The aim of this study was to assess the effectiveness of safety regulations governing traditional Mongolian horse racing on the frequency and severity of injuries among child jockeys. Regulations introduced in 2019 mandate the wearing of helmets and protective clothing, prohibit the participation of jockeys aged <7 years, and ban horse racing during the cold season (November–April). National injury surveillance data were used to compare the profile of injuries that occurred among children aged <15 years in the 4-year periods before and after the introduction of the regulations (2015–2018 and 2019–2022) and to investigate whether injuries continued to occur among underage children and during the banned season. The proportion of head injuries among injured children was calculated before and after the regulations were introduced. During the study periods, 6309 animal-riding injuries were recorded among children aged 3–14 years; 2539 occurred before the regulations were introduced and 3770 occurred after. Following the introduction of the regulations, the proportion of injured children aged <7 years decreased slightly. However, during 2019–2022, 294 animal-riding injuries were observed among underage children and 855 during the banned season. The proportion of head injuries among children with animal-riding injuries remained unchanged before and after the regulations were implemented (33.7% and 34.6%, respectively). The regulations have been ineffective. To reduce the burden of injuries among child jockeys, safety regulations need to be enforced throughout the year, and more stringent penalties for noncompliance should be imposed.

OBJECTIVESTo investigate the prevalence of non-alcoholic fatty liver disease (NAFLD) in children and its relationship to metabolic syndrome, insulin resistance, and waist circumference (WC).

METHODSThis was a population-based cross-sectional, case-control study. Cases were selected among students of a primary and junior high school, respectively, and age- and sex-matched control subjects were selected randomly (ratio of cases to control subject was 37:113).

RESULTSOf the 846 students, aged between 6 and 15 years, enrolled in the study and screened by ultrasonography, 37 children were diagnosed as having NAFLD (score >/= 1). There was a significant sex difference in the prevalence of NAFLD(P = 0.003). The trend test revealed a strong dose-response relationship (P < 0.001) between pediatric NAFLD and the number of the proposed components of pediatric metabolic syndrome in Japan (MetS-JC), such as a clustering of the components of MetS-JC. Additionally, the linear trend of the odds ratios (ORs) with increasing percentile of the homeostasis model assessment-insulin resistance (HOMA-IR) was statistically significant (P < 0.001). However, when WC was added to the logistic model, the ORs were no longer significant, whereas WC turned out to be an independent risk factor for NAFLD regardless of the HOMA-IR index.

CONCLUSIONThe prevalence of NAFLD in children and adolescents is closely related to metabolic syndrome, insulin resistance, and WC.

The preoperative pulmonary arterial pressure of 38 patients aged over 50 undergoing surgical closure of a secundum atrial septal defect was studied. They were divided into three groups according to systolic pulmonary arterial pressure (PAP): Group A (PAP<30mmHg, n=14), Group B (30≤PAP<50mmHg, n=16), and Group C (PAP≥50mmHg, n=8). The mean age of group C patients was older than that of group A patients. With higher PAP, the Pp/Ps, Rp/Rs and cardiothoracic ratios increased, atrial fibrillation and heart failure (NYHA≥2) were more frequent, and PaO₂ levels declined. There were no differences in left to right shunt ratio and Qp/Qs among the three groups. The PAP and Rp/Rs were under 70mmHg and 0.30, respectively in all patients. High pulmonary blood flow seems to be the cause of pulmonary hypertension in most elderly patients because PAP and Rp/Rs decreased after surgery in all groups. Findings of cardiomegaly and heart failure also improved after surgery. Surgical intervention is recommended even in elderly patients with a ASD.