Aspirin for Metabolic Dysfunction-Associated Steatotic Liver Disease Without Cirrhosis: A Randomized Clinical Trial.

Importance: Aspirin may reduce severity of metabolic dysfunction-associated steatotic liver disease (MASLD) and lower the incidence of end-stage liver disease and hepatocellular carcinoma, in patients with MASLD. However, the effect of aspirin on MASLD is unknown. Objective: To test whether low-dose aspirin reduces liver fat content, compared with placebo, in adults with MASLD. Design, Setting, and Participants: This 6-month, phase 2, randomized, double-blind, placebo-controlled clinical trial was conducted at a single hospital in Boston, Massachusetts. Participants were aged 18 to 70 years with established MASLD without cirrhosis. Enrollment occurred between August 20, 2019, and July 19, 2022, with final follow-up on February 23, 2023. Interventions: Participants were randomized (1:1) to receive either once-daily aspirin, 81 mg (n = 40) or identical placebo pills (n = 40) for 6 months. Main Outcomes and Measures: The primary end point was mean absolute change in hepatic fat content, measured by proton magnetic resonance spectroscopy (MRS) at 6-month follow-up. The 4 key secondary outcomes included mean percentage change in hepatic fat content by MRS, the proportion achieving at least 30% reduction in hepatic fat, and the mean absolute and relative reductions in hepatic fat content, measured by magnetic resonance imaging proton density fat fraction (MRI-PDFF). Analyses adjusted for the baseline value of the corresponding outcome. Minimal clinically important differences for study outcomes were not prespecified. Results: Among 80 randomized participants (mean age, 48 years; 44 [55%] women; mean hepatic fat content, 35% [indicating moderate steatosis]), 71 (89%) completed 6-month follow-up. The mean absolute change in hepatic fat content by MRS was -6.6% with aspirin vs 3.6% with placebo (difference, -10.2% [95% CI, -27.7% to -2.6%]; P = .009). Compared with placebo, aspirin treatment significantly reduced relative hepatic fat content (-8.8 vs 30.0 percentage points; mean difference, -38.8 percentage points [95% CI, -66.7 to -10.8]; P = .007), increased the proportion of patients with 30% or greater relative reduction in hepatic fat (42.5% vs 12.5%; mean difference, 30.0% [95% CI, 11.6% to 48.4%]; P = .006), reduced absolute hepatic fat content by MRI-PDFF (-2.7% vs 0.9%; mean difference, -3.7% [95% CI, -6.1% to -1.2%]; P = .004]), and reduced relative hepatic fat content by MRI-PDFF (-11.7 vs 15.7 percentage points; mean difference, -27.3 percentage points [95% CI, -45.2 to -9.4]; P = .003). Thirteen participants (32.5%) in each group experienced an adverse event, most commonly upper respiratory tract infections (10.0% in each group) or arthralgias (5.0% for aspirin vs 7.5% for placebo). One participant randomized to aspirin (2.5%) experienced drug-related heartburn. Conclusions and Relevance: In this preliminary randomized clinical trial of patients with MASLD, 6 months of daily low-dose aspirin significantly reduced hepatic fat quantity compared with placebo. Further study in a larger sample size is necessary to confirm these findings. Trial Registration: ClinicalTrials.gov Identifier: NCT04031729.

Open Science Practices in Gambling Research Publications (2016-2019): A Scoping Review.

The replication crisis has stimulated researchers around the world to adopt open science research practices intended to reduce publication bias and improve research quality. Open science practices include study pre-registration, open data, open access, and avoiding methods that can lead to publication bias and low replication rates. Although gambling studies uses similar research methods as behavioral research fields that have struggled with replication, we know little about the uptake of open science research practices in gambling-focused research. We conducted a scoping review of 500 recent (1/1/2016-12/1/2019) studies focused on gambling and problem gambling to examine the use of open science and transparent research practices. Our results showed that a small percentage of studies used most practices: whereas 54.6% (95% CI: [50.2, 58.9]) of studies used at least one of nine open science practices, each practice's prevalence was: 1.6% for pre-registration (95% CI: [0.8, 3.1]), 3.2% for open data (95% CI: [2.0, 5.1]), 0% for open notebook, 35.2% for open access (95% CI: [31.1, 39.5]), 7.8% for open materials (95% CI: [5.8, 10.5]), 1.4% for open code (95% CI: [0.7, 2.9]), and 15.0% for preprint posting (95% CI: [12.1, 18.4]). In all, 6.4% (95% CI: [4.6, 8.9]) of the studies included a power analysis and 2.4% (95% CI: [1.4, 4.2]) were replication studies. Exploratory analyses showed that studies that used any open science practice, and open access in particular, had higher citation counts. We suggest several practical ways to enhance the uptake of open science principles and practices both within gambling studies and in science more generally.

Time out: Prediction of self-exclusion from daily fantasy sports.

OBJECTIVE: Responsible gambling (RG) tools that include play management software, self-limit features, and self-exclusion are relatively common offerings on major online gambling platforms. However, how online gaming and daily fantasy sports (DFS) players use such tools is less clear. The goals of this article were to understand how players use self-exclusion at a major DFS platform and to identify DFS activity-related predictors of self-exclusion. METHOD: During November 2015, DraftKings, a major DFS provider, rolled out a self-exclusion feature that allows players to self-exclude from the platform for a specified amount of time, up to 5 years. We used player records from DraftKings, examining play patterns and self-exclusion across 3 + years of data. RESULTS: We found that less than 0.5% of subscribers in our sample self-excluded during the study period and almost one third of those who self-excluded did so more than once. In general, self-excluders engaged with a greater variety of contests and sports and entered contests with higher entry fees than those who did not self-exclude. Repeat self-excluders selected shorter initial self-exclusion terms and also engaged with a greater variety of game types and sports than one-time self-excluders. However, self-excluders did not engage in riskier contests or experience higher percent losses. CONCLUSION: Our findings have implications for our understanding of RG feature use among DFS subscribers and markers of risk for experiencing problems with DFS and gambling more generally. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Changes to the playing field: A contemporary study of actual European online sports betting.

BACKGROUND AND AIMS: Online sports wagering is a popular and still growing gambling activity around the world. Like other types of gambling, it can lead to problems that include devastating financial, social, and health-related harms. The first analysis of actual online sports wagering activity (LaBrie et al., 2007) suggested that levels of financial and time involvement were more moderate than anticipated from earlier self-report studies. However, these findings are now more than a decade old. METHODS: The current study examined actual online sports wagering activity of a similar cohort of 32,262 gamblers who subscribed to a European online betting platform in February 2015 to understand how sports betting might have changed in ten years. Measures included subscriber characteristics, betting activities, and transactional activities. RESULTS: Players placed a median of 15 bets during the 8-month study period, made a median of 2.5 bets per betting day, had a median bet size of 6.1 euros, and experienced a median net loss of 25 euros. We were able to distinguish highly involved bettors in the top 2% of total wagered, net loss, and number of bets, whose behavior differed from that of the rest of the sample. DISCUSSION AND CONCLUSIONS: Sports wagering behavior has remained relatively stable over time despite legislative changes and an increase in popularity, with a small subset of subscribers exhibiting disproportionately high engagement, transactional activity, and in-game betting. Further investigation of individual trajectories of wagering behavior and engagement with different types of sports wagering products is merited.