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We study the effect of religious constraints on individual's labor supply decisions in the context of Ramadan, one of the central pillars of Islam, consisting of an entire lunar month of fasting from sunrise to sunset. Using household panel data from Malawi for the years 2010, 2013, and 2016, we find that females reallocate their time, from their jobs to household work. For males, we do not find such reallocation of hours, as they increase both, their hours worked at their jobs but also in the household. As a robustness check to our results, we use household data from Bangladesh to support the estimates on the extensive margins, where we do not find any effect on labor force both for females and males or the likelihood of working during Ramadan. These findings show that we need to go beyond general beliefs that labor supply goes down, but individuals keep working at home or more hours overall, when religious constrains appear. [ABSTRACT FROM AUTHOR]

The health advantages of Ramadan fasting, a time-restricted eating from dawn to dusk, have garnered attention. Nevertheless, prior observational studies have found inconsistent findings because of challenges regulating variables such as sleep patterns, dietary habits, and physical activity. This study sought to investigate the impact of the Ramadan fasting model (RFM) on longevity and metabolic biomarkers in obese and non-obese rats. For 12 weeks, 48 male Wistar albino rats were separated into two groups and fed either a standard or a high-fat diet (HFD). During the final four weeks, rats in each group were separated into four subgroups to investigate the effect of RFM with/without training (on Treadmill) or glucose administration on the biomarkers of interest. The HFD groups subjected to RFM had significantly lower Insulin-like growth factor 1 (IGF-1) and mechanistic target of rapamycin (mTOR) serum, whereas AMPK, anti-inflammatory, and antioxidative stress serum levels were significantly higher. All groups reported decreased serum levels of Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-α) compared to the HFD control group. Furthermore, the Real-Time Quantitative Polymerase Chain Reaction (RT-qPCR) results indicated a significant elevation in the TP53 gene expression in groups subjected to RFM. The data indicate that RFM can improve longevity and metabolic biomarkers and reduce pro-inflammation and oxidative stress. Also, RFM improves anti-inflammatory and antioxidant markers in HFD-induced obese rats. [ABSTRACT FROM AUTHOR]

Background: Fasting headaches frequently occur during the first few days of Ramadan, and treatment is challenging because of fasting. Objective: This study aimed to evaluate the effect of extended‐release paracetamol on preventing fasting headaches. Methods: A randomized, open‐label clinical trial investigated the efficacy of extended‐release paracetamol at a daily dose of 1330 mg in preventing fasting headache. Adults aged 18 years and older were recruited through the Clinical Trial Unit at the King Saud University Medical City. The eligible participants in the study fasted 13.5 h daily during the first week of Ramadan. Participants in the treatment and control arms were followed up to investigate the occurrence, severity, and timing of headache symptoms via self‐reporting using a standardized headache diary scale with a daily online link or phone call. The primary outcome was the frequency of headache episodes while fasting during the first week of Ramadan. Results: A total of 238 participants were enrolled and randomized. Of these, 173 followed the protocol (80 treated, 93 control) for at least the first day and were included in the analysis. Most participants were young and healthy, with a mean age of 32.2 ± 10.2 years. More men were included in the study (102/173; 59.0%), a small proportion of participants were smokers (31/173; 17.9%), and almost all participants reported being coffee drinkers (165/173; 95.4%); nonetheless, these characteristics were evenly distributed between the two groups in the study. The overall incidence of headache episodes was 33.0% (57/173) on day 1 and decreased to 11.3% (18/159) on day 7. On average over the 7 days, no significant effect was observed for the treatment on the incidence of headache, as the findings from the generalized estimating equation model indicated (β = −0.398, p = 0.084; odds ratio = 0.67, 95% confidence interval [CI] 0.42–1.06). Moreover, there was initially no significant difference in the incidence of headache episodes between the treatment and control groups. However, the treatment group had significantly fewer headache episodes during fasting than the control group on day 3 (4/72 [5.6%] vs. 15/91 [16.5%], p = 0.031; relative risk [RR] = 0.34, 95% CI 0.12–0.97) and day 6 (5/69 [7.2%] vs. 20/90 [22.2%], p = 0.010; RR = 0.33, 95% CI 0.13–0.82). No adverse effects were observed during the study period. Conclusion: No significant differences were observed in the occurrence of fasting headaches between the two groups on most days during the study period. Additional studies are required to address fasting headaches during the first week of Ramadan. Plain Language Summary: Ramadan is a month in which millions of Muslims fast from dawn to dusk; however, fasting during the day (e.g., for 13 hours) may cause headache and discourage individuals from this spiritual practice and can impact normal productivity, especially during the first week as the body adapts. We tested whether taking extended‐release paracetamol before fasting in the morning could avert fasting‐induced headache. Extended‐release paracetamol can be partially beneficial in delaying, but not necessarily preventing, fasting‐induced headache. [Correction added on 12th September 2024, after the first online publication: The Plain Language Summary has been updated.] [ABSTRACT FROM AUTHOR]

BACKGROUND Intermittent fasting, such as during Ramadan, is prevalent among pregnant women. However, the association between Ramadan during pregnancy and offspring health along the life course has not been fully established. OBJECTIVE AND RATIONALE Fetal programming research indicates that prenatal exposures, particularly during early pregnancy, can cause long-term structural and physiological changes that adversely affect offspring health. Our objective was to systematically identify and assess the evidence regarding Ramadan during pregnancy. SEARCH METHODS A total of 31 studies were sourced from PubMed, EMBASE, Web of Science, and EconLit. Included studies evaluated outcomes in individuals with prenatal Ramadan exposure, compared to unexposed Muslim controls. Main outcomes were birth weight, gestational length, and sex ratio in newborns; height, mortality, and cognition in children; and disabilities, chronic diseases, and human capital accumulation in adults. Each study was evaluated for risk of bias. The overall quality of evidence was appraised using the GRADE system. Random-effects meta-analyses were conducted for outcomes analyzed in at least three primary studies. OUTCOMES The initial search identified 2933 articles, 1208 duplicates were deleted. There were 31 publications fulfilled the eligibility criteria for the qualitative synthesis; 22 studies were included in meta-analyses. The overall quality of the evidence was low to moderate and differed by study design and outcome. Among newborns, prenatal Ramadan exposure was not associated with birth weight (mean difference (MD) −3 g (95% CI −18 to 11; I 2 = 70%) or the likelihood of prematurity (percentage point difference (PPD) 0.19 (95% CI −0.11 to 0.49; I 2 = 0%)). The probability that the newborn is male was reduced (PPD −0.14 (95% CI −0.28 to −0.00; I 2 = 0%)). This potentially reflects sex-specific mortality rates resulting from adverse in utero circumstances. In childhood, the exposed performed slightly poorer on cognitive tests (MD −3.10% of a standard deviation (95% CI −4.61 to −1.58; I 2 = 51%)). Height among the exposed was reduced, and this pattern was already visible at ages below 5 years (height-for-age z -score MD −0.03 (95% CI −0.06 to −0.00; I 2 = 76%)). A qualitative literature synthesis revealed that childhood mortality rates were increased in low-income contexts. In adulthood, the prenatally exposed had an increased likelihood of hearing disabilities (odds ratio 1.26 (95% CI 1.09 to 1.45; I 2 = 32%)), while sight was not affected. Other impaired outcomes included chronic diseases or their symptoms, and indicators of human capital accumulation such as home ownership (qualitative literature synthesis). The first trimester emerged as a sensitive period for long-term impacts. WIDER IMPLICATIONS Despite the need for more high-quality studies to improve the certainty of the evidence, the synthesis of existing research demonstrates that Ramadan during pregnancy is associated with adverse offspring health effects in childhood and especially adulthood, despite an absence of observable effects at birth. Not all health effects may apply to all Muslim communities, which are diverse in backgrounds and behaviors. Notably, moderating factors like daytime activity levels and dietary habits outside fasting hours have hardly been considered. It is imperative for future research to address these aspects. REGISTRATION NUMBER PROSPERO (CRD42022325770). [ABSTRACT FROM AUTHOR]

We examined the degree to which an extended religious experience during Ramadan might promote interpersonal forgiveness. With six waves of data from a sample of N = 215 Pakistani Muslim students, we used random-intercept cross-lagged panel modeling to examine the associations between decisional and emotional forgiveness from before to after Ramadan in 2020. We observed three key findings. First, we demonstrated the strong cross-time measurement invariance of both the Decision to Forgive and the Emotional Forgiveness scales. Second, both decisional and emotional forgiveness remained relatively stable during the holy month of Ramadan. Third, there was evidence supporting positive bidirectional temporal relations between decisional and emotional forgiveness, such that each construct demonstrated at least one positive lagged association with the other. We discuss some implications of the findings, including the potential for positive emotional changes to evoke positive changes in behavioral intentions towards transgressors. [ABSTRACT FROM AUTHOR]

Context Ramadan fasting (RF) is associated with various physiological and metabolic changes among fasting Muslims. However, it remains unclear whether these effects are attributable to changes in meal timing or changes in dietary energy and macronutrient intakes. Furthermore, the literature on the associations between RF, meal timing, and energy and macronutrient intakes is inconclusive. Objectives This systematic review aimed to estimate the effect sizes of RF on energy and macronutrient intakes (carbohydrates, protein, fats, dietary fiber, and water) and determine the effect of different moderators on the examined outcomes. Data Sources The Cochrane, CINAHL, EMBASE, EBSCOhost, Google Scholar, PubMed/MEDLINE, ProQuest Medical, Scopus, ScienceDirect, and Web of Science databases were searched from inception to January 31, 2022. Data Extraction The studies that assessed energy, carbohydrate, protein, fat, fiber, and water intakes pre- and post-fasting were extracted. Data Analysis Of the 4776 identified studies, 85 relevant studies (n = 4594 participants aged 9–85 y) were selected. The effect sizes for the studied variables were as follows: energy (number of studies [K] = 80, n = 3343 participants; mean difference [MD]: −142.45; 95% confidence interval [CI]: −215.19, −69.71), carbohydrates (K = 75, n = 3111; MD: −23.90; 95% CI: −36.42, −11.38), protein (K = 74, n = 3108; MD: −4.21; 95% CI: −7.34, −1.07), fats (K = 73, n = 3058; MD: −2.03; 95% CI: −5.73, 1.67), fiber (K = 16, n = 1198; MD: 0.47; 95% CI: −1.44, 2.39), and water (K = 17, n = 772; MD: −350.80; 95% CI: −618.09, 83.50). Subgroup analyses showed age significantly moderated the 6 dietary outcomes, and physical activity significantly moderated water intake. There were significant reductions in energy, carbohydrate, and protein intakes during RF. Conclusions The change in meal timing rather than quantitative dietary intake may explain various physiological and health effects associated with RF. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this work was to assess the safety and effectiveness of concomitant iGlarLixi and sodium-glucose co-transporter-2 inhibitors (SGLT-2i) use in adults with type 2 diabetes (T2D) who fasted during Ramadan. Methods: Of the 420 eligible participants from the SoliRam study, 174 were using SGLT-2i in addition to iGlarLixi and 246 were not using SGLT-2i, referred to as SGLT-2i user and non-user, respectively. The primary endpoint was the proportion of participants experiencing ≥ 1 severe and/or symptomatic documented (< 70 mg/dl [< 3.9 mmol/l]) hypoglycemia. Results: More than 50% of participants in both groups were male. The mean weight, glycated hemoglobin (HbA1c), and fasting plasma glucose (FPG) were similar in both groups. Approximately half of participants in the SGLT-2i-user group and ~ 25% participants in the SGLT-2i-non-user group were on two oral anti-hyperglycemic drugs (OADs), whereas ~ 20% in the SGLT-2i-user group and ~ 1% of participants in the SGLT-2i-non-user group were on three OADs in addition to iGlarLixi. Around 35% and 55% of participants in the SGLT-2i-user and SGLT-2i-non-user groups, respectively, were taking concurrent sulphonylureas. About 97% of participants in both groups were able to fast for ≥ 25 days. The incidence of primary endpoint was low in both groups; SGLT-2i user: 0.6%, 4.2%, and 0.6% and SGLT-2i-non-user: 1.3%, 0.9% and 0% during pre-Ramadan, Ramadan, and post-Ramadan period, respectively. The incidence of severe and/or symptomatic documented (< 54 mg/dl [< 3.0 mmol/l]) hypoglycemia events was also low throughout the study, including during Ramadan. No severe hypoglycemia occurred during Ramadan in either group. Improvements in HbA1c and FPG, with a small reduction in weight, were observed from pre- to post-Ramadan in both groups. No serious adverse event was reported in either group. Conclusions: Concomitant iGlarLixi and SGLT-2i therapy with or without other OADs was demonstrated to be safe in adults with T2D during Ramadan fast, with a low risk of hypoglycemia and improvements in glycemic outcomes. [ABSTRACT FROM AUTHOR]

Context For Muslim patients on levothyroxine (L-T4) therapy, the best approach for L-T4 intake during Ramadan fasting remains unclear. Objective We compared 2 practical approaches for L-T4 intake during Ramadan. Methods We randomly assigned 69 patients (21 males, 48 females, median age 44 years) with differentiated thyroid cancer (DTC) who underwent thyroidectomy in the past and are on stable LT4 doses to 2 arms. Arm A (33 patients) ingested their pre-Ramadan L-T4 dose at the evening meal and ate immediately. Arm B (36 patients) increased their pre-Ramadan dose by 25 µg if their regular L-T4 dose was ≤150 µg/day or by 50 µg if their pre-Ramadan dose was >150 µg/day and ate immediately. Results At the beginning of Ramadan (baseline), the median thyrotropin (TSH) level and the numbers of patients in euthyroidism, subclinical hyperthyroidism (Shyper), or subclinical hypothyroidism (Shypo) were comparable between the 2 arms (P =.69 and P =.65, respectively). At the end of Ramadan, in arm A there were 17 (51.5%), 3 (9.1%), and 13 (39.4%) patients in euthyroidism, Shyper, and Shypo compared with 17 (47.2%), 14 (38.9%), and 5 (13.9%) patients, respectively, in arm B (P =.005). The mean ± SD TSH levels in arms A and B at the end of Ramadan were 5.6 ± 6.0 mU/L and 1.67 ± 2.6 mU/L, respectively (P =.0001). Conclusion No overt thyroid dysfunction developed but there were more cases of Shypo in arm A and Shyper in arm B. Arm B achieved desirable levels of TSH (normal or slightly suppressed) in 86% of cases and might be a preferable approach, especially for patients who need TSH suppression (eg, DTC). [ABSTRACT FROM AUTHOR]

There is a large body of research on Ramadan intermittent fasting (RIF) and health in Muslim communities, that can offer insights to promote the achievement of Sustainable Development Goal 3 (SDG 3), which encompasses good health and well-being. Based on recent bibliometric evidence, we hypothesized that RIF research is highly relevant to SDG 3, particularly Targets 3.1, 3.2, 3.4, and 3.5. Therefore, this bibliometric study quantified RIF literature supporting SDG 3 and associated targets over the past seven decades and explored themes and trends. All types of research articles were extracted from the Scopus database from inception to March 2022. Microsoft Excel, Biblioshiny, and VOSviewer were used to qualitatively and quantitatively examine RIF research trends supporting SDG 3 and associated targets. We identified 1729 relevant articles. The number of publications notably increased since 1986, with a dramatic increase in 2019–2020. RIF research predominantly supported Target 3.4 (reducing risk for non-communicable diseases), with research hotspots being diabetes, diabetes medications, pregnancy, physiology, metabolic diseases, and obesity and metabolism. This target was also the most commonly supported by dedicated authors and institutions publishing on RIF, whereas other SDG 3 targets were negligibly addressed in comparison. Our comprehensive bibliometric analysis of RIF literature showed growing support for SDG 3 through positive contributions to half of the SDG 3 targets, although Target 3.4 received the most attention. We also identified knowledge gaps that may shape further research directions on RIF and promote the achievement of SDG 3 in Muslim communities. [ABSTRACT FROM AUTHOR]

Intermittent fasting (IF) regimens have emerged as a dietary tool to improve the glycemic profile, but a critical appraisal of clinical studies assessing the effects of IF regimens in patients with diabetes is needed. Thus, this review encompasses clinical studies examining the impact of different IF regimens on markers of glycemic control in patients with diabetes. Furthermore, clinical nuances relative to pharmacological treatment are also addressed, mainly insulin therapy, to discuss the risk of hypoglycemic events. Only a handful of clinical studies have investigated the effects of IF on patients with diabetes. Overall, IF regimens may elicit modest benefits on glycemic parameters in patients with diabetes, but their effects are not necessarily greater than those of control diets. Last, although IF regimens may be considered safe for patients receiving insulin therapy within interventional and observational research, markers of glycemic control must be constantly monitored in clinical practice to reduce the risk of hypoglycemia and its related complications. [ABSTRACT FROM AUTHOR]

Prevalence of diabetes in Arab region has significantly increased, resulting in a significant economic burden on healthcare systems. This surge can be attributed to obesity, rapid urbanization, changing dietary habits, and sedentary lifestyles. The Arab Diabetes Forum (ADF) has established localized recommendations to tackle the region's rising diabetes prevalence. The recommendations, which incorporate worldwide best practices, seek to enhance the quality of treatment for people with diabetes by raising knowledge and adherence among healthcare providers. The guidelines include comprehensive recommendations for screening, diagnosing, and treating type 1 and type 2 diabetes in children and adults for better overall health results. • Early intervention at prediabetes stage reduces the risk of related complications. • Tailored glycemic targets and individualized diabetes management plans for safety. • Patients aged over 55 years with 2 or more of: HTN, dyslipidemia, obesity, albuminuria, or smoking at high risk of ASCVD. • Ramadan Risks: Hyper/hypoglycemia, dehydration. It's essential to have blood glucose monitoring tools. • Avoid fasting during fatigue, stress, glucose extremes. [ABSTRACT FROM AUTHOR]

Abstract The health advantages of Ramadan fasting, a time-restricted eating from dawn to dusk, have garnered attention. Nevertheless, prior observational studies have found inconsistent findings because of challenges regulating variables such as sleep patterns, dietary habits, and physical activity. This study sought to investigate the impact of the Ramadan fasting model (RFM) on longevity and metabolic biomarkers in obese and non-obese rats. For 12 weeks, 48 male Wistar albino rats were separated into two groups and fed either a standard or a high-fat diet (HFD). During the final four weeks, rats in each group were separated into four subgroups to investigate the effect of RFM with/without training (on Treadmill) or glucose administration on the biomarkers of interest. The HFD groups subjected to RFM had significantly lower Insulin-like growth factor 1 (IGF-1) and mechanistic target of rapamycin (mTOR) serum, whereas AMPK, anti-inflammatory, and antioxidative stress serum levels were significantly higher. All groups reported decreased serum levels of Interleukin-6 (IL-6) and Tumor Necrosis Factor-alpha (TNF-α) compared to the HFD control group. Furthermore, the Real-Time Quantitative Polymerase Chain Reaction (RT-qPCR) results indicated a significant elevation in the TP53 gene expression in groups subjected to RFM. The data indicate that RFM can improve longevity and metabolic biomarkers and reduce pro-inflammation and oxidative stress. Also, RFM improves anti-inflammatory and antioxidant markers in HFD-induced obese rats.

Background: Gestational diabetes mellitus (GDM) affects >50% of pregnancies in many Arab countries. However, few studies have explored the impact of Ramadan fasting on pregnant women with GDM and no such study has been conducted in Oman. Therefore, this is the first study in Oman which aimed to examine the experience of pregnant women with GDM during Ramadan fasting. Methods: This study employed a rigorous qualitative design, guided by a constructivist grounded theory approach. Semi-structured interviews were conducted with women with GDM in the North Batinah Governorate of Oman at four primary health-care institutions. Purposive and theoretical sampling was utilized. Results: The experiences of 20 women were discussed during the interviews. Two main themes, “encouraging experiences” and “worrying experiences” emerged from the constant comparative analysis. Encouraging experiences included belief, family influence, embarrassment, sharing spiritual moments, and coping approaches. Worrying experiences included health problems, fear of harming babies, and advice from health-care professionals. This led to the development of the core category “Finding A Balance,” which means that women with GDM who fasted and did not fast during Ramadan were attempting to maintain their blood sugar to avoid harming themselves and their fetus. Conclusion: The insights gained from understanding the experiences of pregnant women with GDM are crucial as they guide the development of the best approaches to health education and supportive programs for pregnant women with GDM. Pregnant women with GDM who wish to fast should be informed about the potential risks associated with fasting during pregnancy.

Abstract Background Fasting-induced headaches (FIHs) have been shown to occur on the first day of Ramadan and clearly decline thereafter. Despite the wealth of knowledge about different types of headaches (e.g., migraine-, cluster-, and tension-type headaches), research on the mechanism underlying FIHs, as well as their treatment, remains scarce. Our study aimed to investigate any association between FIHs during the first day of Ramadan and potential headache-related biomarkers, including fasting blood glucose (FBG), C-reactive protein (CRP), magnesium, vitamin B9, vitamin B12, homocysteine, and calcitonin gene related peptide (CGRP), and to assess whether a prophylactic use of paracetamol may influence these biomarkers. Methods As part of a randomized, open-label clinical trial that evaluated the effect of paracetamol as a prophylactic therapy for FIH, blood samples from stratified subjects in the prophylaxis and control groups were withdrawn while fasting after the 1st dose of paracetamol (in the prophylaxis group) and prior to reporting headache occurrence. Results Plasma and serum were separated for 61 subjects; 31 and 30 subjects from the prophylaxis and control groups, respectively. Overall, no significant differences were found in the levels of FBG, CRP, magnesium, vitamin B9, and vitamin B12 in headache-suffering subjects compared to those without headache despite the use of paracetamol for prophylaxis. Homocysteine, however, was significantly reduced in all subjects who experienced FIH compared to those without headache (median 6.9 [1.6] vs. 7.7 [2.7] umol/L; p = 0.041). On the contrary, when the CGRP was measured using immunoassay, it was found to be significantly elevated in all headache-suffering subjects compared to those without headache (median 126.1 [17.7] vs. 105.8 [19.6] pg/mL; p ≤ 0.0001). This difference was maintained upon comparing the headache to non-headache subjects in both the prophylaxis (median 121.5 [15.4] vs. 105.8 [9.4] pg/mL; p

The aim of this article is to clarify Nedžad Grabus' claim that Muslims in Slovenia are Ramadan Muslims. The article shows how many Muslims in Slovenia choose to fast and presents the celebration of Ramadan Bayram in Slovenia. It also highlights the problem of consumerism during Ramadan, which helps to raise awareness of the holiday while distancing it from its very essence.

Purpose: During Ramadan month, Muslims often continue training to maintain their muscle performance. However, trainers should stress the importance of the time of day chosen for practicing resistance training (RT) during Ramadan fasting to avoid health and performance alteration. Thus, this study aimed to investigate the effects of the timing of RT during Ramadan intermittent fasting (RIF) on muscle strength and hypertrophy in healthy male adults. Methods: Forty men were randomly allocated to 2 matched groups: 20 practicing whole-body RT in the late afternoon in a fasted state and 20 training in the late evening in a fed state (FED). Both groups performed 4 days per week of whole-body RT (∼75%–85% 1-repetition maximum, 12 repetitions/3–4 sets) during RIF. Anthropometric measurements and 1-repetition-maximum test for the squats, deadlift, and bench press were measured. A cross-sectional area of the quadriceps and biceps brachii was examined using ultrasound scans. All measurements were taken at 4 time points: 24 hours before the start of Ramadan, on the 15th day of Ramadan, on the 29th day of Ramadan, and 21 days after Ramadan. Results: Post hoc tests indicated significant preimprovement to postimprovement in FED at the 29th day of Ramadan for the 1-repetition-maximum test for the squats (P =.02; effect size = 0.21) and deadlift (P =.03; effect size = 0.24) when compared to 24 hours before the start of Ramadan. No significant changes were observed in the fasted-state group or for cross-sectional area for both groups. Conclusions: Practicing RT during RIF appears not to have adverse effects on muscle hypertrophy and strength no matter whether it is practiced in FED or fasted state. However, RT had greater effects on muscle strength when applied in FED. Our findings suggest that training sessions should be scheduled after breaking the fast during Ramadan. [ABSTRACT FROM AUTHOR]

Background: The effect of the 2020 COVID-19 lockdown on athlete sleep and training behavior is documented, albeit without a worldwide soccer-specific focus. Method: Soccer (football) players (N = 1639; 30 countries; age 22.5 [5.7] y; 81% ≤25 y; 56% male; 30% elite; 66% Muslim) answered a retrospective, cross-sectional questionnaire related to their behavioral habits before and during COVID-19 lockdown (survey period July to September 2020), including (1) Pittsburgh Sleep Quality Index PSQI, (2) Insomnia Severity Index (ISI), (3) bespoke questions about training behaviors, and (4) Muslim player focused sleep and training behavior questions. Results: During lockdown (compared to prelockdown), PSQI (P <.001; moderate effect size [ES]) and ISI (P <.001; moderate ES) scores were higher in the overall sample and in elite versus nonelite (PSQI: P <.05; small ES and ISI: P <.001; small ES), >25 years versus ≤25 years (PSQI: P <.01; small ES and ISI: P <.001; moderate ES), females versus males (PSQI: P <.001; small ES), <1 month versus >1 month lockdown (PSQI: P <.05; small ES and ISI: P <.05; small ES), and players maintaining versus reducing training intensity (PSQI: P <.001; moderate ES and ISI: P <.001; small ES). Muslim players (41%) reported unfavorable sleep and/or training behaviors during Ramadan in lockdown compared to lockdown outside of Ramadan. Conclusions: Specific subgroups appear more vulnerable to lockdown effects, with training-intensity maintenance moderating negative effects relative to sleep. Policy and support (respectful of subgroup nuances) during lockdown-like challenges that facilitate training (including intensity) appear prudent, given their favorable relationship with sleep, mental health, and physical health, in the present data and elsewhere. [ABSTRACT FROM AUTHOR]

During the sacred period known as Ramadan in the Islamic faith, abstaining from food and drink is observed from dawn until dusk. This fasting practice can lead to alterations in the circadian rhythm due to sudden shifts in dietary habits and sleep patterns. Given that changes in circadian rhythm can impact sleep patterns, a relational survey model was implemented in this investigation. Data collection involved the utilization of the Pittsburgh Sleep Quality Index (PSQI) alongside a sociodemographic survey. A total of seventy-three athletes willingly participated in the study. Statistical analysis was conducted using SPSS 25.0, employing the Mann-Whitney U test for variables with two parameters and the Kruskall-Wallis H test was for those with three or more parameters. The significance level was established at p ≤ 0.05. Upon comparing the PSQI and its sub-dimensions, a statistically significant difference was observed in relation to age, alterations in mealtimes, changes in appetite, duration of sleep, and time required to fall asleep. Consequently, the data gathered in our study indicates that modifications in eating and sleeping schedules during Ramadan can disrupt the sleep quality of athletes.

BackgroundMethodsResultsConclusionThe impact of Ramadan fasting on various neurological emergencies remains relatively unexplored. This study aimed to clarify the incidence and pattern of the different neurological emergencies in Ramadan compared to Shaaban.In this cross-sectional study, all adult patients attending the emergency room at two Egyptian centers with neurological emergencies during Shaaban and Ramadan were evaluated. Clinical, laboratory, and radiological assessments were made on an individual basis upon which the diagnosis of neurological disorder was made. IBM SPSS Version 25 was used to analyze the data.Seventy-twenty patients were included, 382 during Shaaban and 338 during Ramadan. Among causes of delirium, the frequency of dehydration was significantly higher, and the frequency of illicit drug abuse was significantly lower during Ramadan compared to Shaaban (P = 0.004, 0.030, respectively). The incidence of ICH was significantly reduced during Ramadan compared to Shaaban (10.8% vs 19.7%, P = 0.031). The incidence of cardioembolic strokes significantly increased during Ramadan than Shaaban (40.5% vs 26.4%, P = 0.014), whereas the incidence of small vessel disease (SVD) significantly decreased during Ramadan than Shaaban (21.6% vs. 42.1%, P < 0.001). The incidence of a single seizure was significantly higher in Ramadan than in Shaaban (69.4% vs. 34.6%, P = 0.007). The incidence of functional neurological disorders was significantly reduced in Ramadan than in Shaaban (P < 0.001).The incidence of delirium caused by illicit drug abuse, ICH, SVD, and functional neurological disorders declined during Ramadan, while the incidence of delirium triggered by dehydration, cardioembolic strokes, and a single seizure increased during Ramadan. [ABSTRACT FROM AUTHOR]

This study aims to analyze the effect of prenatal exposure to certain nutritional disruptions in utero on human capital formation. In order to resolve the endogeneity driven by maternal dietary deficiencies, we use the Islamic holy month of Ramadan, during which observers abstain from eating and drinking entirely from sunrise to sunset, as a natural experiment to assess the effects of fetal malnourishment on educational and labor market outcomes. We compare schooling and employment measures of individuals who are prenatally exposed to Ramadan with those who are not using the 2016 round of the Turkish Family Structure Survey dataset. Our results indicate that men who are exposed to Ramadan in utero in the first or third trimester complete 0.53 fewer years of schooling and are less likely to obtain middle school, high school, and college degrees. These effects are stronger when Ramadan coincides with summer. [ABSTRACT FROM AUTHOR]

In this paper, we examine how religious mandates of the holy month of Ramadan affect the gendered distribution of time use within Muslim households in India. Using rich data on time use from a nationally representative time use survey and employing a difference-in-differences methodology, we test if Ramadan accentuates gender differences in time use. We find that, contrary to popular belief, Ramadan moderates the gender disparities in intra-household time use for Muslim households. The moderating influence is stronger in districts with a higher Muslim proportion. We find that the reduction in gender differences is due to declines in gender-specific time use in employment, learning activities, domestic work and self-care. Reduction in domestic work time for women, especially food preparation time, is more pronounced in districts with a high Muslim proportion, suggesting 'communalisation of domestic work' due to Ramadan. [ABSTRACT FROM AUTHOR]

Background: Managing diabetes during Ramadan fasting is a challenge due lifestyle changes. We described the characteristics and patterns of care for type 2 diabetes mellitus (T2DM) during Ramadan 2020 and 2022. Methods: Our study included multinational Muslims with T2DM who were during routine consultation. We collected data on demographics, fasting characteristics, and complications. Descriptive statistics, chi-square test, and multiple testing were performed. Results: 12,529 patients participated. Mean age was 55.2 ± 11.8 years; 52.4% were females. Mean diabetes duration was 9.9 ± 7.4 years; 27.7% were with HbA1c >9% (75 mmol/mol) and 70% had complications. Metformin was the most used medication followed by insulin. 85.1% fasted ≥1 day; fasting mean duration was 27.6 ± 5.6 days. Hypoglycemia occurred in 15.5% of whom 11.7% attended emergency department or were hospitalized; this was significantly associated with age and/or duration of diabetes. Hyperglycemia occurred in 14.9% of whom 6.1% attended emergency department or were hospitalized and was also associated with age or duration of diabetes. 74.2% performed SMBG during fasting. 59.2% were educated on Ramadan fasting, with 89.7% receiving it during routine consultation. Conclusions: Ramadan fasting in T2DM is high. Multidisciplinary approach is required to mitigate complications. Our findings support current recommendations for safe fasting. PLAIN LANGUAGE SUMMARY: The goal of this survey was to describe the characteristics and current ways of care for Muslim patients with type 2 diabetes mellitus fasting during and after Ramadan 2020 and 2022. Most of the participants fasted a minimum of one day during Ramadan (85.1%). Overall, 15.5 and 14.9% reported low blood sugar levels or high blood sugar levels during fasting, respectively. Low blood sugar level was more reported in patients with older age, patients with longer diabetes duration, and women. High blood sugar level was more reported in patients with longer diabetes duration. Educational programs focusing on the risks occurring with fasting and practices that improve control of the disease will raise knowledge and awareness among patients with diabetes. Improving blood sugar control during Ramadan fasting remains a major need for both patients and healthcare providers who should collaborate to reduce the risk of diabetes-related problems. [ABSTRACT FROM AUTHOR]

Religion/spirituality has been linked to virtue development across individuals, but most of this evidence is derived from decontextualized one-time survey studies. We employed a three-wave experience sampling study to examine whether Ramadan heightens Muslim American adolescents' connectedness to Allah, inhibitory self-control, initiatory self-control, patience, and compassion within individuals. Adolescents (N = 202) were prompted to complete three daily surveys for a week before, during, and after Ramadan each. Results indicated that adolescents grew more connected to Allah and exhibited greater inhibitory self-control, initiatory self-control, and patience in their daily lives from pre-Ramadan to Ramadan, with continued elevated effects for initiatory self-control and patience – but not for inhibitory self-control – after Ramadan. In contrast, adolescents reported high levels of daily compassion before and during Ramadan, but lower levels after Ramadan. Our findings emphasized the importance of disentangling within- and between-person effects and have implications for virtue theories and the design of intervention programs. [ABSTRACT FROM AUTHOR]

Idiopathic intracranial hypertension (IIH) is a disorder that primarily affects obese women of reproductive age. The exact pathogenesis of IIH is unknown though multiple etiologies have been proposed. We report a case of IIH triggered by first-time Ramadan intermittent fasting (RIF) in an 18-year-old woman. Our patient developed new onset headaches, diplopia, and pulsatile tinnitus with examination notable for bilateral papilledema and lumbar puncture revealing an elevated opening pressure. Her symptoms resolved after cessation of RIF, apart from persistent left sided tinnitus which later resolved with acetazolamide administration. This case report uniquely illustrates that RIF may provoke symptomatic IIH. We hypothesize that a decreased concentration of glucagon-like peptide-1 (GLP-1) induced by fasting results in decreased GLP-1 receptor activation in the choroid plexus, allowing for increased CSF secretion into the ventricles invoking increased intracranial pressure (ICP). This theoretical mechanism provides further insight as to the possible underlying pathophysiology of IIH. [ABSTRACT FROM AUTHOR]

Objectives: This study examines the potential impact of Ramadan fasting on sleep patterns and physical fitness in under 14 (U14) and under 17 (U17) female handball players. Methods: For this study, sixty-five female handball players' (U14, n = 33 and U17, n = 32) sleep habits were assessed before (BR) and during the first (R1) and last weeks (R4) of Ramadan using: the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS). Physical ability tests including balance and jumps were conducted throughout these periods.; Results: During Ramadan, both groups noted significant increases in PSQI and ISI scores during R1 (p < 0.01 and p < 0.05, respectively) and R4 (p < 0.05 and p < 0.05, respectively) compared to before Ramadan (BR). For the U14 group, a significant increase occurred in ESS scores during R1 (p < 0.01) and R4 (p < 0.05), whereas for the U17 group, this increase was limited over the R1 period (p < 0.05). In contrast, for all physical ability parameters, both groups showed no significant difference during R1 and R4; Conclusions: During adolescence, Ramadan fasting may alter sleep patterns in young female athletes but appears to have no effect on their performance in short-duration exercises. [ABSTRACT FROM AUTHOR]

AbstractThis article examines the transformation of Direklerarası Street, located on Istanbul’s historical Divanyolu, from the 1720s to the 1920s. Originally built in 1729 as an arasta to generate revenue for Ibrahim Pasha’s madrasa, it featured an innovative architectural style comprising rows of shops facing each other and colonnaded sidewalks. It served as a commercial and social centre for the Janissary Corps until their abolition in 1826. Around the 1860s, Direklerarası integrated into the entertainment and social milieu surrounding Beyazıt Square, particularly during the Ramadan months, and evolved into the primary promenade street of intramural Istanbul with the proliferation of literary cafés, teahouses, and theatres from the 1880s onwards. However, starting from the 1910s, changing socio-cultural and urban dynamics led to the decline of Direklerarası’s reputation and popularity. Conceptualizing Direklerarası as both a spatial entity and a reflection of the cultural dynamics of the late Ottoman capital, this article scrutinizes its transformation driven by social interactions, local entrepreneurship, and political interventions, focusing on spatial experiences, entertainment, spectacle, promenade culture, and clientele. [ABSTRACT FROM AUTHOR]

Background: Commonly heard statements such as "Christmas comes around more quickly each year" suggest that the passage of time between annual events can become distorted, leading to the sensation of time passing more quickly than normal. At present however, it is unclear how prevalent such beliefs are and, what factors are predictive of it. Aim: To explore the prevalence of beliefs that annual events such as Christmas (Study 1 UK sample) and Ramadan (Study 2 Iraqi sample) feel like they come around more quickly each year. To establish the association between distortions to the passage of time between annual events and emotional wellbeing, event specific enjoyment, memory function and self-reported attention to time. Methods: Participants completed an online questionnaire exploring their subjective experience of time in relation to Christmas and Ramadan. In addition, measures of attention to time, memory function, quality of life and event specific emotion were also taken. Findings: There was widespread agreement that Christmas and Ramadan appeared to come around more quickly each year. In both countries, this belief was associated with greater prospective memory errors, greater attention to time and greater enjoyment of the event. Furthermore, in the UK greater belief that Christmas comes around more quickly was associated with lower social quality of life and in Iraq, greater belief that Ramadan comes around more quickly each year was associated with lower age and female gender. Conclusions: Distortions to the passage of time for annual events are widespread, occur across multiple cultures and are consistently predicted by prospective function, event enjoyment and attention to time. The absence of an association between older age (above 55 years) and a faster passage of time suggests that caution should be taken when concluding that time passes more quickly with increasing age. [ABSTRACT FROM AUTHOR]

Purpose: To determine change in biometric values of eye after fasting and to elucidate whether this change is significant enough to delay the refractive and cataract surgeries during fasting. Study Design: Cross sectional observational. Place and Duration of Study: Eye department, DHQ-UTH, Gujranwala, from April 2021 to May 2021. Methods: Thirty subjects of either gender between 20-40 years of age who participated in both phases were enrolled in this study. Phase 1 was conducted one week before Ramadan and 2nd phase in the last week of Ramadan. After routine ophthalmic examination, keratometric(K) values were obtained with Auto Ref-Keratometer (Canon), while Axial length (AL), Anterior chamber depth (ACD), and Intraocular lens power (IOLp)were obtained from Master-Vu A-scan (Sonomed, Model # MV4500). Data was analyzed using SPSS version 25. Results: Out of 30 participants, 66.6% were female and 33.3%were male with mean age of 29.8 years. Mean K1 increased to 43.03 D during fasting from non-fasting reading of 42.24 D, while Mean K2 increased to 43.87 D during fasting from non-fasting reading of 43.28 D with significant p-value (<0.05). Mean ACD was 3.15mm in non-fasting that also increased to 3.21D in fasting state. Mean AL in non-fasting state was 23.41mm that remains the same in fasting state as well. Mean IOLp in non-fasting state was 21.18D that reduced to 20.42D in fasting state with significant p-value. Conclusion: Fasting increased the keratometry and ACD values with no effect on AL but that reduced overall intraocular lens power [ABSTRACT FROM AUTHOR]

This paper examines the effect of religious fasting on truth‐telling using a laboratory experiment in Egypt. While fasting‐induced religiosity may promote truth‐telling, the physiological and psychological changes during fasting, due to alimentary abstention and self‐control exertion, may reduce honesty, especially when fasting is augmented with effort. We examine this question by tracing individual truth‐telling decisions, in the absence and presence of additional effort, both before and during Ramadan. We find that neither effort nor fasting alone affects honesty, but exerting effort while fasting reduces honesty. We provide suggestive evidence on the mechanisms potentially driving this negative effect on honesty. [ABSTRACT FROM AUTHOR]

The aim of the training and assistance activities in making healthy drinks to relieve heartburn are to provide knowledge, skills to individuals or groups and provide solutions regarding healthy drinks to relieve heartburn that are good to drink, especially when breaking the fast in the month of Ramadan and to develop entrepreneurial character. The method used the provision of preparation materials for making healthy drink recipes, questions and answers, discussions, practice and mentoring carried out for 24 students of the SMK Kesehatan Surabaya in the classroom and gazebo of the school environment. The result are the service to community through training activities and assistance in making healthy drinks to relieve heartburn getting a positive and enthusiastic response from the participants present. [ABSTRACT FROM AUTHOR]

Objectives: Ramadan, a significant month for Muslims, presents unique challenges, particularly in the context of the USA. This study aimed to explore the relationship between mental health factors (depression, anxiety, and stress), sleep quality, and psychological well-being (subjective happiness and life satisfaction) during the month of Ramadan among participants and by gender. Methods: This study enlisted 163 participants (74% female, 25.7% male), with an average age of 36.8 years (SD = 13.1), mostly of Middle Eastern descent. Recruitment was conducted via flyers at local community mosques, social media, and outreach through local religious leaders. Data collection took place in the last three weeks of Ramadan, utilizing a Qualtrics survey that included the Depression Anxiety and Stress Scale (DASS-21), the Subjective Happiness Scale (SHS), Satisfaction with Life Scale (SWLS), and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed by means of descriptive statistics and multiple linear regression models using SPSS version 28. Results: The study indicates that while mental health and psychological well-being remained within normal levels during Ramadan, sleep scores indicated significant sleep disturbance among participants. Multiple linear regression models revealed that subjective happiness, sleep duration, and the global PSQI score were significant predictors of stress for the total sample (F = 9.816, p = 0.001). Life satisfaction was the only significant predictor of anxiety (F = 7.258, p = 0.001), and it, alongside subjective happiness, significantly predicted depression (F = 12.317, p = 0.001). For men, subjective happiness alone predicted stress, while life satisfaction was a predictor for both anxiety and depression (F = 4.637, p = 0.001). In women, sleep duration and medication usage were linked to stress but not anxiety. Life satisfaction and subjective happiness were, however, predictors of depression (F = 6.380, p = 0.001). Conclusion: Fostering positive affective states can serve as a protective mechanism against the potential psychological distress associated with altered sleep patterns and lifestyle changes that accompany Ramadan. This study highlights that Ramadan is a tool for bolstering happiness and life satisfaction, thereby lowering levels of stress, anxiety, and depression. In non-Muslim majority contexts like the USA, there is a need for accommodations to safeguard against potential psychological distress. [ABSTRACT FROM AUTHOR]

The number of shopping malls and vehicles in Baghdad has quickly increased along with the city's population. This has resulted in an increase in daily trips, which affects the roadway network's traffic flow and causes congestion, particularly on Al-Mansour Street and Al-Rowad Street near the city center. To determine the best signal time, the 14th Ramadan signalized intersection was evaluated and analyzed using the SIDRA 8.0 and SYNCHRO 11.0 software. First, the findings revealed that the chosen traffic facility is presently experiencing a substantial reduction in service level that is leading to forced conditions (LOS "F"). It is suggested that the cycle time at the intersection of the 14th Ramadan be changed from 240 seconds to 160 seconds and 125 seconds in SIDRA and SYNCHRO, respectively. Signal timings have reduced the delay for the 14th Ramadan intersection (76.8%), thus improving LOS from (F) to (D) for the intersection. The best delays after optimization in SYNCHRO 11.0, however, were 31% reduction with LOS of (E and D). Cycle times have also been lowered for the intersection to 25% as part of the optimum signal timing optimization. In SYNCHRO 11.0, which is better than SIDRA 8.0, the back of the queue has improved at the 14th Ramadan intersection by 33%. However, SYNCHRO has a better representation than SIDRA for current traffic saturation. [ABSTRACT FROM AUTHOR]

Aims: To assess clinical and metabolic parameters in patients with diabetes during Ramadan fasting. Patients and method: It was a prospective evaluative study based in the National Institute of Nutrition of Tunis (Departement C) in a population of patients with diabetes prepared for fasting by education and therapeutic adjustment. Results: 140 diabetics, mainly at high and very high risk (70.7 %), were analyzed. The frequencies of hypo and hyperglycemia were 12.1 and 11.4 % respectively. The mean weight and the mean systolic and diastolic blood pressure remained stable. Fasting blood glucose and HbA1C decreased significantly (−0.7 ± 3.1 mmol/L (p = 0.009), −0.18 ± 1.1 % (p = 0.047). The mean creatinine clearance had remained stable. Conclusion: Ramadan fasting can be well-tolerated, even for patients at high and very high risk, with an improvement in glycemic control, provided prior education and adequate therapeutic adjustment.

ABSTRACTFasting during Ramadan involves abstaining from food and drink from dawn to sunset, potentially influencing cognitive functions essential for the intellectual development of the youth. Therefore, understanding the effects of fasting on these functions in children/adolescents provides valuable perspectives to enhance education and promote mental well-being. However, studies on children/adolescents in this context are still limited. To evaluate the impact of Ramadan fasting on cognitive functions, including information processing speed, inhibition, decision-making, and auditory attention processes among children and adolescents aged 11 to 15 years. This study was conducted with 24 healthy children/adolescents (aged 12.84 ± 0.69 years). The experimental protocol consisted of two sessions: Before-Ramadan (BR) and at the beginning of the second week of Ramadan (R2). At each session, the boys were randomly tested on simple reaction time (SRT), choice reaction time (CRT), negative priming reaction time (NPRT), and auditory discrimination (P300). The tests were administered and scored by the same person in the different sessions. The study found that Ramadan fasting did not have an effect on various reaction times or on electro-physiological data, including P300 amplitude and latency. The current study, conducted with healthy children/adolescents, indicates that Ramadan fasting had no impact on various reaction times (SRT, CRT, NPRT), suggesting the preservation of information processing speed and decision-making, even in the face of increased task complexity. This is evident, on the one hand, through the maintenance of the ability to react to unexpected events, and, on the other hand, through the mastery of resistance to automatism, thus reflecting the preservation of inhibitory function (NPRT). Regarding P300 data, the absence of changes in latencies and amplitudes suggests that Ramadan fasting did not alter either the evaluation time of auditory stimuli or auditory attention processes.

Aims: The DAR 2020 survey summarised fasting practices and complications in people with type 2 diabetes (T2D) who fasted during Ramadan, and impact of pre-Ramadan diabetes education towards controlling the complications. Methods: Eight week post-Ramadan, Muslim people with T2D from 13 countries of five regions (South Asia, Southeast Asia, Gulf Nations, Middle East and North Africa) consented to answer questionnaire on breaking fast, hypoglycaemia, hyperglycaemia, Ramadan-focused diabetes education and self-monitoring of blood glucose (SMBG). Results: Among 4889 participants who observed Ramadan fast (>25 days), 51.1 % were females. Hypoglycaemia and hyperglycaemia was recorded mostly in North Africa (25.2 %) and Gulf Nations (30.2 %), respectively. In Middle East, 2.5 % and 3.1 % people required hospitalisation following hypoglycaemia and hyperglycaemia respectively. In South Asia, lowest incidents of hypoglycaemia (8.4 %) and hyperglycaemia (7.0 %) were noted. Pre-Ramadan diabetic education was received by total 45.9 % participants. SMBG was performed more frequently in North Africa (19.5 %). Metformin, Sulfonylureas and basal insulin were used most commonly in all regions. Conclusions: Fasting complications occurred in each region, but well-managed by the participants, physicians and family members amidst difficult time of COVID-19. The findings promote the necessity of patient education programmes for more people with diabetes to ensure safe fasting during Ramadan.

The Journal of Plant Research, Vol. 137, 2024, expresses gratitude to the numerous reviewers who contributed to the manuscript review process. The list includes a diverse range of individuals from various cultural backgrounds and regions, showcasing a global collaboration in the field of plant research. The editorial board acknowledges their valuable cooperation in ensuring the quality and integrity of the published articles. [Extracted from the article]

This scoping review aimed to investigate the role of lifestyle changes during Ramadan in controlling metabolic syndrome (MetS) in adults. The lifestyle factors investigated were diet, physical activity (PA) and sleep. The review was guided by the Preferred Reporting Items for Systematic Reviews, Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist, and Joanna Briggs Institute methodological frameworks. The Web of Science, Google Scholar, PubMed, CINAHL (EBSCO), and Scopus databases were searched using the following terms: “diet”, “physical activity”, “sleep” and/or “lifestyle” with “Ramadan”, “Ramadan month” or “the month of Ramadan”. The selection included all research articles published from January 1998 until the end of June 2023. Only full-text studies that met the selection criteria were reviewed. A lack of robust evidence exists on the impact of lifestyle changes during Ramadan on MetS components. The scarcity of cohort studies in this area is likely because they could only be conducted during a particular month each year. However, the available evidence shows that lifestyle changes during Ramadan, including PA, diet and sleep, may be significant in MetS control. The evidence suggests that diet is the most influential factor on MetS components during Ramadan month, whereas sleep is the least influential. Ramadan represents an opportunity for patients to enhance their control of MetS components by combining a healthy diet with PA and good sleep hygiene. Further robust studies are required to develop an in-depth understanding of the impact of lifestyle changes during Ramadan on MetS components.

Introduction: Intermittent fasting (IF) represents a dietary intervention similar to caloric restriction, characterized by the strategic limitation of food consumption. Among the diverse array of practices for IF, Ramadan IF (RIF), a religious observance in Islam, mandates that healthy adult Muslims abstain from both food and drinks during daylight hours. In sports, researchers have extensively studied IF effects on health, including sleep and physical performance, but its impact on cognitive functions during RIF remains understudied. Therefore, this study was conducted to evaluate the influence of RIF on psychomotor and cognitive performance among young female athletes. Methods: To achieve this purpose, a cohort of 23 female handball players, aged 17.2 ± 0.5 years, participated in a series of six testing sessions: one conducted prior to Ramadan (R0), and others during the first (R1), second (R2), third (R3), and fourth (R4) weeks of Ramadan, followed by a session in the week after Ramadan (R5). Each session involved assessments using a Simple Reaction Time Test (SRT), Choice Reaction Time Test (CRT), Vigilance Test (VT), and Mental Rotation Test (MRT). Additionally, dietary intake, body composition, and Pittsburgh Sleep Quality Index (PSQI) scores were evaluated during these periods. Results and discussion: The obtained data illustrated that there was a decrease in SRT, CRT, VT, and MRT performances during R1 in comparison to R0 (all p < .001). This reduction was also observed in R2, R3, R4, and R5. Notably, during the fourth week of Ramadan (R4), these cognitive and psychomotor parameters were significantly lower than during the earlier weeks (R1, R2, R3; all p < .001). Furthermore, a gradual decrease in total PSQI scores, sleep quality, and sleep duration was observed throughout the Ramadan period, reaching the lowest levels during R4. These findings illustrate that RIF has a significantly detrimental impact on neuromuscular and cognitive abilities as well as sleep quality in young female athletes. The study also highlights a fluctuating pattern in cognitive function across the four weeks of Ramadan, with the most pronounced decline observed during the final week of fasting illustrating the importance of conducting similar studies on normal individuals from both genders with larger sample size. [ABSTRACT FROM AUTHOR]

Identifying a clear relationship between rebel group structures and the use of violence faces the challenge that group structures rarely change over time. We exploit the analytical advantage provided by long religious holidays to address this issue using the principal-agent framework. Religious holidays serve as a focal point and reduce group coordination costs, but also raise the societal costs of violence. We argue the principal of rebel groups is more sensitive to the increased societal costs than the agents and thereby attempts to restrain the agents from attacking during religious holidays. However, the success of these attempts depends on the group's institutionalization level. Long religious holidays exacerbate the principal-agent problem due to the high costs of restraining agents from attacking for an extended period, making them the most likely case for our analysis. We test the theory by first conducting microlevel analysis of Islamic separatist groups in three Southeast Asian countries and then analyzing a cross-sectional sample of Islamic rebel groups. Results show that highly institutionalized groups that have a central command system and control over constituent groups are less likely to attack during long religious holidays than on other days, and vice versa for weakly institutionalized groups. [ABSTRACT FROM AUTHOR]

Context It is well known that the microbiome undergoes cyclical diurnal rhythms. It has thus been hypothesized that meal timing may affect gut microbial composition, function, and host health. Objective This review aims to examine the effects of time-restricted eating (TRE) and Ramadan fasting (RF) on the composition of the gut microbiota in animal and human studies. The associations between composition of microbiota and host metabolic parameters are also examined. Data Sources A search was performed on the PubMed, Cochrane, Scopus, and Web of Science databases up to December 31, 2022. The search strategy was performed using the Medical Subject Heading (MeSH) terms "intermittent fasting" and "gastrointestinal microbiome" and the key words "Ramadan fasting" and "microbes." Data Extraction Seven human studies (4 TRE and 3 RF) and 9 animal studies (7 TRE, 2 RF-like) were retrieved. Data Analysis TRE and RF in human studies lead to an increase in gut microbial community alpha-diversity. In animal studies (both TRE and RF-like), fasting is not associated with improved alpha-diversity, but enhancement of microbial fluctuation is observed, compared with high-fat diet ad libitum groups. Within Firmicutes and Bacteroidetes phyla, no specific direction of changes resulting from fasting are observed in both animals and human. After TRE or RF, a greater abundance of the Faecalibacterium genus is observed in human studies; changes in Lactobacillus abundance are found in animal studies; and increases in Akkermansia are seen both in humans and in animals fed a feed-pellet diet. Only 2 human studies show a beneficial correlation between microbiota changes and host metabolic (HDL cholesterol) or anthropometric parameters (body mass index). Conclusions These findings support the importance of both regimens in improving the gut microbiota composition. However, based on results of animal studies, it can be suggested that diet remains the essential factor in forming the microbiota's environment. Systematic Review Registration PROSPERO registration no. CRD42021278918. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the effect of nursing students' fasting during Ramadan on their risky behaviors. This study was conducted in a university located in 2022 using the prospective cohort study method. The data were collected from the nursing department students through face-to-face questionnaires. The sample of the study consisted of 186 nursing students. The data were obtained using a descriptive information form, which consists of questions regarding the descriptive characteristics of the nursing students, and the risky behaviors form, created by the researchers, to evaluate the effect of fasting during Ramadan on nursing students' risky behaviors. According to the findings of the research, it has been determined that the students who always fast during Ramadan have regular sahur. When the students' level of religious faith and fasting and having sahur status were compared with their risky behaviors, the mean scores of exercise and nutrition increased significantly, and the mean scores of interpersonal relationships decreased significantly. It was determined that the majority of students had a high level of religious faith, fasted and had sahur during Ramadan. Consequently, while Ramadan fasting negatively affected students' physical activity, nutrition and sleep patterns, it positively affected their interpersonal relationship status. [ABSTRACT FROM AUTHOR]

This study aims to investigate the effect of Ramadan intermittent fasting on cognitive work performance using a more natural approach. To achieve the objective of this study, a natural experimental approach was employed by incorporating a pretest-posttest control group design. A forward-type Digit Span Test (DST) was utilized as the measure of the cognitive work performance and was administered to participants twice, before and during Ramadan, with one-month gap between the tests. Two hundred and sixty-seven participants were naturally grouped into fasting and non-fasting groups according to their report during Ramadan session and into morning and afternoon periods, or AM and PM hours, according to their module scheduling. The results of the analyses suggest that the cognitive work performance of the fasting participants during the PM hours is better, after controlling the DST scores before Ramadan. The study also concludes that the cognitive work performance of the fasting participants between AM and PM hours does not differ. This result could be explained using the perspectives of post-lunch performance dip and the beneficial effect of breakfast. Methodological limitations and potential practical implementation of this study are also discussed. [ABSTRACT FROM AUTHOR]

Fasting Ramadan can affect the normal circadian pattern, especially in terms of sleep times and patterns. The objective was to analyze sleep quality and habits in diseased and healthy population using the Pittsburgh Sleep Quality Index (PSQI) both during and outside of Ramadan. A cross-sectional descriptive study was carried out on 240 subjects (cardiovascular diseases [CVD], diabetes [DM]) and 120 healthy subjects. Data entry and processing were performed with R. 3.2.4 software. The significance level was 0.05. Regarding fasting, 88.33% of subjects with CVD fasted during Ramadan against 55.83% of subjects with DM (P > 0.05). PSQI results showed that subjects with CVD and DM were poor sleepers (PSQI > 5), regardless of the period during or outside Ramadan, unlike healthy subjects who had a good quality of sleep during Ramadan (PSQI ≤ 5). Sleep latency did not change for all subjects regardless of the period (P > 0.05). While the duration of sleep was always higher during Ramadan despite the population (P < 0.05). The observance of Ramadan influenced the potential duration of sleep, which was found to be longer during the holy month. However, no significant impact was observed on the quality of sleep of diseased subjects, nor on sleep latency for all subjects. [ABSTRACT FROM AUTHOR]

Studies have shown that fasting during Ramadan has different effects on circulating levels of several biochemical markers. This study aims to conduct a comprehensive evaluation of studies related to the effect of fasting in the holy month of Ramadan on lipid profile, uric acid, and HbA1c in CKD patients. Studies were systematically searched and collected from three databases (PubMed, Scopus, and Web of Science). After screening, the quality and risk of bias assessment of the selected articles were evaluated. Study heterogeneity was assessed using the Cochrane test and I² statistic. In case of any heterogeneity random effects model with the inverse-variance method was applied. All analyses were performed using STATA software version 16. Four observational studies were included in this study. The results of this meta-analysis were that cholesterol (Weighted mean differences (WMD):0.21 with 95% CI:-0.09–0.51 (P-value=:0.18)), LDL (WMD:0.06 with 95% CI −0.24–0.36 (P-value:0.69)), triglyceride (WMD:0.05 with 95% CI:-0.25–0.35 (P-value:0.73)) had not-significant increase. Uric acid (WMD: −0.11 with 95% CI: −0.42–0.21 (P-value:0.51)) and HbA1c (WMD: −0.22 with 95% CI: −0.79–0.36 (P-value: 0.46)) show a non-significant decrease. The results of the analyses did not report significant changes in the lipid profile, uric acid, and HbA1c in CKD patients after Ramadan fasting. • There were no significant changes in the lipid profile or HbA1c. • Healthcare providers when advising their CKD patients about fasting. • Further research, taking into account factors such as disease stage, co-morbidities. [ABSTRACT FROM AUTHOR]

Ramadan-focused diabetes education is critical to facilitate safer Ramadan fasting amongst Muslim people living with diabetes. We present the design, delivery, and evaluation of two parallel massive open online courses (MOOCs) in Ramadan-focused diabetes education for people with diabetes and HCPs. Two Ramadan-focused diabetes education MOOCs were developed and delivered for Ramadan 2023: one for HCPs in English, and another for people with diabetes in English, Arabic and Malay. A user-centred iterative design process was adopted, informed by user feedback from a 2022 pilot MOOC. Evaluation comprised a mixed-methods evaluation of pre- and post-course user surveys. The platform was utilised by people with diabetes and their family, friends and healthcare professionals. Overall, a total of 1531 users registered for the platform from 50 countries, 809 started a course with a 48% subsequent completion rate among course starters. Qualitative analysis showed users found the course a user-friendly and authoritative information source. In the HCP MOOC, users reported improved post-MOOC Ramadan awareness, associated diabetes knowledge and ability to assess and advise patients in relation to their diabetes during Ramadan (p<0.01). We demonstrate the potential of MOOCs to deliver culturally tailored, high-quality, scalable, multilingual Ramadan-focused diabetes education to HCPs and people with diabetes. • Education is needed to help Muslim people with diabetes navigate Ramadan fasting. • Existing self-management education lacks accessibility and scalability. • We delivered Massive Open Online Courses (MOOCs) on diabetes and Ramadan. • 1531 individuals from 50 countries registered for the MOOCs. • Mixed-method evaluation found MOOCs as acceptable and engaging platforms. [ABSTRACT FROM AUTHOR]

Purpose: The main purpose of this research is investigation of effect of the users' religiosity on their relevance judgment. Method: This research is practical in terms of purpose and was conducted using the descriptive survey design. The statistical population of the research consisted of all fourth-level doctoral students at Al-Zahra University, whose number was 69. Mean and Standard deviation were used to describe the statistical data, and Pearson's correlation coefficient and simultaneous regression analysis were used to analyze the data. In order to collect information about the level of users' adherence to religiosity dimensions, Glock and Stark's religiosity questionnaire (1968) was used which includes 26 items arranged in 4 dimensions of beliefs, emotional, consequential, and ritual. Then, in order to determine the degree of relevance judgment, 6 simulated work tasks were defined and the most important criteria of relevance judgment were evaluated during the execution of work tasks. First, the users searched on the topic of work tasks in Persian paper databases, including Magiran, SID and Ensani Portal (Iran's Humanities Portal), and they selected 10 papers for each task. After reading each scenario and the demand related to it, users evaluated the papers related to each scenario in a related, somewhat related, unrelated format. Therefore, each user evaluated 30 papers related to 6 work tasks. Findings: The findings indicates that among the religiosity dimensions, the interactive behavior of users showed a higher average than the interactive performance and relevance judgment. Moreover, the average of practices dimension was the highest, followed by belief dimension, and emotion dimension. Finally, the works dimension showed the lowest average. The results of multiple regression test showed that users' ritual and behavioral dimension (such as worship, prayer, participation in special religious rites, fasting, etc.) and belief dimension and religious beliefs are effective in increasing relevance judgment, but the two affective and emotional dimensions have nothing to do with the judgment of users. In other words, despite the change in the emotional dimension of the users, i.e., the change in the degree of emotions, imaginations and feelings related to having a relationship with a divine entity such as God or an ultimate reality or a supreme authority, their relevance judgment would not change. Furthermore, despite the change in the 'consequences dimension' of religiosity, i.e., the change in the effects of religious beliefs, actions, experiences and knowledge on the daily life of users, the level of their relevance judgment did not show a change. Originality/value: The present research is the first research that has explored the effect of users' religiosity scales on relevance judgment. According to the findings, it is suggested that system designers and experts, in addition to considering technical issues and hardware and software equipment, should also manage the interactions of users with the system and consider the different conditions and situations of users. Librarians, while knowing the society in which the users are located and considering the religious context of the society as well as knowing the religious approaches of the users, can provide the necessary guidance to them when retrieving information. [ABSTRACT FROM AUTHOR]

Current descriptive studies have demonstrated both positive and negative impacts of Ramadan on consumption among Muslims. However, it is crucial to convey a deep understanding of the causal relationships between Ramadan and consumption behavior to inform policymakers and guide the development of efficient policy recommendations. In exploring the dynamic between Ramadan and consumer behavior, this study delves into the causal effects of the holy month on the purchasing patterns of Muslims. Utilizing a natural field experiment, the research examines data from 1837 observations involving 267 Muslim and non-Muslim personnel at the Police Headquarters in Bangladesh. The study employs a difference-in-differences method to isolate the impact of Ramadan and Eid festivities. Our findings reveal a substantial purchase increase among Muslims during these periods— 40.6% during Ramadan and 76.3% for Eid. These results underscore the importance of ensuring a preemptive ample supply of Ramadan- and Eid-related goods in the market to manage demand-pull inflation early in and during Ramadan. Moreover, the study accentuates the necessity for further research on the broader implications of Ramadan on Muslim spending habits across Bangladesh, aiming to inform and guide national economic policies. [ABSTRACT FROM AUTHOR]

Introduction: Acute pain caused by kidney stones is considered one of the most prevalent reasons for referring to treatment centers or hospitals. One of the essential issues in this field, which still has many questions, is the probability of an increase in kidney stone formation during fasting. This study assessed the relationship between kidney stone pain and fasting during Ramadan. Methods: This study conducted a descriptive cross-sectional check on the patients who referred to 3 central urgencies named Imam Khomeini-Shahid Labafi Nejad and Baghiatallah due to Colic pain generated from kidney stones during three periods of time, including before, in, and after Ramadan. Results: The study indicates ureteral stones are more prevalent than kidney stones in patients with Kidney Colic Pain during three periods. Also, it was released that the most amount of Colic pain was experienced by males under 40 years during three periods of time, so there is a significant relevance between the male gender and Renal Colic (P<0.05). A noticeable change in diet and more usage of carbohydrate compounds in addition to high-protein diets was reported here, so there is a significant difference between more carbohydrates and Renal Colic before and after Ramadan (P=0.022). Conclusion: It is specified that factors such as male gender, age under 40, being overweight, high-calorie diet, and low physical activity are the risk factors associated with Renal Colic. Also, this study found that the reception of renal colic patients in Ramadan had no significant difference in another two months. [ABSTRACT FROM AUTHOR]

Objective: To determine trend of following medical advice and safety of high-risk diabetic patients during Ramadan practicing updated IDF DAR guidelines Methods: The cross-sectional study was conducted at Outpatient Department of Diabetes, Endocrinology and Metabolic Disorders Hayatabad Medical Complex Peshawar, Pakistan from April to June 2022, and comprised of high-risk diabetic patients (>6.0) based on updated IDF-DAR guidelines 2022 intending to fast. A questionnaire was designed to document patient risk factors score, type and duration of diabetes, HbAlc, comorbidities and complications developed during Ramadan. Data was analyzed using SPSS 20. Results: Among all 130 participants, 78(60%) followed medical advice and did not fast and 52(40%) patients fasted against medical advice during month of Ramadan. Out of 130 participants, 89.2% were having type-2 diabetes Mellitus, 55.4% were female and mean age of participants was 52+14.6.40%. In fasting group, 57.7% were in the age range of 16 to 50 years while in non-fasting group 69.2% participants were more than 50 years old (P-value 0.031). There were 80.8% female participants in fasting group versus 38.5% in non-fasting group (P-value 0.001). Hypoglycemia occurred in 58.3% patients in fasting group and 29.3% non-fasting group. (P-value 0.021). On the other hand, 27.8% patients in fasting group and 55.2% of non-fasting group had hyperglycemia (P-value 0.025). Conclusion: Despite advised against fasting in these high-risk patients as per IDF DAR guidelines, almost half of patients fasted considering fasting a religious obligation. Those who fasted had significant hypoglycemia despite adjustment of medications as in guidelines. There is need of more intensive education before fasting, especially in high-risk diabetic patients. [ABSTRACT FROM AUTHOR]