Suicidal attempts and ideation are increased in ASD; however, the extent of the increase and the risk factors identified within this group remain under-investigated. There is a lack of research on protective factors. The correlation between ASD and suicidality needs further examination with longitudinal research.

There is increasing recognition of the co-occurrence of autism and schizophrenia spectrum disorders. However, the clinical significance of this on outcomes such as depression and suicidal thinking has not been explored. This study examines the association of autism spectrum traits, depressive symptoms and suicidal behaviour in individuals with psychotic experiences. In two cross sectional studies, individuals from a non-help seeking university student sample and patients with first episode psychosis (FEP) service completed standardized measures of autism spectrum traits, psychotic experiences, depressive symptoms and suicidal thinking. In healthy non-help seeking students, increased autism traits and increased subclinical psychotic experiences were significantly associated with depressive symptoms; a significant interaction effect suggests their combined presence has a greater impact on depression. In FEP, high autism traits and positive symptoms were associated with increased depression, hopelessness and suicidality, however there was no significant interaction effect. In FEP a multiple mediation model revealed that the relationship between autism traits and risk for suicidality was mediated through hopelessness. Young people with subclinical psychotic experiences and all patients with FEP should be screened for autism spectrum traits, which may have significant impact on clinical outcomes. Tailored interventions for patients with high levels of autistic spectrum co-morbidities in FEP should be a priority for future research.

Tarsem Cooner, Glynis Murphy), to the postgraduate researchers who contributed to other aspects of the project (Primrose Nyamayaro, and Dean Thompson), to the organisations (notably Midland Mencap, Dudley Advocacy, Apna, Keyring, Birmingham Community Healthcare NHS Trust, Bournville College, Options for Life, Voices for Choices, and Multicare-Asha) who supported it, and of course, to all of the people who participated in our data collection and partnership events. Author contributions: 2 ML, BKS and JR conceived the study, in response to a focused funding call. GU and ML further developed the design, sampling strategy, data collection materials and ethics application, in consultation with the project steering group, which included experts-by-experience. GU and KM conducted the interviews, with supervisory support from ML, BKS and JR. ML and GU conducted preliminary analysis, and MI developed a template which extended this to the remainder of the sample. These findings were discussed at a large stakeholder reference event run by GU and ML, and co-facilitated by JR, BKS, KM, MI, and IT. SZ and IT conducted the focused secondary analyses presented here, with supervision from ML and GU. KM also conducted a focused analysis at sub-sample level, supervised by JR and ML, and reported elsewhere. ML wrote this paper, drawing on materials developed by the authorship team.

Hepatocellular carcinoma remains a leading cause of cancer-related deaths worldwide. Liver disease including cirrhosis and viral hepatitis remains among the leading causes of hepatocellular carcinoma and despite increased screening, many patients are diagnosed in the advanced stages precluding them from locoregional therapy. Therapeutic agents for advanced hepatocellular carcinoma were limited to Sorafenib for several years; however, with the emergence of molecular targeted therapies including tyrosine kinase inhibitors and vascular endothelial growth factor inhibitors, in addition to immunotherapies, the way hepatocellular carcinoma is treated has changed significantly. In this review, we summarize the key clinical trials that lead to the approval of these agents for systemic treatment of hepatocellular carcinoma and discuss the preferred sequence of treatment options as well as prospective studies for management of hepatocellular carcinoma.