The effect of emotional freedom techniques (EFT) on anxiety and caregiver burden of family caregivers of patients with heart failure: A quasi-experimental study.

BACKGROUND: Family members are at the forefront of providing care to patients with chronic illnesses, such as heart failure (HF). Since patient caregiving can affect the mental and physical health of family caregivers, the implementation and training of new psychological interventions by nurses are considered important and necessary for family caregivers. Therefore, the aim of this study was to evaluate the effect of emotional freedom techniques (EFTs) on anxiety and caregiver burden of family caregivers of patients with HF. MATERIALS AND METHODS: This study was a quasi-experimental study, in which 91 family caregivers participated. The family caregivers were assigned into two groups of intervention (n = 46) and control (n = 45). Data were collected using a demographic information form, Zung Self-Rating Anxiety Scale (SAS), and Caregiver Burden Inventory (CBI) developed by Novak and Guest. The intervention group underwent EFT training within six sessions, while the control group received no training. Descriptive statistics (mean, standard deviation, and absolute and relative frequency) and inferential statistical tests such as Chi-square, Fisher's exact, and independent t-tests were run, and the data were analyzed by Statistical Package for the Social Sciences (SPSS) version 23 software. RESULTS: The findings showed that the intervention group had a significant improvement in reducing anxiety (P > 0.001). In addition, EFT significantly reduced caregiver burden among family caregivers of HF patients (P > 0.001). CONCLUSION: EFT could significantly reduce anxiety and caregiver burden in family caregivers of patients with HF in our study. Therefore, nurses working in clinical settings are recommended to learn and use EFT to reduce the anxiety and caregiver burden of patients' family caregivers.

Evaluation of acceptance, attitude, and knowledge towards artificial intelligence and its application from the point of view of physicians and nurses: A provincial survey study in Iran: A cross-sectional descriptive-analytical study.

Background and Aims: The prospect of using artificial intelligence (AI) in healthcare is bright and promising, and its use can have a significant impact on cost reduction and decrease the possibility of error and negligence among healthcare workers. This study aims to investigate the level of knowledge, attitude, and acceptance among Iranian physicians and nurses. Methods: This cross-sectional descriptive-analytical study was conducted in eight public university hospitals located in Tehran on 400 physicians and nurses. To conduct the study, convenient sampling was used with the help of researcher-made questionnaires. Statistical analysis was done by SPSS 21 The mean and standard deviation and Chi-square and Fisher's exact tests were used. Results: In this study, the level of knowledge among the research subjects was average (14.66 ± 4.53), the level of their attitude toward AI was relatively favorable (47.81 ± 6.74), and their level of acceptance of AI was average (103.19 ± 13.70). Moreover, from the participant's perspective, AI in medicine is most widely used in increasing the accuracy of diagnostic tests (86.5%), identifying drug interactions (82.75%), and helping to analyze medical tests and imaging (80%). There was a statistically significant relationship between the variable of acceptance of AI and the participant's level of education (p = 0.028), participation in an AI training course (p = 0.022), and the hospital department where they worked (p < 0.001). Conclusion: In this study, both the knowledge and the acceptance of the participants towards AI were proved to be at an average level and the attitude towards AI was relatively favorable, which is in contrast with the very rapid and inevitable expansion of AI. Although our participants were aware of the growing use of AI in medicine, they had a cautious attitude toward this.

Comparing the effect of emotional freedom technique on sleep quality and happiness of women undergoing breast cancer surgery in military and nonmilitary families: A quasi-experimental multicenter study.

PURPOSE: The aim of this study was to compare the effect of emotional freedom technique (EFT) on sleep quality and happiness of women who underwent breast cancer surgery and lived in military and nonmilitary families. DESIGN AND METHODS: The patients were randomly divided into four groups of military intervention (n = 34), nonmilitary intervention (n = 33), military control (n = 31), and nonmilitary control (n = 35). Data were collected using demographic information form, Pittsburgh Sleep Quality Index, and Oxford Happiness Questionnaire. FINDINGS: The mean scores of sleep quality and happiness in military and nonmilitary intervention groups improved significantly immediately and 1 month after the intervention compared to control groups (p < 0.001). However, there was no statistically significant difference between the military and nonmilitary intervention groups regarding the mean scores of sleep quality and happiness before, immediately, and 1 month after the intervention (p > 0.05). PRACTICE IMPLICATIONS: Given the efficacy of EFT in improving sleep quality and happiness, it is recommended that this technique be taught to nurses to implement in the entire process of providing nursing care to cancer patients.

The effect of cognitive-behavioral therapy on death anxiety and depression in patients with heart failure: A quasi-experimental study.

PURPOSE: In this study, the effect of cognitive-behavioral therapy (CBT) on death anxiety and depression was investigated in patients with heart failure. DESIGN AND METHODS: In this quasi-experimental study, 66 patients with heart failure were randomly assigned to intervention (n = 33) and control (n = 33) groups. Data collection was done using a demographic questionnaire, Templer death anxiety scale, and Beck depression inventory. FINDINGS: It was found that the overall scores of death anxiety and depression in posttest were significantly lower than those at the follow-up stage in the intervention group. PRACTICE IMPLICATIONS: CBT could significantly reduce death anxiety and depression in patients with heart failure. Therefore, it is recommended to equip nurses with CBT trainings to manage patients with heart failure better.

Encapsulation of spinel CuCo2O4 hollow sphere in V2O5-decorated graphitic carbon nitride as high-efficiency double Z-type nanocomposite for levofloxacin photodegradation.

In this study, spinel CuCo2O4 (CCO) with a hierarchical hollow sphere morphology was encapsulated in V2O5-decorated ultra-wrinkled graphitic carbon-nitride (VO-UCN) for the first time via a facile glycerol-assisted solvothermal method in the interest of developing a novel high-efficiency double Z-type nano-photocatalyst (denoted as VO-UCN@CCO). The remarkable physicochemical features of the as-prepared nano-photocatalysts were verified using diverse characterization techniques including TGA, XRD, FT-IR, FE-SEM, TEM, BET, UV-vis DRS, PL, EIS, and transient photocurrent techniques. Herein, VO-UCN@CCO nanocomposite was employed for the photodisintegration of levofloxacin (LVOF) antibiotic under visible-light irradiation and the impact of certain operative reaction system variables was explored in an effort to optimize the photocatalytic capability. The 40% loading of CCO in VO-UCN@CCO nanocomposite was found to display maximum photocatalytic performance (about 95%) for LVOF photodecomposition, which was 9.3, 6.6, and 13.8 times greater when compared with pristine VO, UCN, and CCO, respectively. A high capability was observed for as-prepared photocatalyst during reusability tests and near 90% degradation efficiency was obtained in the sixth run. The complete mineralization of LVOF was achieved by the VO-UCN@CCO photocatalyst process after 300 min of reaction. An excellent synergy factor towards the degradation of LVOF was obtained for VO-UCN@CCO compared to each of its components alone. This peculiar design is envisaged to provide new inspirations for ameliorating the photocatalytic decontamination of tenacious and non-biodegradable species present in real wastewater.

Effective promotion of g-C3N4 photocatalytic performance via surface oxygen vacancy and coupling with bismuth-based semiconductors towards antibiotics degradation.

In this research, the potential of bismuth chromate (BCO), a new bismuth-based semiconductor belongs to the family of Bi2XO6 (X = Mo, W, or Cr), was introduced by a novel 1D/2D structure consist of BCO nanobelts and N2-freezed ultra-wrinkled graphitic carbon nitride (N-CN) nanosheets. To enhance intimate contact between BCO and N-CN (BCO/N-CN composite), surface oxygen vacancy (VO) was created as an efficient electron transfer highway using a simple alkaline-treatment-assisted method. Various characterization techniques, including XRD, FT-IR, EPR, FE-SEM, TEM, BET, DRS, PL, EIS, and photocurrent transient analyses were conducted to elucidate the physicochemical aspects of catalysts. The synthesized catalysts were subjected to levofloxacin (LVFX) photodegradation and optimum conditions were found under LED irradiation. Under optimum conditions, about 92.5% of LVFX was catalytically degraded over VO-rich BCO/N-CN heterojunction after 120 min of reaction, which was 2.3 folds higher than that of VO-free composite. The obtained heterojunction maintained superior performance after five consecutive runs with no noticeable changes in the XRD and FT-IR patterns, demonstrating the high stability of synthesized nanocomposite. Thus, the proposed interfacial engineering in this study opens new insight for ameliorating the insufficient interfacial contact between components of heterojunctions. This study not only presents a new bismuth-based photocatalyst for antibiotic degradation but also sheds light on the charge migration behavior in favor of efficient Z-type heterojunction.

Efficacy of throwing exercise with TheraBand in male volleyball players with shoulder internal rotation deficit: a randomized controlled trial.

BACKGROUND: The Glenohumeral internal-rotation deficit (GIRD) is related to the altered eccentric external-rotator (ER), the concentric internal-rotator (IR), muscle strength, and the ER: IR ratio. GIRD has been documented as a risk factor for shoulder injuries. However, few studies have investigated the effect of an exercise training on these parameters in athletes with GIRD. Therefore, the purpose of this study was to evaluate the effects of an 8-week throwing exercise with a TheraBand for retraining the rotator cuff on Electromyography (EMG) activity of selected muscles, rotator cuff muscle strength, the glenohumeral (GH) joint IR range of motion (ROM) and GH joint position sense in asymptomatic male volleyball players with GIRD. METHODS: Sixty male volleyball players with GIRD were randomized into either a training group or a control group. The experimental group underwent an 8-week throwing exercise with a TheraBand including 5 sessions of stretching and 3 sessions of strengthening exercises per week. The control group received an active self-exercise program. EMG (onset time and muscle activation), shoulder range of motion (ROMs), strength and GH joint position sense were all assessed pre and post trainings. RESULTS: There were statistically significant within-group differences in the EMG activity of the anterior deltoid (p = 0.005), middle deltoid (p = 0.007), posterior deltoid (p = 0.004), infraspinatus (p = 0.001) and supraspinatus (p = 0.001) muscles, IR ROM (p = 0.001), rotator cuff muscle strength ratio (p = 0.001), and GH joint position sense (p = 0.033) in the experimental group. A 2 × 2 analysis of variance with a mixed model design and independent and paired t-tests were used for statistical analysis. CONCLUSIONS: Throwing exercise with a TheraBand improved shoulder muscle activation, IR ROM, rotator cuff muscle strength ratio and GH joint position sense in participants with GIRD. These findings may improve the treatment of GIRD in a clinical setting. Although the results are significant, further studies should follow up the long-term effects of the Throwing exercise with a TheraBand on GIRD. TRIAL REGISTRATION: Current Controlled Trials using the UMIN-RCT website with ID number of, UMIN000038416 "Retrospectively registered" at 2019/10/29.

RUNX1 variant as a genetic predisposition factor for acute myeloid leukemia.

Acute myeloid leukemia (AML) is the most common hematological malignancy among adults and is characterized by accumulation of immature myeloid cells. Different genetic factors have role in the occurrence of AML. Among different proteins, RUNX1 and BAALC are involved in the development AML. It has been shown that BAALC overexpression is a factor that indicate shorter disease free survival in a subset of AML patients. RUNX1 has been implicated in the development of breast, prostate, lung, and skin cancers. The aim of this study is determination of the prevalence of common polymorphisms in BAALC (rs6999622 and rs62527607) and RUNX1 (rs13051066 and rs61750222) in AML patients compared with healthy subjects. A total of 100 AML patients and 100 healthy control subjects were included in our study. Genomic DNA was isolated from peripheral blood and the polymorphisms were genotyped by applying ARMS and PCR-RFLP methods. Finally, data was analyzed using SPPSS software. Our results demonstrate a significant association between the RUNX1 rs13051066 and AML in the co-dominant (odd ratio = 6.66, 95% Cl = 1.85-25, p = .006) and dominant (GT + TT versus GG: odd ratio = 6.15, 95% CI = 1.73-21.87, p = .002) models. The RUNX1 rs13051066 polymorphism is associated with risk of AML in Iranian population. Future studies should consider larger sample size for assessment of RUNX1 gene polymorphisms, and employ cytogenetic and molecular analyses in AML patients from different ethnic origins.

Dual biomarkers long non-coding RNA GAS5 and its target, NR3C1, contribute to acute myeloid leukemia.

Acute myeloid leukemia (AML) is a complex hematological neoplasm with poor prognosis. At present, overwhelming evidence indicates that different genetic abnormalities are relevant to the pathogenesis of AML. Nevertheless, its exact molecular mechanism is still unknown. Recently, it was reported that lncRNAs play crucial roles in tumorigenesis. But, their role in the molecular pathogenesis of AML has not been extensively explored. GAS5, one of the earliest known lncRNAs, has an essential role in the formation and progression of multiple human cancers. It was recently demonstrated that GAS5 acts as a riborepressor of the Glucocorticoid receptor) GR) and abnormal levels of GAS5 may alter response of hematopoietic cells to glucocorticoids. GAS5 can have interaction with the GR that encoded by NR3C1 gene and inhibit its transcriptional activity. To test whether the genetic variants can be associated with AML risk, we genotyped rs55829688 (T > C) polymorphism in GAS5 and three NR3C1 SNPs namely rs6195, rs41423247 and rs6189/rs6190 in a population of 100 Iranian AML patients and 100 healthy subjects. The analysis of the data showed the frequency of alleles and genotypes of rs55829688 and rs6189/rs6190 polymorphisms did not differ between patients and healthy subjects. But, rs41423247 and rs6195 demonstrated a significant correlation with AML risk. The rs6195 was associated with higher AML susceptibility in the co-dominant (OR = 4.58, 95% CI = 2.11-9.981, P < .0001), dominant (OR = 4.55, 95% CI = 2.155-9.613, P < .0001), and over-dominant (OR = 4.43, 95% CI = 2.042-9.621, P < .0001) models. Also, the rs41423247 polymorphism was associated with higher risk of AML in co-dominant (OR = 2.07, 95% CI = 1.171-4.242, P = .012) and dominant (OR = 2.47, 95% CI = 1.192-5.142, P = .010) models. Furthermore, haplotype analysis (rs41423247, rs6189.rs6190, rs6195, and rs55829688 respectively) demonstrated that GGAT, CGGT, and GGGT haplotypes were associated with higher risk of AML in the studied population (p-values = .007, 0.042 and 0.044, respectively). The present study reveals a possible role for NR3C1 in the pathogenesis of AML.

Vertical ground reaction force and knee muscle activation asymmetries in patients with ACL reconstruction compared to healthy individuals.

PURPOSE: Gait analysis is an important index in the clinical treatment of people with anterior cruciate ligament (ACL) injury. Following unilateral ACL reconstruction (ACLR), the knee kinetic asymmetries are likely to affect the gait cycle. Therefore, the aim of this study was to examine the symmetries of vertical ground reaction force (vGRF) and select the knee muscle activity in gait cycles in participants with and without unilateral ACLR. METHODS: In this cross-sectional study, vGRF and muscle activity data in difference gait cycles were collected from 56 male subjects (28 with unilateral ACLR and 28 healthy subjects) using force plate and electromyography (EMG), respectively. MATLAB software was used for data analysis and independent t test was employed to compare the two groups. RESULTS: No significant difference was seen between the two groups in the variable of first peak force symmetry (n.s). However, there was a significant difference in the second-peak force symmetry index between the two groups (p ≤ 0.001). Regarding muscle activity symmetry in the braking phase of gait, a significant difference was observed in rectus femoris between the two groups (p ≤ 0.001), while no difference was seen in medial gastrocnemius and biceps femoris activity (n.s). In the propulsive phase of gait, there was a significant difference in medial gastrocnemius and biceps femoris muscles activity between the two groups (p ≤ 0.001), while no difference was found in rectus femoris muscle activity (n.s). CONCLUSIONS: The results revealed that unilateral ACLR creates asymmetry in vGRF and muscle activities in different phases of the gait cycle. So, more attention should be paid to this problem in clinical settings, and also to the use of therapeutic interventions to reduce the amount of kinetic asymmetries. LEVEL OF EVIDENCE: III.

Role of NR3C1 and GAS5 genes polymorphisms in multiple sclerosis.

Introduction: Multiple sclerosis (MS) as a progressive chronic disease of the central nervous system (CNS) is characterized by demyelination and axonal loss. Results of genetic studies and clinical trials have proved a key role for the immune system in the pathogenesis of MS. Glucocorticoids (GR) are regarded as potent therapeutic compounds for autoimmune and inflammatory diseases which act through their receptors encoded by Nuclear Receptor Subfamily 3 Group C Member 1 (NR3C1) gene. Meanwhile, the long non-coding RNA (lncRNA) growth arrest specific 5 (GAS5) interacts with GR through binding to the DNA-binding domain (DBD) region and reduces GR transcriptional activity.Methods: The purpose of our study was to evaluate the association between MS and polymorphisms within NR3C1 (rs6189/6190, rs56149945, rs41423247) and GAS5 (rs55829688) genes in 300 relapsing-remitting MS patients and 300 healthy subjects.Results: We demonstrated significant differences in distribution of genotype, allele and haplotype frequencies of rs6189, rs41423247 and rs55829688 between the study groups.Conclusion: Our data may suggest that rs6189, rs41423247 and rs55829688 are associated with the increased risk of MS development. Future studies are needed to verify our results in larger sample sizes and elaborate the underlying mechanisms for contribution of these variants in MS disease.

Polyhydroxybutyrate Production from Natural Gas in A Bubble Column Bioreactor: Simulation Using COMSOL.

In this study, the simulation of microorganism ability for the production of poly-ß-hydroxybutyrate (PHB) from natural gas (as a carbon source) was carried out. Based on the Taguchi algorithm, the optimum situations for PHB production from natural gas in the columnar bubble reactor with 30 cm length and 1.5 cm diameter at a temperature of 32 °C was evaluated. So, the volume ratio of air to methane of 50:50 was calculated. The simulation was carried out by COMSOL software with two-dimensional symmetric mode. Mass transfer, momentum, density-time, and density-place were investigated. The maximum production of biomass concentration reached was 1.63 g/L, which shows a 10% difference in contrast to the number of experimental results. Furthermore, the consequence of inlet gas rate on concentration and gas hold up was investigated Andres the simulation results were confirmed to experimental results with less than 20% error.

First Report of Congenital Short Bowel Syndrome in an Iranian Patient Caused by a Mutation in the CLMP Gene.

Congenital short bowel syndrome (CSBS) is a rare congenital neonatal disorder. CSBS results from intestinal impairment during embryogenesis. Mutated CXADR-like membrane protein ( CLMP ) and Filamin A genes are involved in the cause of CSBS. In this study, due to our misdiagnosis, we had to perform whole exome sequencing on the patient, and also we implemented cosegregation analysis on his parents with consanguineous marriage and also parents' mothers. We identified a homozygous loss of function mutation in the CLMP gene in exon 5 (c.664C > T, p.R222X). Also, both parents and grandmothers of the proband were heterozygous for this mutation. Loss of function mutation in CLMP causes CSBS, leading to impaired intestinal development.

The Neuronal Ceroid Lipofuscinoses-Linked Loss of Function CLN5 and CLN8 Variants Disrupt Normal Lysosomal Function.

Neuronal ceroid lipofuscinoses (NCLs) are a group of neurodegenerative disorders caused by mutations in fourteen distinct ceroid lipofuscinoses, neuronal (CLN) genes described with various severe symptoms such as seizures, visual failure, motor decline, and progressive cognitive deterioration. The current research represents novel CLN5 (c.741G > A) and CLN8 (c.565delT) mutations in two different Iranian families with late-infantile NCL (LINCL) and their relatives by using whole-exome sequencing (WES). The first family had a 10-year-old male with consanguineous parents and severe NCL symptoms, including motor clumsiness, telangiectasia, and cerebellar atrophy. The second family with a child who suffered from nystagmus rotation, motor difficulties, and seizure was a 5-year-old male with consanguineous parent. WES of probands 1 and 2 revealed homozygotic mutations in exon 4 of CLN5 (c.741G > A, p.W247X) and deletion in exon 3 (c.565delT, p.F189fs) of CLN8, respectively. Both patients' parents were heterozygous for these alterations. In concordance with previous studies, our results indicate that pathogenic mutations in CLN genes, especially CLN5 and 8, are a main cause of LINCL; these results also suggest that LINCL is not a regionally or nationally dependent disorder and can occur in any ethnic group despite the fact that some populations may be more at risk. Consequently, CLN gene screening for patients with typical signs of LINCL is recommended.

Genetic discoveries and advances in late-onset Alzheimer's disease.

Alzheimer's disease (AD) is a heterogeneous disorder with multiple patterns of clinical manifestations. Recently, due to the advance of linkage studies, next-generation sequencing and genome-wide association studies, a large number of putative risk genes for AD have been identified using acquired genome mega data. The genetic association between three causal genes, including amyloid precursor protein, presenilin1, and presenilin2 in early-onset AD (EOAD), was discovered over the past few decades. These discoveries showed that there should be additional genetic risk factors for both EOAD and late-onset AD (LOAD) to help fully explain the leading molecular mechanisms in a single pathophysiological entity. This study reviews the clinical features and genetic etiology of LOAD and discusses a variety of AD-mediated genes that are involved in cholesterol and lipid metabolism, endocytosis, and immune response according to their mutations for more efficient selection of functional candidate genes for LOAD. New mechanisms and pathways have been identified as a result.

Comparison the time to stabilization and activity of the lower extremity muscles during jump-landing in subjects with and without Genu Varum.

BACKGROUND: Knee muscles activity changes from Genu Varum deformity(GVD), may cause this individual more exposed to lower extremity injuries especially in high-risk activities like landing. OBJECTIVE: The aim of this study was to compare the activity of the lower limb stabilizer muscles during jump-landing and time to stabilization(TTS) in subjects with and without GVD. METHOD: A total of 44 men (group 1, with GVD n = 22 and group 2, without GVD n = 22); with mean age = 17.6 ± 3.12 years, height = 178.2 ± 5.39 cm, mass = 80.39 ± 8.3 kg) participated in this study. Subjects were asked to do a jump-landing task and Quadratus Lumborum(QL), Gluteus Maximus(GMax), Gluteus Medius(GMed), Biceps Femoris (BF), Semitendinosus, and Medial Gastrocnemius(MG) muscles activity was recorded. Also, changes in the amount of ground reaction force(GRF) were used to an indicator for TTS. RESULTS: Our results showed that subjects with GVD had increased QL activity before(P = 0.008) and after(P = 0.017) landing. But, these subjects had a decreased activity of GMed compared to the healthy ones before(P = 0.033) and after(P = 0.005) landing. but there was no statistically significant difference before landing in gluteus maximus(P = 0.252), biceps femoris(P = 0.613), semitendinosus(P = 0.313), and medial gastrocnemius(P = 0.140) muscles and after landing in gluteus maximus (P = 0.246), biceps femoris(P = 0.512), semitendinosus(P = 0.214), and medial gastrocnemius(P = 0.209) muscles between the two groups. Also, the TTS was higher in subjects with GV than healthy ones in the Resultant Vector TTS (P = 0.015) and medial-lateral(P = 0.013) directions. CONCLUSIONS: The altered activity of the QL and GMed, in subjects with GVD may indicate instability of the spinal column, pelvis and hip during jump-landing task. Although the GVD is referred to the frontal plane deformity, the results showed that this complication might affect stability in other motion planes.

Association Study of ANRIL Genetic Variants and Multiple Sclerosis.

Multiple sclerosis (MS) is an autoimmune disorder of central nervous system with several genetic and environmental risk factors. Genes with regulatory roles on immune system have been implicated in its pathogenesis. Recently, long non-coding RNAs (lncRNAs) have been demonstrated to control some aspects of immune response. Among them is antisense non-coding RNA in the INK4 locus (ANRIL) whose involvement in NF-κB signaling pathway has been highlighted. In the current study, we evaluated the association between rs1333045, rs4977574, rs1333048, and rs10757278 variants of ANRIL and MS risk in a population of 410 Iranian MS patients and 410 healthy subjects. There was no significant difference in allele and genotype frequencies between MS patients and healthy subjects. However, haplotype analysis (rs1333045, rs1333048, rs4977574, and rs10757278 respectively) demonstrated protective effect of CCGG and TAAA haplotypes against MS (P values of 0.043 and 0.0026 respectively). In addition, TAGG and CCGA haplotypes were significantly associated with MS risk in the studied population (P values of 0.0065 and 0.024 respectively). The present study reveals a possible role for ANRIL in the pathogenesis of MS.

Influenza A (H1N1) in Hamedan Province, Western Iran in 2009: A Case-Control Study.

BACKGROUND: The novel influenza A (H1N1) virus was first detected in March 2009 in Mexico and then disseminated to many other countries worldwide. In this study, we assessed the potential risk factors of swine flu as well as the most important clinical manifestations of this infectious disease among confirmed cases during early phase of pandemic H1N1. METHODS: Subjects (cases and controls) were selected from those patients with signs and symptoms of respiratory tract infection who referred to health centers of eight cities throughout Hamedan Province, western Iran form July to December 2009. Characteristics of the participants were obtained by interviewers using pre-determined questionnaire. Cases were distinguished by pharyngeal soap speci-mens positive for influenza A virus using polymerase chain reaction (PCR). Logistic regression model was conducted at 0.05 significance level using Stata 9.1 statistical software to assess the effects of various risk factors on H1N1 influenza infection. RESULTS: Totally, 245 confirmed cases of H1N1 influenza were compared with 388 controls. Case fatality rate of influenza infection was about 2.86%. In comparison with age group of 1-19 yr old, adjusted odds ratio estimates was 1.91 [95% CI: 1.06, 3.46] for age group of 20-39 yr old, 0.94 [0.37, 2.38] for age group of 40-59 yr old, and 0.34 [0.09, 1.37] for age group of 60-79 yr old. Adjusted odds ratio estimates of influenza A infection was 8.12 [95% CI: 3.11, 21.6] for pregnant women compared to non-pregnant women; 1.84 [95% CI: 1.32, 2.86] for high educated individuals in comparison with low educated individuals; 2.11 [95% CI: 1.25, 3.57] for whose who had close contact with suspected influenza patients; and 2.15 [95% CI: 1.16, 3.98] for individuals with normal body mass index (BMI= 25-30) compared with underweight individuals (BMI< 20). There were no significant differences in clinical manifestations between cases and controls. CONCLUSION: The risk of influenza A infection is highest among children and adolescents, pregnant women, high educated individuals, and those who had close contact with suspected influenza patients during pandemic phase. In addition, there is no pathogonomonic sign or symptom to distinguish influenza infection clinically from other kinds of respiratory track infections.