Digital Infrastructure Research Articles

A comparison of artificial intelligence-enhanced electrocardiography approaches for prediction of time-to-mortality using electrocardiogram images

Abstract Background Most artificial intelligence-enhanced ECG (AI-ECG) models used to predict adverse events including death require that the ECGs be stored digitally. However, the majority of clinical facilities worldwide store ECGs as images. Methods 1,163,401 ECGs (189,539 patients) from a secondary care dataset were available as both natively digital traces and PDF images. A digitisation pipeline extracted signals from PDFs. Separate 1D convolutional neural network (CNN) models were trained on natively digital or digitised ECGs, with a discrete-time survival loss function to predict time-to-mortality. A 2D CNN model was trained on 310x868 pixel ECG images. External validation was performed in 958,954 ECGs (645,373 patients) from a Brazilian primary care cohort and 1022 ECGs (1022 patients) from a Chagas disease cohort. Results The image 2D CNN model and digitised 1D CNN model performed comparably to natively digital 1D CNN model in internal (C-index 0.780 (0.779-0.781), 0.772 (0.771-0.774) and 0.775 (0.774-0.776 respectively) and external validation. Models trained on natively digital 1D ECGs had comparable performance when applied to digitised 1D ECGs (C-index 0.773 (0.771-0.774). Conclusion Both the image 2D CNN and digitised 1D CNN enable mortality prediction from ECG images, with comparable performance to natively digital 1D CNN. Models trained on natively digital 1D ECGs can also be applied to digitised 1D ECGs, without any significant loss in performance. This works allows AI-ECG mortality prediction to be applied in diverse global settings lacking digital ECG infrastructure.

(Micro)soft power in Dutch public education: making classrooms platform-ready through partner work

ABSTRACT This article explores how the global technology company Microsoft, supported by local partners, makes Dutch classrooms platform-ready by influencing how schools approach three key public governance responsibilities in their digital transformation: developing a vision for digital education, creating strategies for educational innovation and fostering digital literacy. Using the concept of soft power and extensive empirical research, the study shows how Microsoft aligns these responsibilities with its own corporate interests. As a result, the company gains control over schools’ digital infrastructure – not only in terms of hardware and software but also in terms of its pedagogical design. The conclusion emphasises the importance of collective and collaborative national efforts to resist the global influence of platforms like Microsoft on local digital education.

Critical Data for Critical Care: A Primer on Leveraging Electronic Health Record Data for Research From Society of Critical Care Medicine’s Panel on Data Sharing and Harmonization

A growing body of critical care research draws on real-world data from electronic health records (EHRs). The bedside clinician has myriad data sources to aid in clinical decision-making, but the lack of data sharing and harmonization standards leaves much of this data out of reach for multi-institution critical care research. The Society of Critical Care Medicine (SCCM) Discovery Data Science Campaign convened a panel of critical care and data science experts to explore and document unique advantages and opportunities for leveraging EHR data in critical care research. This article reviews and illustrates six organizing topics (data domains and common data elements; data harmonization; data quality; data interoperability and digital infrastructure; data access, sharing, and governance; and ethics and equity) as a data science primer for critical care researchers, laying a foundation for future publications from the SCCM Discovery Data Harmonization and Sharing Guiding Principles Panel.

The impact of InsurTech on advancing sustainable specialty agricultural product insurance in China

The development of specialized agricultural product insurance is crucial for perfecting China’s agricultural insurance system and promoting rural revitalization. Currently, specialized agricultural product insurance in China faces numerous challenges in key areas such as rate determination, risk assessment, and loss adjustment, which have become bottlenecks restricting its sustainable development. This paper explores how insurance technology (InsurTech) can enhance the ecological system of specialized agricultural product insurance through technological innovation and overcome these industry pain points. It elaborates on how InsurTech can enhance farmers’ interactive experience and satisfaction, improve the management efficiency of insurance companies, strengthen government regulation, and promote the sustainable development of the insurance business. Moreover, this study deeply analyzes the practical barriers in implementing InsurTech and proposes corresponding strategies, including establishing innovative incentive mechanisms, improving relevant policies and regulations, building a multidimensional data platform to achieve data interoperability, and strengthening the construction of digital rural infrastructure to enhance farmers’ technological literacy, thereby advancing the sustainable development of InsurTech in specialized agricultural product insurance.

Between the cracks: Blind spots in regulating media concentration and platform dependence in the EU

Alongside the recent regulations addressing platforms and digital markets – the Digital Services Act (DSA) and the Digital Markets Act (DMA) – the European Union’s (EU) European Media Freedom Act (EMFA) aims to safeguard media freedom and pluralism, two essential pillars of democracy. The EMFA introduces several provisions, including rules specifically focused on assessing media concentration in "the online environment". While these initiatives are commendable, there are noticeable blind spots in how EU regulations tackle the issues of dependence on, and the power of, platforms amidst the rising trend of media concentration. An essential aspect that needs attention is the technological power of these platforms, underpinned by their economic and political power. We find that neither the infrastructural power of platforms – transforming them from “gatekeepers” to “digital infrastructure and AI providers” – nor their relational power – creating imbalances and dependencies while posing sustainability challenges for (local) journalism – are effectively addressed in the current EU regulatory frameworks, despite both forms of power driving digital media concentration. The article then concludes with recommendations for a way forward capable of preserving values such as media pluralism and editorial independence.

The Promise of Remote Patient Monitoring.

The promise of remote patient monitoring (RPM) lies in its ability to revolutionize health care delivery by enabling continuous, real-time tracking of patient health outside traditional clinical settings. The COVID-19 pandemic accelerated the adoption of RPM, particularly in underserved and rural populations, highlighting both its potential and the persistent barriers that limit its widespread use. This paper explores the critical role of technological advancements-such as wearables, artificial intelligence (AI), and broadband expansion-in sustaining and optimizing RPM in the postpandemic era. We examine Michigan as a microcosm of national health care challenges, focusing on its diverse population and geographic barriers, and propose condition-specific RPM protocols to address these inequities. Key facilitators and barriers to RPM implementation are discussed, with a focus on AI integration, community engagement, and digital infrastructure. We also explore the role of policy reform and public-private partnerships in supporting RPM's scalability and long-term sustainability. Our findings suggest that while RPM offers a powerful tool for improving health care access and outcomes, especially for chronic conditions and rural maternal health, sustained investment in technology and infrastructure is critical. By addressing these challenges, RPM can become a cornerstone of modern health care, reducing disparities and improving care delivery for underserved populations.

Louveira Digital City

The Louveira Digital City is a municipal information network designed to promote digital appications development, offering e-government services in areas such as health, education, social assistance, safety, and public works. The project began as an academic initiative focused on Louveira's Information Highway, which was presented to the City Council in August 2010. It outlines the key components of the information highway, including the optical backbone architecture, feasibility study, radio link specifications, logical network design, equipment specifications, and project budget. This digital infrastructure enables all residents to access various communication services and applications, such as data, video, and voice traffic. The network is comprised of radio and fiber optic links, designed to benefit various areas of public administration, including health, safety, education, and planning. Additionally, it aims to enhance public access to information, culture, education, and leisure, laying the groundwork for a smart city. This project showcases the implementation of the information highway in Louveira, highlighting how academic institutions can contribute to the economic, social, and technological development of society and serving as a model for similar initiatives.

Has digital infrastructure accelerated enterprises' specialization? Evidence from China

PurposeThis paper intends to explore the impact and mechanism of digital infrastructure development on enterprises vertical specialization. The following questions are discussed: (1) What is the impact of digital infrastructure on enterprise vertical specialization? (2) If the digital infrastructure serves to raise the level of vertical specialization of enterprises, does the impact differ depending on the level of city, industry and enterprise?Design/methodology/approachThe research employs the “Broadband China” strategy as a quasi-natural experiment for digital infrastructure development, with a multi-period difference-in-difference model constructed to test the research hypothesis. The study examined data from Chinese A-share enterprises listed between 2007 and 2019.FindingsThe study’s findings indicate that the construction of digital infrastructure significantly increases firms' vertical specialization. According to the mechanism analysis, digital infrastructure can increase vertical specialization by lowering market transaction costs. This study employs group regressions in terms of cities, industries and companies to gain a better understanding of the heterogeneity of this effect. The results indicate that digital infrastructure contributes more significantly to higher levels of vertical specialization among enterprises in areas with higher levels of innovation and entrepreneurship as well as in eastern and central cities, service industries, and mature firms.Research limitations/implicationsThere are two shortcomings to this study that warrant investigating further. The first limitation is the mechanism. This study simply looked at the mechanism between variables in terms of transaction costs, using existing theories. As the level of technology continues to improve, the process of digital infrastructure’s impact on vertical specialization requires greater investigation. Another weakness of this study is its country-specific focus. The effect of digital infrastructure on vertical specialization differs by country, reflecting disparities in economic growth. Further discussion of cross-national comparative studies is required.Originality/valueThe study’s marginal contributions are largely represented in the two aspects listed below: (1) This paper includes a comprehensive theoretical study of the influence of digital infrastructure development on vertical specialization, focusing on transaction costs. This provides a theoretical foundation for the empirical study presented in this paper; (2) this study fills the gap in earlier research in this field, and the findings broaden research findings in areas such as digital infrastructure development and vertical specialization.

Can digital finance boost regional innovation? From the perspective of resource mismatch in China

ABSTRACT Digital finance provides new possible ways to promote innovation-driven development strategies. Using data of 257 prefecture-level cities in China from 2011 to 2019, this paper examines the impact of digital finance on regional innovation, as well as the mediating effect of resource mismatch underlies it. The empirical results are as follows. First, digital finance can significantly boost innovation, both in terms of the quantity and quality. Second, the incentive effects of innovation have been more obviously observed in the eastern cities and the cities with high financial levels or light digital divides in China. Third, the mechanism effect implies that digital finance works positively on innovation through improving the factor allocation efficiency by alleviating the misallocation of labour and capital. These conclusions indicate that to better promote regional innovation, it is crucial to encourage the digital transformation of the financial industry, enhance digital infrastructure development, and facilitate the free flow of resources among regions. The paper offers both theoretical and empirical evidence that digital finance influences regional innovation by alleviating resource mismatches. It also examines the role of the ‘digital divide’ in shaping innovation through digital finance. These two points constitute the key innovations of the paper.

Leveraging digital infrastructure for sustainable grain production: evidence from China

IntroductionAgriculture faces significant challenges in ensuring global food security while minimizing resource costs and environmental impacts. The development of digital infrastructure offers transformative potential for agricultural systems and aligns with the United Nations Sustainable Development Goals. This study examines the role of digital infrastructure in enhancing grain production capacity in China, a key player in the global food system.MethodsWe analyzed data from 277 prefecture-level cities in China from 2011 to 2021. A double machine learning model was employed to empirically assess the impact of digital infrastructure on grain production capacity, allowing for robust insights into causal relationships.ResultsResults reveal that digital infrastructure significantly enhances grain production. Mechanism analysis results indicate that digital infrastructure construction drives agricultural technological advancements and farmland scale, contributing to increased production capacity. Heterogeneity analysis results show that the impact of digital infrastructure construction is significant in major grain-producing regions and the central-eastern regions, while its effects are relatively limited in grain production-consumption balanced regions, main grain consumption regions, and the western regions.DiscussionThe results underscore the importance of strengthening digital infrastructure in rural areas to improve grain production capacity. Tailored policy implications are suggested to enhance sustainable food production and contribute to global food security, particularly in regions with varying agricultural dynamics.

Making the mos(s)t of nature? Cleantech, smart nature-based solutions, and the ‘rendering investable’ of urban moss

This article examines the ways in which ‘nature-based solutions’ (NBS) to urban environmental problems are contributing to a re-imagining of the forms and roles of vegetal life in cities. Specifically, we examine the versions of nature that are being produced within a subset of nature-based solutions described as ‘smart’ – that is, those involving the enrolment of non-human lifeforms into digital infrastructures comprising sensors, data flows and automated support systems. Whilst NBS are often celebrated for opening up cities to lively ecological processes – thereby contributing to more convivial, ‘more-than-human’ forms of urbanism – their smart incarnations are becoming a playground for entrepreneurial and financial actors seeking new ways to enclose, commodify and derive profit from non-human life in cities. To explicate this argument, we examine the case of a proprietary ‘nature-based solution’ to urban air pollution developed and sold to local authorities and corporate actors by a European cleantech start-up, predicated on optimising the air-filtering capacities of moss. Our analysis proceeds in three stages. First, we draw on scholarship on the bioeconomy to show how the commodification of moss in this case is predicated on discursive arguments which depict moss as at once inherently productive and regenerative, but also fragile and scarce in urban environments. Secondly, we show how this smart NBS is rendered investable through the enrolment of moss into a carefully designed digital apparatus, which purports to stabilise and optimise its air purifying work, thereby making its contributions to urban air quality continuous, consistent and calculable. Finally, building on an assessment of the entanglement of this example with specific urban geographies and modes of urban governance, we critically reflect on the role that smart NBS in general might yet play in either reinforcing or disrupting prevailing dynamics of privatisation, enclosure and green gentrification in cities.

Enhancing resource recovery in Indonesian upcycled food supply chains: collaborative innovation networks and their drivers

ABSTRACT This study provides theoretical and practical perspectives on resource recovery (RR) in upcycled food (UF) supply chains. The goal of RR in UF supply chains is to minimize food waste and maximize the value derived from food byproducts and surplus. However, since these supply chains are fragmented and recovering and utilizing food waste involve inherent uncertainties, implementation is challenging. This study employs the fuzzy Delphi method and a fuzzy decision-making trial and evaluation laboratory. The analysis validates 29 attributes of RR in UF supply chains, examines their causal relationships, and assesses hierarchical interdependencies. The findings reveal that financial resources, managerial strategies, and digital infrastructure causally drive collaborative innovation networks. This study provides managerial implications for the UF industry, highlighting the importance of engaging business stakeholders, supporting collaborative problem solving, allocating budgets strategically, developing lifecycle value strategies, and focusing on value creation. These insights can inform strategies and sustainable practices in the food sector.

Beautifying urban environment: Smart city construction and sustainable pollution control in China

Faced with the environmental pollution challenges brought by urbanization, smart city construction (SCC) offers a practical and viable pathway for environmental protection. This study treats China's SCC policy as a quasi-natural experiment, utilizing balanced panel data from 285 cities across the country spanning from 2003 to 2019. Through the multi-period Difference-in-Differences (DID) model, the influence of smart city initiatives on urban pollution emissions is systematically examined. Results demonstrate that SCC effectively control urban pollution emissions, leading to a 1.46% decrease in pollution levels in pilot cities. These findings are robust to various tests, including parallel trends analysis, placebo tests, Propensity Score Matching (PSM)-DID, alternative pollution calculation methods, pollution intensity adjustments, control for other policy interferences, and sample adjustments, alongside endogeneity tests using instrumental variables. SCC achieves pollution control through mechanisms that enhance urban technological innovation, facilitate industrial restructuring, and talent agglomeration and financial agglomeration. Heterogeneity analysis reveals a more pronounced impact in the eastern area, large cities, higher administrative levels, cities with superior digital infrastructure, and those with higher human capital levels and pollution severity. This research explores a practical approach towards achieving sustainable pollution control by optimizing technology, industrial structure, and human resources.

How Does the Nexus Between Digitalization and Banking Performance Drive Digital Transformation in Central and Eastern European Countries?

The aim of this paper is to create a digitalization index for banking sectors using a set of indicators based on World Bank data for the period of 2010–2021, which will allow us to rank the sectors of Central and Eastern European countries (CEECs). The digitalization index is built based on how ready banks are for digitalization, the potential customers available for digital banking, and the level of digital infrastructure, with each of these aspects representing one pillar. Based on the calculation of the digitalization index, we emphasize that Romania is the leader, followed by Latvia and Lithuania, while Hungary and Estonia are at the opposite pole. Furthermore, we applied the fully modified ordinary least squares (FMOLS) method to measure the impact of digitalization on banking performance. This study reveals that Romania, Latvia, and Lithuania lead in digital banking transformation due to significant investments in infrastructure and customer engagement, while Hungary and Poland lag in terms of digital readiness. The results indicate that digitalization has a significant positive effect on banking performance (ROE), although countries experiencing market saturation had the potential to see a decline post-2018, necessitating further innovation to sustain growth. In the digitalization context, the results are relevant for policymakers, showing that investing more in digitalization is important and that there is a need to help people have greater access to banking services due to a lack of willingness and financial education, factors which prevent them from embracing digital changes. The results show that improving banking digitalization positively influences banking performances. This study provides an innovative and complex index for assessing banking digitalization in Central and Eastern Europe, with valuable implications for policymakers. We highlight the need to align digitalization policies with the specific level of digital development of each country in order to optimize the integration of digital technologies and enhance economic competitiveness.

The impact of virtual laboratories on the academic performance of grade 12 learners in impulse and momentum

Virtual laboratories (labs) have evolved as an important tool in the sciences, delivering interactive and engaging platforms for learners to conduct experiments and comprehend complex concepts without the limitations of physical resources. They are an emerging teaching tool that offers interactive and immersive experiences that improve comprehension of complicated scientific concepts. This study assesses the impact of virtual labs on the academic achievement of Grade 12 learners on the topic of impulse and momentum in physics. It uses a quasi-experimental methodology to compare the performance of learners who used virtual labs to those who learned in the prevailing theoretical settings. A pre-test and post-test were used to assess learners’ academic success, and surveys were used to gather learner feedback on the learning tool. Preliminary data analysis indicates a statistically significant improvement in the test scores of learners using virtual labs, corroborating earlier studies that highlight the advantages of technologically enhanced learning environments. Furthermore, qualitative feedback indicates that learners found virtual labs more interesting and accessible, resulting in a more conducive learning environment. This work adds to the expanding body of evidence supporting the use of virtual labs in science teaching, especially in resource-constrained contexts where traditional laboratory equipment is limited or non-existent. The implications for curriculum design and educational policy are examined, with a focus on the importance of investing in digital infrastructure to support innovative teaching approaches.

Paradoxes of Openness: Trans Experiences in Open Source Software

In recent years, concerns have increased over the lack of contributor diversity in open source software (OSS), despite its status as a paragon of open collaboration. OSS is an important form of digital infrastructure and part of a career path for many developers. While there exists a growing body of literature on cisgender women's under-representation in OSS, the experiences of contributors from other marginalized groups are comparatively absent from the literature. Such is the case for trans contributors, a historically influential group in OSS. In this study, we interviewed 21 trans participants to understand and represent their experiences in the OSS literature. From their experiences, we theorize two related paradoxes of openness in OSS: the paradox of openness and display and the paradox of openness and governance. In an increasingly violent world for trans people, we draw on our theorizing to build recommendations for more inclusive and safer OSS projects for contributors.

Research on the Impact of Digital Infrastructure on Urban Breakthrough Green Innovation: A Case Study of the Yangtze River Economic Belt in China

Breakthrough green innovation acts as a critical leverage point and a fundamental driver of the development of new productive forces. This study employs a sample of 108 cities along the Yangtze River Economic Belt from 2011 to 2021 to investigate the impact of digital infrastructure on urban breakthrough green innovation and its underlying mechanisms. The findings are as follows: (1) Digital infrastructure construction facilitates urban breakthrough green innovation, with a notably more substantial impact on strategic breakthrough green innovation. This result is validated through robustness and endogeneity tests. (2) Heterogeneity analysis indicates that the enhancement effect of digital infrastructure on breakthrough green innovation is more prominent in non-resource-based cities, cities with higher levels of marketisation, and those with weaker environmental regulations, with a particularly significant influence on substantive breakthrough green innovation. (3) Mechanism analysis reveals that upgrading industrial structures, optimising market resource allocation, and increasing public environmental awareness are critical mechanisms through which digital infrastructure strengthens urban breakthrough green innovation capacity. Additionally, as improvements occur in industrial structure, market resource allocation efficiency, and public environmental awareness, the impact of digital infrastructure on urban breakthrough green innovation capacity displays a nonlinear effect.

Digital Economy, Marine Industrial Structure Upgrading, and the High-Quality Development of Marine Economy Based on the Static and Dynamic Spatial Durbin Model

Achieving marine sustainable development goals requires improving the quality of the marine economy. In this study, we constructed a multi-dimensional evaluation index system to quantify the high-quality development of the marine economy (HDME) and digital economy for China’s 11 coastal regions between 2012 and 2020, and systematically explored the mechanisms between the digital economy, marine industrial structure upgrading, and high-quality development of the marine economy. We further empirically analyzed the influence of the digital economy and marine industrial structure upgrading on the HDME by using the static and dynamic spatial Durbin model and threshold model. We found that the digital economy improved the HDME of local and neighboring regions, and the sub-dimensional indicators had a significant heterogeneous effect. The marine industrial structure upgrading only positively affected the quality of the marine economy in neighboring areas. Furthermore, the digital economy and marine industrial structure upgrading also had synergistic effects on improving the marine economy, which mainly depended on digital infrastructure and digital industrialization. There also existed digital infrastructure and digital industrialization thresholds within marine industrial structure upgrading, affecting the HDME. Our results provide new insights for the green and sustainable development of the marine industry and marine economy from a broader technical perspective in the digital age. Governments should recognize the spatial spillover and synergistic effects of the digital economy and marine industrial structure between different regions and implement policies considering their impacts to achieve the marine sustainable development goals.

Beyond Borders : Addressing the Legal Quagmire of Jurisdiction in Cyberspace

This article delves into the complex scenario of governing cyberspace, addressing key issues such as accessibility, digital disparities, and the regulatory challenges posed by cross-border activities, and applicable test by judiciary across the globe while resolving such emerging issues. Despite technological progress, cyberspace largely remains an unregulated realm, creating opportunities for cybercrimes such as stalking, data breaches, exploitation of minors, and hacking. The lack of a cohesive global governance structure makes tackling these issues a formidable task. The article offers a critical assessment of the Budapest Convention on Cybercrime, the sole international treaty on cybercrimes, pointing to its limited acceptance, especially among ASEAN nations. This hesitation underscores an ideological rift: some countries prioritize cyber sovereignty, while others support a multi-stakeholder model that incorporates contributions from governments, private enterprises, and civil society. These divergent views present barriers to legal harmonization and obstruct cross-border collaboration in prosecuting cyber offenders and ensuring data protection. To address these multifaceted challenges, the article suggests a layered governance approach, integrating global frameworks with regional alliances and national strategies. This model encourages international cooperation while respecting national sovereignty, emphasizing the importance of public-private partnerships to bolster cybersecurity. Furthermore, it advocates for investments in digital infrastructure and cyber literacy programs to reduce the digital divide, facilitating broader, fairer access to online spaces. Ultimately, the proposed governance model seeks a balanced approach, safeguarding individual rights alongside the imperatives of security and accountability, and aiming to cultivate a cyberspace that is safer, more inclusive, and subject to responsible oversight.

The Public Service Digitalization in the Philippines Towards a National Program to Capacitate Digital Frontliners

The rapid advancement of technology has driven a global transformation in public service delivery. In the Philippines, efforts to digitalize public services are crucial for inclusive development and efficient governance. This study, titled "The Public Service Digitalization in the Philippines Towards a National Program to Capacitate Digital Frontliners," examines this transformation through the experiences of government employees, known as digital frontliners. These individuals are key to implementing and managing digital technologies across public sectors.Using a mixed-method research design, the study integrates descriptive, correlative-comparative, and phenomenological approaches to gather quantitative and qualitative data. A total of 400 digital frontliners participated in a survey, while 10 key informants were interviewed. This approach provides a comprehensive analysis of the digitalization process, focusing on demographic profiles, challenges, job satisfaction, and service effectiveness.The theoretical framework includes the Theory of Digital Government Transformation, the Unified Theory of Acceptance and Use of Technology (UTAUT), and Capacity Building and Development Theory. These frameworks help understand the dynamics of public service digitalization, technology acceptance, and the importance of capacity building.Key findings reveal a diverse workforce among digital frontliners, significant challenges such as infrastructure limitations and digital literacy disparities, and varying levels of job satisfaction. The research underscores the need for robust digital infrastructure, tailored training programs, and streamlined administrative processes. It also highlights the importance of public-private collaboration.The study proposes a national program to enhance the capabilities of digital frontliners through continuous professional development and innovation support. This program aims to improve digital public services, making them more efficient, transparent, and accessible. The findings provide a foundation for evidence-based policymaking and strategic planning, contributing to the Philippines' digital transformation and inclusive growth.