DHBW Ravensburg

This paper unveils a cutting-edge end-to-end learning approach to tackle laser phase noise in coherent optical orthogonal frequency-division multiplexing (CO-OFDM) fiber communications. Inspired by the autoencoder concept, a powerful deep neural network, the proposed approach tackles this challenge by learning resilient symbol sequences that can withstand laser phase noise impairments, even from low-cost distributed feedback lasers with linewidths up to 2 MHz. This makes it ideally suited for high-order modulation formats and large FFT sizes in CO-OFDM systems, where maximizing spectral efficiency is crucial. By eliminating the need for computationally intensive conventional techniques, this approach opens the door to a simpler, potentially more efficient solution.

Background Increased levels of physical activity are associated with a reduction of breast cancer mortality, especially in postmenopausal women with positive hormone receptor status. So far, previous observational case–control and cohort studies have focused on associations between overall leisure time physical activity and survival of women with breast cancer in general. Methods In this multicenter prospective cohort study, conducted in Germany between 30th August 2012 to 29th December 2017, we investigated general physical activity in a homogenous sample of n = 1440 postmenopausal women with advanced (inoperable locally advanced or metastatic), hormone receptor-positive breast cancer receiving the same therapy (everolimus and exemestane). Self-reported physical activity was assessed using the Godin Leisure Time Exercise Questionnaire (GLTEQ) before and every 3 months during treatment. Participants were then classified into “active” and “insufficiently active” to screen their activity behavior the week prior to medical treatment. In addition, changes in physical activity patterns were assessed. Adjusted Cox regression analyses were performed for the activity categories to determine hazard ratios (HR). Besides progression-free survival (PFS), adverse events (AEs), QoL, and fatigue were assessed every 3 months until study termination. Results Compared to “insufficiently active” patients, “active” individuals indicated a significantly longer PFS (HR: 0.84 [0.74; 0.984], p = .0295). No significant differences were observed for changes of physical activity behavior. Patients who reported to be “active” at baseline revealed significantly fewer AEs compared to “insufficiently” active patients. In detail, both severe and non-severe AEs occurred less frequently in the “active” patients group. In line with that, QoL and fatigue were better in physical “active” patients compared to their insufficient active counterparts at the last post-baseline assessment. Participants who remained or become active indicated less AEs, a higher QoL, and reduced fatigue levels. Conclusions Physical activity behavior prior to medical treatment might have prognostic value in patients with advanced breast cancer in terms of extending the PFS. Moreover, physical activity before and during treatment may reduce treatment-related side effects and improve patients’ QoL and fatigue. Trial registration EUPAS9462. Registered 30th October 2012 “retrospectively registered.”

Anamnese und klinischer Befund Eine 59-jährige, gesunde und aktive Frau litt nach durchgemachter Corona-Infektion unter einem ausgeprägten körperlichen und kognitiven Fatigue-Syndrom im Sinne eines Post-COVID-Syndroms. Diese Einschränkungen waren von außen nicht erkennbar. Der Leidensdruck der Betroffenen war groß – mit depressiven Stimmungsschwankungen und Zukunftsängsten in der Folge. Eine stationäre Rehabilitationsbehandlung schaffte keine Linderung. Eine Berentung war notwendig. Diagnostik Die Fatigue-Skala für Motorik und Kognition FSMC [1] lässt eine Einschätzung des Ausmaßes der motorischen und kognitiven Fatigue-Symptomatik zu. Therapie und Verlauf Der ATP-Wert (Adenosintriphosphat) charakterisiert die Mitochondrien-Funktion der Zellen. Seine Bestimmung kann als Maß für die einem Patienten zur Verfügung stehenden Energiereserven dienen. Der verminderte ATP-Wert deckt sich mit der Selbsteinschätzung der Erschöpfung auf einer Skala von 1–10. Ein Pacing-System – mit Dokumentation der Beschwerden und Einteilung in Schweregrade – ermöglichte der Patientin einen Zugang zu ihrer körperlichen Leistungsfähigkeit und zu ihren emotionalen Reaktionen. Folgerung Die Tagesplanung nach einer Prioritätenliste und abhängig von den Körpersymptomen lässt optimistisch in die Zukunft blicken. Die Patientin benötigt für den Heilungsverlauf Geduld.