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The combined impact of new computing resources and techniques with an increasing avalanche of large datasets, is transforming many research areas and may lead to technological breakthroughs that can be used by billions of people. In the recent years, Machine Learning and especially its subfield Deep Learning have seen impressive advances. Techniques developed within these two fields are now able to analyze and learn from huge amounts of real world examples in a disparate formats. While the number of Machine Learning algorithms is extensive and growing, their implementations through frameworks and libraries is also extensive and growing too. The software development in this field is fast paced with a large number of open-source software coming from the academy, industry, start-ups or wider open-source communities. This survey presents a recent time-slide comprehensive overview with comparisons as well as trends in development and usage of cutting-edge Artificial Intelligence software. It also provides an overview of massive parallelism support that is capable of scaling computation effectively and efficiently in the era of Big Data.

BackgroundThis study investigates the association between frailty and mortality in Eastern European populations, which remains largely unexplored compared with Western Europe. The aim is to assess the risk of all-cause and cardiovascular mortality associated with varying levels of frailty.MethodsA prospective multicentre cohort study was conducted, involving random population samples from the Czech Republic, Poland and Lithuania. The baseline survey (2002–2005) included 26 746 individuals aged 45–69 years, with an average follow-up of 13 years. Frailty was measured using a Comprehensive Geriatric Assessment (CGA)-based Frailty Index (FI), calculating the number of deficits in each domain. Cox proportional regression models and inverse probability weighting (IPW) were employed to account for risk factor differences among the frailty groups: robust, prefrail, mild, moderate and severe.ResultsThe study included 14 287 people, among whom 891 were frail, with a total of 2402 deaths.Compared with non-frail persons, those with mild (IPW HR 2.06, 95% CI 1.60 to 2.66) and severe (IPW HR 2.71, 95% CI 1.45 to 5.07) frailty had more than twofold elevated risk of all-cause mortality. For cardiovascular mortality, the corresponding HRs were (IPW HR 3.05, 95% CI 2.14 to 4.35) and (IPW HR 3.88, 95% CI 1.95 to 7.74). Men exhibited a higher mortality risk at all frailty levels only in unweighted analysis. Country-specific differences were not significant.ConclusionsA CGA-based FI is an independent predictor of all-cause and cardiovascular mortality, with even mild frailty increasing the risk. Implementing frailty assessments can improve health risk prediction in older adults from Eastern Europe.

ABSTRACT Background Evidence on the relationship between physical and cognitive functions remains inconsistent, and the role of sex differences is underexplored. This study examines the predictive value of a composite Physical Functioning Score (PFS) for cognitive function and assesses sex‐specific associations in an Eastern European population. Methods Data from 7309 participants (mean age 59 ± 7.3 years) from the Czech Republic and Poland arms of the HAPIEE study were analyzed. PFS was derived from a 23‐item measure including activity of daily living (ADL/IADL), grip strength, functional limitations, and physical activity. Cognitive function was assessed using standardized tests of memory, verbal fluency, and speed/concentration. Logistic regression, adjusted for demographic, lifestyle, and health factors, was used to examine the association between PFS and cognitive status. Model performance was evaluated using AUC‐ROC and cross‐validation. Results PFS exhibited a dose‐dependent association with cognitive impairment (adjusted odds ratios: 1.15 for moderate, 1.79 for low PFS, compared with higher PFS). PFS demonstrated robust predictive ability for cognition (AUC = 0.75). Sex differences were significant: women with moderate PFS had a 44% higher risk of cognitive impairment (OR: 1.44, 95% CI: 1.15–1.79), while those with low PFS had double the risk (OR: 2.28, 95% CI: 1.69–3.08). Associations were weaker in men, even at very low PFS (OR: 1.32, 95% CI: 0.91–1.92). Conclusions PFS is a practical tool for predicting cognitive decline, with stronger associations in women. Interventions to improve PF may preserve cognitive health, particularly in older women. Longitudinal studies are needed to confirm these findings.

BackgroundOlder adults are at greater risk for becoming severely ill from COVID-19; however, the impact of the pandemic on their economic activity and non-COVID-19-related healthcare utilisation is not well understood. The aim of this study was to examine the prevalence and predictors of COVID-19-related unemployment and healthcare utilisation in a sample of older adults across 27 European countries.MethodsWe used data from the Survey of Health, Ageing and Retirement in Europe COVID-19 Survey, collected between June and August 2020. Participants (n=52 061) reported whether they lost a job, forwent medical treatment and whether their appointment was postponed due to COVID-19. Three-level models were estimated for each outcome to test the effects of individual, household and country-level characteristics.ResultsThe mean prevalence of reported job loss, and forgone and postponed medical care was 19%, 12% and 26%, respectively. Job loss was associated with female sex, lower education and household income, and older age in women. For example, the OR of job loss, comparing primary versus tertiary (college) education, was 1.89 (95% CI 1.59 to 2.26). Forgone and postponed medical care was associated with older age in men, female sex and higher education. At the country level, postponed medical care was associated with more stringent governmental anti-COVID measures.ConclusionJob loss and lower healthcare utilisation for non-COVID-19-related reasons were common among older adults and were associated with several sociodemographic characteristics. Job loss appeared to disproportionally affect already economically vulnerable individuals, raising concerns about the exacerbation of social inequalities.

It is unclear whether the dose–response relationship between lung function and all-cause and cardiovascular mortality in the Central and Eastern European populations differ from that reported in the Western European and American populations. We used the prospective population-based HAPIEE cohort that includes randomly selected people with a mean age of 59 ± 7.3 years from population registers in Czech, Polish, Russian and Lithuanian urban centres. The baseline survey in 2002–2005 included 36,106 persons of whom 24,944 met the inclusion criteria. Cox proportional hazards models were used to estimate the dose–response relationship between lung function defined as FEV1 divided by height cubed and all-cause and cardiovascular mortality over 11–16 years of follow-up. Mortality rate increased in a dose–response manner from highest to lower FEV1/height 3 deciles. Adjusted hazard ratios (HR) of all-cause mortality for persons in the 8th best, the 5th and the worst deciles were 1.27 (95% CI 1.08‒1.49), 1.37 (1.18–1.60) and 2.15 (1.86‒2.48), respectively; for cardiovascular mortality, the respective HRs were 1.84 (1.29–2.63), 2.35 (1.67–3.28) and 3.46 (2.50‒4.78). Patterns were similar across countries, with some statistically insignificant variation. FEV1/height 3 is a strong predictor of all-cause and cardiovascular mortality, across full distribution of values, including persons with preserved lung function.

Background The association between impaired lung function and mortality has been well documented in the general population of Western European countries. We assessed the risk of death associated with reduced spirometry indices among people from four Central and Eastern European countries. Methods This prospective population-based cohort includes men and women aged 45–69 years, residents in urban settlements in Czech Republic, Poland, Russia and Lithuania, randomly selected from population registers. The baseline survey in 2002–2005 included 36,106 persons of whom 24,993 met the inclusion criteria. Cox proportional hazards models were used to estimate the hazard ratios of mortality over 11–16 years of follow-up for mild, moderate, moderate-severe and very severe lung function impairment categories. Results After adjusting for covariates, mild (hazard ratio (HR): 1.25; 95% CI 1.15‒1.37) to severe (HR: 3.35; 95% CI 2.62‒4.27) reduction in FEV1 was associated with an increased risk of death according to degree of lung impairment, compared to people with normal lung function. The association was only slightly attenuated but remained significant after exclusion of smokers and participants with previous history of respiratory diseases. The HRs varied between countries but not statistically significant; the highest excess risk among persons with more severe impairment was seen in Poland (HR: 4.28, 95% CI 2.14‒8.56) and Lithuania (HR: 4.07, 95% CI 2.21‒7.50). Conclusions Reduced FEV1 is an independent predictor of all-cause mortality, with risk increasing with the degree of lung function impairment and some country-specific variation between the cohorts.

Background Population studies that assess lung function usually exclude results of individuals with poor-quality measurements, which often means excluding many subjects. Impaired cognition is frequently associated with poor-quality spirometry; excluding such subjects may introduce a selection bias in studies with lung function as either outcome or exposure. We investigated the association between poor-quality spirometry and impaired cognitive function and whether poor-quality spirometry is associated with future mortality risk independently of cognitive function. Methods We used data from a prospective cohort in three Central and Eastern European countries; 12,087 individuals aged 45–75 years (54% females) with complete information on variables of interest were included. Standard memory, verbal fluency, and executive cognitive domain tests were converted into latent variable z-scores and divided into quartiles. Spirometry tests were classified into two categories based on repeatability criteria: good- (71%) vs. poor-quality spirometry (29% of participants). Those with good-quality spirometry were further classified, using forced vital capacity (FVC) and forced expiratory volume in the first second (FEV 1 ), as healthy spirometry (63%) or impaired spirometry (8%). Multinomial logistic regression was used to assess the association between poor-quality spirometry and cognitive function, and a Cox proportional regression was used to analyze the risk of total mortality over a 17-year follow-up. Results After controlling for a range of covariates, higher cognitive function predicted lower odds of poor-quality spirometry. In the highest cognitive function quartile, compared with the lowest quartile, the odds ratio of poor-quality spirometry was 0.82 (95%CI: 0.72–0.92). Impaired spirometry was associated with higher mortality risk even after adjusting for cognition (adjusted hazard ratio 1.63, 95%CI: 1.45–1.84), but mortality risk was similar in subjects with poor- vs. good-quality (HR 1.02, 95%CI: 0.93–1.10). Conclusion Higher cognitive function was associated with a lower risk of poor-quality spirometry. The lack of independent association of poor-quality spirometry with mortality suggests that excluding poor-quality spirometry measurements from analyses is unlikely to introduce a major bias. However, discarding poor-quality spirometry from epidemiological analyses might imply the exclusion of vulnerable subjects. These findings should be confirmed in future studies representing other populations.

BackgroundNumerous studies reported higher levels of mental health issues during the COVID-19 pandemic but only a minority used repeated measurements. We investigated change in depressive symptoms in the Czech ageing cohort and the impact of pre-existing and COVID-19-related stressors.MethodsWe used data on 2853 participants (mean age 73.4 years) from the Czech part of the prospective Health, Alcohol and Psychosocial factors In Eastern Europe cohort that participated in postal questionnaire surveys before (September 2017–June 2018) and during the pandemic (October 2020–April 2021). Participants reported their depressive symptoms using the Centre for Epidemiological Studies-Depression Scale including 10 (CESD-10) tool. A principal component analysis (PCA) was used to create representative components of the pandemic-related stressors. The impact of the stressors on change in depressive symptoms was tested using multivariable linear regression, after adjustment for age and potential confounders.ResultsThree patterns of the pandemic-related stressors (‘financial stressors’, ‘social and perception stressors’ and ‘death and hospitalisation stressors’) were extracted from the PCA. The mean CESD-10 score increased from 4.90 to 5.37 (p<0.001). In fully adjusted models, significantly larger increases in depression score were reported by older people (β=0.052; p=0.006), those with poor self-rated health (β=0.170; p<0.001), those who experienced death or hospitalisation of a close person (β=0.064; p<0.001), social deprivation (β=0.057; p<0.001), delays in healthcare (β=0.048; p=0.005) and those who suffered from COVID-19 (β=0.045; p=0.008).ConclusionThis study confirms an increase in depressive symptoms in older persons during the pandemic and identified several pandemic-related risk factors suggesting that public health policies should address this vulnerable group by adopting the preventing strategies.

ObjectivesWe investigated whether social gradient in all-cause mortality in the Czech Republic changed during the postcommunist transition by comparing two cohorts, recruited before and after the political changes in 1989.MethodsParticipants (aged 25–64 years) in two population surveys (n=2530 in 1985, n=2294 in 1992) were followed up for mortality for 15 years (291 and 281 deaths, respectively). Education was classified into attainment categories and years of schooling (both continuous and in tertiles). Cox regression was used to estimate HR of death by educational indices in each cohort over a 15-year follow-up.ResultsAll three educational variables were significantly associated with reduced risk of death in both cohorts when men and women were combined; for example, the adjusted HRs of death in the highest versus lowest tertile of years of schooling were 0.65 (95% CI 0.47 to 0.89) in 1985 and 0.67 (95% CI 0.48 to 0.93) in 1992. Adjustment for covariates attenuated the gradients. In sex-specific analysis, the gradient was more pronounced and statistically significant in men. There were no significant interactions between cohort and educational indices.ConclusionsThe educational gradient in mortality did not differ between the two cohorts (1985 vs 1992), suggesting no major increase in educational inequality during the early stage of postcommunist transition. Further research is needed to understand trends in health inequalities during socioeconomic transitions.

ObjectiveExamine changes in SARS-CoV-2 seropositivity before and during the national vaccination campaign in the Czech Republic.DesignProspective national population-based cohort study.SettingMasaryk University, RECETOX, Brno.Participants22 130 persons provided blood samples at two time points approximately 5–7 months apart, between October 2020 and March 2021 (phase I, before vaccination), and between April and September 2021 (during vaccination campaign).Outcome measuresAntigen-specific humoral immune response was analysed by detection of IgG antibodies against the SARS-CoV-2 spike protein by commercial chemiluminescent immunoassays. Participants completed a questionnaire that included personal information, anthropometric data, self-reported results of previous RT-PCR tests (if performed), history of symptoms compatible with COVID-19 and records of COVID-19 vaccination. Seroprevalence was compared between calendar periods, previous RT-PCR results, vaccination and other individual characteristics.ResultsBefore vaccination (phase I), seroprevalence increased from 15% in October 2020 to 56% in March 2021. By the end of phase II, in September 2021, prevalence increased to 91%; the highest seroprevalence was seen among vaccinated persons with and without previous SARS-CoV-2 infection (99.7% and 97.2%, respectively), while the lowest seroprevalence was found among unvaccinated persons with no signs of disease (26%). Vaccination rates were lower in persons who were seropositive in phase I but increased with age and body mass index. Only 9% of unvaccinated subjects who were seropositive in phase I became seronegative by phase II.ConclusionsThe rapid increase in seropositivity during the second wave of the COVID-19 epidemic (covered by phase I of this study) was followed by a similarly steep rise in seroprevalence during the national vaccination campaign, reaching seropositivity rates of over 97% among vaccinated persons.