{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T01:55:05Z","timestamp":1769997305431,"version":"3.49.0"},"reference-count":52,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T00:00:00Z","timestamp":1718409600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T00:00:00Z","timestamp":1718409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Deputyship for Research & Innovation, Ministry of Education in Saudi Arabia"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Data on the pathophysiological mechanisms of hemostatic alterations in the thrombotic events that occur during Ramadan intermittent fasting (RIF), particularly in the natural coagulation inhibitors, are very limited. Thus, our objective was to evaluate the effect of\u00a0RIF on the natural anticoagulants level, antithrombin, protein C, and total and free protein S (PS) in healthy participants. Participants were divided into two groups. Group I consisted of 29 healthy fasting participants whose blood samples were taken after 20 days of fasting. Group II included 40 healthy non-fasting  participants\u00a0whose blood samples were taken 2\u20134 weeks before the month of Ramadan. Coagulation screening tests including prothrombin time (PT), activated partial thromboplastin time (APTT) and plasma fibrinogen level, natural anticoagulants; antithrombin, protein C, free and total PS and C4 binding protein (C4BP) levels were evaluated in the two groups. High levels of total and free PS without change in antithrombin, protein C, and C4BP levels were noted in the fasting group as compared with non-fasting ones (p\u2009&lt;\u20090.05). PT and APTT showed no difference between the two groups. However, the fibrinogen level was higher in the fasting group. In conclusion, RIF was found to be associated with improved anticoagulant activity in healthy participants, which may provide temporal physiological protection against the development of thrombosis in healthy fasting people.<\/jats:p>","DOI":"10.1038\/s41598-024-64582-8","type":"journal-article","created":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T14:01:31Z","timestamp":1718460091000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Ramadan intermittent fasting is associated with improved anticoagulant activity among healthy people: a case\u2013control study"],"prefix":"10.1038","volume":"14","author":[{"given":"Abeer Khalid","family":"Al-Ghumlas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,15]]},"reference":[{"key":"64582_CR1","volume":"5","author":"NG AbdulKareem","year":"2017","unstructured":"AbdulKareem, N. G., Khalil, N. S., Jasim, A. E. & Alkabban, M. Some biochemical changes during summer Islamic fasting in diseased patients in comparison with normal. Am. J. Med. Sci. 5, e34 (2017).","journal-title":"Am. J. Med. Sci."},{"key":"64582_CR2","first-page":"7","volume":"30","author":"HARH Khafaji","year":"2011","unstructured":"Khafaji, H. A. R. H., Bener, A., Osman, M., Al Merri, A. & Al Suwaidi, J. The impact of diurnal fasting during Ramadan on the lipid profile, hs-CRP, and serum leptin in stable cardiac patients. Vasc. Health Risk Manag. 30, 7\u201314 (2011).","journal-title":"Vasc. Health Risk Manag."},{"key":"64582_CR3","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1007\/s10943-013-9687-0","volume":"53","author":"S Kul","year":"2014","unstructured":"Kul, S., Sava\u015f, E., \u00d6zt\u00fcrk, Z. A. & Karada\u011f, G. Does Ramadan fasting alter body weight and blood lipids and fasting blood glucose in a healthy population? A meta-analysis. J. Relig. Health. 53, 929\u2013942 (2014).","journal-title":"J. Relig. Health."},{"issue":"12","key":"64582_CR4","first-page":"144","volume":"1","author":"H Al Nahari","year":"2014","unstructured":"Al Nahari, H. & Kouja, H. Impact of Ramadan fasting on some biochemical aspects in healthy subjects. Int. J. Med. Health Sci. Res. 1(12), 144\u2013154 (2014).","journal-title":"Int. J. Med. Health Sci. Res."},{"issue":"7","key":"64582_CR5","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1038\/sj.ejcn.1602393","volume":"60","author":"L Dewanti","year":"2006","unstructured":"Dewanti, L., Watanabe, C. & Ohtsuka, R. Unexpected changes in blood pressure and hematological parameters among fasting and nonfasting workers during Ramadan in Indonesia. Eur. J. Clin. Nutr. 60(7), 877\u2013881 (2006).","journal-title":"Eur. J. Clin. Nutr."},{"issue":"5","key":"64582_CR6","first-page":"91","volume":"8","author":"NA Sliman","year":"1993","unstructured":"Sliman, N. A., Ajlouni, K. S. & Faisal, K. Effect of fasting on some blood hormones in healthy Muslim males. Mutah J. Res. Stud. 8(5), 91\u2013109 (1993).","journal-title":"Mutah J. Res. Stud."},{"issue":"4","key":"64582_CR7","doi-asserted-by":"publisher","first-page":"745","DOI":"10.3803\/EnM.2021.405","volume":"36","author":"BH Kim","year":"2021","unstructured":"Kim, B. H. et al. Effects of intermittent fasting on the circulating levels and circadian rhythms of hormones. Endocrinol. Metab. 36(4), 745\u2013756 (2021).","journal-title":"Endocrinol. Metab."},{"issue":"8","key":"64582_CR8","doi-asserted-by":"publisher","first-page":"2273","DOI":"10.1016\/j.numecd.2021.05.002","volume":"31","author":"HA Jahrami","year":"2021","unstructured":"Jahrami, H. A. et al. Does four-week consecutive, dawn-to-sunset intermittent fasting during Ramadan affect cardiometabolic risk factors in healthy adults? A systematic review, meta-analysis, and meta-regression. Nutr. Metab. Cardiovasc. Dis. 31(8), 2273\u20132301 (2021).","journal-title":"Nutr. Metab. Cardiovasc. Dis."},{"issue":"1","key":"64582_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1017\/S000711451900254X","volume":"123","author":"ME Faris","year":"2020","unstructured":"Faris, M. E., Jahrami, H. A., Alsibai, J. & Obaideen, A. A. Impact of Ramadan diurnal intermittent fasting on the metabolic syndrome components in healthy, non-athletic Muslim people aged over 15 years: A systematic review and meta-analysis. Br. J. Nutr. 123(1), 1\u201322 (2020).","journal-title":"Br. J. Nutr."},{"issue":"6","key":"64582_CR10","first-page":"537","volume":"10","author":"P Sasannejad","year":"2012","unstructured":"Sasannejad, P. et al. Cerebral vein thrombosis in women using short course oral contraceptive consumption. Iran. J. Reprod. Med. 10(6), 537 (2012).","journal-title":"Iran. J. Reprod. Med."},{"issue":"3","key":"64582_CR11","doi-asserted-by":"publisher","first-page":"1853","DOI":"10.15218\/zjms.2017.043","volume":"21","author":"IK AlShimmery","year":"2017","unstructured":"AlShimmery, I. K. et al. Association between Ramadan Fasting and cerebrovascular diseases. Zanco J. Med. Sci. 21(3), 1853\u20131858 (2017).","journal-title":"Zanco J. Med. Sci."},{"issue":"2","key":"64582_CR12","doi-asserted-by":"publisher","first-page":"NP2","DOI":"10.1177\/1747493017743799","volume":"13","author":"H Javanmardi","year":"2018","unstructured":"Javanmardi, H., Safari, A. & Borhani-Haghighi, A. Effect of Ramadan fasting in incidence of cerebral venous sinus thrombosis. Int. J. of Stroke. 13(2), NP2 (2018).","journal-title":"Int. J. of Stroke."},{"issue":"8","key":"64582_CR13","doi-asserted-by":"publisher","first-page":"794","DOI":"10.1179\/016164109X12445505689481","volume":"31","author":"M Saadatnia","year":"2009","unstructured":"Saadatnia, M., Zare, M., Fatehi, F. & Ahmadi, A. The effect of fasting on cerebral venous and dural sinus thrombosis. Neurol. Res. 31(8), 794\u2013798 (2009).","journal-title":"Neurol. Res."},{"issue":"1","key":"64582_CR14","doi-asserted-by":"publisher","first-page":"63","DOI":"10.4103\/JCMRP.JCMRP_3_17","volume":"2","author":"YT Kishk","year":"2017","unstructured":"Kishk, Y. T., Youssef, A. A., Ahmed, A. A. & Gerges, M. M. Circadian pattern of acute coronary syndrome patients in Ramadan fasting. J. Curr. Med. Res. Pract. 2(1), 63 (2017).","journal-title":"J. Curr. Med. Res. Pract."},{"issue":"4","key":"64582_CR15","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1016\/j.jsha.2018.05.011","volume":"30","author":"H Alshareef","year":"2018","unstructured":"Alshareef, H. Acute coronary syndrome in hajj women-gender specific characteristics-single center experience. J. Saudi Heart Assoc. 30(4), 359 (2018).","journal-title":"J. Saudi Heart Assoc."},{"issue":"5","key":"64582_CR16","doi-asserted-by":"publisher","first-page":"344","DOI":"10.5144\/0256-4947.2018.344","volume":"38","author":"A Elbarsha","year":"2018","unstructured":"Elbarsha, A. et al. Outcomes and hospital admission patterns in patients with diabetes during Ramadan versus a non-fasting period. Ann. Saudi Med. 38(5), 344\u2013351 (2018).","journal-title":"Ann. Saudi Med."},{"issue":"1","key":"64582_CR17","doi-asserted-by":"publisher","first-page":"23","DOI":"10.5144\/0256-4947.1991.23","volume":"11","author":"MT Kordy","year":"1991","unstructured":"Kordy, M. T. & Gader, A. G. M. The effect of fasting in Ramadan on hemostatic variables. Ann. Saudi Med. 11(1), 23\u201327 (1991).","journal-title":"Ann. Saudi Med."},{"key":"64582_CR18","doi-asserted-by":"publisher","first-page":"377","DOI":"10.5144\/0256-4947.2000.377","volume":"20","author":"N Sarraf-Zadegan","year":"2000","unstructured":"Sarraf-Zadegan, N. et al. The effect of fasting in Ramadan on the values and interrelations between biochemical, coagulation and hematological factors. Ann. Saudi Med. 20, 377\u2013381 (2000).","journal-title":"Ann. Saudi Med."},{"issue":"3","key":"64582_CR19","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/0268-9499(91)90020-5","volume":"5","author":"SM Bakir","year":"1991","unstructured":"Bakir, S. M., Kordy, M. M. T. & Gader, A. M. A. The effect of change in the rhythm of food intake and sleeping time during Ramadan on the diurnal variation of fibrinolytic activity. Fibrinolysis 5(3), 177\u2013180 (1991).","journal-title":"Fibrinolysis"},{"issue":"2","key":"64582_CR20","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1159\/000084739","volume":"49","author":"FB Aksungar","year":"2005","unstructured":"Aksungar, F. B., Eren, A., Ure, S., Teskin, O. & Ates, G. Effects of intermittent fasting on serum lipid levels, coagulation status and plasma homocysteine levels. Ann. Nutr. Metab. 49(2), 77\u201382 (2005).","journal-title":"Ann. Nutr. Metab."},{"issue":"02","key":"64582_CR21","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1055\/s-0037-1604092","volume":"44","author":"B Dahlb\u00e4ck","year":"2018","unstructured":"Dahlb\u00e4ck, B. Vitamin K\u2013dependent protein S: Beyond the protein C pathway. Semin. Thromb. Hemost. 44(02), 176\u2013184 (2018).","journal-title":"Semin. Thromb. Hemost."},{"issue":"11","key":"64582_CR22","doi-asserted-by":"publisher","first-page":"2801","DOI":"10.1111\/jth.15025","volume":"18","author":"M Gierula","year":"2020","unstructured":"Gierula, M. & Ahnstr\u00f6m, J. Anticoagulant protein S\u2014New insights on interactions and functions. J. Thromb. Haemost. 18(11), 2801\u20132811 (2020).","journal-title":"J. Thromb. Haemost."},{"issue":"07","key":"64582_CR23","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1160\/TH07-04-0269","volume":"98","author":"B Dahlb\u00e4ck","year":"2007","unstructured":"Dahlb\u00e4ck, B. The tale of protein S and C4b-binding protein, a story of affection. Thrombosis and Haemostasis. 98(07), 90\u201396 (2007).","journal-title":"Thrombosis and Haemostasis."},{"issue":"9","key":"64582_CR24","doi-asserted-by":"publisher","first-page":"3106","DOI":"10.1073\/pnas.0504240103","volume":"103","author":"TM Hackeng","year":"2006","unstructured":"Hackeng, T. M., Ser\u00e9, K. M., Tans, G. & Rosing, J. Protein S stimulates inhibition of the tissue factor pathway by tissue factor pathway inhibitor. Proc. Natl. Acad. Sci. 103(9), 3106\u20133111 (2006).","journal-title":"Proc. Natl. Acad. Sci."},{"issue":"3","key":"64582_CR25","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1080\/17474086.2019.1583555","volume":"12","author":"E Campello","year":"2019","unstructured":"Campello, E., Spiezia, L., Adamo, A. & Simioni, P. Thrombophilia, risk factors and prevention. Expert Rev. Hematol. 12(3), 147\u2013158 (2019).","journal-title":"Expert Rev. Hematol."},{"issue":"4","key":"64582_CR26","first-page":"412","volume":"3","author":"AM Soare","year":"2010","unstructured":"Soare, A. M. & Popa, C. Deficiencies of proteins C, S and antithrombin and activated protein C resistance\u2013their involvement in the occurrence of arterial thromboses. J. Med. Life 3(4), 412 (2010).","journal-title":"J. Med. Life"},{"issue":"23","key":"64582_CR27","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.018917","volume":"9","author":"E Campello","year":"2020","unstructured":"Campello, E. et al. Direct oral anticoagulants in patients with inherited thrombophilia and venous thromboembolism: A prospective cohort study. J. Am. Heart Assoc. 9(23), e018917 (2020).","journal-title":"J. Am. Heart Assoc."},{"issue":"1","key":"64582_CR28","doi-asserted-by":"publisher","first-page":"37","DOI":"10.14740\/jh478","volume":"8","author":"A Fearon","year":"2019","unstructured":"Fearon, A., Pearcy, P., Venkataraman, S. & Shah, P. Protein S deficiency and arterial thromboembolism: A case report and review of the literature. J. Hematol. 8(1), 37 (2019).","journal-title":"J. Hematol."},{"key":"64582_CR29","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1097\/01.mbc.0000174080.54871.6b","volume":"16","author":"AK Al-Ghumlas","year":"2005","unstructured":"Al-Ghumlas, A. K., Gader, A. M. A. & Al Faleh, F. Z. Hemostatic abnormalities in liver disease: Could some hemostatic tests be useful as liver function tests?. Blood Coag. Fibrinol. 16, 329\u2013335 (2005).","journal-title":"Blood Coag. Fibrinol."},{"issue":"01","key":"64582_CR30","doi-asserted-by":"publisher","first-page":"083","DOI":"10.1055\/s-2002-23205","volume":"22","author":"L Amitrano","year":"2002","unstructured":"Amitrano, L., Guardascione, M. A., Brancaccio, V. & Balzano, A. Coagulation disorders in liver disease. Semin. Liver Dis. 22(01), 083\u2013096 (2002).","journal-title":"Semin. Liver Dis."},{"issue":"26","key":"64582_CR31","doi-asserted-by":"publisher","first-page":"2541","DOI":"10.1056\/NEJMra1905136","volume":"381","author":"R De Cabo","year":"2019","unstructured":"De Cabo, R. & Mattson, M. P. Effects of intermittent fasting on health, aging, and disease. N. Engl. J. Med. 381(26), 2541\u20132551 (2019).","journal-title":"N. Engl. J. Med."},{"issue":"14","key":"64582_CR32","doi-asserted-by":"publisher","first-page":"e365","DOI":"10.1161\/CIRCULATIONAHA.111.044412","volume":"124","author":"B Lipe","year":"2011","unstructured":"Lipe, B. & Ornstein, D. L. Deficiencies of natural anticoagulants, protein C, protein S, and antithrombin. Circulation. 124(14), e365\u2013e368 (2011).","journal-title":"Circulation."},{"issue":"6","key":"64582_CR33","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1111\/j.1365-2516.2008.01775.x","volume":"14","author":"MK Ten Kate","year":"2008","unstructured":"Ten Kate, M. K. & Van Der Meer, J. Protein S deficiency: A clinical perspective. Haemophilia. 14(6), 1222\u20131228 (2008).","journal-title":"Haemophilia."},{"key":"64582_CR34","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1182\/blood.V71.3.562.562","volume":"71","author":"HP Schwarz","year":"1988","unstructured":"Schwarz, H. P., Muntean, W., Watzke, H., Richter, B. & Griffin, J. H. Low total protein S antigen but high protein S activity due to decreased C4b-binding protein in neonates. Blood. 71, 562\u2013565 (1988).","journal-title":"Blood."},{"key":"64582_CR35","doi-asserted-by":"publisher","first-page":"2527","DOI":"10.1182\/blood.V76.12.2527.2527","volume":"76","author":"PC Comp","year":"1990","unstructured":"Comp, P. C., Forristall, J., West, C. D. & Trapp, R. G. Free protein S levels are elevated in familial C4b-binding protein deficiency. Blood. 76, 2527\u20132529 (1990).","journal-title":"Blood."},{"issue":"5","key":"64582_CR36","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1002\/ccr3.1464","volume":"6","author":"R Mulder","year":"2018","unstructured":"Mulder, R., de Vries, J. K., M\u00fcskens, R. P., Mulder, A. B. & Lukens, M. V. High protein S activity due to C4b-binding protein deficiency in a 34-year-old Surinamese female with ischemic retinopathy. Clin. Case Rep. 6(5), 935 (2018).","journal-title":"Clin. Case Rep."},{"issue":"2","key":"64582_CR37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/S0049-3848(00)00379-0","volume":"101","author":"AR Rudnicka","year":"2001","unstructured":"Rudnicka, A. R., Miller, G. J., Nelson, T., Doray, D. & Comp, P. C. An association between plasma free protein concentration and risk of coronary heart disease in middle-aged men. Thrombosis Res. 101(2), 1\u201311 (2001).","journal-title":"Thrombosis Res."},{"issue":"8","key":"64582_CR38","doi-asserted-by":"publisher","first-page":"958","DOI":"10.1093\/aje\/kwr203","volume":"174","author":"G Ken-Dror","year":"2011","unstructured":"Ken-Dror, G. et al. Free protein S level as a risk factor for coronary heart disease and stroke in a prospective cohort study of healthy United Kingdom men. Am. J. Epidemiol. 174(8), 958\u2013968 (2011).","journal-title":"Am. J. Epidemiol."},{"issue":"1","key":"64582_CR39","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4103\/1658-5127.181114","volume":"7","author":"AK Al-Ghumlas","year":"2016","unstructured":"Al-Ghumlas, A. K. Natural coagulation inhibitors in liver diseases. J. Appl. Hematol. 7(1), 1 (2016).","journal-title":"J. Appl. Hematol."},{"issue":"4","key":"64582_CR40","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1182\/blood.V67.4.1168.1168","volume":"67","author":"DS Fair","year":"1986","unstructured":"Fair, D. S., Marlar, R. A. & Levin, E. G. Human endothelial cells synthesize protein S. Blood. 67(4), 1168\u20131171 (1986).","journal-title":"Blood."},{"issue":"2","key":"64582_CR41","doi-asserted-by":"publisher","first-page":"483","DOI":"10.1182\/blood.V84.2.483.483","volume":"84","author":"WC Hooper","year":"1994","unstructured":"Hooper, W. C. et al. Tumor necrosis factor-alpha downregulates protein S secretion in human microvascular and umbilical vein endothelial cells but not in the HepG-2 hepatoma cell line. Blood. 84(2), 483\u2013489 (1994).","journal-title":"Blood."},{"issue":"1","key":"64582_CR42","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1111\/j.1601-0825.2011.01830.x","volume":"18","author":"OA Gonz\u00e1lez","year":"2012","unstructured":"Gonz\u00e1lez, O. A., Tobia, C., Ebersole, J. L. & Novak, M. J. Caloric restriction and chronic inflammatory diseases. Oral Dis. 18(1), 16\u201331 (2012).","journal-title":"Oral Dis."},{"issue":"12","key":"64582_CR43","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1016\/j.nutres.2012.06.021","volume":"32","author":"ME Faris","year":"2012","unstructured":"Faris, M. E. et al. Intermittent fasting during Ramadan attenuates proinflammatory cytokines and immune cells in healthy subjects. Nutr. Res. 32(12), 947\u2013955 (2012).","journal-title":"Nutr. Res."},{"key":"64582_CR44","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.jnim.2018.11.005","volume":"15","author":"ME Faris","year":"2019","unstructured":"Faris, M. E., Jahrami, H. A., Obaideen, A. A. & Madkour, M. I. Impact of diurnal intermittent fasting during Ramadan on inflammatory and oxidative stress markers in healthy people: Systematic review and meta-analysis. J. Nutr. Intermed. Metab. 15, 18\u201326 (2019).","journal-title":"J. Nutr. Intermed. Metab."},{"issue":"1","key":"64582_CR45","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12916-021-02185-0","volume":"19","author":"H Kolb","year":"2021","unstructured":"Kolb, H. et al. Ketone bodies: From enemy to friend and guardian angel. BMC Med. 19(1), 1\u201315 (2021).","journal-title":"BMC Med."},{"issue":"8","key":"64582_CR46","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1056\/NEJM198408233110804","volume":"311","author":"L Wilhelmsen","year":"1984","unstructured":"Wilhelmsen, L. et al. Fibrinogen as a risk factor for stroke and myocardial infarction. N. Engl. J. Med. 311(8), 501\u2013505 (1984).","journal-title":"N. Engl. J. Med."},{"issue":"281","key":"64582_CR47","first-page":"565","volume":"35","author":"MC Stone","year":"1985","unstructured":"Stone, M. C. & Thorp, J. M. Plasma fibrinogen\u2014A major coronary risk factor. J. R. Coll. Gener. Pract. 35(281), 565\u2013569 (1985).","journal-title":"J. R. Coll. Gener. Pract."},{"key":"64582_CR48","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1007\/BF03324226","volume":"6","author":"K Hager","year":"1994","unstructured":"Hager, K., Felicetti, M., Seefried, G. & Platt, D. Fibrinogen and aging. Aging Clin. Exp. Res. 6, 133\u2013138 (1994).","journal-title":"Aging Clin. Exp. Res."},{"key":"64582_CR49","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1007\/978-1-4684-7319-3_11","volume-title":"The Physiology of Hemostasis","author":"D Ogston","year":"1983","unstructured":"Ogston, D. The influence of physical activity, mental stress and injury on the hemostatic mechanism. In The Physiology of Hemostasis (ed. Ogston, D.) 327\u2013342 (Croom Helm, 1983)."},{"issue":"2","key":"64582_CR50","first-page":"117","volume":"5","author":"M Kazemi","year":"2006","unstructured":"Kazemi, M. et al. The effect of Ramadan fasting on psychological health and depression in Sirjan Azad University students. J. Rafsanjan Univ. Med. Sci. 5(2), 117\u2013122 (2006).","journal-title":"J. Rafsanjan Univ. Med. Sci."},{"issue":"49","key":"64582_CR51","first-page":"54","volume":"13","author":"MT Moghadam Nia","year":"2004","unstructured":"Moghadam Nia, M. T. & Maghsoudi, S. H. A survey of effects of fasting in Ramadan on the level of stress. J. Guilan Univ. Med. Sci. 13(49), 54\u201360 (2004).","journal-title":"J. Guilan Univ. Med. Sci."},{"issue":"6","key":"64582_CR52","doi-asserted-by":"publisher","first-page":"3270","DOI":"10.1007\/s10943-018-00740-3","volume":"59","author":"AA Bayani","year":"2020","unstructured":"Bayani, A. A., Esmaeili, R. & Ganji, G. The impact of fasting on the psychological well-being of Muslim graduate students. J. Relig. Health 59(6), 3270\u20133275 (2020).","journal-title":"J. Relig. Health"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-64582-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-64582-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-64582-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,15]],"date-time":"2024-06-15T15:06:23Z","timestamp":1718463983000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-024-64582-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,15]]},"references-count":52,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["64582"],"URL":"https:\/\/doi.org\/10.1038\/s41598-024-64582-8","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,15]]},"assertion":[{"value":"20 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"13855"}}