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Background: Hepatocellular carcinoma (HCC) is considered the most common type of liver cancer and the fourth leading cause of cancer-related deaths in the world. Since the disease is usually diagnosed at advanced stages, it has poor prognosis. Therefore, reliable biomarkers are urgently needed for early diagnosis and prognostic assessment. Methods: We used genome-wide gene expression profiling datasets from human and rat early HCC (eHCC) samples to perform integrated genomic and network-based analyses, and discovered gene markers that are expressed in blood and conserved in both species. We then used independent gene expression profiling datasets for peripheral blood mononuclear cells (PBMCs) for eHCC patients and from The Cancer Genome Atlas (TCGA) database to estimate the diagnostic and prognostic performance of the identified gene signature. Furthermore, we performed functional enrichment, interaction networks and pathway analyses. Results: We identified 41 significant genes that are expressed in blood and conserved across species in eHCC. We used comprehensive clinical data from over 600 patients with HCC to verify the diagnostic and prognostic value of 41-gene-signature. We developed a prognostic model and a risk score using the 41-geneset that showed that a high prognostic index is linked to a worse disease outcome. Furthermore, our 41-gene signature predicted disease outcome independently of other clinical factors in multivariate regression analysis. Our data reveals a number of cancer-related pathways and hub genes, including EIF4E, H2AFX, CREB1, GSK3B, TGFBR1, and CCNA2, that may be essential for eHCC progression and confirm our gene signature's ability to detect the disease in its early stages in patients' biological fluids instead of invasive procedures and its prognostic potential. Conclusion: Our findings indicate that integrated cross-species genomic and network analysis may provide reliable markers that are associated with eHCC that may lead to better diagnosis, prognosis, and treatment options.
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OBJECTIVE: To understand the influence of demographics and education levels on awareness levels, and on the prevalence of hesitancy to receive the influenza vaccine among adult patients at King Saud University Medical City (KSUMC). METHOD: A crosssectional study in the outpatient pharmacy area at KSUMC was conducted. Data was collected from January 1 to January 31, 2020. A total of 318 random adult patients were encountered and a predesigned survey was administered. After capturing demographic information, respondents were categorized into 3 groups: group A consisted of respondents who had never heard of the influenza vaccine; group B was comprised of respondents who answered that they had never received the influenza vaccine; and group C included respondents who answered that they had received at least one influenza vaccine. RESULTS: Out of the 317 survey respondents, 36 (11%) had never heard of the influenza vaccine (Group A). Of the remaining 281 (89%), 122 (39%) had not received the vaccine (Group B), whereas 159 (50%) had received it (Group C). Chi-square test results indicated a significant association between age group and awareness of the vaccine (p = .023). Moreover, there was a significant association between education level and awareness of the vaccine (p = .002). The prevalence of vaccination hesitancy was 42%. Chi-square test results indicated a significant association between gender and vaccination hesitancy (p < .001), and between education level and vaccination hesitancy (p = .011). CONCLUSION: Influenza vaccination hesitancy is prevalent among the study's population. Further efforts by health care providers and public health services may be necessary to educate the community regarding the influenza vaccine's safety and efficacy.