The nfkb1 and nfkb2 genes encode closely related products regulating immune and inflammatory responses. Their role during development and differentiation remains unclear. The generation of nfkb1 null mice (p50-/-) resulted in altered immune responses, but had no effect on development. Similarly, nfkb2 knockout mice (p52-/-) did not show developmental defects (J.C. et al., manuscript submitted). We have investigated the potential for in vivo compensatory functions of these genes by generating double-knockout mice. The surprising result was that the animals developed osteopetrosis because of a defect in osteoclast differentiation, suggesting redundant functions of NF-kappaB1 and NF-kappaB2 proteins in the development of this cell lineage. The osteopetrotic phenotype was rescued by bone marrow transplantation, indicating that the hematopoietic component was impaired. These results define a new mouse osteopetrotic mutant and implicate NF-kappaB proteins in bone development, raising new directions in the treatment of bone disorders.

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Background Reporting near misses is a practical approach to improve the confounding challenge of patient safety. Evidence suggests that patient safety culture and the characteristics of errors might have important impacts on reporting. No studies, however, have examined the relationships among patient safety culture, perceived severity of near misses and near-miss reporting. Aims To explore the relationship between patient safety culture and nurses’ near-miss reporting intention, and examine the potential moderating effect the perceived severity of near misses might have on this relationship. Methods Using a cross-sectional survey, data were collected with three validated survey instruments completed by 920 Registered Nurses in eight tertiary hospitals in China. Multiple regression analysis tested relationships among the variables. Results Nurses reported a moderate–high level of near-miss reporting intention. Patient safety culture was positively associated with nurses’ near-miss reporting intention. Perceived severity of near misses did not significantly moderate the relationship between patient safety culture and reporting intention. Conclusions Nurses generally showed a positive willingness to report near misses. A specific near-miss management and education system within a learning, supportive working environment are key components to improve reporting intention among nurses which could significantly improve patient safety.

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With widespread advances in the diffusion and application of medical technologies, the phenomena of misuse and overuse have become pervasive. These phenomena not only increase the cost of health care systems and deplete the accessibility and availability of health care services, they also jeopardize patient autonomy. From a literature review on this aspect of medical technology, an impact on patient autonomy is found in almost all cases, with the exception of philosophical or ethical writings, in which there is not much practical application for health policy and law. In this article, the major finding is that in the area of patient autonomy, it does not matter much whether the “physician decides” or the “patient decides” in the current “disease care” health system, where most of the doctors focus only on disease treatment using aggressive medical technologies. It is also our “disease care” system that ensures that the patients, the health care professionals, or the health care management cannot safeguard their autonomy. Only when the genuine health care system is restored will patient autonomy be protected.