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We stratified post-COVID patients into four newly established clinical groups based on the presence or absence of at least one subjective respiratory symptom and at least one objective sign of pulmonary involvement. Nearly half of outpatients and one third of hospitalized post-COVID patients had objective signs of pulmonary involvement without accompanying subjective respiratory symptoms three months after diagnosis.

Our customer preference model is based on aggregation of partly linear relaxations of value filters often used in e-commerce applications. Relaxation is motivated by the Analytic Hierarchy Processing method and combining fuzzy information in web accessible databases. In low dimensions our method is well suited also for data visualization. The process of translating models (user behavior) to programs (learned recommendation) is formalized by Challenge-Response Framework ChRF. ChRF resembles remote process call and reduction in combinatorial search problems. In our case, the model is automatically translated to a program using spatial database features. This enables us to define new metrics with visual motivation. We extend the conference paper with inductive ChRF, new representation of user and an additional method and metric. We provide experiments with synthetic data (items) and users.

This position paper has been drafted by experts from the Czech national board of diseases with bronchial obstruction, of the Czech Pneumological and Phthisiological Society. The statements and recommendations are based on both the results of randomized controlled trials and data from cross-sectional and prospective real-life studies to ensure they are as close as possible to the context of daily clinical practice and the current health care system of the Czech Republic. Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable heterogeneous syndrome with a number of pulmonary and extrapulmonary clinical features and concomitant chronic diseases. The disease is associated with significant mortality, morbidity and reduced quality of life. The main characteristics include persistent respiratory symptoms and only partially reversible airflow obstruction developing due to an abnormal inflammatory response of the lungs to noxious particles and gases. Oxidative stress, protease-antiprotease imbalance and increased numbers of pro-inflammatory cells (mainly neutrophils) are the main drivers of primarily non-infectious inflammation in COPD. Besides smoking, household air pollution, occupational exposure, low birth weight, frequent respiratory infections during childhood and also genetic factors are important risk factors of COPD development. Progressive airflow limitation and airway remodelling leads to air trapping, static and dynamic hyperinflation, gas exchange abnormalities and decreased exercise capacity. Various features of the disease are expressed unequally in individual patients, resulting in various types of disease presentation, emerging as the "clinical phenotypes" (for specific clinical characteristics) and "treatable traits" (for treatable characteristics) concept. The estimated prevalence of COPD in Czechia is around 6.7% with 3,200-3,500 deaths reported annually. The elementary requirements for diagnosis of COPD are spirometric confirmation of post-bronchodilator airflow obstruction (post-BD FEV1/VCmax

Introduction: The aim of this study was to evaluate technique of inhalation in response to targeted education in large COPD population during anuall follow up. Methods: Patients enrolled consecutively into Czech Multicentric Research Database of COPD were prospectively assessed during four years. The inhaler technique was measured annually by a pulmonary nurse specialists using a previously validated and published scoring instrument (Five Steps Assessment). Training focused on all detected errors was done subsequently. Results: Five hundred forty six COPD subjects (25% female;66.7 years;FEV1 45%) were included. Most (88%) used two or more types of inhalers. Four hundred and eight (75%) subjects were treated by DPI plus non-DPI inhalers. The overall error rate declined progressively during four years of follow up. Significant differences between DPI and non-DPI was not found. Completely correct inhalation technique was found at 31%; 45%; 55%; 80% and 88% of inhalers at baseline; after 1 year; 2 years; 3 years and 4 years. Conclusion: Presented study demonstrated clearly the posivite effect of regular assessment and targeted training on correct inhalation technique in real-life COPD population. Registration number of this study: Clinicaltrials.gov NCT01923051.

Introduction: Various characteristics (e.g. FEV1, BMI) or composite tools are used to asess prognosis in COPD patients. Some of these tools are time-consuming and may be unpractical for use in daily practice. Aims: Our aim was to analyze prognostic performance of COPD phenotypes, treatable traits and GOLD stages + groups in relation to long-term outcomes. Methods: We analyzed 5-year survival of 720 patients of the Czech Multicenter Research Database of COPD. Kaplan-Meier (KM) analysis was performed to estimate survival for Spanish phenotypes, Czech guidelines-defined treatable traits and GOLD stages + groups. Moreover, we performed a classification tree analysis to assess the role of confounders. Results: KM analysis showed GOLD stage IV (HR 2.42) and group D (HR 2.77) being associated with poor outcome (both p Conclusion: For a tentative prognosis assessment, careful description of COPD characteristics and comorbidities may be sufficient.

Background: Association between nutrition status and mortality in COPD patients was studied in a limited number of studies. Nutrition status can affect mortality rate. Aim: To assess mortality in COPD patients from the Czech Multicentre Research Database of COPD (CMRD) according to nutrition status. Methods: CMRD of COPD is a multicenter observational real-life prospective study of patients with COPD and post bronchodilator FEV1≤60 %, with enrolled 784 consecutive patients. Patients with assessed Body Mass Index (BMI) and Fat-Free Mass Index (FFMI) at the baseline were included into analysis. Their nutrition status was determined and mortality during 5-years follow-up was evaluated. Results: A total of 343 patients were included into the analysis, 253 men, ex-smokers 73.5 %, mean age 66.6 years, mean FEV1 44.9 %, mean BMI 27.3, average CAT 16.8. There were 18.9 % patients with poor nutrition (incl.cachexia and underweight), 18.1 % normal, 32.1 % overweight and 30.9 % obese patients. Hazard ratio of death HR (95% CI) was 2.398 (1.20-4.778) for patients with underweight, 0.514 (0.288-0.918) for patients with overweight and and 0.682 (0.392-1.188) for obese patients, compared to patients with normal BMI and FFMI (p Conclusion: Nutrition status can be used as a marker for prediction of mortality in COPD patients. The highest mortality in 5-years follow-up was in underweight patient and the lowest in overweight group. Using of combined FFMI and BMI assessment improved prediction of mortality in COPD in comparison to using BMI only.

Rationale: Upper and lower airways are considered a unified functional unit in the field of bronchial asthma. Presence of upper and lower respiratory symptoms in a cohort of COPD patients is discussed. Methods: The presence of upper (SNOT-22 questionnaire), and lower (mMRC scale, CAT questionnaire) respiratory symptoms were assessed in a group of non-mild COPD subjects from Czech Multicentre Research Database of COPD over the course of three years. Patients were stratified according to the GOLD guidelines, predefined clinical phenotypes (one patient = one phenotype), and basic treatable traits (one or more for each patient). Results: 614 COPD individuals (66.3yrs;73%males;post-BDFEV144.7%;RV/TLC182%;TLco53%) were enrolled. Of these 432, 345, and 216 were eligible for one, two, and three-yrs follow-up. Baseline total CAT score (15.7) correlated (Figure 1) with SNOT-22 (17). The same correlation was apparent in all eight CAT-items and SNOT-22. The total CAT scores positively correlated with SNOT-22 over all three yrs (p Conclusion: Upper respiratory symptoms and lower respiratory symptoms in non-mild COPD individuals correlated in cross-sectional and prospective analyses. Some of the treatable traits, and GOLD categories were related with more pronounced upper respiratory symptoms.

Our customer preference model is based on aggregation of partly linear relaxations of value filters often used in e-commerce applications. Relaxation is motivated by the Analytic Hierarchy Processing method. In low dimensions our method is well suited also for data visualization.

Introduction: The importance of COPD phenotyping is currently discussed across respiratory expert panels. The Czech national COPD guidelines recognize 6 different COPD phenotypes represented by bronchitic, emphysematous, COPD/asthma overlap, cachexia, frequent exacerbator and COPD/bronchiectasis. The Czech multicenter research database of COPD (CMRD) is a prospective project focused on long-term mortality and on disease evolution in a real-life COPD patient cohort. Aims: Our aim was to assess differences in long-term all-cause mortality in the CMRD cohort with respect to the above mentioned phenotypes and their combinations. Methods: Prospective data from the CMRD cohort (comprising 784 COPD patients) were analyzed. Kaplan-Meier (KM) survival plots have been calculated for each phenotype and for their most abundant combinations. Results: KM survival analysis revealed that emphysematous (p=0.005), cachectic (p Conclusion: Our results suggest that a cluster phenotypic approach might be valuable for identifying COPD subpopulations at high risk of poor outcome.

Aim: To assess the nutrition and muscle mass loss in patients with severe COPD and its phenotypes. Methods: We analysed baseline data of patients with severe COPD from the Czech Multicenter Research Database. We assessed BMI (Body Mass Index), FFMI (Fat Free Mass Index) measured by Skinfold Anthropometry and MAMC (Mid-arm muscle circumference) in non-dominant upper arm. Results: A total of 337 patients were included in the analysis, 248 men, mean age 66.7 years, mean FEV1 44.9%, average CAT 16.8. There were 10.1% patients with cachexia, 5.1% with underweight, 31.2 % patients were obese. Total of 79.5% patients had normal muscle mass, 20.5% had muscle mass loss. Emphysematic phenotype was associated with cachexia (p=0.02), underweight and muscle mass loss (p=0.002), obesity was less common in emphysematic phenotype (p Conclusion: Poor nutrition status and non-physiological muscle mass loss are associated with certain COPD phenotypes, with worse lung function and with higher frequency of symptoms and exacerbations. Prospective follow-up and prognostic evaluation of nutritional status will continue.

Introduction: According to the GOLD 2017 guidelines, the assessment of COPD is based on symptoms and exacerbation history. Currently, major part of COPD patients is classified stage B. This fact stresses the need for identifying risk factors of mortality in subpopulations of COPD patients. Aims: Our aim was to identify risk factors predictive of severe outcome in COPD patients. Methods: Prospective data from the Czech research database of COPD were analyzed with emphasis on respiratory parameters. Patients that completed blood gas examination and 36 months of follow-up were included. Kaplan-Meier survival plots were calculated for each pre-defined parameter (oxemia, capnemia, hemoglobin saturation, minimal saturation at rest or during 6MWT) for COPD patients overall and for subgroups with stage B and D. Analyses were performed for both GOLD 2016 and 2017 guideline. Results: To date, 722 patients were included in the registry. According to GOLD 2016 guidelines, 20.2% of these patients were classified stage B. Following the GOLD 2017 guidelines, the portion of stage B patients was 53.0%. Overall 391 patients met the inclusion criteria for our study. We have found significant differences in 3-year mortality in patients with COPD stage B if moderate hypoxemia (p Conclusion: Moderate hypoxemia, decreased saturation and minimal saturation at rest or at 6MWT predict outcome in patients with COPD stage B.

Introduction: Physical activity is the 4 th leading risk factor for global mortality. Healthy people who have less than 5000 steps per day are very inactive. However, there is not enough information which amount of steps per day can adversely affect mortality in patients with chronic obstructive disease (COPD). This study aimed to evaluate functional status, the level of daily physical activity (DPA) in patients with COPD and assess the association between DPA and mortality in following 3 years. Methods: DPA was evaluated in 174 patients (FEV 1 = 44.6%; 66.2 years) from the Czech Multicentre Research Database of COPD. Patients wore pedometer daily for 1 month. Pulmonary functions, exercise tolerance, COPD assessment test, mortality indexes were assessed at baseline. We monitored mortality in this group in following 3 years. Results: According to ROC analysis we confirmed that less than 4000 steps per day are a limit for higher mortality in patients with severe COPD. Furthermore, lower DPA than 4000 steps per day is associated with significantly worse functional status (Table 1). Conclusion: From given results it can be concluded that maintaining DPA higher than 4000 steps per day in patients with severe COPD should be one of the most important goals of treatment to avoid functional decline and mortality in these patients.

Introduction and objectives: COPD is a heterogeneous disorder associated with significant mortality. Prognostic markers or indices are needed especially in populations with severe COPD. The main objective was to develop a risk score for predicting death, and to compare this score with already existing indices (BODE, ADO, Yokohama). Methods: A total of 637 patients were involved in the analysis. The patient cohort was divided into a training set (N=453, 71%) and a testing set (N=184, 29%). The best cut-off values for predicting death were determined for all of the aforementioned variables by applying ROC analysis on the training set, and two risk scores were subsequently developed. The first index corresponded to the sum of statistically significant binary parameters based on the Cox proportional hazards model. In the second index, individual factors were HR-weighted. Both new indices were tested on the testing set. Finally, long-term survival and the abilities of new and existing indices (BODE, ADO, Yokohama) to predict deaths were compared; the existing indices had also been categorised by the ROC analysis. Results: The abilities of new and existing indices to predict death were compared: while the BODE index (with cut-off value ≥ 4) showed the highest sensitivity (0.870), the newly developed indices showed the highest specificity (0.702 and 0.702 for the first and second index, respectively) and the highest overall accuracy (0.693 and 0.710 for the first and second index, respectively). Conclusion: It was confirmed that indices represent a useful tool for predicting death in COPD patients. The BODE index has the highest sensitivity, whereas newly developed indices display higher specificity and overall accuracy.

Background: COPD is a condition with several clinical variants:non-exacerbation phenotype(NON-AE),frequent exacerbations with chronic bronchitis(AE CB),frequent exacerbations without chronic bronchitis(AE NON-CB),and asthma–COPD overlap syndrome(ACOS).The evolution of COPD phenotypes in time and their impact on lung function and symptoms remains largely unknown. Methods: The Czech Research Database of COPD(NCT01923051)is a multicentre,observational,and prospective study of consecutive patients with severe COPD.Signs identifying phenotypes, lung function, and respiratory symptoms were assessed annually. Results: 647 severe COPD subjects were enrolled until Jan 16. 113 of them were eligible for two-year analysis (66.8±9.1yrs,73.8% males,post-BD FEV 1 43.0±17.7%).On the whole 62.6% were NON-AE,18.8% were AE CB, 7.1% were AE NON-CB,and 11.5 % were ACOS subjects.We found apparent differences in term of COPD phenotypes stability during follow-up.There were stable (ACOS,and NON-AE) and unstable (AE CB, and AE NON-CB) phenotypes (Fig1). With respect to changes of lung function and symptoms we noted significant differences between above mentioned phenotypes. Conclusion: Two clinical phenotypes (ACOS and NON-AE) of subjects with severe COPD we can described as stable over time.Significant differences in FEV 1 declination and symptoms evolution between different COPD phenotypes in the prospective two-year evaluation were noted.

In this paper we are concerned with user understanding in content based recommendation. We assume having explicit ratings with time-stamps from each user. We integrate three different movie data sets, trying to avoid features specific for single data and try to be more generic. We use several metrics which were not used so far in the recommender systems domain. Besides classical rating approximation with RMSE and ratio of order agreement we study new metrics for predicting Next-k and at least 1-hit at Next-k. Using these Next-k and 1-hit we try to model display of our recommendation --- we can display k objects and hope to achieve at least one hit. We trace performance of our methods and metrics also as a distribution along each single user. We define transparent and complicated users with respect to number of methods which achieved at least one hit. We provide results of experiments with several combinations of methods, data sets and metrics along these three axes.

We consider the problem of user-item recommendation as a multiuser instance ranking learning. A user-item preference is monotonizable if the learning can restrict to monotone models. A preference model is monotone if it is a monotone composition of rankings on domains of explanatory attributes (possibly describing user behavior, item content but also data aggregations). Target preference ordering of users on items is given by a preference indicator (e.g. purchase, rating).

Introduction and Aims: COPD is a heterogeneous syndrome marked by pulmonary obstruction and the presence of multiple comorbidities. The high incidence of cardiovascular disease in patients with COPD may be the result of common risk factors, particularly smoking, systemic inflammation and hypoxia.The aim of this work is to examine the cardiovascular status of patients with a severe form of COPD (post-BD FEV1 Method: The analyzed data is taken from The Czech Multicenter Database of COPD[1], a prospective study. This is the first-stage analysis at enrollment. Results: The presence of cardiovascular disease was analyzed in 343 patients. Ischemic heart disease (IHD) was present in 25.9%, heart failure (HF) 13.7%, atrial fibrillation 13.1% and hypertension 53.9%. Cachexic patients were less likely to have hypertension and HF (p= 0.055, p=0.002 respectively). The presence of IHD was statistically significant in patients with Asthma COPD overlap syndrome (p= 0.035). The incidence of hypertension was most significant in the D category (GOLD 2011) (57.3%, p=0.036). The use of cardiovascular medications was monitored; Diuretics 38.5%, ACEI 32.9%, Antiaggregants 32.7%, Statins 28.9%, Calcium antagonists 21.3%, Amiodarone 5.5%. Betablockers are used by 23%, out of which 2.4% used a known non-selective betablocker. Conclusions: Some COPD phenotypes seem to have a higher prevalence to certain types of comorbidities. Due to the high prevalence of heart disease in COPD patients, cardiovascular diseases should be actively searched for in clinical practice. NCT 01923051. 1. Novotna B et al. Czech multicenter research database of severe COPD. Int J Chron Obstruct Pulmon Dis. 2014 Nov 10;9:1265-74.

In this paper, we present an algorithm for evaluating the similarity of pairs of signs used in sign language. The proposed algorithm is based on the visual similarity on the sign and compares sequences of static positions of the signing person. The algorithm does not rely on any particular way of obtaining necessary geometric form of signs. The usability of the proposed algorithm has already been tested in its pilot implementation in a dictionary between Czech and Czech sign language. Geometric data available for a 3D animated model was used to enhance the dictionary with the possibility of searching for signs in dictionary according to partial information obtained from the user as well as retrieval of visually similar signs for a currently selected one.

Object databases are usually referring to those data management products that are specifically designed for use with an object programming language and are very closely coupled with one or more object programming languages. Typically, the most of the recent OODBMSs use C++ and/or Smalltalk languages as their database programming language. The application programmer may access database objects directly using the database operations in the programming language, or may perform associative lookups of objects using the query language. Unfortunately, the latter includes many problems concerning both the design of such languages and their implementation. Two significant development lines are recently at disposal: ODMG-93 standard with its language OQL [Ca93] and the work proposed by the ANSI X3H2 group well-known as SQL3 [Me94] that stores objects in special kinds of columns in relations.