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In the aftermath of the 2008 global crisis, excessive financialization in the economic system, along with extreme shortening of the holding times of assets, led to a disconnection between the real economy and financial markets. In the post-crisis period, participation finance, which is expected to re-establish the eroded link between the real and financial economy, has attracted more attention. Countries are in an increasing competition at an international scale to benefit from relevant demand; however, the quantification process should be scrutinized in order to realize the potential of the sector and to create a benchmark for global market actors. Consequently, developing alternative approaches for comparing countries in the field is crucial. Evaluation of countries in the context of participation finance at a global scale is an emerging field in the literature. The approach in this study is to develop a new tool based on transparency and objectivity in participation finance and to provide benefits in the process of determining the participation finance rankings. Moreover, this study acts as an anchor for understanding global participation finance. In the study, country data are compiled from organizations that produce and share data on participation finance and countries are listed with a criteria importance through intercriteria correlation (CRITIC)-based technique for order preference by similarity to an ideal solution (TOPSIS) method. Using the CRITIC method, the theme of regulation and governance has the highest weight in participation finance, followed by banking and nonbanking sectors, education and research, and perception and awareness. Based on the weighted criteria, TOPSIS is used to produce rankings. The top three countries in the ranking are Malaysia, Indonesia, and Saudi Arabia. According to the weighting results applied to the variables, countries are recommended to take the following actions: establish institutions that will ensure compliance with the relevant legal framework, develop a legally based monitoring system, create areas for Islamic fintech research and development and related legislation.

Thrombotic coronary artery occlusions usually manifest as acute coronary syndrome with cardiogenic shock, acute pulmonary edema, cardiac arrest, fatal arrhythmias, or sudden cardiac death. Although it usually occurs based on atherosclerosis, it can also occur without atherosclerosis. There is no predictor of coronary artery thrombosis clinically and no consensus regarding the optimal treatment. In the current literature, treatment options include emergency coronary artery bypass grafting, entrapment of thrombus in vessel wall with stent implantation, intracoronary thrombolysis, glycoprotein IIb/IIIa inhibitors, anticoagulation with heparin, and thrombus aspiration as reperfusion strategies. Here, we reviewed a new treatment strategy based on the literature, and a case series with successful results in hemodynamically stable patients with low-dose slow infusion tissue plasminogen activator (tPA) for thrombotic coronary artery occlusions that allow coronary flow was reported. Prospective randomized studies and common consensus are needed on low-dose, slow-infusion tissue plasminogen activator treatment regimen and optimal treatment management for thrombotic coronary artery occlusions.

Obesity is a common health problem and the prevalence is increasing worldwide. The improper and unregulated use of unconventional therapies, especially herbal treatment methods, has grown due to widespread availability. In our case, a 41-year-old male patient developed palpitation, confusion, loss of consciousness, and cardiac arrest while at home. An emergency medical team was called and chest compressions were performed by his wife until the medical team arrived. Ventricular fibrillation was detected on the monitor 5 minutes after the cardiac arrest occurred and the patient was defibrillated. A physical evaluation revealed hypotension and tachycardia. Electrocardiography (ECG) showed a fast idioventricular rhythm with capture and fusion beats and evident J waves in leads DII, DIII, and aVF. Brain magnetic resonance imaging and thoracic tomography revealed no pathology to explain his clinical condition and the coronary angiography results were not significant. The laboratory parameters included potassium (K): 2.23 mEq/L, ionized K (arterial blood): 2.43 mEq/L, sodium: 142 mEq/L, calcium: 9.3 mg/dL, creatinine: 1.6 mg/dL, pH: 7.29, cardiac troponin I: 0.12 (normal range: 0–0.11 ng/mL) and creatinine kinase mass: 8.3 (normal range: 0–3.23 ng/mL). After fluids and electrolyte replacement therapy were administered, the ECG results revealed narrow QRS complex atrial fibrillation followed by a normal sinus rhythm with a 490 ms corrected QT interval. The patient was extubated in follow-up. There were no risk factors for coronary artery disease, no history of drug or other substance use, and no exposure to excessive emotional or physical stress. The patient said that he had been consuming a large quantity of teff tea for 5 days to lose weight. He was discharged without any complications and has been asymptomatic in 9 months of follow-up. The inappropriate use of weight loss alternatives, especially herbal therapies such as teff tea, and the incidence of associated side effects are increasing due to wide availability and easy access. The general population should be warned about this issue.

Today's European cities exhibit a great cultural and linguistic diversity. Highly diverse urban areas bring together people from different sociolinguistic backgrounds and thus facilitate intense language contact, with speakers accessing diverse linguistic resources that they creatively use and mix (cf. e. g. Wiese 2020; Otsuji/Pennycook 2010; Pennycook/Otsuji 2015). Such linguistic practices include code-switching. In previous research on code-switching the focus was on relatively homogeneous settings, mostly bilingual communities (cf. Poplack 2015; Torres Cacoullos/Travis 2015; Bullock/ Toribio 2009). As a part of a larger project, we collected spontaneous speech data through audio and video recordings from a highly diverse street market in Berlin-Neukölln that is popular among locals and tourists, the “Maybachufer-Markt”. The analysis of our data reveals new insights with respect to sociolinguistic motivations underlying code-switching. In light of commercial intentions, vendors try to switch to a language according to how they construct the customers’ identity (cf. Bucholtz/Hall 2005; Pfaff-Czarnecka 2011). Besides vendors also commodify specific languages or multilingualism (Heller 2010) based on their and others’ language attitudes or they switch to a language for the purpose of maintaining the communication in sales conversations. Correlating these different factors, we will argue that code-switching is used with a commercial motivation in interactions between vendors and customers.

Isotretinoin is widely used in the treatment of acne vulgaris and other dermatological diseases. Numerous side effects have been reported in the literature. A myocardial bridge occurs when segments of the coronary artery create an intramyocardial tunnel. Atherosclerotic plaque formation frequently occurs in the segment proximal to a myocardial bridge. Coronary thrombus formation, which is often the cause of myocardial infarction in young patients, can be triggered by many factors. Kounis syndrome is described as acute coronary syndromes associated with allergic or hypersensitivity reactions. This article is a description of the case of a patient predisposed to the development of a thrombus by a myocardial bridge who was successfully treated for coronary thrombosis and which may represent a case of Kounis syndrome associated with isotretinoin use presented in the context of the relevant literature.

Acute myocardial infarction (AMI) is associated with a high incidence of maternal and fetal complications when it develops during pregnancy or the early postpartum period. The pathophysiology involves various factors, including alterations in the vascular wall and hypercoagulability as a result of the hormonal and hemodynamic effects of pregnancy. It frequently occurs due to the development of a thrombus following a ruptured plaque. In addition, coronary artery dissection constitutes a significant cause of AMI in pregnancy. In the literature, the therapeutic approach covers a wide spectrum, ranging from conservative follow-up to percutaneous coronary intervention, urgent bypass surgery, and occasionally, thrombolytic therapy. The success rate is often low; however, maternal and fetal complications are seen more frequently during invasive interventions and bypass surgeries because of the structural changes in the coronary intima and media wall. Presently described is the case of a woman in the 36th week of pregnancy who presented with AMI. The occlusion could not be detected during the primary percutaneous intervention, and thrombolytic treatment and a stepwise percutaneous intervention were performed with a successful result.

Background and Objectives: An inter-arm systolic blood pressure difference (IASBPD) is defined as a blood pressure (BP) disparity of ≥10 mmHg between arms. IASBPDs are associated with an increased risk of cardiovascular disease (CVD). Similarly, visceral fat accumulation (VFA) is clinically important because it is associated with higher cardiovascular disease risk. Accordingly, this study compared the body composition parameters of IASBPD individuals with individuals who did not express an IASBPD. Materials and Methods: The analysis included 104 patients. The blood pressures of all participants were measured simultaneously in both arms using automated oscillometric devices. Then patients were divided into two groups according to their IASBPD status: Group 1 (IASBPD− (Results: In 42 (40%) patients, the simultaneously measured IASBPD was equal to or higher than 10 mmHg. The right brachial SBP was higher in 63% of patients. There were no differences between the groups in terms of demographic and clinical characteristics. Regarding the two groups’ body composition parameter differences, VFA was significantly higher in group 2 (p = 0.014). Conclusions: The IASBPD is known to be associated with an increased risk of cardiovascular events. Although the body mass indexes (BMIs) of the two groups were similar, VFA levels in those with a greater than 10 mmHg IASBPD were found to be significantly higher. This finding may explain the increased cardiovascular risk in this group.

Background and Objectives: The number of cardiac pacemakers being used has increased in recent decades, and this increase has led to a rise in device-related complications, requiring percutaneous device extraction. Our aim was to present our single-center clinical experience in percutaneous lead extractions. Materials and Methods: We analyzed an observational retrospective cohort study of 93 patients for the transvenous removal of a total of 163 endocardial leads. We evaluated the device details, indications, lead characteristics, extraction methods, complications, reimplantation procedure, follow-up data, effectiveness, and safety. Results: Patients’ mean age was 68.6 ± 11.6 years. Lead extraction indications were pocket infection in 33 (35.5%), lead dysfunction in 33 (35.5%), and system upgrade in 21 (23%) cases, and lead endocarditis in 6 (6%) cases. The duration from implantation to extraction time was a detected median of 43 (24–87) months. The most common retracted lead type was the RV defibrillator lead (62%), and the lead fixation type was active for one hundred (61%) patients. A new device was inserted in 74 (80%) patients, and the device type was most commonly a CRT-D (61%). Patients were followed up at a median of 17 (8–36) months, and 18 patients (19%) died at follow-up. Complete procedural success was obtained in 78 (84%) patients, and clinical procedural success was obtained in 83 (89%) patients. Procedural failure was detected in 15 (16%) patients. Major and minor complications were detected in 10 (11%) and 6 (6.5%) patients, respectively. The most common minor complication was pocket hematoma. Conclusions: Our experience suggests that transvenous lead extraction has a high success rate with an acceptable risk of procedural complications. The simple manual traction method has a high rate of procedural success, despite a high dwell time of the lead.

This study aims to determine the antecedents, consequences, and coping strategies of job stress among school administrators. A exploratory sequential design was used in the study. Interviews were conducted with 19 administrators using a semi-structured interview form to collect qualitative data. Quantitative data was collected using the Marmara Job Stress Scale. The scale was applied to 439 school administrators, and a t-test was used to determine if there were significant differences in the antecedents, consequences, and coping strategies of job stress. As a result of the qualitative interviews, it was found that the antecedents that cause most stress among school administrators are "responsibility" and "difficulty with colleagues, loneliness". As a result of the qualitative interviews, it was found that as a result of job stress, the administrators "do not have time for their families" and "are offensive to the business environment". According to qualitative data, school administrators were found to use individual coping strategies to manage job stress. The qualitative and quantitative results were interpreted together at the end of the study. As a result of the research, it is suggested that educational environments and legislation should be regulated according to the antecedents of work stress, which have a high effect on school administrators.

Abstract Introduction Cardiac resynchronization therapy (CRT) is a device‐based method of treatment which decreases morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). This study was aimed to investigate the effects of CRT on hemodynamic and arterial stiffness parameters evaluated by noninvasive method, and determine whether there is a correlation between the changes after CRT in these parameters and the clinical response to CRT or not. Methods The study included 46 patients with HFrEF who were planned to undergo CRT implantation. Before the CRT implantation, clinical and demographic data were recorded from all patients. Hemodynamic and arterial stiffness parameters were measured oscillometrically by an arteriograph before CRT implantation. The patients were re‐evaluated minimum three months after CRT; the above‐mentioned parameters were measured again and compared to the pre‐CRT period. Results Compared to the period before CRT, mean systolic blood pressure (SBP) (116.8 ± 19.1 mm Hg vs 127.7 ± 20.9 mm Hg, P = .005), central SBP (cSBP) (106.2 ± 17.3 mm Hg vs 116.8 ± 18.7 mm Hg, P = .015), cardiac output (CO) (4.6 ± 0.8 lt/min vs 5.1 ± 0.8 lt/min, P = .002), stroke volume (65.6 ± 16.3 mL vs 72.0 ± 14.9 mL), and pulse wave velocity (PWV) (10 ± 1.6 m/sec vs 10.4 ± 1.8 m/sec, P = .004) increased significantly in post‐CRT period. In addition, the same parameters were significantly increased post‐CRT period in patients with clinical response. However, there was not any similar increase in nonresponder patients. Conclusion This study demonstrated that SBP, CO, and PWV increased significantly after CRT. The modest increases in these parameters were observed to be associated with positive clinical outcomes.

Objective: Although it is known that revascularization is useful for the treatment of patients with ischemic mitral regurgitation (MR), the effects of revascularization on MR have not been well examined. In this study, we aimed to show the effect of revascularization alone on patients with moderate schemic MR, quantitatively and prospectively. Methods: Forty-seven patients with moderate MR (2 to 3 +) who were offered revascularization due to the diagnosis of coronary artery disease were enrolled in the study. Patients were divided into three groups according to their treatments. Patients who underwent percutaneous coronary intervention (PCI) were defined as group 1 (n=18), patients who underwent surgical revascularization (CABG) as group 2 (n=17) and patients who received medical treatment as group 3 (n=12). Transthoracic echocardiography (TTE) was performed on all patients at the beginning of the study, and after three months. Semi-quantitative (I-IV) and quantitative (EOA, RV, and RF) parameters were calculated for MR grading. Results: MR parameters of three groups were similar for TTE, performed at the beginning of the study. When the initial and the third month MR parameters of patients were compared, there was a significant decrease in group 1 in effective orifice area (EOA) (p=0.002), regurgitant volume (RV) (p=0.005), regurgitant fraction (RF) (p=0.002) and semi-quantitative MR (p=0.002). There was also a similar significant decrease in group 2 in EOA (p=0.002), RV (p=0.001), RF (p=0.001) and semi-quantitative MR (p=0.005) grades. However, EOA (p=0.10), RV (p=0.19), RF (p=0.07) and semi-quantitative MR grades (p=0.48) of group 3 patients were found to be similar to initial parameters. There was no difference between groups when residual MR grades at the third month were compared with each other (p>0.05). Conclusion: Our study showed that percutaneous or surgical revascularization significantly improved MR parameters, on the other hand there was no difference obtained with medical treatment. However, it was found that revascularization alone was related with important residual MR in the treatment of patients with ischemic MR. For this reason it can be suggested that revascularization is effective but not sufficient for the treatment of patients with ischemic MR. [ABSTRACT FROM AUTHOR]

Background and Objectives: The mean platelet volume (MPV) represents a possible marker of platelet activation. There is an association between the platelet count (PC) and inflammation and platelet reactivity. We assessed the association between the MPV/PC ratio and circadian alterations in blood pressure (BP). Material and Methods: One hundred and twenty subjects in total, 80 hypertensive subjects and 40 healthy subjects (controls), were enrolled in the study group. Twenty four hour ambulatory BP monitoring (ABPM) was applied to all subjects. According to ABPM results, the hypertensive subjects were separated into two groups, such as dippers (n = 40) and non-dippers (n = 40). In all subjects, the collection of venous peripheral blood samples was performed on admission for PC and MPV measurements. Results: The two groups exhibited similar clinical baseline characteristics. A significantly higher MPV/PC ratio was determined in non-dippers compared to that in dippers and normotensives. The higher MPV/PC ratio was observed in non-dippers in comparison with that in dippers and normotensives (0.046 ± 0.007 to 0.032 ± 0.004 fL/[109/L]; 0.046 ± 0.007 to 0.026 ± 0.004 fL/[109/L], p < 0.001, respectively). A receiver operating characteristic (ROC) curve analysis showed that the optimum cut-off value of the MPV/PC ratio for predicting non-dipping patterns in hypertensive patients was 0.036 (area under the curve [AUC]: 0.98, p < 0.001). According to the cut-off value, sensitivity and specificity were found to be 95% and 95%, respectively. Conclusions: The higher MPV/PC ratio was determined in non-dipper hypertensive subjects in comparison with that in dipper hypertensive subjects. An elevation of platelet activity and an increase in thrombus burden are reflected by an increase in the MPV/PC ratio. The MPV/PC ratio may underlie the increase in cardiovascular risk in non-dippers compared to that in dippers.

We report the case of a female patient under oral prednisolone therapy due to a diagnosis of idiopathic intracranial hypertension with papilledema. Unfortunately, short-term treatment with prednisolone caused an unusual complication in the patient, i.e., recurrent myocardial ischemia. Possible mechanisms leading to this complication were evaluated in the light of current knowledge. Resumo: Descrevemos o caso clínico de um paciente sob terapia prednisolona oral devido a um diagnóstico de hipertensão intracraniana idiopática com papiledema. Infelizmente, o tratamento a curto prazo com prednisolona causou uma complicação incomum no paciente, isto é, isquemia miocárdica recorrente. Os possíveis mecanismos que conduzem a esta complicação foram avaliados em função das literaturas correntes. Keywords: Steroid, Prednisolone, Myocardial ischemia, Myocardial infarction, Coronary slow flow, Palavras-chave: Esteróides, Prednisolona, Isquemia miocárdica, Enfarte agudo do miocárdio, Fluxo lento coronário