"Cord Blood Stem Cell Transplantation"[MeSH Terms] AND "Blood Banks"[MeSH Terms]

umbilical cord blood banking public vs private ACOG AAP recommendation collection procedure indications

umbilical cord blood collection hematopoietic stem cells bank

ls -la /tmp/workspace/; mkdir -p /tmp/workspace/cord-blood-assignment/assets /tmp/workspace/cord-blood-assignment/output; python3 -c "import matplotlib,os;p=os.path.join(os.path.dirname(matplotlib.__file__),'mpl-data/fonts/ttf');print(p);print([f for f in os.listdir(p) if 'DejaVuSans' in f])"

cat > /tmp/workspace/cord-blood-assignment/make_figs.py <<'EOF' import matplotlib matplotlib.use("Agg") import matplotlib.pyplot as plt from matplotlib.patches import Circle, FancyBboxPatch, FancyArrowPatch, Ellipse out="/tmp/workspace/cord-blood-assignment/assets/" # Fig 1: cord cross-section fig,ax=plt.subplots(figsize=(5,4.2)) ax.set_aspect('equal'); ax.axis('off'); ax.set_xlim(-6,6); ax.set_ylim(-5,5) ax.add_patch(Circle((0,0),3.4,fc='#fff3d6',ec='black',lw=2)) ax.add_patch(Circle((0,0),3.4,fc='none',ec='black',lw=1)) ax.add_patch(Circle((-1.3,-0.9),0.85,fc='#e57373',ec='black',lw=1.5)) ax.add_patch(Circle((-1.3,-0.9),0.4,fc='white',ec='black',lw=1)) ax.add_patch(Circle((1.3,-0.9),0.85,fc='#e57373',ec='black',lw=1.5)) ax.add_patch(Circle((1.3,-0.9),0.4,fc='white',ec='black',lw=1)) ax.add_patch(Ellipse((0,1.2),2.2,1.5,fc='#64b5f6',ec='black',lw=1.5)) ax.add_patch(Ellipse((0,1.2),1.2,0.75,fc='white',ec='black',lw=1)) ax.annotate("Umbilical vein (1)\ncarries oxygenated blood\nto the fetus",(0.6,1.7),(3.8,3.9),fontsize=8,arrowprops=dict(arrowstyle='-')) ax.annotate("Umbilical artery (2)\ncarry deoxygenated blood\nto the placenta",(2,-1.3),(3.8,-3.6),fontsize=8,arrowprops=dict(arrowstyle='-')) ax.annotate("",(-2,-1.4),(3.8,-3.4),arrowprops=dict(arrowstyle='-')) ax.annotate("Wharton's jelly\n(protective gelatinous tissue)",(-2.4,1.5),(-5.9,3.8),fontsize=8,arrowprops=dict(arrowstyle='-')) ax.annotate("Amniotic epithelium\n(outer covering)",(-2.4,2.4),(-5.9,-3.6),fontsize=8,arrowprops=dict(arrowstyle='-')) ax.set_title("Fig. 1: Cross-section of the umbilical cord",fontsize=10,fontweight='bold') plt.savefig(out+"fig1_cord.png",dpi=200,bbox_inches='tight'); plt.close() # Fig 2: flowchart steps=["Antenatal counselling\n& informed consent","Donor screening\n(history, maternal\ninfection tests)","Delivery of baby,\ncord clamped\nand cut","Cord blood drawn from\numbilical vein into\nCPD bag (40-150 mL)","Labelling and\ntransport to bank\n(within 24-48 h)","Processing: cell count,\nCD34+, sterility, HLA,\nvolume reduction","Cryopreservation\n(10% DMSO) and storage\nin liquid nitrogen (-196 C)","Listing in registry /\nrelease for transplant"] fig,ax=plt.subplots(figsize=(5.6,6.4)); ax.axis('off'); ax.set_xlim(0,10); ax.set_ylim(0,len(steps)*1.6+0.4) n=len(steps) for i,s in enumerate(steps): y=(n-1-i)*1.6+0.5 ax.add_patch(FancyBboxPatch((1.5,y),7,1.05,boxstyle="round,pad=0.05",fc='#e3f2fd',ec='black',lw=1.3)) ax.text(5,y+0.52,s,ha='center',va='center',fontsize=8) ax.text(0.8,y+0.52,str(i+1),ha='center',va='center',fontsize=10,fontweight='bold') if i<n-1: ax.add_patch(FancyArrowPatch((5,y-0.02),(5,y-0.5),arrowstyle='-|>',mutation_scale=12,lw=1.3)) ax.set_title("Fig. 2: Flow of cord blood from collection to storage",fontsize=10,fontweight='bold') plt.savefig(out+"fig2_flow.png",dpi=200,bbox_inches='tight'); plt.close() # Fig 3: public vs private/hybrid schematic fig,ax=plt.subplots(figsize=(6,3)); ax.axis('off'); ax.set_xlim(0,12); ax.set_ylim(0,6) ax.add_patch(FancyBboxPatch((4,4.6),4,1.1,boxstyle="round,pad=0.05",fc='#fff9c4',ec='black')) ax.text(6,5.15,"Cord blood unit\nafter delivery",ha='center',va='center',fontsize=9) for x,t,c in [(0.3,"PUBLIC BANK\nDonated, free,\navailable to any\nmatched patient","#c8e6c9"),(4.2,"PRIVATE BANK\nPaid storage for\nthe family only","#ffccbc"),(8.1,"HYBRID BANK\nUnits meeting criteria\nlisted publicly, rest\nstored privately","#d1c4e9")]: ax.add_patch(FancyBboxPatch((x,0.5),3.6,2.5,boxstyle="round,pad=0.05",fc=c,ec='black')) ax.text(x+1.8,1.75,t,ha='center',va='center',fontsize=8) ax.add_patch(FancyArrowPatch((6,4.55),(x+1.8,3.1),arrowstyle='-|>',mutation_scale=12,lw=1.2)) ax.set_title("Fig. 3: Types of cord blood banks",fontsize=10,fontweight='bold') plt.savefig(out+"fig3_types.png",dpi=200,bbox_inches='tight'); plt.close() EOF python3 /tmp/workspace/cord-blood-assignment/make_figs.py && ls /tmp/workspace/cord-blood-assignment/assets

cat > /tmp/workspace/cord-blood-assignment/make_pdf.py <<'EOF' from reportlab.lib.pagesizes import A4 from reportlab.lib.units import mm from reportlab.lib import colors from reportlab.lib.styles import ParagraphStyle from reportlab.lib.enums import TA_CENTER, TA_JUSTIFY from reportlab.platypus import BaseDocTemplate, PageTemplate, Frame, Paragraph, Spacer, Image, Table, TableStyle, PageBreak, NextPageTemplate, KeepTogether from reportlab.pdfbase import pdfmetrics from reportlab.pdfbase.ttfonts import TTFont fp="/opt/amazon/genesis1p-tools/venv/lib64/python3.12/site-packages/matplotlib/mpl-data/fonts/ttf/" pdfmetrics.registerFont(TTFont("DV",fp+"DejaVuSans.ttf")) pdfmetrics.registerFont(TTFont("DVB",fp+"DejaVuSans-Bold.ttf")) pdfmetrics.registerFont(TTFont("DVI",fp+"DejaVuSans-Oblique.ttf")) pdfmetrics.registerFontFamily("DV",normal="DV",bold="DVB",italic="DVI",boldItalic="DVB") A="/tmp/workspace/cord-blood-assignment/assets/" OUT="/tmp/workspace/cord-blood-assignment/output/Umbilical_Cord_Blood_Banking_Assignment.pdf" NAVY=colors.HexColor("#1a3c6e"); RED=colors.HexColor("#b71c1c") def border(c,d,cover=False): c.saveState() W,H=A4 c.setStrokeColor(NAVY); c.setLineWidth(2.2); c.rect(10*mm,10*mm,W-20*mm,H-20*mm) c.setStrokeColor(RED); c.setLineWidth(0.8); c.rect(13*mm,13*mm,W-26*mm,H-26*mm) if cover: c.setStrokeColor(NAVY); c.setLineWidth(0.8); c.rect(16*mm,16*mm,W-32*mm,H-32*mm) else: c.setFont("DV",8); c.setFillColor(colors.grey); c.drawCentredString(W/2,16.5*mm,"Page %d"%(d.page-1)) c.restoreState() doc=BaseDocTemplate(OUT,pagesize=A4,title="Umbilical Cord Blood Banking - Assignment 1",author="") W,H=A4 cover=Frame(22*mm,22*mm,W-44*mm,H-44*mm,id="c") body=Frame(20*mm,22*mm,W-40*mm,H-40*mm,id="b") doc.addPageTemplates([PageTemplate("cover",[cover],onPage=lambda c,d:border(c,d,True)),PageTemplate("body",[body],onPage=lambda c,d:border(c,d))]) H1=ParagraphStyle("h1",fontName="DVB",fontSize=14,textColor=NAVY,spaceBefore=10,spaceAfter=5,leading=18) P=ParagraphStyle("p",fontName="DV",fontSize=9.2,leading=14.5,alignment=TA_JUSTIFY,spaceAfter=5) B=ParagraphStyle("b",parent=P,leftIndent=14,bulletIndent=3,spaceAfter=2) CAP=ParagraphStyle("cap",parent=P,fontName="DVI",fontSize=8,alignment=TA_CENTER,textColor=colors.grey) S=[] def h(t): S.append(Paragraph(t,H1)) def p(t): S.append(Paragraph(t,P)) def bl(items): for i in items: S.append(Paragraph(i,B,bulletText="\u2022")) S.append(Spacer(1,4)) def img(f,w): from PIL import Image as PI iw,ih=PI.open(A+f).size S.append(Image(A+f,width=w*mm,height=w*mm*ih/iw)); S.append(Spacer(1,4)) def tbl(data,cw): cs=ParagraphStyle("t",fontName="DV",fontSize=8.3,leading=11.5) csb=ParagraphStyle("tb",parent=cs,fontName="DVB",textColor=colors.white) rows=[[Paragraph(x,csb if r==0 else cs) for x in row] for r,row in enumerate(data)] t=Table(rows,colWidths=[c*mm for c in cw],repeatRows=1) t.setStyle(TableStyle([("BACKGROUND",(0,0),(-1,0),NAVY),("GRID",(0,0),(-1,-1),0.6,colors.black),("VALIGN",(0,0),(-1,-1),"TOP"),("ROWBACKGROUNDS",(0,1),(-1,-1),[colors.white,colors.HexColor("#eef3fa")]),("TOPPADDING",(0,0),(-1,-1),3),("BOTTOMPADDING",(0,0),(-1,-1),3)])) S.append(t); S.append(Spacer(1,8)) # COVER S.append(Spacer(1,25*mm)) S.append(Paragraph("ASSIGNMENT 1",ParagraphStyle("a",fontName="DVB",fontSize=16,alignment=TA_CENTER,textColor=RED))) S.append(Spacer(1,10*mm)) S.append(Paragraph("UMBILICAL CORD<br/>BLOOD BANKING",ParagraphStyle("t",fontName="DVB",fontSize=30,leading=38,alignment=TA_CENTER,textColor=NAVY))) S.append(Spacer(1,8*mm)) S.append(Paragraph("<i>\"Saving a life at the moment of birth\"</i>",ParagraphStyle("q",fontName="DVI",fontSize=12,alignment=TA_CENTER,textColor=colors.grey))) S.append(Spacer(1,6*mm)) img("fig1_cord.png",85) S[-2].hAlign="CENTER" S.append(Spacer(1,10*mm)) lab=ParagraphStyle("l",fontName="DVB",fontSize=11,leading=14) rows=[[Paragraph(x,lab),Paragraph("_"*34,ParagraphStyle("u",fontName="DV",fontSize=11))] for x in ["Name:","Roll No.:","Class / Year:","Subject:","Submitted to:","Date of submission:"]] t=Table(rows,colWidths=[48*mm,100*mm]); t.setStyle(TableStyle([("TOPPADDING",(0,0),(-1,-1),6)])); S.append(t) S.append(NextPageTemplate("body")); S.append(PageBreak()) # INDEX h("Contents") bl(["1. Introduction","2. Meaning and Concept","3. History and Development","4. Types","5. Indication and Potential Uses","6. Procedure for Cord Blood Collection","7. Role of Nurses and Midwives","8. Advantages and Limitations","9. Current Trends and Research in Cord Blood Banking","10. Conclusion","11. References"]) h("1. Introduction") p("The umbilical cord connects the fetus to the placenta during pregnancy. After the baby is delivered and the cord is clamped, the blood left in the cord and placenta was traditionally discarded as biological waste. This blood is now known to be a rich source of <b>hematopoietic stem cells (HSCs)</b>, the cells that give rise to all blood and immune cells.") p("Cord blood can be collected safely and painlessly at birth, tested, frozen and stored for many years in a <b>cord blood bank</b>. When a patient needs a stem cell transplant, a suitably matched unit can be released quickly. Cord blood is now an accepted alternative source of stem cells to bone marrow and peripheral blood. More than 700,000 cord blood units are available worldwide (Tietz Textbook of Laboratory Medicine, 7th Ed., p. 2497).") p("For nurses and midwives, cord blood banking is an important topic because they counsel parents, assist at delivery and are often responsible for collection and documentation.") h("2. Meaning and Concept") p("<b>Umbilical cord blood (UCB)</b> is the blood remaining in the placenta and umbilical cord after birth. It contains a high concentration of hematopoietic stem and progenitor cells, along with red cells, white cells, platelets and plasma.") p("<b>Cord blood banking</b> is the process of collecting, testing, processing, cryopreserving (freezing at very low temperature) and storing cord blood so that it can be used later for transplantation or research.") p("<b>Concept:</b> Stem cells in cord blood are young and immunologically naive. Because of this, they tolerate a greater degree of HLA mismatch between donor and recipient and cause less graft-versus-host disease (GVHD) than adult bone marrow cells. The units are frozen and listed in advance, so they are available immediately when needed.") p("<b>Key terms</b>") bl(["<b>HSC:</b> blood-forming stem cell, identified by the CD34 marker.","<b>HLA:</b> human leukocyte antigen; matching between donor and recipient affects transplant success.","<b>TNC:</b> total nucleated cell count, a measure of the dose of cells in a unit.","<b>Cryopreservation:</b> freezing in liquid nitrogen at about -196 C using a protectant, dimethyl sulfoxide (DMSO).","<b>Autologous use:</b> the baby's own cells. <b>Allogeneic use:</b> cells given to another person."]) img("fig1_cord.png",70); S[-2].hAlign="CENTER" S.append(Paragraph("Draw: cross-section of the umbilical cord showing two arteries, one vein and Wharton's jelly",CAP)) h("3. History and Development") tbl([["Year","Event"], ["1970s-80s","Researchers (including Broxmeyer and colleagues) showed that human cord blood is rich in hematopoietic progenitor cells and suggested it could be used for transplantation."], ["1988","First successful cord blood transplant in Paris (Gluckman and team) for a child with Fanconi anemia, using cord blood from an HLA-matched sibling. Published in 1989 (Henry's Clinical Diagnosis, p. 2637)."], ["1991-1992","First public cord blood bank established at the New York Blood Center, to supply unrelated patients with no matched donor."], ["1993-1996","First transplants of unrelated donor cord blood in children and then in adults."], ["1997-2004","Cord Blood Transplantation (COBLT) study set standard procedures for donor screening, HLA matching, processing, storage and data collection. Two-year event-free survival was 55% in children with high-risk malignancies and 78% in children with non-malignant conditions (Henry's, p. 2637)."], ["2000s","Private (family) cord blood banks spread worldwide, including India. Registries and international networks were formed; accreditation bodies (such as FACT-NetCord and AABB) set quality standards."], ["2010s","Double cord blood transplants for adults; ex vivo expansion; professional bodies (AAP 2017, ACOG 2019, IAP 2018) issued recommendations favouring public banking."], ["Today","About 9% of allogeneic transplants from 2012 to 2016 used cord blood (Henry's, p. 2645). Use has fallen with the rise of haploidentical transplants, while research on regenerative uses continues."]],[26,134]) h("4. Types") p("<b>A. Based on the type of bank</b>") img("fig3_types.png",120); S[-2].hAlign="CENTER" tbl([["Feature","Public bank","Private (family) bank"], ["Ownership","Donated; unit belongs to the bank and is listed in a registry","Owned by the family"], ["Cost","Free for the donor","Collection fee plus yearly storage fee"], ["Who can use it","Any matched patient (unrelated allogeneic use)","Baby or family member only"], ["Quality standards","Strict; many units rejected for low volume or cell count","Variable; less regulated in many countries"], ["Professional view","Preferred and recommended (AAP, ACOG, IAP)","Recommended only when a family member already has a disease treatable by cord blood transplant"]],[32,64,64]) p("<b>B. Hybrid bank:</b> A unit that meets public criteria is listed in the public registry, while units that fall short are stored for the family. This model is a developing option (Laue et al., 2024, systematic review).") p("<b>C. Directed (sibling) donation:</b> Cord blood is collected and stored free or at reduced cost for a sibling who has a disease that may be treated by transplant, such as thalassemia or leukemia.") p("<b>D. Based on use of the unit:</b>") bl(["<b>Autologous:</b> the child's own cord blood. It is rarely used, because it carries the same genetic defect or pre-leukemic changes that may cause the child's later disease.","<b>Allogeneic related:</b> given to a matched sibling or relative.","<b>Allogeneic unrelated:</b> given to a matched stranger through a registry."]) p("<b>E. Cord tissue banking:</b> Many private banks also store a piece of cord tissue, which contains mesenchymal stem cells. This use is still investigational.") h("5. Indication and Potential Uses") p("<b>A. Established indications (allogeneic transplant)</b>") tbl([["Group","Examples"], ["Malignant disorders","Acute myeloid leukemia, acute lymphoblastic leukemia, chronic myeloid leukemia, myelodysplastic syndrome, juvenile myelomonocytic leukemia, lymphomas"], ["Bone marrow failure","Severe aplastic anemia, Fanconi anemia, Diamond-Blackfan anemia"], ["Hemoglobinopathies","Beta-thalassemia major, sickle cell disease"], ["Immune deficiencies","Severe combined immunodeficiency, Wiskott-Aldrich syndrome, chronic granulomatous disease"], ["Inherited metabolic disorders","Hurler syndrome, Krabbe disease, adrenoleukodystrophy, other storage disorders"], ["Others","Osteopetrosis, hemophagocytic lymphohistiocytosis"]],[42,118]) p("More than 35,000 cord blood transplants had been done by 2019 for such conditions (ACOG Committee Opinion, 2019). Cord blood is especially helpful for patients from ethnic minority groups who rarely find a matched adult donor (Tietz, p. 2599).") p("<b>B. Potential (investigational) uses</b>") bl(["Regenerative medicine: cerebral palsy, hypoxic-ischemic encephalopathy, autism, stroke, congenital heart defects.","Autoimmune and metabolic disease such as type 1 diabetes.","Cell-based immunotherapy, for example natural killer cells and CAR-based cells prepared from cord blood.","Gene therapy and research tools."]) p("<i>Note:</i> These newer uses are not yet standard care. Private banking as \"biological insurance\" is not supported by current evidence. The chance that a child will ever use his or her own stored cord blood is very low.") h("6. Procedure for Cord Blood Collection") p("<b>A. Before delivery</b>") bl(["Counsel the mother in the antenatal period (ideally before the third trimester) about public, private and hybrid options.","Obtain written informed consent before labour.","Screen the mother: medical, family and genetic history, and blood tests for HIV, hepatitis B, hepatitis C, syphilis, HTLV and CMV as required by the bank. Exclude donors with high-risk factors.","Make sure the collection kit (sterile bag with anticoagulant, needle, clamps, antiseptic, labels, transport box) is ready."]) p("<b>B. At delivery</b>") bl(["Collection must never interfere with care of the mother or newborn. Delayed cord clamping (30 to 60 seconds) is encouraged for healthy term babies.","Two methods: <b>in utero</b> (after the baby is delivered, before the placenta is delivered) or <b>ex utero</b> (after the placenta is delivered). In utero collection usually gives a larger volume.","Clean the cord with antiseptic (for example povidone iodine, then alcohol or chlorhexidine) and allow it to dry.","Puncture the umbilical vein with the needle attached to the collection bag containing anticoagulant (CPD/CPDA). Let blood flow into the bag by gravity and mix gently.","Aim for a volume of about 40 to 150 mL, which gives about 4 to 11 x 10<super>8</super> nucleated cells. Units below about 40 mL are usually discarded (Henry's, p. 2641).","Clamp the tubing, seal the bag, and label it with the mother's and baby's identifiers, date and time."]) p("<b>C. After collection</b>") bl(["Collect maternal blood samples for infectious disease and genetic testing.","Place the unit in the transport container at the temperature set by the bank and send it to the laboratory promptly, usually within 24 to 48 hours.","Complete the documentation: consent form, maternal history, collection time, volume, staff name."]) p("<b>D. Laboratory processing and storage</b>") bl(["Tests: volume, TNC count, CD34+ count, cell viability, sterility culture, ABO and Rh group, HLA typing.","Volume or red cell reduction in many banks (practices vary; some freeze units without reducing volume).","Add DMSO, freeze in a controlled-rate freezer, and store in liquid nitrogen at about -196 C.","Register HLA data in a registry for public units. Stored units do not appear to lose viability with time (Tietz, p. 2599)."]) img("fig2_flow.png",95); S[-2].hAlign="CENTER" h("7. Role of Nurses and Midwives") bl(["<b>Educator and counsellor:</b> give unbiased, evidence-based information on public, private and hybrid banking, costs, limits and chances of use.","<b>Advocate:</b> encourage public donation and respect the woman's right to choose or to decline.","<b>Consent:</b> make sure written informed consent is taken, and explain that collection may not be possible in some conditions (for example emergency delivery, preterm birth, low volume).","<b>Screening:</b> take history and record risk factors; send maternal blood samples.","<b>Collection:</b> prepare the kit, maintain asepsis and perform or assist with collection without delaying routine care.","<b>Labelling and documentation:</b> correct identification, time of collection and chain of custody.","<b>Transport and storage coordination:</b> arrange timely transport at the right temperature.","<b>Ethical care:</b> maintain confidentiality, avoid commercial pressure and conflicts of interest.","<b>Follow-up:</b> inform the mother if a unit is found unsuitable, and support parents if a stored unit is needed for treatment."]) h("8. Advantages and Limitations") tbl([["Advantages","Limitations"], ["Collection is painless, safe and non-invasive for mother and baby; no risk to the donor","Small volume and low cell dose; slower engraftment (about 21 days) and higher risk of graft failure"], ["Ready to use: frozen, tested and listed, so less time to transplant","Hard to use in adults with a single unit; may need two units or expansion"], ["Less strict HLA matching needed; lower risk of severe GVHD","Single use: the donor cannot be recalled for more cells"], ["Low risk of transmitting latent viruses (CMV, EBV)","Delayed immune recovery and risk of infection after transplant"], ["Helps patients from ethnic groups under-represented in adult donor registries","High cost of unit acquisition and of private storage"], ["Waste material that would otherwise be discarded","Autologous unit cannot treat the child's own genetic disease or leukemia; very low chance of use; many units fail quality criteria; private bank claims may be misleading"]],[80,80]) p("(Sources: Henry's Clinical Diagnosis, p. 2645; Tietz Textbook of Laboratory Medicine, pp. 2497 and 2599.)") h("9. Current Trends and Research in Cord Blood Banking") bl(["<b>Public banking is preferred.</b> The American Academy of Pediatrics (2017) and ACOG (2019) recommend public banking and do not support routine private banking. The Indian Academy of Pediatrics (2018) consensus also promotes public banking, with private banking advised only when a sibling or parent has a disease treatable by allogeneic transplant.","<b>Hybrid banking</b> is being studied as a way to combine public benefit and family access (Laue et al., 2024).","<b>Double-unit transplants and ex vivo expansion</b> aim to overcome low cell dose and slow engraftment in adults. Expansion protocols can partly correct the cell dose and neutrophil recovery delay (Tietz, p. 2497). Expanded cord blood products have now reached regulatory approval in some countries.","<b>Competition from haploidentical transplants</b> using post-transplant cyclophosphamide has reduced the use of cord blood in some centres, because haploidentical donors are cheaper and quickly available.","<b>Regenerative medicine trials</b> are testing cord blood and cord-derived cells in cerebral palsy, hypoxic-ischemic injury, autism and heart disease. A 2025 systematic review of umbilical cord-derived stem cell therapy in cerebral palsy was published (Salari et al., Orphanet J Rare Dis), but larger controlled trials are still needed before it can be routine.","<b>Improved quality and regulation:</b> national guidelines, accreditation and licensing of banks; better donor selection to improve unit quality.","<b>Other directions:</b> cord blood derived immune cells for cancer therapy, gene-edited cord blood stem cells and artificial intelligence-based HLA matching."]) h("10. Conclusion") p("Umbilical cord blood is a valuable source of hematopoietic stem cells that is collected without risk at birth and stored for future transplantation. Public banking increases the chance that patients without a matched donor will find a suitable unit and is the model recommended by professional bodies. Private banking is useful mainly when a family member already needs a transplant. Claims of wide future use are not yet proven. Nurses and midwives play a central part in counselling, consent, safe collection and documentation, and must give accurate, unbiased information so that parents can make an informed choice.") h("11. References") for r in ["Henry's Clinical Diagnosis and Management by Laboratory Methods. Hematopoietic progenitor cell banking: Umbilical Cord Blood, pp. 2637-2645.", "Tietz Textbook of Laboratory Medicine, 7th Edition. Cord Blood; Cord Blood as a Graft Source, pp. 2497 and 2599.", "Harrison's Principles of Internal Medicine, 22nd Edition. Categories of Hematopoietic Cell Transplantation.", "Goldman-Cecil Medicine, International Edition. Allogeneic hematopoietic cell transplantation.", "American College of Obstetricians and Gynecologists. Committee Opinion No. 771: Umbilical Cord Blood Banking. Obstet Gynecol 2019.", "Shearer WT, et al. Cord blood banking for potential future transplantation. Pediatrics 2017 (AAP policy statement).", "Indian Academy of Pediatrics. Umbilical Cord Blood Banking: Consensus Statement. Indian Pediatrics 2018;55:489-494.", "Gluckman E, et al. Hematopoietic reconstitution in a patient with Fanconi's anemia by means of umbilical-cord blood from an HLA-identical sibling. N Engl J Med 1989;321:1174-8.", "Laue J, Ambuhl J, Surbek D. Hybrid umbilical cord blood banking: literature review. Arch Gynecol Obstet 2024 (PMID 37093267).", "Salari N, et al. Safety and efficacy of umbilical cord-derived stem cell therapy for cerebral palsy: a systematic review. Orphanet J Rare Dis 2025 (PMID 41107995)."]: S.append(Paragraph(r,B,bulletText="\u2022")) doc.build(S) EOF cd /tmp/workspace/cord-blood-assignment && python3 make_pdf.py && python3 -c " import pypdf;r=pypdf.PdfReader('output/Umbilical_Cord_Blood_Banking_Assignment.pdf');print(len(r.pages))"

cd /tmp/workspace/cord-blood-assignment && python3 -c " import fitz d=fitz.open('output/Umbilical_Cord_Blood_Banking_Assignment.pdf') for i in [0,1,5]: d[i].get_pixmap(dpi=60).save(f'assets/p{i}.png') " ; ls assets

cd /tmp/workspace/cord-blood-assignment && python3 -c " import pdfplumber with pdfplumber.open('output/Umbilical_Cord_Blood_Banking_Assignment.pdf') as pdf: for i in [0,1,5]: pdf.pages[i].to_image(resolution=60).save(f'assets/p{i}.png') "; ls assets

cd /tmp/workspace/cord-blood-assignment && python3 - <<'EOF' import re s=open('make_figs.py').read() s=s.replace("fontsize=8,arrowprops","fontsize=11,arrowprops").replace("figsize=(5,4.2)","figsize=(7,5.4)") s=s.replace("ax.set_xlim(-6,6)","ax.set_xlim(-8,8)").replace("(3.8,3.9)","(3.9,3.7)").replace("(-5.9,3.8)","(-7.8,3.8)").replace("(-5.9,-3.6)","(-7.8,-3.8)") s=re.sub(r'ax\.set_title\([^\n]*\)\n','',s) # flow chart: bigger font s=s.replace("ha='center',va='center',fontsize=8)\n ax.text(0.8","ha='center',va='center',fontsize=10.5)\n ax.text(0.8").replace("fontsize=10,fontweight='bold')\n if i","fontsize=12,fontweight='bold')\n if i") s=s.replace("figsize=(5.6,6.4)","figsize=(5.6,7)").replace("fontsize=9)\nfor x","fontsize=11)\nfor x").replace("ha='center',va='center',fontsize=8)\n ax.add_patch(FancyArrowPatch((6","ha='center',va='center',fontsize=10)\n ax.add_patch(FancyArrowPatch((6") open('make_figs.py','w').write(s) p=open('make_pdf.py').read() p=p.replace('img("fig1_cord.png",85)','img("fig1_cord.png",120)') p=p.replace('S.append(Paragraph("Draw: cross-section','S.append(Paragraph("Fig. 1: Cross-section') p=p.replace('img("fig2_flow.png",95); S[-2].hAlign="CENTER"','img("fig2_flow.png",105); S[-2].hAlign="CENTER"\nS.append(Paragraph("Fig. 2: Flow of cord blood from collection to storage",CAP))') p=p.replace('img("fig3_types.png",120); S[-2].hAlign="CENTER"','img("fig3_types.png",140); S[-2].hAlign="CENTER"\nS.append(Paragraph("Fig. 3: Types of cord blood banks",CAP))') p=p.replace(' with Wharton\'s jelly"',' with Wharton\'s jelly"') open('make_pdf.py','w').write(p) EOF python3 make_figs.py && python3 make_pdf.py && python3 -c " import pdfplumber with pdfplumber.open('output/Umbilical_Cord_Blood_Banking_Assignment.pdf') as pdf: print(len(pdf.pages)) for i in [0,1,3,5]: pdf.pages[i].to_image(resolution=70).save(f'assets/p{i}.png') "

cd /tmp/workspace/cord-blood-assignment && sed -i 's/Units meeting criteria\\nlisted publicly, rest\\nstored privately/Qualifying units\\nlisted publicly,\\nrest kept for\\nthe family/' make_figs.py && python3 make_figs.py && python3 make_pdf.py && ls -la output