Association between vitamin D receptor gene FokI polymorphism and mortality in patients with sepsis.

BACKGROUND: Sepsis is life-threatening organ dysfunction as a result of the host's dysregulated immune response to infection. The vitamin D receptor (VDR) gene FokI polymorphism influences immune cell behavior. In the present study, we aimed to investigate the association between VDR FokI polymorphism and mortality in sepsis and non-sepsis patients in the intensive care unit (ICU). METHODS AND RESULTS: This is a prospective observational study involving 96 sepsis and 96 non-sepsis patients admitted to the Ege University ICU. VDR FokI polymorphisms were investigated, as well as the relationship between the identified polymorphisms and mortality.  In-hospital mortality was 27.1% in the sepsis group and 8.33% in the non-sepsis group (p = 0.001). The frequencies of VDR FokI TT, TC, and CC genotypes were 8 (8.33%), 48 (50.0%), and 40 (41.7%) in the sepsis group, and 11 (11.5%), 42 (43.8%), and 43 (44.8%) in the non-sepsis group, respectively (p = 0.612). In the sepsis group, the frequencies of Fokl TT, TC, and CC genotypes did not differ significantly between survivors and non-survivors. However, homozygous C allele carriers had lower overall mortality (p = 0.047). CONCLUSION: The VDR FokI polymorphism, particularly the CC genotype, appears to be associated with lower mortality in ICU patients.

Dynamic eye-tracking evaluation of responding joint attention abilities and face scanning patterns in children with attention deficit hyperactivity disorder.

There has been growing evidence that autistic traits are more represented in children with attention-deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate autistic traits associated with responding joint attention (RJA) abilities and face scanning patterns using eye-tracking in children with ADHD, and to compare with typically developing peers (TDs). All child participants viewed a series of videos related to male and female children under congruent and incongruent conditions during eye-tracking evaluation. The object and face regions of the models within the videos were determined as areas of interest (AOIs). Children with ADHD had significantly elevated ratings of autistic traits than TDs. Time course analysis of the proportion of fixations (PoF) on object region determined that children with ADHD tended to show more interest in the objects and had higher PoF on face interest area, including eyes and mouth compared to TD children in the videos when the male/female model shifts his/her gaze to the corner. Higher SRS scores were associated with higher PoF on the Face AOI in both groups. Given these findings, social skill interventions directly targeting the core deficits of RJA and problems in facial scanning appears to be beneficial in children with ADHD.

Pupil Dilation Response to Prosody and Syntax During Auditory Sentence Processing.

Pupil dilation response has been shown to reflect different levels of sentence processing during prosodic and syntactic processing in language comprehension. Our pupillometry experiment aimed to investigate whether pupil diameter was sensitive to the auditory sentence processing involved in comprehending congruent and incongruent statements. Twenty-one participants were presented with 300 auditory stimuli consisting of syntactically and/or prosodically congruent and incongruent sentences in Turkish. The pupillary response results were significant only for syntactically incongruent sentences and for sentences that were both syntactically and prosodically incongruent. This indicates that prosody had no significant effect on its own. Based on the hypothesis that prosodic and syntactic processing require cognitive sensitivity for auditory sentence comprehension, we expected an increase in pupil diameter for both processes. However, our findings are consistent with the previous assumptions that pupil size increases during syntactic manipulation, but our findings showed that prosodic processing does not increase pupil size, contrary to previous studies.

Increasing farm size is an effective way to decrease the carbon footprint in dairy cattle production.

The purpose of this study was to investigate the effects of the farm size on the carbon footprint of dairy cattle farms in Isparta province in Türkiye. For this purpose, face-to-face interviews were conducted with 159 farms which represent 1866 dairy cattle farms in Isparta province. The number of animals on the farm was converted into animal unit (AU) and the farms were divided into three groups. Accordingly, farms were classified as small, medium, and large farms. The carbon footprint produced per AU in the farm was the sum of feed, enteric fermentation, CH4 from manure, CO2 from manure, N2O from manure, and anthropogenic emissions. The milk produced in the farms was standardized according to 4% fat and 3.3% protein (FPCM) and the ratio of meat to milk was found by dividing the total live weight gain produced except for cows by FPCM. Accordingly, 65% of the greenhouse gas emissions of dairy farms were allocated to milk and 35% to meat. Of the total emissions, enteric fermentation and emission on feed contributed the highest proportion. Results showed that when using the IPCC (2021) global warming potential (GWP) values, the carbon footprint for 1 kg of FPCM milk was 1.26 kg CO2-eq on average, whereas the carbon footprint for 1 kg of meat was 11.78 kg CO2-eq on average. Results showed that as farm size increased carbon footprint for a kilogram of FPCM and meat decreased and this showed the effectiveness of farm size on decreasing carbon footprint per unit of product.

Dynamic changes in the food-cue processing of obese adolescents: A controlled eye-tracking study from a dual-system perspective.

Adolescent obesity is a growing global health problem. Studies have demonstrated that exposure to food cues plays a role in both the development and the persistence of obesity. Understanding how visual attention changes dynamically in response to food cues may explain how they contribute to obesity. The primary aims were to evaluate attentional bias for food cues and conduct a time-course analysis of obese adolescents' food-cue processing. We also investigated the roles of inhibition, cognitive flexibility, and eating styles in their visual attention to food stimuli. A total of 60 age- and gender-matched 12-16-year-olds (n = 30, obese group; n = 30, control group; M = 13.9 years, SD = 1.26) were included in this study's sample. The participants viewed a series of high-calorie and low-calorie food images along with nonfood images in the free exploration paradigm during eye-tracking. Time-course analysis of the proportion of fixations on images of food and high-calorie foods determined that the attentional processing of the two groups differed, especially in later stages. The obese group had higher Stroop Interference and Trail Making Test-B scores than the control group, but these executive functions' scores did not affect their proportions of fixations on food and high-calorie food images over time. Higher Perceptual Reasoning Index scores led to a decrease in the proportions of fixations on high-calorie food images over time in the obese group, and this was particularly noticeable after about 4000 ms. This study found that time-course analysis of visual attention to food cues allows us to understand how it changes dynamically over larger time intervals. Future studies should provide knowledge about maintained attention for food cues and their relationship with top-down factors in obese adolescents.

The cost and profitability analysis of different dairy farm sizes.

Dairy cattle production is a substantial industry in Türkiye's livestock sector, with a significant economic impact. Because of its proximity to Türkiye's major market zone, the Mediterranean and Aegean regions, the province of Isparta can develop its milk production capacity and make investments in dairy production. Therefore, the purpose of this study was to look into production costs and drivers of profitability for dairy farms of various sizes in Isparta, a major milk-producing region in Türkiye. The study included data from 159 dairy cattle farms operating in the production period 2020-2021 in the designated area. Dairy farms were separated into three groups based on size and analysed consequently. The findings revealed that total feed consumption was higher on small-scale farms, while milk production was lower. Feed costs were the highest portion of the total production cost among the cost items (72.86%), followed by permanent labour costs (7.12%). Furthermore, milk sales income (64.39%) was the largest contributor to the average income in terms of the gross product value. Aside from milk production, it was discovered that cattle value appreciation (24.12%) increased farm income. Consequently, as farm size increased, production costs per animal unit fell while net profit rose. Finally, feed is the most significant input that boosts milk production costs. Also, larger farms were found to be more profitable in the study area. Thus, it was concluded that policies that could have a favourable effect on an increase in the cattle population on the farm should be advanced in the study area.

Production of time reference in Turkish Broca's aphasia: The effect of morphological complexity.

In PWA (people with aphasia) difficulties with sentences that refer to the past compared to non-past time reference have been shown for many languages, including Turkish. However, the impact of morphological complexity on past time reference ability in production has not yet been reported for Turkish-speaking PWA. Turkish, where verb forms have complex inflectional paradigms and exhibit overt and non-overt morphology, facilitates the examination of the effects of morphological complexity. The current study has two objectives: 1) to investigate whether the morphological complexity of the verb form affects time reference production of Turkish-speaking PWA and 2) to provide analysis for the error patterns discovered. Seventeen Turkish individuals with Broca's aphasia who were matched in age with a control group of 17 neurologically intact Turkish individuals were tested with a picture sentence completion task. Test conditions were present progressive, simple past, past perfect, past progressive, and future tense. The task required the participants to complete each sentence frame with a verb. Our findings show that Turkish-speaking PWA were more successful in producing verb forms referring to non-past than verb forms referring to the past time reference. The current study supports previous findings that past is more difficult than non-past time reference for Turkish-speaking PWA. In terms of morphological complexity, we find that PWA were more impaired when producing morphologically complex verb forms rather than morphologically simple forms. We argue that these impairments lie in the realization of overt morphology.

Discordant Hemoglobin Values Determined by Blood Gas Analyzer and Hematology Analyzer Synchronously Is a Warning for Inappropriate Blood Sampling.

A patient may have two contemporary hemoglobin test results; one received from a hematology analyzer and the other from a blood gas analyzer. Such results may pose a dilemma if validated without investigation. A 27-year-old female patient presented to the emergency department because of worsening dyspnea and hemoptysis. Her hemogram revealed Hb 4.5 g/dL; Hct 16.1% while blood gas analysis showed Hb 8.1 g/dL; Hct 25.3%. The results were evaluated to be suspicious. All results were rejected and new requests were made. Hb 9.8 g/dL; Hct 31.9% were seen in repeated hemogram while blood gas analysis showed Hb 10.2 g/dL; Hct 31.5%. It was understood that the nurse used the vein with an intravenous fluid for sampling the first hemogram. A multitude of factors affect the accuracy of hemoglobin concentration measurements. Literature suggests that hemoglobin values of hematology analyzers and blood gas analyzers should be in harmony. Any discordance must be an alarm to stop and review the test results before validation.

Effects of Complement Regulators and Chemokine Receptors in Type 2 Diabetes.

CD55 and CD59 are complement regulatory proteins suggested to be related with progression of diabetes and its complications. The stromal cell-derived factor 1 (SDF-1) and C-X-C chemokine receptor type 4 (CXCR-4) are chemokine proteins. We aimed to investigate the relation of CD55 and CD59 expression levels and polymorphisms of SDF-1 and CXCR-4 with type 2 diabetes mellitus (T2DM) and its complications. Seventy-five T2DM patients and 73 controls were enrolled. Expression levels of CD55 and CD59 were measured by FACS Calibur; qRT-PCR was used to determine SDF-1 and CXCR-4 gene polymorphisms. CD55 and CD59 expressions in patients with nephropathy, retinopathy and cardiovascular disease were significantly lower than controls. Frequency of CXCR-4 T allele carrying was high in patients and created 1.6 fold risk for the disease (p = .07). CXCR-4 a allele carriers had decreased nephropathy; although there was no statistical significance in carrying CXCR-4 T allele, presence of nephropathy was approximately 2 times higher (p = .254). The nephropathy risk increased 10-fold in CXCR-4 TT genotype carriers (p = .02). All SDF-1 CC genotype carriers had retinopathy, so, it was considered that the CC genotype was effective in retinopathy development (p = .031). For the presence of cardiovascular disease, significant difference was observed for SDF-1 genotypes. Increased cardiovascular risk of 5- and 1.9-fold in SDF-1 T (p = .007) and CXCR-4 T (p = .216) allele carriers, respectively, was observed. We suggest that CD55 and CD59 protein levels and SDF-1 and CXCR-4 have predictive importance in process, complications and tendency of T2DM.

Atypical cells parameter in an automated urine analyzer: Does it have a future?

Sysmex UN-Series automated urine analyzer has recently introduced "atypical cells" parameter. These cells are supposed to be epithelial cells with features of suspicion for a neoplastic proliferation. Atypical cells parameter in urinalysis should be considered to be as useful as the blast parameter in hematology. However, it has many disadvantages compared to its counterpart. I suggest it should be used as a caution flag rather than a quantitative value to appear in the patient result page. A decision limit must be defined; perhaps the color parameter should be matched to define patients with both hematuria and atypical cells.

The Comparison of the Morphological and Syntactic Awareness Skills of Deaf and Hard of Hearing Students Regarding Agreement and Tense Categories that Exist in Verbs in Reading Activities with those of Students Without Hearing Disabilities.

The difficulties in learning skills that deaf and hard of hearing students encounter stem from morphology and syntactic morphology (morpho-syntax) and it is clear that there are limited studies related to these. In this study, it is aimed at examining hearing and deaf and hard of hearing students' morpho-syntactic actions which are compatible with the Turkish Sign Language and the awareness skills of these actions in the time categories. In total 122 students; 57 deaf and hard of hearing students from secondary and high school and 65 hearing students have participated this study. The data is gathered through DMASTR and SuperLab 5 software programs where data is collected by a process with a "word reading method" and "an inclusion of agreement and tense categories in actions". In the outcome of the study it is identified that students hard of hearing had an underachievement in the agreement and tense categories compared to hearing students. At the agreement category, in terms of reading duration it is seen that deaf students' verbs with disagreement compared with verbs with agreement, they read faster. In the tense category, it is clear that deaf and hard of hearing students' accuracy rate of reading words have got similarities in the categories of past and future tenses whereas they have got inadequacies in the present tense, when the data is observed in terms of the speed of reaction and reading duration, it is seen that they are more successful in the past tense. In accordance with these findings, it is indicated that hard of hearing students have shared the same reading skills with their hearing peers whereas they had plenty of difficulties related to reading skills some of them which are from the fields of morphology and syntactic morphology, in the steps of formal education.

Regional distribution of genetic mutation in lung cancer in Turkey (REDIGMA).

INTRODUCTION: The results of standard chemotherapy in lung cancer are not very satisfactory, so it is important to identify genetic mutations that provide targeted therapies. Recent reports have suggested influences of racial difference on the frequency of mutation in lung cancer. We aimed to determine the frequency and regional distribution of genetic mutations of non-small cell lung cancer (NSCLC) in Turkey. MATERIALS AND METHODS: Regional distribution of genetic mutations in lung cancer in Turkey (REDIGMA) study was carried out as a prospective, cross-sectional, observational study in a large number of centers in which lung cancer patients were followed and could perform genetic mutation analysis on patients' biopsy materials. RESULT: The 703 patients (77.7% male, mean age 63.3 ± 12.5 years) who were diagnosed as NSCLC from 25 different centers were included in the study. Tumor samples from patients were reported as 87.1% adenocarcinoma, 6.4% squamous cell carcinoma and 6.5% other. Mutation tests were found to be positive in 18.9% of these patients. The mutations were 69.9% EGFR, 26.3% ALK, 1.6% ROS and 2.2% PDL. Mutations were higher in women and non-smokers (p<0.000, p<0.001). Again, the frequency of mutations in adenocarcinoma was higher in metastatic disease. There was no difference between the patient's age, area of residence, comorbidity and clinical stage and mutation frequency. CONCLUSIONS: Our study revealed that the EGFR mutation rate in Turkey with NSCLC was similar to East European, African-American and Caucasian patients, and was lower than in East Asia.

A Picture Database for Verbs and Nouns with Different Action Content in Turkish.

In this study we present a picture database of 160 nouns and 160 verbs. All verbs and nouns are divided into two groups as action and non-action words. Age of acquisition, familiarity, imageability, name agreement and complexity norms are reported alongside frequency, word length and morpheme count for each word. Data were collected from 600 native Turkish adults in total. The results show that although several measures have weak correlations with each other, only age of acquisition had moderate downhill relationships with familiarity and frequency with familiarity and frequency having a rather strong positive correlation with each other. The norms and the picture database are available as supplemental materials for use in psycholinguistic studies in Turkish.

Platelet indices in obstructive sleep apnea: the role of mean platelet volume, platelet distribution widht and plateletcrit.

INTRODUCTION: Because studies report controversial findings of mean platelet volume (MPV) and platelet distribution width (PDW), we aimed to investigate platelet indices in patients with obstructive sleep apnea (OSA). MATERIALS AND METHODS: One hundred seventy three patients with OSA and 43 control subjects included in analyses. Patients with an apnea-hypopnea index (AHI) ≥ 5 were considered to have OSA and an AHI < 5 were considered as control. Platelet indices (MPV, PDW, plateletcrit) were obtained from routine analysis of blood samples using an automated blood cell counter. RESULT: Among platelet indices, only PDW was higher in patients with OSA, especially in severe OSA when compared to control group (16.80 ± 0.56 vs. 16.21 ± 1.51, p= 0.015 and 16.82 ± 0.06 vs.16.21 ± 1.51, p= 0.014, respectively). Correlation analysis showed a significant but a weak correlation between the PDW and AHI (r= 0.161, p= 0.018) and the PDW and the desaturation index (r= 0.171, p= 0.016). The ROC curve analysis showed that the optimal cut-off value, distinguishing patients with OSA from those in control group, for PDW was 16.62 (sensitivity 57.8%, specificity 58.1%, AUROC 0.60, p= 0.042). After the exclusion of patients with comorbid diseases (cardiovascular diseases, diabetes mellitus and chronic inflammatory diseases), we also found weak but a significant correlation between PDW and AHI (r= 0.179, p= 0.040). CONCLUSIONS: In conclusion, among the platelet indices, only PDW was found to be higher in patients with OSA, especially in severe OSA. PDW was also correlated with apnea-hypopnea index and oxygen desaturation index.

The Cutoff Level for Urine Protein in Urine Immunofixation Electrophoresis.

BACKGROUND: Immunofixation electrophoresis (IFE) maintains its importance in diagnosing monoclonal gammopathies. In particular, urine IFE detects free light chains (FLC) in urine samples even at low concentrations and offers higher sensitivity compared to serum electrophoresis and serum IFE. The aim of the present study was to determine the place and significance of quantitative urinary protein measurement before IFE in interpreting the results of subsequent IFE and to determine the most appropriate protein concentrations for the appearance of bands. METHODS: The records of a total of 600 patients, who underwent screening for Bence Jones proteinuria using IFE on 24-hour urine, were retrospectively reviewed. Urine IFE was performed using Helena SAS-I and SAS-I devices. The total protein concentration in the urine was quantitatively determined by the Pyrogallol red method, and the urine albumin level was determined using the immunoturbidimetric method. These analyses were measured on an Olympus/Beckmann AU5800. RESULTS: The evaluation of IFE results revealed that 311 patients had normal results, 108 patients had monoclonal bands, five patients had biclonal bands, 28 had polyclonal bands, and 148 patients had various degrees of proteinuria. ROC curves were created in order to determine the most appropriate urinary protein and albumin levels to observe bands in IFE. Accordingly, urine baseline protein level (mg/dL) showed the highest AUC value (cutoff value: 19.4 mg/dL, sensitivity: 92%, specificity: 98.2%, AUC: 0.972). CONCLUSIONS: The present study showed that quantitative protein measurement before IFE eliminated the disadvantages associated with the IFE method and its interpretation.

Multiple myeloma: relationship to antioxidant esterases.

OBJECTIVE: To investigate the status of the oxidant/antioxidant balance in patients with multiple myeloma compared to healthy controls. MATERIALS AND METHODS: This study was conducted on 40 multiple myeloma patients and 40 healthy controls of matched age and sex. Serum total thiol, oxidative stress index (OSI), total oxidant status (TOS), and total antioxidant status (TAS) were measured using colourimetric methods; paraoxonase-1 and arylesterase enzyme activities were also quantified. RESULTS: Serum paraoxonase-1 and arylesterase activities and total thiol levels were significantly lower (p = 0.0001, p = 0.036 and p < 0.0001, respectively), whereas TOS and OSI levels were significantly higher (p < 0.0001 for both parameters) in multiple myeloma patients compared to controls. However, no significant differences in TAS were identified when the two groups were compared. CONCLUSIONS: Our findings indicate an impaired oxidative/antioxidative balance in multiple myeloma. We recommend further studies with larger groups to investigate the possible relationship between oxidative stress and the aetiopathogenesis of multiple myeloma.

Investigating Sensitivity to Auditory Cognition in Listening Effort Assessments: A Simultaneous EEG and Pupillometry Study.

BACKGROUND: It is still not fully explained what kind of cognitive sources the methods used in the assessment of listening effort are more sensitive to and how these measurement results are related to each other. The aim of the study is to ascertain which neural resources crucial for listening effort are most sensitive to objective measurement methods using differently degraded speech stimuli. METHODS: A total of 49 individuals between the ages of 19 and 34 with normal hearing participated in the study. In the first stage, simultaneous pupillometry, electroencephalogram (EEG), and single-task paradigm reaction time (RT) measurements were made during the challenging listening and repetition task with noise-vocoded speech. Two speech reception thresholds (SRT) (50% and 80%) for two vocoding conditions (16 and 6 channels) were collected, resulting in 4 conditions. In the second stage, the Rey Auditory Verbal Learning Test (RAVLT) and the test of attention in listening (TAIL) were applied. Stepwise linear regression analyses were conducted to examine the predictors of listening effort measurements. RESULTS: A significant difference was found between 6 and 16 channel stimuli in both pupil dilation change and EEG alpha band power change. In the hardest listening condition, whereas RAVLT scores are significant predictors of pupil dilation change, TAIL scores are significant predictors of EEG alpha power. As the stimulus difficulty decreased, the factors that predicted both EEG and pupillometry results decreased. In the single-task paradigm, a significant regression model could not be obtained at all four difficulty levels. CONCLUSION: As a result of the study, it was found that the pupil dilation change was more sensitive to auditory memory skills and the EEG alpha power change was more sensitive to auditory attention skills. To our knowledge, this study is the first to investigate the sensitivity of different listening effort measurement methods to auditory cognitive skills.

Pupillary dilation response to the auditory food words in adolescents with obesity without binge eating disorder.

Childhood obesity is a growing global public health problem. Studies suggest that environmental cues contribute to developing and maintaining obesity. We aimed to evaluate pupillary changes to auditory food words vs. nonfood words and to conduct a dynamic temporal analysis of pupil size changes in adolescents with obesity without binge eating disorder by comparing healthy-weight adolescents. In this study, a total of 63 adolescents aged 12-18 years (n = 32, obesity group (OG); n = 31, control group (CG)) were included. In an auditory paradigm, participants were presented with a series of high and low-calorie food and nonfood words. A binocular remote eye-tracking device was used to measure pupil diameter. Generalized additive mixed models (GAMMs) were used for dynamic temporal analysis of pupillometry data. The results of GAMM analysis indicated that CG had larger pupil dilation than the OG while listening to auditory food words. CG had larger pupil dilation in food words than in nonfood words. However, the OG had a similar pupillary response in food and nonfood words. Pupil dilation response to higher-calorie foods was extended over the later stages of the time period (after 2000 ms) in the OG. In summary, our findings indicated that individuals with obesity had lower pupil dilation to auditory food words compared to normal-weight peers. Adolescents with obesity had prolonged pupillary dilation in higher calories of food words. The individual psychological factors affecting the dynamic changes of pupil responses to food cues in adolescents with obesity should be examined in further studies.

Eighty-One Percent of Unrepaired Interportal Capsulotomies Showed Healed Capsules on Magnetic Resonance Imaging 5 Years After Primary Hip Arthroscopy.

Purpose: To evaluate whether unrepaired interportal capsulotomy presents with capsular defect on magnetic resonance imaging (MRI) 5 years after primary hip arthroscopy and to determine its effect on functional results and findings of osteoarthritis on radiographs or MRI scans. Methods: Patients with femoroacetabular impingement (without arthritis or dysplasia) were retrospectively reviewed after arthroscopic labral repair or debridement and femoroplasty through interportal capsulotomy without closure. Patients were assessed preoperatively and at a minimum of 5 years postoperatively using patient-reported outcomes (Hip Outcome Score-Activities of Daily Living scale, modified Harris Hip Score, and visual analog scale pain score), radiographic measures, and MRI scans. Results: Forty patients (42 hips) were deemed eligible for the study and were evaluated. Of the hips, 81% had healed capsules, whereas 8 (19%) had capsular defects on the latest MRI scan. There were 3 hips with subchondral edema in the defect group compared with 1 in the healed-capsule group (P = .01) on the latest MRI scan, which was not present on preoperative MRI (still positive on multivariate analysis when the preoperative alpha angle was also taken into consideration). Functional results did not differ between the groups (P > .05). Conclusions: In this study, 81% of interportal capsulotomies healed without repair at 5 years after primary hip arthroscopy. Clinical Relevance: Understanding the prevalence and implications of unhealed capsulotomies could encourage surgeons to be meticulous in capsular closure.

How Do Exercise, Sleep and Depression Affect Disease Scores and Quality of Life in Primary Sjögren's Syndrome Patients?

Purpose: Primary Sjögren's syndrome (PSS) has many effects such as fatigue, pain, physical activity limitation and sleep disturbance, which limit patient's daily and social lives. The aim of our study was to assess fatigue, depression, physical activity status and quality of life in patients with PSS, and to determine the relationship between these data and disease-related parameters. Patients and Methods: This study was conducted with 117 primary Sjögren's syndrome patients. Demographic and anthropometric characteristics, disease activity (ESSDAI), quality of life scale (SF36), depression (Beck Depression Scale), physical activity status (International Physical Activity Questionnaire Short Form (IPAQ) score) and sleep status (Pittsburgh Sleep Quality Scale) of PSS patients were evaluated and relationships have been examined. Results: According to the results of our study, we found that sleep disorders are common in PSS patients (74.4%). Overweight patients, particularly higher lean mass sleep better (r:-0.201, p:0.043). Poor sleep causes fatigue (p=0.062) and depression (p=0.030). Sleep disturbance could not be explained by depressive state alone. However, after controlling for depression, the effect of sleep on fatigue seriously decreases (p=0.311). Exercise did not improve sleep quality (p=0.35) and the rate of poor sleep was higher among who exercised (p=0.192). Conclusion: Based on the results of our study, we believe that, treating depression in PSS patients is crucial for reducing fatigue. Patients need education on performing the correct exercises and weight gain should done in a professional manner. Gaining a deeper understanding of the multisystem involvement of the disease and the impact of exercise on the disease, will have positive effects on patient care and treatment decisions.