tested for CMV because only a certain amount of CMV-negative blood needs to be available to supply patient needs. Other than positivity for CMV, any products tested positive for infections are not used.[13]
Leukocyte reduction is the removal of white blood cells by filtration. Leukoreduced blood products are less likely to cause HLA alloimmunization (development of antibodies against specific blood types), febrile non-hemolytic transfusion reaction, cytomegalovirus infection, and platelet-transfusion refractoriness.[14]
Pathogen Reduction treatment that involves, for example, the addition of riboflavin with subsequent exposure to UV light has been shown to be effective in inactivating pathogens (viruses, bacteria, parasites and white blood cells) in blood products.[15][16][17] By inactivating white blood cells in donated blood products, riboflavin and UV light treatment can also replace gamma-irradiation as a method to prevent graft-versus-host disease (TA-GvHD).[18][19][20]

text: Compatibility testing[edit]

text: Before a recipient receives a transfusion, compatibility testing between donor and recipient blood must be done. The first step before a transfusion is given is to type and screen the recipient's blood. Typing of recipient's blood determines the ABO and Rh status. The sample is then screened for any alloantibodies that may react with donor blood.[21] It takes about 45 minutes to complete (depending on the method used). The blood bank scientist also checks for special requirements of the patient (e.g. need for washed, irradiated or CMV negative blood) and the history of the patient to see if they have previously identified antibodies and any other serological anomalies.

text: A positive screen warrants an antibody panel/investigation to determine if it is clinically significant. An antibody panel consists of commercially prepared group O red cell suspensions from donors that have been phenotyped for antigens that correspond to commonly encountered and clinically significant alloantibodies. Donor cells may have homozygous (e.g. K+k−), heterozygous (K+k+) expression or no expression of various antigens (K−k−). The phenotypes of all the donor cells being tested are shown in a chart. The patient's serum is tested against the various donor cells. Based on the reactions of the patient's serum against the donor cells, a pattern will emerge to confirm the presence of one or more antibodies. Not all antibodies are clinically significant (i.e. cause transfusion reactions, HDN, etc.). Once the patient has developed a clinically significant antibody it is vital that the patient receive antigen-negative red blood cells to prevent future transfusion reactions. A direct antiglobulin test (Coombs test) is also performed as part of the antibody investigation.[22]

text: If there is no antibody present, an immediate spin crossmatch or computer assisted crossmatch is performed where the recipient serum and donor rbc are incubated. In the immediate spin method, two drops of patient serum are tested against a drop of 3–5% suspension of donor cells in a test tube and spun in a serofuge. Agglutination or hemolysis (i.e., positive Coombs test) in the test tube is a positive reaction and the unit should not be transfused.

text: If an antibody is suspected, potential donor units must first be screened for the corresponding antigen by phenotyping them. Antigen negative units are then tested against the patient plasma using an antiglobulin/indirect crossmatch technique at 37 degrees Celsius to enhance reactivity and make the test easier to read.

text: In urgent cases where crossmatching cannot be completed, and the risk of dropping hemoglobin outweighs the risk transfusing uncrossmatched blood, O-negative blood is used, followed by crossmatch as soon as possible. O-negative is also used for children and women of childbearing age. It is preferable for the laboratory to obtain a pre-transfusion sample in these cases so a type and screen can be performed to determine the actual blood group of the patient and to check for alloantibodies.

text: Compatibility of ABO and Rh system[edit]

text: This chart shows possible matches in blood transfusion between donor and receiver using ABO and Rh system.

text:
Donor

O-
O+
B-
B+
A-
A+
AB-
AB+

Recipient
AB+

AB-

A+

A-

B+

B-

O+

O-

text: Adverse effects[edit]

text: In the same way that the safety of pharmaceutical products is overseen by pharmacovigilance, the safety of blood and blood products is overseen by haemovigilance. This is defined by the World Health Organization (WHO) as a system "...to identify and prevent occurrence or recurrence of transfusion related unwanted events, to increase the safety, efficacy and efficiency of blood transfusion, covering all activities of the transfusion chain from donor to recipient." The system should include monitoring, identification, reporting, investigation and analysis of adverse events near-misses and reactions related to transfusion and manufacturing.[23] In the UK this data is collected by an independent organisation called SHOT (Serious Hazards Of Transfusion).[24]

text: Transfusions of blood products are associated with several complications, many of which can be grouped as immunological or infectious. There is controversy on potential quality degradation during storage.[25]

text: Immunologic reaction[edit]

text:
Acute hemolytic reactions are defined according to Serious Hazards of Transfusion (SHOT) as "fever and other symptoms/signs of haemolysis within 24 hours of transfusion; confirmed by one or more of the following: a fall of Hb, rise in lactate dehydrogenase (LDH), positive direct antiglobulin test (DAT), positive crossmatch" [26] This is due to destruction of donor red blood cells by preformed recipient antibodies. Most often this occurs due to clerical errors or improper ABO blood typing and crossmatching resulting in a mismatch in ABO blood type between the donor and the recipient. Symptoms include fever, chills, chest pain, back pain,[27] hemorrhage, increased heart rate, shortness of breath, and rapid drop in blood pressure. When suspected, transfusion should be stopped immediately, and blood sent for tests to evaluate for presence of hemolysis. Treatment is supportive. Kidney injury may occur due to the effects of the hemolytic reaction (pigment nephropathy).[28] The severity of the transfusion reaction is depended upon amount of donor's antigen transfused, nature of the donor's antigens, the nature and the amount of recipient antibodies.[27]
Delayed hemolytic reactions occur more than 24 hours until 14 days after a transfusion. This is due to low amount of antibodies available during the start of the transfusion. Therefore, acute haemolytic reaction does not manifests until after 24 hours when enough amount of antibodies are available to cause a reaction. The red blood cells are removed by macrophages from the blood circulation into liver and spleen to be destroyed, which leads to extravascular haemolysis. This process usually mediated by anti-Rh and anti-Kidd antibodies. However, this type of transfusion reaction is less severe when compared to acute haemolytic transfusion reaction[27]
Febrile nonhemolytic reactions are the most common type of blood transfusion reaction and occur due to the release of inflammatory chemical signals released by white blood cells in stored donor blood[14] or attack on donor's white blood cells by recipient's antibodies.[27] This type of reaction occurs in about 7% of transfusions. Fever is generally short lived and is treated with antipyretics, and transfusions may be finished as long as an acute hemolytic reaction is excluded. This is a reason for the now-widespread use of leukoreduction – the filtration of donor white cells from red cell product units.[14]
Allergic reactions is caused by IgE anti-allergen antibodies. When antibodies are bound to its antigens, histamine is released from mast cells and basophils. Either IgE antibodies from the donor's or recipient's side can cause the allergic reaction. It is more common in patients who has allergic conditions such as hay fever. Patient may feel itchy or having hives but the symptoms are usually mild and can be controlled by stopping the transfusion and giving antihistamines.[27]
Anaphylactic reactions is a rare by life-threatening allergic condition caused by IgA anti-plasma protein antibodies. For patient who has selective immunoglobulin A deficiency, the reaction is presumed to be caused by IgA antibodies in the donor's plasma. The patient may presented with symptoms of fever, wheezing, coughing, shortness of breath, and circulatory shock. Urgent treatment with epinephrine is needed.[27]
Post-transfusion purpura is a complication that occurs after transfusion of platelets and is associated with the presence of antibodies in the patient's blood directed against both the donor's and recipient's platelets HPA (human platelet antigen). Recipients who lack this protein develop sensitization to this protein from prior transfusions or previous pregnancies, can develop thrombocytopenia, bleeding into the skin, and causes purplish discolouration of skin which is known as purpura. Intravenous immunoglobulin is the treatment of choice to neutralise such antibodies.[27][29]
Transfusion-associated acute lung injury (TRALI) is a syndrome that is similar to Acute respiratory distress syndrome (ARDS), which develops within 6 hours during a plasma-product containing blood products transfusion. Fever, hypotension, shortness of breath, and tachycardia often occurs in this type of reaction. It occurs in 15% of the transfused patient with mortality rate of 5 to 10%. Recipient risk factors includes: end-stage liver disease, sepsis, haematological malignancies, sepsis, and ventilated patients. Human Neutrophil Antigen (HNA) has been associated with this type of transfusion reaction. Donor's antibodies would interact with recipient's neutrophils and monocytes, releasing inflammatory cytokines and causes pulmonary capillary leakage. The treatment is supportive.[30]
Transfusion-associated graft versus host disease frequently occurs in immunodeficient patients where recipient's body failed to eliminate donor's T cells. Instead, donor's T cells attack the recipient's cells. It occurs one week after transfusion.[27] Fever, rash, diarrhoea are often associated with this type of transfusion reaction. Mortality rate is high, with 89.7% of the patients died after 24 days. Immunosuppressive treatment is the most common way of treatment.[31] Irradiation and leukoreduction of blood products is necessary for high risk patients for prevent T cells from attacking recipient cells.[27]

text: Infection[edit]

text: The use of greater amount of red blood cells is associated with a high risk of infections. In those who were given red blood only with significant anemia infection rates were 12% while in those who were given red blood at milder levels of anemia infection rates were 17%.[32] [clarification needed]

text: On rare occasions, blood products are contaminated with bacteria. This can result in a life-threatening infection known as transfusion-transmitted bacterial infection. The risk of severe bacterial infection is estimated, as of 2002, at about 1 in 50,000 platelet transfusions, and 1 in 500,000 red blood cell transfusions.[33] Blood product contamination, while rare, is still more common than actual infection. The reason platelets are more often contaminated than other blood products is that they are stored at room temperature for short periods of time. Contamination is also more common with longer duration of storage, especially if that means more than 5 days. Sources of contaminants include the donor's blood, donor's skin, phlebotomist's skin, and containers. Contaminating organisms vary greatly, and include skin flora, gut flora, and environmental organisms. There are many strategies in place at blood donation centers and laboratories to reduce the risk of contamination. A definite diagnosis of transfusion-transmitted bacterial infection includes the identification of a positive culture in the recipient (without an alternative diagnosis) as well as the identification of the same organism in the donor blood.

text: Since the advent of HIV testing of donor blood in the mid/later 1980s, ex. 1985's ELISA, the transmission of HIV during transfusion has dropped dramatically. Prior testing of donor blood only included testing for antibodies to HIV. However, due to latent infection (the "window period" in which an individual is infectious, but has not had time to develop antibodies) many cases of HIV seropositive blood were missed. The development of a nucleic acid test for the HIV-1 RNA has dramatically lowered the rate of donor blood seropositivity to about 1 in 3 million units. As transmittance of HIV does not necessarily mean HIV infection, the latter could still occur at an even lower rate.

text: The transmission of hepatitis C via transfusion currently stands at a rate of about 1 in 2 million units. As with HIV, this low rate has been attributed to the ability to screen for both antibodies as well as viral RNA nucleic acid testing in donor blood.

text: Other rare transmissible infections include hepatitis B, syphilis, Chagas disease, cytomegalovirus infections (in immunocompromised recipients), HTLV, and Babesia.

text: Inefficacy[edit]

text: Transfusion inefficacy or insufficient efficacy of a given unit(s) of blood product, while not itself a "complication" per se, can nonetheless indirectly lead to complications – in addition to causing a transfusion to fully or partly fail to achieve its clinical purpose. This can be especially significant for certain patient groups such as critical-care or neonatals.

text: For red blood cells (RBC), by far the most commonly transfused product, poor transfusion efficacy can result from units damaged by the so-called storage lesion – a range of biochemical and biomechanical changes that occur during storage. With red cells, this can decrease viability and ability for tissue oxygenation.[34] Although some of the biochemical changes are reversible after the blood is transfused,[35] the biomechanical changes are less so,[36] and rejuvenation products are not yet able to adequately reverse this phenomenon.[37] There has been controversy about whether a given product unit's age is a factor in transfusion efficacy, specifically about whether "older" blood directly or indirectly increases risks of complications.[38][39] Studies have not been consistent on answering this question,[40] with some showing that older blood is indeed less effective but with others showing no such difference; these developments are being closely followed by hospital blood bankers – who are the physicians, typically pathologists, who collect and manage inventories of transfusable blood units.

text: Certain regulatory measures are in place to minimize RBC storage lesion – including a maximum shelf life (currently 42 days), a maximum auto-hemolysis threshold (currently 1% in the US, 0.8% in Europe), and a minimum level of post-transfusion RBC survival in vivo (currently 75% after 24 hours).[41] However, all of these criteria are applied in a universal manner that does not account for differences among units of product.[42] For example, testing for the post-transfusion RBC survival in vivo is done on a sample of healthy volunteers, and then compliance is presumed for all RBC units based on universal (GMP) processing standards (of course, RBC survival by itself does not guarantee efficacy, but it is a necessary prerequisite for cell function, and hence serves as a regulatory proxy). Opinions vary as to the "best" way to determine transfusion efficacy in a patient in vivo.[43] In general, there are not yet any in vitro tests to assess quality or predict efficacy for specific units of RBC blood product prior to their transfusion, though there is exploration of potentially relevant tests based on RBC membrane properties such as erythrocyte deformability[44] and erythrocyte fragility (mechanical).[45]

text: Physicians have adopted a so-called "restrictive protocol" – whereby transfusion is held to a minimum – due in part to the noted uncertainties surrounding storage lesion, in addition to the very high direct and indirect costs of transfusions.[46][47][48] Of course, restrictive protocol is not an option with some especially vulnerable patients who may require the best possible efforts to rapidly restore tissue oxygenation.

text: Although transfusions of platelets are far less numerous (relative to RBC), platelet storage lesion and resulting efficacy loss is also a concern.[49]

text: Other[edit]

text:
A known relationship between intra-operative blood transfusion and cancer recurrence has been established in colorectal cancer.[50] In lung cancer intra-operative blood transfusion has been associated with earlier recurrence of cancer, worse survival rates and poorer outcomes after lung resection.[51][52] Also studies shown to us, failure of the immune system caused by blood transfusion can be categorized as one of the main factors leading to more than 10 different cancer types that are fully associated with blood transfusion and the innate and adaptive immune system.[53] Allogeneic blood transfusion, through five major mechanisms including the lymphocyte-T set, myeloid-derived suppressor cells (MDSCs), tumor-associated macrophages (TAMs), natural killer cells (NKCs), and dendritic cells (DCs) can help the recipient’s defense mechanisms. On the other hand, the role for each of the listed items includes activation of the antitumor CD8+ cytotoxic T lymphocytes (CD8+/CTL), temporal inactivation of Tregs, inactivation of the STAT3 signaling pathway, the use of bacteria to enhance the antitumor immune response and cellular Immunotherapy.[54]
Transfusion-associated volume overload is a common complication simply due to the fact that blood products have a certain amount of volume. This is especially the case in recipients with underlying cardiac or kidney disease. Red cell transfusions can lead to volume overload when they must be repeated due to insufficient efficacy (see above). Plasma transfusion is especially prone to causing volume overload due to its hypertonicity.
Hypothermia can occur with transfusions with large quantities of blood products which normally are stored at cold temperatures. Core body temperature can go down as low as 32 °C and can produce physiologic disturbances. Prevention should be done with warming the blood to ambient temperature prior to transfusions.
Transfusions with large amounts of red blood cells, whether due to severe hemorrhaging and/or transfusion inefficacy (see above), can lead to an inclination for bleeding. The mechanism is thought to be due to disseminated intravascular coagulation, along with dilution of recipient platelets and coagulation factors. Close monitoring and transfusions with platelets and plasma is indicated when necessary.
Metabolic alkalosis can occur with massive blood transfusions due to the breakdown of citrate stored in blood into bicarbonate.
Hypocalcemia can also occur with massive blood transfusions due to the complex of citrate with serum calcium.
Blood doping is often used by athletes, drug addicts or military personnel for reasons such as to increase physical stamina, to fake a drug detection test or simply to remain active and alert during the duty-times respectively. However a lack of knowledge and insufficient experience can turn a blood transfusion into a sudden death. For example, when individuals run the frozen blood sample directly in their veins this cold blood rapidly reaches the heart, where it disturbs the heart's original pace leading to cardiac arrest and sudden death.

text: Frequency of use[edit]

text: Globally around 85 million units of red blood cells are transfused in a given year.[2]

text: In the United States, blood transfusions were performed nearly 3 million times during hospitalizations in 2011, making it the most common procedure performed. The rate of hospitalizations with a blood transfusion nearly doubled from 1997, from a rate of 40 stays to 95 stays per 10,000 population. It was the most common procedure performed for patients 45 years of age and older in 2011, and among the top five most common for patients between the ages of 1 and 44 years.[55]

text: According to the New York Times: "Changes in medicine have eliminated the need for millions of blood transfusions, which is good news for patients getting procedures like coronary bypasses and other procedures that once required a lot of blood." And, "Blood bank revenue is falling, and the decline may reach $1.5 billion a year this year [2014] from a high of $5 billion in 2008." Job losses will reach as high as 12,000 within the next three to five years, roughly a quarter of the total in the industry, according to the Red Cross.[56]

text: History[edit]

text: Beginning with William Harvey's experiments on the circulation of blood, research into blood transfusion began in the 17th century, with successful experiments in transfusion between animals. However, successive attempts by physicians to transfuse animal blood into humans gave variable, often fatal, results.

text: Pope Innocent VIII is sometimes said to have been given "the world's first blood transfusion" by his Jewish physician Giacomo di San Genesio, who had him drink (by mouth) the blood of three 10-year-old boys. The boys subsequently died. The evidence for this story, however, is unreliable and may have been motivated by anti-semitism.[57]

text: Early attempts[edit]

text: Animal blood[edit]

text: Working at the Royal Society in the 1660s, the physician Richard Lower began examining the effects of changes in blood volume on circulatory function and developed methods for cross-circulatory study in animals, obviating clotting by closed arteriovenous connections. The new instruments he was able to devise enabled him to perform the first reliably documented successful transfusion of blood in front of his distinguished colleagues from the Royal Society.

text: According to Lower's account, "...towards the end of February 1665 [I] selected one dog of medium size, opened its jugular vein, and drew off blood, until … its strength was nearly gone. Then, to make up for the great loss of this dog by the blood of a second, I introduced blood from the cervical artery of a fairly large mastiff, which had been fastened alongside the first, until this latter animal showed … it was overfilled … by the inflowing blood." After he "sewed up the jugular veins," the animal recovered "with no sign of discomfort or of displeasure."

text: Lower had performed the first blood transfusion between animals. He was then "requested by the Honorable [Robert] Boyle … to acquaint the Royal Society with the procedure for the whole experiment," which he did in December 1665 in the Society's Philosophical Transactions. [58]

text: The first blood transfusion from animal to human was administered by Dr. Jean-Baptiste Denys, eminent physician to King Louis XIV of France, on June 15, 1667.[59] He transfused the blood of a sheep into a 15-year-old boy, who survived the transfusion.[60] Denys performed another transfusion into a labourer, who also survived. Both instances were likely due to the small amount of blood that was actually transfused into these people. This allowed them to withstand the allergic reaction.

text: Denys' third patient to undergo a blood transfusion was Swedish Baron Gustaf Bonde. He received two transfusions. After the second transfusion Bonde died.[61] In the winter of 1667, Denys performed several transfusions on Antoine Mauroy with calf's blood. On the third account Mauroy died.[62]

text: Six months later in London, Lower performed the first human transfusion of animal blood in Britain, where he "superintended the introduction in [a patient's] arm at various times of some ounces of sheep's blood at a meeting of the Royal Society, and without any inconvenience to him." The recipient was Arthur Coga, "the subject of a harmless form of insanity." Sheep's blood was used because of speculation about the value of blood exchange between species; it had been suggested that blood from a gentle lamb might quiet the tempestuous spirit of an agitated person and that the shy might be made outgoing by blood from more sociable creatures. Coga received 20 shillings (equivalent to £158 in 2016) to participate in the experiment.[63]

text: Lower went on to pioneer new devices for the precise control of blood flow and the transfusion of blood; his designs were substantially the same as modern syringes and catheters.[58] Shortly after, Lower moved to London, where his growing practice soon led him to abandon research.[64]

text: These early experiments with animal blood provoked a heated controversy in Britain and France.[61] Finally, in 1668, the Royal Society and the French government both banned the procedure. The Vatican condemned these experiments in 1670. Blood transfusions fell into obscurity for the next 150 years.

text: Human blood[edit]

text: The science of blood transfusion dates to the first decade of the 20th century, with the discovery of distinct blood types leading to the practice of mixing some blood from the donor and the receiver before the transfusion (an early form of cross-matching).

text: In the early 19th century, British obstetrician Dr. James Blundell made efforts to treat hemorrhage by transfusion of human blood using a syringe. In 1818 following experiments with animals, he performed the first successful transfusion of human blood to treat postpartum hemorrhage. Blundell used the patient's husband as a donor, and extracted four ounces of blood from his arm to transfuse into his wife. During the years 1825 and 1830, Blundell performed 10 transfusions, five of which were beneficial, and published his results. He also invented a number of instruments for the transfusion of blood.[65] He made a substantial amount of money from this endeavour, roughly $2 million ($50 million real dollars).[66]

text: In 1840, at St George's Hospital Medical School in London, Samuel Armstrong Lane, aided by Dr. Blundell, performed the first successful whole blood transfusion to treat haemophilia.

text: However, early transfusions were risky and many resulted in the death of the patient. By the late 19th century, blood transfusion was regarded as a risky and dubious procedure, and was largely shunned by the medical establishment.

text: Work to emulate James Blundell continued in Edinburgh. In 1845 the Edinburgh Journal described the successful transfusion of blood to a woman with severe uterine bleeding. Subsequent transfusions were successful with patients of Professor James Young Simpson after whom the Simpson Memorial Hospital in Edinburgh was named.[67]

text: The largest series of early successful transfusions took place at the Edinburgh Royal Infirmary between 1885 and 1892. Edinburgh later became the home of the first blood donation and blood transfusion services.[67]

text: Modern era[edit]

text: It was not until 1901, when the Austrian Karl Landsteiner discovered three human blood groups (O, A, and B), that blood transfusion was put onto a scientific basis and became safer.

text: Landsteiner discovered that adverse effects arise from mixing blood from two incompatible individuals. He found that when incompatible types are mixed, an immune response is triggered and the red blood cells clump. The immunological reaction occurs when the receiver of a blood transfusion has antibodies against the donor blood cells. The destruction of red blood cells releases free hemoglobin into the bloodstream, which can have fatal consequences. Landsteiner's work made it possible to determine blood group and allowed a way for blood transfusions to be carried out much more safely. For this discovery he was awarded the Nobel Prize in Physiology and Medicine in 1930, and many other blood groups have been discovered since.

text: George Washington Crile is credited with performing the first surgery using a direct blood transfusion in 1906 at St. Alexis Hospital in Cleveland while a professor of surgery at Case Western Reserve University.[when?][68]

text: Jan Janský also discovered the human blood groups in 1907 which he classified blood into four groups I, II, III, IV. Titled in Czech "Hematologická studie u psychotiků". His nomenclature is still used in Russia and states of the former USSR, in which blood types O, A, B, and AB are respectively designated I, II, III, and IV.

text: Dr. William Lorenzo Moss's (1876–1957) Moss-blood typing technique of 1910 was widely used until World War II.[69][70]

text: William Stewart Halsted, M.D. (September 23, 1852 – September 7, 1922) was an American surgeon who emphasized strict aseptic technique during surgical procedures, was an early champion of newly discovered anesthetics, and introduced several new operations, including the radical mastectomy for breast cancer. Halsted returned to New York in 1880 and for the next six years led an extraordinarily vigorous and energetic life. He operated at multiple hospitals, including Roosevelt Hospital, the College of Physicians and Surgeons, Charity Hospital, Emigrant Hospital, Bellevue Hospital and Chambers Street Hospital. He was an extremely popular, inspiring and charismatic teacher. In 1882 he performed one of the first gallbladder operations in the United States (a cholecystotomy performed on his mother on the kitchen table at 2 am). Halsted also performed one of the first blood transfusions in the United States. He had been called to see his sister after she had given birth. He found her moribund from blood loss, and in a bold move withdrew his own blood, transfused his blood into his sister, and then operated on her to save her life.

text: Blood banks in WWI[edit]

text: While the first transfusions had to be made directly from donor to receiver before coagulation, it was discovered that by adding anticoagulant and refrigerating the blood it was possible to store it for some days, thus opening the way for the development of blood banks. John Braxton Hicks was the first to experiment with chemical methods to prevent the coagulation of blood at St Mary's Hospital, London in the late 19th century. His attempts, using phosphate of soda, however, were unsuccessful.

text: The first non-direct transfusion was performed on March 27, 1914 by the Belgian doctor Albert Hustin, though this was a diluted solution of blood. The Argentine doctor Luis Agote used a much less diluted solution in November of the same year. Both used sodium citrate as an anticoagulant.[71]

text: The First World War acted as a catalyst for the rapid development of blood banks and transfusion techniques. Canadian doctor and Lieutenant Lawrence Bruce Robertson was instrumental in persuading the Royal Army Medical Corps to adopt the use of blood transfusion at the Casualty Clearing Stations for the wounded. In October 1915, Robertson performed his first wartime transfusion with a syringe to a patient suffering from multiple shrapnel wounds. He followed this up with four subsequent transfusions in the following months and his success was reported to Sir Walter Morley Fletcher, director of the Medical Research Committee.[72]

text: Robertson published his findings in the British Medical Journal in 1916 and, with the help of a few like minded individuals (including the eminent physician Edward William Archibald who introduced the citrate anticoagulant method), was able to persuade the British authorities of the merits of blood transfusion. Robertson went on to establish the first blood transfusion apparatus at a Casualty Clearing Station on the Western Front in the spring of 1917.[72] [73]

text: Oswald Hope Robertson, a medical researcher and U.S. Army officer was attached to the RAMC in 1917, where he was instrumental in establishing the first blood banks, in preparation for the anticipated Third Battle of Ypres.[74] He used sodium citrate as the anticoagulant and the blood was extracted from punctures in the vein and was stored in bottles at British and American Casualty Clearing Stations along the Front. He also experimented with preserving separated red blood cells in iced bottles.[73] Geoffrey Keynes, a British surgeon, developed a portable machine that could store blood to enable transfusions to be carried out more easily.

text: Expansion[edit]

text: The world's first blood donor service was established in 1921 by the secretary of the British Red Cross, Percy Oliver. In that year, Oliver was contacted by King's College Hospital, where they were in urgent need of a blood donor. [75] After providing a donor, Oliver set about organizing a system for the voluntary registration of blood donors at clinics around London, with Sir Geoffrey Keynes appointed as a medical adviser. Volunteers were subjected to a series of physical tests to establish their blood group. The London Blood Transfusion Service was free of charge and expanded rapidly in its first few years of operation. By 1925, it was providing services for almost 500 patients and it was incorporated into the structure of the British Red Cross in 1926. Similar systems were established in other cities including Sheffield, Manchester and Norwich, and the service's work began to attract international attention. Similar services were established in France, Germany, Austria, Belgium, Australia and Japan.[76]

text: An academic institution devoted to the science of blood transfusion was founded by Alexander Bogdanov in Moscow in 1925. Bogdanov was motivated, at least in part, by a search for eternal youth, and remarked with satisfaction on the improvement of his eyesight, suspension of balding, and other positive symptoms after receiving 11 transfusions of whole blood. Bogdanov died in 1928 as a result of one of his experiments, when the blood of a student suffering from malaria and tuberculosis was given to him in a transfusion.[77] Following Bogdanov's lead, Vladimir Shamov and Sergei Yudin in the USSR pioneered the transfusion of cadaveric blood from recently deceased donors. Yudin performed such a transfusion successfully for the first time on March 23, 1930 and reported his first seven clinical transfusions with cadaveric blood at the Fourth Congress of Ukrainian Surgeons at Kharkiv in September. However, this method was never used widely, even in Russia.

text: One of the earliest blood banks was established by Frederic Durán-Jordà during the Spanish Civil War in 1936. Duran joined the Transfusion Service at the Barcelona Hospital at the start of the conflict, but the hospital was soon overwhelmed by the demand for blood and the paucity of available donors. With support from the Department of Health of the Spanish Republican Army, Duran established a blood bank for the use of wounded soldiers and civilians. The 300–400 ml of extracted blood was mixed with 10% citrate solution in a modified Duran Erlenmeyer flask. The blood was stored in a sterile glass enclosed under pressure at 2 °C. During 30 months of work, the Transfusion Service of Barcelona registered almost 30,000 donors, and processed 9,000 liters of blood. [78]

text: In 1937 Bernard Fantus, director of therapeutics at the Cook County Hospital in Chicago, established the first hospital blood bank in the United States. In creating a hospital laboratory that preserved, refrigerated and stored donor blood, Fantus originated the term "blood bank". Within a few years, hospital and community blood banks were established across the United States.[79]

text: Frederic Durán-Jordà fled to Britain in 1938, and worked with Dr Janet Vaughan at the Royal Postgraduate Medical School at Hammersmith Hospital to create a system of national blood banks in London.[80] With the outbreak of war looking imminent in 1938, the War Office created the Army Blood Supply Depot (ABSD) in Bristol headed by Lionel Whitby and in control of four large blood depots around the country. British policy through the war was to supply military personnel with blood from centralized depots, in contrast to the approach taken by the Americans and Germans where troops at the front were bled to provide required blood. The British method proved to be more successful at adequately meeting all requirements and over 700,000 donors were bled over the course of the war. This system evolved into the National Blood Transfusion Service established in 1946, the first national service to be implemented. [81]

text: Medical advances[edit]

text: A blood collection program was initiated in the US in 1940 and Edwin Cohn pioneered the process of blood fractionation. He worked out the techniques for isolating the serum albumin fraction of blood plasma, which is essential for maintaining the osmotic pressure in the blood vessels, preventing their collapse.

text: The use of blood plasma as a substitute for whole blood and for transfusion purposes was proposed as early as 1918, in the correspondence columns of the British Medical Journal, by Gordon R. Ward. At the onset of World War II, liquid plasma was used in Britain. A large project, known as 'Blood for Britain' began in August 1940 to collect blood in New York City hospitals for the export of plasma to Britain. A dried plasma package was developed, which reduced breakage and made the transportation, packaging, and storage much simpler.[82]

text: The resulting dried plasma package came in two tin cans containing 400 cc bottles. One bottle contained enough distilled water to reconstitute the dried plasma contained within the other bottle. In about three minutes, the plasma would be ready to use and could stay fresh for around four hours.[83] Dr. Charles R. Drew was appointed medical supervisor, and he was able to transform the test tube methods into the first successful technique for mass production.

text: Another important breakthrough came in 1939–40 when Karl Landsteiner, Alex Wiener, Philip Levine, and R.E. Stetson discovered the Rhesus blood group system, which was found to be the cause of the majority of transfusion reactions up to that time. Three years later, the introduction by J.F. Loutit and Patrick L. Mollison of acid–citrate–dextrose (ACD) solution, which reduced the volume of anticoagulant, permitted transfusions of greater volumes of blood and allowed longer term storage.

text: Carl Walter and W.P. Murphy Jr. introduced the plastic bag for blood collection in 1950. Replacing breakable glass bottles with durable plastic bags made from PVC allowed for the evolution of a collection system capable of safe and easy preparation of multiple blood components from a single unit of whole blood.

text: In the field of cancer surgery replacement of massive blood loss became a major problem. The cardiac arrest rate was high. In 1963, C. Paul Boyan and William S. Howland discovered that the temperature of the blood and the rate of infusion greatly affected survival rates, and introduced blood warming to surgery.[84][85]

text: Further extending the shelf life of stored blood was an anticoagulant preservative, CPDA-1, introduced in 1979, which increased the blood supply and facilitated resource-sharing among blood banks.

text: As of 2006, there were about 15 million units of blood products transfused per year in the United States.[86] By 2013, the number had declined to about 11 million units, due to the shift towards laparoscopic surgery and other surgical advances and studies that have shown that many transfusions were unnecessary. For example, the standard of care reduced that amount of blood transfused from 750 to 200 ml.[87]

text: Special populations[edit]

text: Neonate[edit]

text: To ensure the safety of blood transfusion to pediatric patients, hospitals are taking additional precaution to avoid infection and prefer to use specially tested pediatric blood units that are guaranteed negative for Cytomegalovirus. Most guidelines recommend the provision of CMV-negative blood components and not simply leukoreduced components for newborns or low birthweight infants in whom the immune system is not fully developed.[88] These specific requirements place additional restrictions on blood donors who can donate for neonatal use. vnv Neonatal transfusions typically fall into one of two categories:

text:
"Top-up" transfusions, to replace losses due to investigational losses and correction of anemia.
Exchange (or partial exchange) transfusions are done for removal of bilirubin, removal of antibodies and replacement of red cells (e.g., for anemia secondary to thalassemias and other hemoglobinopathies).[89]

text: Massive trauma[edit]

text: A massive transfusion protocol is used for massive trauma resuscitation, when more than ten units of blood are needed. Packed red blood cells, fresh frozen plasma, and platelets are administered in lieu of crystalloids or whole blood.[90] Typically higher ratios of fresh frozen plasma and platelets are given relative to packed red blood cells.[90]

text: Unknown blood type[edit]

text: Because blood type O negative is compatible with anyone, it is often overused and in short supply.[91] According to the American Association of Blood Banks, the use of this blood should be restricted to persons with O negative blood, as nothing else is compatible with them, and women who might be pregnant and for whom it would be impossible to do blood group testing before giving them emergency treatment.[91] Whenever possible, the AABB recommends that O negative blood be conserved by using blood type testing to identify a less scarce alternative.[91]

text: Religious objections[edit]

text: Jehovah's Witnesses object to blood transfusions due to their belief that blood is sacred.[92]

text: Research into alternatives[edit]

text: Although there are clinical situations where transfusion with red blood cells is the only clinically appropriate option, clinicians look at whether alternatives as feasible. This can be due to several reasons, such as patient safety, economic burden or scarcity of blood. Guidelines recommend blood transfusions should be reserved for patients with or at risk of cardiovascular instability due to the degree of their anaemia.[93][94] In these cases parenteral iron is recommended.

text: Thus far, there are no available oxygen-carrying blood substitutes, which is the typical objective of a blood (RBC) transfusion; however, there are widely available non-blood volume expanders for cases where only volume restoration is required. These are helping doctors and surgeons avoid the risks of disease transmission and immune suppression, address the chronic blood donor shortage, and address the concerns of Jehovah's Witnesses and others who have religious objections to receiving transfused blood.

text: A number of blood substitutes have been explored (and still are), but thus far they all suffer from many challenges. Most attempts to find a suitable alternative to blood thus far have concentrated on cell-free hemoglobin solutions. Blood substitutes could make transfusions more readily available in emergency medicine and in pre-hospital EMS care. If successful, such a blood substitute could save many lives, particularly in trauma where massive blood loss results. Hemopure, a hemoglobin-based therapy, is approved for use in South Africa.

text: Other uses[edit]

text: Minor blood transfusions are used by a minority of nyaope drug addicts in South Africa to economically share the high the drug induces in a practice colloquially known as Bluetoothing, named after the wireless technology of the same name.[95]

text: Veterinary use[edit]

text: Veterinarians also administer transfusions to other animals. Various species require different levels of testing to ensure a compatible match. For example, cats have 3 known blood types, cattle have 11, dogs have 12, pigs 16 and horses have 34. However, in many species (especially horses and dogs), cross matching is not required before the first transfusion, as antibodies against non-self cell surface antigens are not expressed constitutively – i.e. the animal has to be sensitized before it will mount an immune response against the transfused blood.

text: The rare and experimental practice of inter-species blood transfusions is a form of xenograft.


document_title: Bass Pro Shops

question_text: where was the first bass pro shop built

question_tokens: where was the first bass pro shop built

root

text: Bass Pro Shops

text: History[edit]

text: The majority owner, John Morris, began his career in sporting goods with a fishing section in the back of a Brown Derby liquor store owned by his father, located in Springfield MO on the road to Table Rock Lake and Branson, Missouri. That small fishing department sold homemade bait and worms, proving popular enough that Bass Pro Shops was incorporated in 1971. These homemade baits were so popular that many people wanted the opportunity to buy these when they had returned home. Thus began the Bass Pro Shops catalog, first mailed in 1974. Soon, it became the world's largest mail order sporting goods store.

tag: p

text: In 1975, to meet the burgeoning demand for Bass Pro Shops exclusive products, American Rod and Gun was established. Acting as a separate wholesaling entity ARG serves more than 7,000 independently owned retail stores worldwide. In 1977, Bass Pro Shops introduced the first fish-ready complete boat motor and trailer package with the Bass Tracker. In 1984, construction began on the Outdoor World Catalog Showroom in Springfield, Missouri. Big Cedar Lodge opened in 1988 on Table Rock Lake.

text: In 1995, Bass Pro Shops Sportsman's Warehouse opened in Atlanta, Georgia, its first store outside the state of Missouri. In November 2001, taking advantage of Outdoor World's popularity as a tourist destination, the Wonders of Wildlife museum was opened next door to the store in Springfield.[2][3] The Wonders of Wildlife Museum & Aquarium closed for renovation in 2007. As of October 2016 it is still closed with an expected reopening by the end of the year. Bass Pro Shops has announced that the grand reopening of the Wonders of Wildlife museum will take place on September 21st, 2017. [4]

text: In 2015, Bass Pro Shops opened a store inside the Memphis Pyramid, a former sports arena and concert venue in Memphis, Tennessee. In addition to the retail store itself, the building houses two restaurants, a bowling alley, a 100-room hotel, an observation deck, and the tallest free-standing elevator in America. At 535,000 sq ft, The Pyramid is Bass Pro's largest store.

text: In October 2016, Bass Pro Shops announced that they had reached a deal to acquire competitor Cabela's for $5.5 billion. The deal is being financed via preferred equity financing from Goldman Sachs and Pamplona. Goldman Sachs will contribute $1.8 billion towards financing and Pamplona will contribute the remainder for a total commitment of $2.4 billion.[13] The new entity is expected to be formed and in operation in Q1 or Q2 of 2017.[5] The new entity will keep Cabela’s base in Sidney and Lincoln, Nebraska. Morris will continue as CEO of the new entity. He will also be the majority shareholder of the new privately held entity. Tommy Milner stressed that the company had reviewed a range of options that would maximize value, with the board choosing to go the route of Bass Pro Shops.

text: House brands[edit]

text: Bass Pro Shops carries a number of house brands. Among these are:

text: Tracker Marine Group[edit]

text: For the article on the company, see Tracker Marine Group.

text: In 1978, Bass Pro Shops introduced the Bass Tracker boat, produced by the Tracker Marine Group. Its brands include Tracker Boats, Nitro, Sun Tracker, Tahoe, Fisher, ProCraft, Kenner, Mako Myacht and SeaCraft. These boats are sold in showrooms attached to every Bass Pro Shops store, in stand alone Tracker dealerships, and to independent marine dealers throughout the United States. All Tracker Marine Group boats are manufactured in multiple plants in southern Missouri. Over 400,000 people have purchased Tracker boats since 1978.[2]

text: Retail stores[edit]

text: Bass Pro Shops has 94 existing stores in the United States and Canada. The store sizes range from 20,000 square feet (1,900 m2) up to 535,000 square feet (49,700 m2). The largest flagship stores are known as Outdoor World stores. The decor of the stores includes taxidermy mounts native to the local area. All stores have an indoor water feature that showcases fish species that are indigenous to the area. The fish in their tanks are game fish of great size. In some of these aquariums, professional anglers and store pro-staff hold demonstrations showing the use of an artificial bait. They catch the fish in these tanks to show how well the bait works. Bass Pro Shops is also known for its Outdoor Skills Workshops, teaching skills as varied as fly fishing, Dutch oven cooking, archery hunting with an archery range in the store, and GPS navigation. They hold many skills workshops with the top names in the outdoor world.[2]

text: The Rancho Cucamonga, California Outdoor World store is used for the exterior shots of the fictional "Outdoor Man" store in the ABC sitcom Last Man Standing, starring Tim Allen, that premiered in 2011. Camera crews have also visited the store several times to film interior shots.[6]

text: Outdoor World locations[edit]

text:
State/Province
City
Size
Year Opened

Alabama
Leeds
150,000 sq ft[7]
2008[8]

Alabama
Prattville
140,000 sq ft[9]
2007[10]

Alabama
Spanish Fort
140,000 sq ft[11]
2008[12]

Alaska
Anchorage
80,000 sq ft[13]
2014

Alberta
Calgary/Rocky View
150,000 sq ft[14]
2009

Arizona
Mesa
170,000 sq ft[15]
2006[16]

Arkansas
Little Rock
120,000 sq ft[17]
2013

British Columbia
Vancouver/Tsawwassen
145,000 sq ft[18]
2016[19]

California
Manteca
120,000 sq ft[20]
2008[16]

California
Rancho Cucamonga
180,000 sq ft[21]
2007

California
Rocklin
100,000 sq ft[22]
2015

California
San Jose
145,000 sq ft[23]
2015

Colorado
Colorado Springs
117,000 sq ft[24]
2013

Colorado
Denver
186,000 sq ft[25]
2005

Connecticut
Bridgeport
150,000 sq ft[26]
2015

Florida
Brandon/Tampa
183,000 sq ft[27]
2015

Florida
Dania Beach
160,000 sq ft[28]
1998

Florida
Ft. Myers
130,000 sq ft[29]
2005

Florida
Orlando
150,000 sq ft[30]
2000

Georgia
Lawrenceville
130,000 sq ft
2001

Georgia
Savannah
103,000 sq ft
2003

Illinois
Bolingbrook
140,000 sq ft[31]
2013

Illinois
East Peoria
150,000 sq ft
2011

Illinois
Gurnee
133,000 sq ft[32]
1997

Indiana
Portage
135,000 sq ft[33]
2007

Indiana
Clarksville
280,000 sq ft[34]
2005

Iowa
Altoona
145,000 sq ft[35]
2009

Iowa
Council Bluffs
130,000 sq ft[36]
2005

Kansas
Olathe
135,000 sq ft[37]
2007

Louisiana
Bossier City
106,000 sq ft[38]
2003

Louisiana
Denham Springs
163,000 sq ft[39]
2008[16]

Maryland
Hanover
130,000 sq ft[40]
2001

Massachusetts
Foxborough
140,000 sq ft[41]
2007

Michigan
Auburn Hills
130,000 sq ft[42]
1998

Mississippi
Pearl
130,000 sq ft[43]
2005[43]

Missouri
Independence
180,000 sq ft[44]
2008[16]

Missouri
Springfield
500,000 sq ft
1981[45]

North Carolina
Concord
106,000 sq ft[46]
1999

Nevada
Las Vegas
165,000 sq ft[47]
2004[48]

New Brunswick
Dieppe
95,000 sq ft[49]
2015

New Hampshire
Hooksett
149,000 sq ft[50]
2014

Ohio
Rossford
150,000 sq ft[51]
2008[16]

Oklahoma
Broken Arrow
130,000 sq ft[52]
2005[16]

Oklahoma
Oklahoma City
110,000 sq ft[52]
2003[16]

Ontario
Vaughan
131,184 sq ft
2004[53]

Pennsylvania
Harrisburg
165,000 sq ft[54]
2004[16]

South Carolina
Myrtle Beach
105,000 sq ft[55]
2003[56]

Tennessee
Bristol
120,000 sq ft
2014

Tennessee
Memphis (at the Pyramid)
535,000 sq ft[57]
2015

Tennessee
Nashville
150,000 sq ft[58]
2001[59]

Tennessee
Sevierville
130,000 sq ft[60]
2005

Texas
Garland
120,000 sq ft[61]
2006[16]

Texas
Grapevine
200,000 sq ft[62]
1999

Texas
Katy
138,000 sq ft[63]
1999

Texas
Pearland
150,000 sq ft[64]
2007

Texas
Round Rock
104,000 sq ft
2015

Texas
San Antonio
200,000 sq ft[65]
2006

Texas
Harlingen
145,000 sq ft[66]
2011[67]

Virginia
Hampton
105,000 sq ft[68]
2003[68]

Virginia
Richmond (Hanover County)
150,000 sq ft[69]
2008[16]

Washington
Tacoma
170,000 sq ft[70]
2014[71]

tag: table

text: Other locations[edit]

text: Bass Pro Shops have several other stores that do not fall under the Outdoor World flagship brand.

text:
State
City
Store Name
Size
Year Opened

Florida
Daytona Beach
Outpost
67,068 sq ft[72]
2017

Florida
Destin
World Wide Sportsman
50,000 sq ft[73]
2003[74]

Florida
Gainesville
Sportsman Center
81,783 sq ft[75]
2017

Florida
Islamorada
World Wide Sportsman
27,000 sq ft
1995

Florida
Palm Bay
Stick Marsh Outpost[76]
112,000 sq ft
2013

Florida
Port St. Lucie
Sportsman's Center[77]
100,000 sq ft
2013

Florida
Miami
Sportsman Center
100,000 sq ft
2007

Florida
Tallahassee
Outpost
70,000 sq ft[78]
2013

Georgia
Macon
Sportsman's Warehouse
120,000 sq ft
2006

Missouri
Branson
White River Outpost
42,000 sq ft
2006[79]

Missouri
Columbia
Sportsman's Center
82,000 sq ft[80]
2005[81]

Missouri
Saint Charles
Sportsman's Warehouse
88,500 sq ft[82]
2001

Missouri
Springfield
Outlet
20,000 sq ft[83]
2015

New Jersey
Atlantic City
Outpost
85,000 sq ft[84]
2015

New York
Auburn
Sportsman's Center
85,000 sq ft[85]
2004

New York
Utica
Outpost
65,000 sq ft[86]
2013

North Carolina
Cary
Sportsman's Center
105,000 sq ft[87]
2013

Ontario
Niagara-on-the-Lake
Outpost
81,000 sq ft
2014

Tennessee
Memphis
Sportsman's Warehouse
84,000 sq ft[88]
2002

Tennessee
Chattanooga
Outpost
85,000 sq ft[89]
2016

text: Upcoming locations[edit]

text: Prior to the Cabela's acquisition, Bass Pro Shops had several stores under construction. Since then, plans have been put on hold and records removed from their website.

text:
State
City
Size
Year Opening

Florida
St. John's County
104,000 sq ft[90]
Unknown[91]

Florida
North Palm Beach
75,000 sq ft[92]
Unknown

Ohio
Boston Heights
100,000 sq ft[93]
Unknown

Ohio
West Chester
150,000 sq ft[94]
Unknown

New York
Uniondale
80,000-120,000 sq ft[95]
Unknown

New York
Victor
145,000 sq ft[96]
Unknown

New Jersey
Sayreville
200,000 sq ft[97]
Unknown

text: Islamorada Fish Company Restaurant[edit]

text: Many locations include an Islamorada Fish Company, a chain of restaurants owned by Bass Pro Shops.

text: Uncle Buck's Fishbowl and Grill[edit]

text: The new San Jose, CA, Bridgeport, CT, Tsawwassen, BC, Altoona, IA, East Peoria, IL, Harlingen, TX, Round Rock, TX, Bristol, TN, Memphis, TN, and Tacoma, WA Outdoor World locations feature a first for Bass Pro Shops: a 12-lane bowling alley. The project is in cooperation with Brunswick Bowling & Billiards. In addition to bowling, the facility offers a full-service restaurant and bar as well as world-class billiards in the Black Widow billiard room. The 15,000 sq ft (1,400 m2) underwater themed facility is connected to the Bass Pro Shops, but features a separate entrance to accommodate late night diners and bowlers.

text: NRA National Sporting Arms Museum[edit]

text: After nearly a decade of work by the NRA and Bass Pro Shops, the NRA National Sporting Arms Museum opened in the flagship store in Springfield, Missouri on August 2, 2013. It showcases almost 1,000 sporting artifacts from the 1600s to today, including some historically significant firearms from the NRA Museum Collection. The museum will host firearms and artwork from the Remington Arms Company factory collection, a multimillion-dollar collection of U.S. military sidearms, engraved Colt revolvers of the American frontier, the guns of Annie Oakley and firearms of U.S. Presidents like Teddy Roosevelt and Dwight Eisenhower.[98]

text: Affiliation with NASCAR[edit]

text: Bass Pro Shops and its owner, John Morris, have had a longtime interest in NASCAR racing. The company has sponsored such racers as Dale Earnhardt, Kerry Earnhardt, and Martin Truex Jr. Truex won the 2004 and 2005 Busch Series championships in the No. 8 Bass Pro Shops-sponsored Chevy, and drove the No. 1 Chevy for Earnhardt Ganassi Racing in the Sprint Cup series from 2005 to 2009. He got his first win at Dover International Speedway and finished 11th in the Chase for the Nextel Cup in 2007. While Truex, Jr. renewed with Bass Pro Shops as his main sponsor for three years in 2007. In 2009, he announced he would be leaving Earnhardt Ganassi Racing for Michael Waltrip Racing in 2010. Jamie McMurray, former driver of the Roush Fenway Racing Crown Royal Ford Fusion and who is from Joplin, MO (approx. 60 miles away from the national headquarters in Springfield), replaced Truex, Jr. for the 2010 season.

text: McMurray won the 2010 Daytona 500 in his first race driving in the Bass Pro Shops-sponsored Chevrolet. He followed that up by winning the 2010 Brickyard 400 at Indianapolis, making him the 3rd driver to win both races in the same season. He also won the 2010 Bank of America 500 at Lowe's Motor Speedway.

text: In the Xfinity Series, Bass Pro Shops was the main sponsor for the No. 3 car driven by Ty Dillon. Also in the Truck Series, Bass Pro Shops sponsors the No. 32 truck driven by Ryan Truex.[99]

text: Beginning with the 2013 season, Bass Pro Shops signed a multi-year agreement to be the primary sponsor for the No. 14 Stewart-Haas Racing Chevrolet SS driven by three-time Sprint Cup Champion Tony Stewart.

text: Bass Pro Shops reunited with Martin Truex Jr. in 2016 to be the primary sponsor of the No. 78 Furniture Row Sprint Cup car at the Daytona 500 and eight more races during the 2016 season.

text: Also in 2016, Bass Pro Shops became the primary sponsor of the August race at Bristol Motor Speedway, one of the most iconic events in NASCAR. The event is now known as the Bass Pro Shops NRA Night Race.

text: In the Disney movie Herbie: Fully Loaded, Bass Pro Shops is one of two main sponsors of Ray Peyton Jr. Herbie also later receives a Bass Pro Shops sticker on his left rear fender.


document_title: Red velvet cake

question_text: where does the red in red velvet cake come from

text: Red velvet cake

text:
Red Velvet cake

Four-layer slice of red velvet cake

Type
Layer cake

Course
Dessert

Place of origin
United States

Region or state
United States

Main ingredients
Flour, buttermilk, butter, sugar, cocoa powder, and/or cream cheese icing, beetroot, or red food colouring

 Cookbook: Red Velvet cake   Media: Red Velvet cake

text: Red Velvet cake is traditionally a red, red-brown, or "mahogany" colored[1] layer cake, layered with white cream cheese icing or Ermine[2] frosting (sometimes called "cooked roux" frosting). It has a distinctive fluffy texture owing to the gas-producing reaction of alkaline buttermilk with acidic vinegar and/or acidic non-alkalized cocoa.[1] The cake is commonly served on Christmas or Valentine's Day. Common modern red velvet cake is made with red dye,[3][4] however the red color was originally due to non-Dutched anthocyanin-rich cocoa.[1]

text: Common ingredients include: buttermilk, butter, cocoa, vinegar, and flour for the cake; beetroot or red food coloring for the color.

text: History[edit]

text: James Beard's reference, American Cookery (1972),[5] describes three red velvet cakes varying in the amounts of shortening, butter, and vegetable oil. All used red food coloring. The reaction of acidic vinegar and buttermilk tends to better reveal the red anthocyanin in cocoa and keeps the cake moist, light, and fluffy. This natural tinting may have been the source for the name "red velvet", as well as "Devil's food" and similar names for chocolate cakes.[6][7] Contemporarily, chocolate has often undergone Dutch processing, which prevents the color change of the anthocyanins.[8] A reconstruction of the original red velvet cake involves reducing or eliminating the vinegar and colorants, and using a non-Dutched cocoa to provide the needed acidity and color.[1]

text: When foods were rationed during World War II, bakers used boiled beet juices to enhance the color of their cakes. Beets are found in some red velvet cake recipes, where they also serve to retain moisture. Adams Extract, a Texas company, is credited with bringing the red velvet cake to kitchens across America during the Great Depression era, by being one of the first to sell red food coloring and other flavor extracts with the use of point-of-sale posters and tear-off recipe cards.[9][10] The cake and its original recipe are well known in the United States from New York City's famous Waldorf-Astoria Hotel, which has dubbed the confection Waldorf-Astoria cake. However, it is widely considered a Southern recipe.[7] Traditionally, red velvet cake is iced with a French-style butter roux icing (also called ermine icing), which is very light and fluffy, but time-consuming to prepare. Cream cheese frosting and buttercream frosting are variations which have increased in popularity.[11][12]

text: In Canada, the cake was a well-known dessert in the restaurants and bakeries of the Eaton's department store chain in the 1940s and 1950s. Promoted as an exclusive Eaton's recipe, with employees who knew the recipe sworn to silence, many mistakenly believed the cake was the invention of the department store matriarch, Lady Eaton.[13]

text: In recent years, red velvet cake and red velvet cupcakes have become increasingly popular in the US and many European countries. A resurgence in the popularity of this cake is attributed by some to the film Steel Magnolias (1989), which included a red velvet groom's cake made in the shape of an armadillo.[7] Magnolia Bakery in Manhattan, has served it since its opening in 1996, as did restaurants known for their Southern cooking like Amy Ruth's in Harlem,[7] which opened in 1998.[14] In 2000,[15] Cake Man Raven opened one of the first bakeries devoted to the cake in Brooklyn.[citation needed]


document_title: The Money Pit

question_text: where did walter hear about the million dollar distress sale mansion

text: The Money Pit

text: Plot[edit]

text: Attorney Walter Fielding and his classical musician girlfriend, Anna Crowley, learn of Walter Sr.'s wedding to a woman named Florinda shortly after fleeing the country for embezzling millions of dollars from their musician clients. The next morning, they are told they need to vacate the apartment they are subletting from Anna's ex-husband, Max Beissart, a self-absorbed conductor who has returned early from Europe.

text: Through an unscrupulous realtor friend, Walter learns about a million dollar distress sale mansion on the market for a mere $200,000. He and Anna meet the owner, Estelle, who claims she must sell it quickly because her husband, Carlos, has been arrested. Her sob story and insistence at keeping the place in candlelight in order to save money "for the goddamn, bloodsucking lawyers", distracts Walter and enchants Anna, who finds it romantic. They decide to buy it, but Anna insists on putting up half of the money needed for the repairs. She turns to Max for her half by selling him back what she got in their divorce. Walter gets his half from his wealthiest client.

text: From the moment Walter and Anna take possession of the house, it quickly begins to fall apart. Amongst other problems, the entire front door frame rips out of the wall, the main staircase collapses, the plumbing is full of gunk, the electrical system catches fire, the bathtub crashes through the floor, the chimney collapses, and a raccoon is living in the dumbwaiter.

text: Contractors Art and Brad Shirk are called in (the only construction company who is willing to take on the work), who summarily tear the house to pieces using Walter's $5,000 down payment, leaving him and Anna embroiled in bureaucracy to secure the necessary building permits to complete the work. His continuing frustration at the escalating costs of restoring the house leads him to brand it a "money pit", whilst the Shirks continue to assure him that the work will take "two weeks".

text: The repair work continues for a grueling four months and Walter and Anna realize they need more money to complete the renovations. She attempts to secure additional funds from Max by selling him some artwork she received in their divorce. Although he does not care for it, he agrees to its purchase. He wines and dines her, and the next morning, when she wakes up in his bed, he allows her to believe that she has cheated on Walter; in reality, Max slept on the couch. Walter later asks her point-blank if she slept with Max, but she hastily denies it. His suspicions push her to admit that she did so, but the damage is done.

text: Due to Walter and Anna's stubbornness, their relationship becomes more and more hostile and in a rare moment of agreement, they vow to sell the house once it is restored and split the proceeds. This nearly happens, but he misses her and says he loves her even if she did sleep with Max. She happily tells him that she didn't and they reconcile. In the end, they are married in front of the newly repaired house.

text: In the very final scene, Estelle and her husband/partner-in-crime, Carlos, resurface in Brazil where they try to persuade Walter's father and his new bride to purchase an old house they claim to have lived in for several years... implying that the vicious cycle is about to start all over again.

text: Cast[edit]

text:
Tom Hanks as Walter Fielding, Jr.
Shelley Long as Anna Crowley
Alexander Godunov as Max Beissart
Maureen Stapleton as Estelle
Joe Mantegna as Art Shirk
Philip Bosco as Curly
Frankie Faison as James
Josh Mostel as Jack Schnittman
Yakov Smirnoff as Shatov
Carmine Caridi as Brad Shirk
Brian Backer as Ethan
Mia Dillon as Marika
John van Dreelen as Carlos
Douglass Watson as Walter Fielding, Sr.
Tetchie Agbayani as Florinda Fielding
Michael Jeter as Arnie

tag: ul

text: Reception[edit]

text: The film received mixed reviews. Rotten Tomatoes, a review aggregator website, reports that 47% of critics have given it a positive review, based on 19 reviews, with an average rating of 4.8/10.[3]

text: Home media release[edit]

text: The film was released on DVD by Universal Pictures Home Entertainment as part of a three-film set, the Tom Hanks Comedy Favorites Collection, along with The 'Burbs and Dragnet.