Ischaemic heart disease is among the most frequent causes of death. Early detection of myocardial pathologies can increase the benefit of therapy and reduce the number of lethal cases. Presence of myocardial scar is an indicator for developing ischaemic heart disease and can be detected with high diagnostic precision by magnetic resonance imaging. However, magnetic resonance imaging scanners are expensive and of limited availability. It is known that presence of myocardial scar has an impact on the well-established, reasonably low cost, and almost ubiquitously available electrocardiogram. However, this impact is non-specific and often hard to detect by a physician. We present an artificial intelligence based approach — namely a deep learning model — for the prediction of myocardial scar based on an electrocardiogram and additional clinical parameters. The model was trained and evaluated by applying 6-fold cross-validation to a dataset of 12-lead electrocardiogram time series together with clinical parameters. The proposed model for predicting the presence of scar tissue achieved an area under the curve score, sensitivity, specificity, and accuracy of 0.89, 70.0, 84.3, and 78.0%, respectively. This promisingly high diagnostic precision of our electrocardiogram-based deep learning models for myocardial scar detection may support a novel, comprehensible screening method.

The specification and application of policies and guidelines for public health, medical education and training, and screening programmes for preventative medicine are all predicated on trust relationships between medical authorities, health practitioners and patients. These relationships are in turn predicated on a verbal contract that is over two thousand years old. The impact of information and communication technology (ICT), underpinning Health 4.0, has the potential to disrupt this analog relationship in several dimensions; but it also presents an opportunity to strengthen it, and so to increase the take-up and effectiveness of new policies. This paper develops an analytic framework for the trust relationships in Health 4.0, and through three use cases, assesses a medical policy, the introduction of a new technology, and the implications of that technology for the trust relationships. We integrate this assessment in a set of actionable recommendations, in particular that the trust framework should be part of the design methodology for developing and deploying medical applications. In a concluding discussion, we advocate that, in a post-pandemic world, IT to support policies and programmes to address widespread socio-medical problems with mental health, long Covid, physical inactivity and vaccine misinformation will be essential, and for that, strong trust relationships between all the stakeholders are absolutely critical.

Domain-specific languages (DSLs) are a popular approach among software engineers who demand for a tailored development interface. A DSL-based approach allows to encapsulate the intricacies of the target platform in transformations that turn DSL models into executable software code. Often, DSLs are even claimed to reduce development complexity to a level that allows them to be successfully applied by domain-experts with limited programming knowledge. Recent research has produced some scientifically backed insights on the benefits and limitations of DSLs. Further empirical studies are required to build a sufficient body of knowledge from which support for different claims related to DSLs can be derived. In this research study, we adopt current DSL evaluation approaches to investigate potential gains in terms of effectiveness and efficiency, through the application of our DSL Athos, a language developed for the domain of traffic and transportation simulation and optimisation. We compare Athos to the alternative of using an application library defined within a general-purpose language (GPL). We specified two sets of structurally identical tasks from the domain of vehicle routing problems and asked study groups with differing levels of programming knowledge to solve the tasks with the two approaches. The results show that inexperienced participants achieved considerable gains in effectiveness and efficiency with the usage of Athos DSL. Though hinting at Athos being the more efficient approach, the results were less distinct for more experienced programmers. The vast majority of participants stated to prefer working with Athos over the usage of the presented GPL’s API.

Requirements for software applications continuously evolve throughout the entire product lifecycle. As a result, the constant adaptation of software often has an impact on its domain model and requires changes to the underlying database. In consequence, data stored in the database must also be adapted accordingly, a well-known problem known as schema evolution. Manual schema evolution using low-level SQL scripts involves both time-consuming and error-prone routine tasks, as well as complicated operations that require expert knowledge. Automation promises significant leverage for cost savings and quality improvements. To date, the most advanced solutions have focused primarily on operator-based approaches. However, these approaches often lack flexibility and prescribe the exact sequence of operations, which can be restrictive. In this paper, we present EvolveDB, a novel approach to model-driven schema evolution in relational databases. EvolveDB enables database administrators to evolve a database by comparing two versions of a model representing the database schema. Both models can be extracted from existing databases by reverse-engineering the data dictionary, or the target version can be created by freely editing the representation of the source schema. By comparing two model versions, EvolveDB identifies the differences and generates executable data migration scripts. Our experimental evaluation, conducted on the MediaWiki database schema, showed promising results, confirming the usability of our approach. A screencast demonstrating EvolveDB is available at https://youtu.be/k57NUi3blbg .