Should storing cord blood be standard?

By Terri Coles

TORONTO (Reuters) -- Public or private? That's the controversial question being asked about a potentially life-saving practice in which cord blood -- the blood collected from a newborn's placenta and umbilical cord -- is stored for future use.

Because cord blood is rich in hematopoietic stem cells, it is one of three possible sources of blood-forming cells used in transplants, along with bone marrow and circulating blood. One of the advantages of cord blood, which is frozen and stored in either a public or private bank, is that there is evidence that the donor/recipient match doesn't have to be as exact as it does for bone marrow and circulating blood.

But the collection of cord blood after birth hasn't been standardized, and some physicians oppose its storage for private use. The American Academy of Pediatrics recently discouraged the use of private cord blood banks, except when a relative has a current need for a transplant, because it is unclear that banked cord blood benefits the individual it was collected from.

Instead, the AAP encourages parents to donate to public cord blood banks, which make the blood available to patients with diseases such as leukemia, neuroblastoma, lymphoma, sickle cell anemia and thalassemia, as well as immune deficiencies and genetic diseases. So far, the appeal has fallen short: Public cord blood banks have received between 60,000 to 70,000 units of cord blood and have used about 6,000 for transplants, the AAP said. Private banks store an estimated 400,000 units, but only 35 to 40 have been transplanted.

The availability of public units is important because 10,000 people a year are diagnosed with diseases that can be treated with cell transplants, and while 30 percent of those people will have a related donor available, 70 percent will not, said Kathy Welte, the director of the United States' National Marrow Donor Program's Center for Cord Blood.

The Center for Cord Blood is connected with related organizations around the world, Welte said, and their resources are available to patients in other countries. Canada, for example, lacks a national public cord blood bank. Many of the transplants done there use cord blood units from the United States and Europe, though they have come from as far afield as Taiwan and Australia, said Dr. John Doyle, director of the blood and marrow transplant program at the Hospital for Sick Children in Toronto.

If families choose to store their infant's cord blood at a private or family bank, where it will be kept -- for a fee -- it will only be available for that child, a sibling or another family member.

Privately banking cord blood is most often recommended when there is someone in the family who already needs a donation, Doyle said -- for example, a sibling. It also appeals to families who have a history of metabolic disorders, or who feel that their ethnic background is unusual enough that the donor pool would be impossibly small if they were to become ill. (Ethnicity is one of the determinants for an HLA match, which is important for a successful transplantation.)

Dr. Clifford Librach, the founder of CReATe Cord Blood Bank in Toronto, Canada, says public banking options are limited in Canada -- only the provinces of Alberta and Quebec have public cord blood banks -- and CReATe gives parents the chance to store a biological resource that would otherwise be wasted. "It's either throw it in the garbage or bank for your family," Librach said.

Though they do deal with some families with a specific need -- CReATe will bank for free for a child in immediate need of a cord blood transplant -- they mostly deal with families who are banking because they want the blood available just in case. "There's a possibility that anyone could use this at any time in their life," Librach said. "What you really are doing is banking for your own family. It's like having insurance for your family."

Some experts say that both banking options offer benefits. "I think there's plenty of room for both private and public cord blood banking," said Doyle. "I don't think there needs to be one or the other, I think that both can coexist." But he warns that families should do their homework and make sure the bank they deal with has been accredited.

The CReAte clinic will be inspected for accreditation with the American Association of Blood Banks in the coming month, Librach said. CReATe has also been inspected by Health Canada and found to comply with their mandatory regulations, he said.

Today, cord blood transplants are used to treat metabolic and malignant disorders like sickle cell anemia and leukemia, but the uses of cord blood could expand in the future. "That potential can be huge," Doyle said. It's possible that stem cells could be used to develop other types of human tissue, such as muscle tissue that could be used to repair damaged hearts. They are also being examined in the treatment of spinal cord injuries. One study found that cord blood transplants were life-saving for infants with Krabbe's disease, an inherited degenerative disorder.

But those uses remain potential uses, and there isn't sufficient research to say for certain that any of them will happen, Doyle said.

But as North American populations become more diverse, publicly-banked cord blood will become more important, Doyle said. "We are going to be increasingly faced with unique HLA types," he said, and those types will be harder to match with the available donor pool.

U.S. sees record world food crops easing crisis

By Charles Abbott

WASHINGTON (Reuters) - Good weather will help the world's farmers reap record wheat and rice crops this year, the U.S. government said on Friday, which should allay fears of shortages and help bring prices down from current high levels.

The U.S. Agriculture Department also forecast a record global crop of feed grain, used to feed livestock.

The USDA announcement was expected to calm fears of food shortages, worsened by the cyclone that hit Myanmar's rich rice-producing Irrawaddy delta last week, and by a larger than expected 500,000 metric ton Malaysian rice purchase on Thursday.

Disappointing harvests, the boom in biofuels and higher meat consumption have pushed up grain prices in the past two years, raising food prices and sparking protests in some 40 poorer countries whose people have felt the effect most strongly.

Officials at the U.N. Human Rights Council said it would hold a special session on May 23 to assess the effect of the food crisis on the right to food of millions of people suffering from high prices, notably in sub-Saharan Africa and South Asia.

"We're keeping our fingers crossed that we get good harvests this year ... and that it brings prices down some from their high peaks," said analyst David Orden of the International Food Policy Research Institute, a think tank.

Even with bountiful crops, Orden said, larger international food aid efforts would be vital because prices would be higher than usual for the next couple of years at least.

The USDA said the world wheat crop would rise 8 percent to a record 656 million metric tons in 2008/09. It projected global rice output at a record 432 million metric tons, up 5 million metric tons from 2007/08."This ought to take the edge off commodity prices" said private U.S. consultant John Schnittker, making it easier for poor people to buy enough food.

Other signals that the supply crisis might be easing came from India, which said on Friday that it might allow limited rice exports, and from the Philippines, where traders held off purchases hoping for new crops soon from southeast Asia.

India, the world's second-biggest rice exporter last year, banned shipments of all rice except basmati in March, one of a series of protectionist measures worldwide that triggered a wave of panic buying.

"We are reviewing the situation and may allow limited exports," Commerce Secretary Gopal Pillai said on the sidelines of a conference in Kochi, adding that the government might also review an export tax on basmati rice.

The USDA forecast depressed wheat prices on the Chicago Board of Trade, but rice prices rose on the USDA prediction that Cyclone Nargis would reduce Myanmar's rice crop by 7 percent. The U.N. Food and Agriculture Organisation had said it expected Myanmar to export 600,000 metric tons of rice this year.

The soaring cost of food has fuelled unease among governments and street protests from Haiti to Bangladesh. The situation has worsened as grain exporting nations curb shipments to ensure domestic supplies and keep inflation under control.

The Philippines, the world's biggest rice importer, has so far bought about 1.7 million metric tons of the 2.2 million metric tons of rice it needs this year, and officials and traders said they expected prices to fall within a few months.

The USDA said the record harvests expected this year meant there would be an end-year world wheat surplus of 124 million metric tons, despite a rise in consumption of 3.5 percent.

The higher rice crop would leave a stockpile of 82.6 million metric tons, the largest in six years, it said.(Additional reporting by Rosemarie Francisco in Manila, Debiprasad Nayak in Kochi)

(Writing by Tim Pearce)

Video games don't create killers, new book says

By Scott Hillis

SAN FRANCISCO (Reuters) - Playing video games does not turn children into deranged, blood-thirsty super-killers, according to a new book by a pair of Harvard researchers.

Lawrence Kutner and Cheryl Olson, a husband-and-wife team at Harvard Medical School, detail their views in "Grand Theft Childhood: The Surprising Truth About Violent Video Games and What Parents Can Do", which came out last month and promises to reshape the debate on the effects of video games on kids.

"What I hope people realize is that there is no data to support the simple-minded concerns that video games cause violence," Kutner told Reuters.

The pair reached that conclusion after conducting a two-year study of more than 1,200 middle-school children about their attitudes towards video games.

It was a different approach than most other studies, which have focused on laboratory experiments that attempt to use actions like ringing a loud buzzer as a measure of aggression.

"What we did that had rarely been done by other researchers was actually talk to the kids. It sounds bizarre but it hadn't been done," Kutner said.

They found that playing video games was a near-universal activity among children, and was often intensely social.

But the data did show a link between playing mature-rated games and aggressive behavior. The researchers found that 51 percent of boys who played M-rated games -- the industry's equivalent of an R-rated movie, meaning suitable for ages 17 and up -- had been in a fight in the past year, compared to 28 percent of non-M-rated gamers.The pattern was even stronger among girls, with 40 percent of those who played M-rated games having been in a fight in the past year, compared to just 14 percent for non-M players.

One of the most surprising things was how popular mature games were among girls. In fact, the "Grand Theft Auto" crime action series was the second-most played game behind "The Sims", a sort of virtual dollhouse.

Kutner and Olson said further study is needed because the data shows only a correlation, not causation. It is unclear whether the games trigger aggression or if aggressive children are drawn to more violent games.

"It's still a minority of kids who play violent video games a lot and get into fights. If you want a good description of 13-year-old kids who play violent video games, it's your local soccer team," Olson said.

The researchers also try to place video games in a larger context of popular culture. The anxiety many parents voice over video games largely mirrors the concerns raised when movies, comic books and television became popular.

"One thing I like about their approach is that they've tried to historicize the whole concept of a media controversy and that we've seen this before," said Ian Bogost, a professor at Georgia Tech known for his studies on video games.

The book urges a common-sense approach that takes stock of the entire range of a child's behavior. Frequent fighting, bad grades, and obsessive gaming can be signs for trouble.

"If you have, for example, a girl who plays 15 hours a week of exclusively violent video games, I'd be very concerned because it's very unusual," Kutner said.

"But for boys (the danger sign) is not playing video games at all, because it looks like for this generation, video games are a measure of social competence for boys."Many video game fans have embraced the pair as champions of the industry, a label that makes them uncomfortable.

"We're not comfortable doing pro and con. We've been asked to do the pro-game side in debates, and I don't consider myself a pro-game person. Video games are a medium," Olson said.

source : reuters