A fuzzy discrete event system approach to determining optimal HIV/AIDS treatment regimens

Utilizing Big Data analytics and electronic health record data in HIV prevention, treatment, and care research: a literature review

Propelled by the transformative power of modern information and communication technologies, digitalization of data, and the increasing affordability of high-performance computing, Big Data science has brought forth revolutionary advancement in many areas of business, industry, health, and medicine. The HIV research and care service community is no exception to the benefits from the availability and utilization of Big Data analytics. Electronic health record (EHR) data (e.g., administrative and billing data, electronic medical records, or other digital records of information pertinent to individual or population health) are an essential source of health and disease outcome data because of the large amount of real-world, comprehensive, and often longitudinal data, which provide a good opportunity for leveraging advanced Big Data analytics in addressing challenges in HIV prevention, treatment, and care. This review focuses on studies that apply Big Data analytics to EHR data with aims to synthesize the HIV-related issues that EHR data studies can tackle, identify challenges in the utilization of EHR data in HIV research and practice, and discuss future needs and directions that can realize the promising potential role of Big Data in ending the HIV epidemic.

Supervised Learning of Multievent Transition Matrices in Fuzzy Discrete-Event Systems

In this article, supervised learning of fuzzy discrete-event systems (FDES) is investigated. A learning algorithm that performs supervised learning for multievent transition matrices of a sequence of fuzzy discrete events is derived. FDES can be used to describe a large class of practical systems that consist of fuzzy discrete states, fuzzy discrete events, and transitions among fuzzy discrete states via fuzzy discrete events. Because fuzzy discrete states, fuzzy discrete events, and fuzzy transitions are well defined in FDES, the FDES model is highly explainable, which is important in many applications, especially in biomedical applications. Based on this explainable model, the proposed learning algorithm can be used to learn events and event sequences in the model. Hence, it allows system developers to build an explainable model for a complex system based on the data available. Simulations using MATLAB are conducted to verify the effectiveness of the proposed algorithm.

Learning Fuzzy Automaton's Event Transition Matrix When Post-Event State Is Unknown

Compared to other system modeling techniques, the fuzzy discrete event systems (FDESs) methodology has the unique capability of modeling a class of event-driven systems as fuzzy automata with ambiguous state and event-invoked state transition. In two recent papers, we developed algorithms for online-supervised learning of the fuzzy automaton's event transition matrix using fuzzy states before and after the occurrence of fuzzy events. The post-event state was assumed to be readily available while the pre-event state was either directly available or estimatable through learning. This article is focused on algorithm development for learning the transition matrix in a different setting-when the pre-event state is available but the post-event state is not. We suppose the post-event state is described by a fuzzy set that is linked to a (physical) variable whose value is available. Stochastic-gradient-descent-based algorithms are developed that can learn the transition matrix plus the parameters of the fuzzy sets when the fuzzy sets are of the Gaussian type. Computer simulation results are presented to confirm the theoretical development.

Artificial intelligence and machine learning assisted drug delivery for effective treatment of infectious diseases

In the era of antimicrobial resistance, the prevalence of multidrug-resistant microorganisms that resist conventional antibiotic treatment has steadily increased. Thus, it is now unquestionable that infectious diseases are significant global burdens that urgently require innovative treatment strategies. Emerging studies have demonstrated that artificial intelligence (AI) can transform drug delivery to promote effective treatment of infectious diseases. In this review, we propose to evaluate the significance, essential principles, and popular tools of AI in drug delivery for infectious disease treatment. Specifically, we will focus on the achievements and key findings of current research, as well as the applications of AI on drug delivery throughout the whole antimicrobial treatment process, with an emphasis on drug development, treatment regimen optimization, drug delivery system and administration route design, and drug delivery outcome prediction. To that end, the challenges of AI in drug delivery for infectious disease treatments and their current solutions and future perspective will be presented and discussed.

A Caputo-Fabrizio Fractional-Order Model of HIV/AIDS with a Treatment Compartment: Sensitivity Analysis and Optimal Control Strategies

Although most of the early research studies on fractional-order systems were based on the Caputo or Riemann–Liouville fractional-order derivatives, it has recently been proven that these methods have some drawbacks. For instance, kernels of these methods have a singularity that occurs at the endpoint of an interval of definition. Thus, to overcome this issue, several new definitions of fractional derivatives have been introduced. The Caputo–Fabrizio fractional order is one of these nonsingular definitions. This paper is concerned with the analyses and design of an optimal control strategy for a Caputo–Fabrizio fractional-order model of the HIV/AIDS epidemic. The Caputo–Fabrizio fractional-order model of HIV/AIDS is considered to prevent the singularity problem, which is a real concern in the modeling of real-world systems and phenomena. Firstly, in order to find out how the population of each compartment can be controlled, sensitivity analyses were conducted. Based on the sensitivity analyses, the most effective agents in disease transmission and prevalence were selected as control inputs. In this way, a modified Caputo–Fabrizio fractional-order model of the HIV/AIDS epidemic is proposed. By changing the contact rate of susceptible and infectious people, the atraumatic restorative treatment rate of the treated compartment individuals, and the sexual habits of susceptible people, optimal control was designed. Lastly, simulation results that demonstrate the appropriate performance of the Caputo–Fabrizio fractional-order model and proposed control scheme are illustrated.

Reliable Decentralized Control of Fuzzy Discrete-Event Systems and a Test Algorithm

A framework for decentralized control of fuzzy discrete-event systems (FDESs) has been recently presented to guarantee the achievement of a given specification under the joint control of all local fuzzy supervisors. As a continuation, this paper addresses the reliable decentralized control of FDESs in face of possible failures of some local fuzzy supervisors. Roughly speaking, for an FDES equipped with n local fuzzy supervisors, a decentralized supervisor is called k-reliable (1 ≤ k ≤ n) provided that the control performance will not be degraded even when n - k local fuzzy supervisors fail. A necessary and sufficient condition for the existence of k-reliable decentralized supervisors of FDESs is proposed by introducing the notions of M̃uc-controllability and k-reliable coobservability of fuzzy language. In particular, a polynomial-time algorithm to test the k-reliable coobservability is developed by a constructive methodology, which indicates that the existence of k-reliable decentralized supervisors of FDESs can be checked with a polynomial complexity.

State-feedback control of fuzzy discrete-event systems

In a 2002 paper, we combined fuzzy logic with discrete-event systems (DESs) and established an automaton model of fuzzy DESs (FDESs). The model can effectively represent deterministic uncertainties and vagueness, as well as human subjective observation and judgment inherent to many real-world problems, particularly those in biomedicine. We also investigated optimal control of FDESs and applied the results to optimize HIV/AIDS treatments for individual patients. Since then, other researchers have investigated supervisory control problems in FDESs, and several results have been obtained. These results are mostly derived by extending the traditional supervisory control of (crisp) DESs, which are string based. In this paper, we develop state-feedback control of FDESs that is different from the supervisory control extensions. We use state space to describe the system behaviors and use state feedback in control. Both disablement and enforcement are allowed. Furthermore, we study controllability based on the state space and prove that a controller exists if and only if the controlled system behavior is (state-based) controllable. We discuss various properties of the state-based controllability. Aside from novelty, the proposed new framework has the advantages of being able to address a wide range of practical problems that cannot be effectively dealt with by existing approaches. We use the diabetes treatment as an example to illustrate some key aspects of our theoretical results.

A self-learning fuzzy discrete event system for HIV/AIDS treatment regimen selection

The U.S. Department of Health and Human Services Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (AIDS) treatment guidelines are modified several times per year to reflect the rapid evolution of the field (e.g., emergence of new antiretroviral drugs). As such, a treatment-decision support system that is capable of self-learning is highly desirable. Based on the fuzzy discrete event system (FDES) theory that we recently created, we have developed a self-learning HIV/AIDS regimen selection system for the initial round of combination antiretroviral therapy, one of the most complex therapies in medicine. The system consisted of a treatment objectives classifier, fuzzy finite state machine models for treatment regimens, and a genetic-algorithm-based optimizer. Supervised learning was achieved through automatically adjusting the parameters of the models by the optimizer. We focused on the four historically popular regimens with 32 associated treatment objectives involving the four most important clinical variables (potency, adherence, adverse effects, and future drug options). The learning targets for the objectives were produced by two expert AIDS physicians on the project, and their averaged overall agreement rate was 70.6%. The system's learning ability and new regimen suitability prediction capability were tested under various conditions of clinical importance. The prediction accuracy was found between 84.4% and 100%. Finally, we retrospectively evaluated the system using 23 patients treated by 11 experienced nonexpert faculty physicians and 12 patients treated by the two experts at our AIDS Clinical Center in 2001. The overall exact agreement between the 13 physicians' selections and the system's choices was 82.9% with the agreement for the two experts being both 100%. For the seven mismatched cases, the system actually chose more appropriate regimens in four cases and equivalent regimens in another two cases. It made a mistake in one case. These (preliminary) results show that 1) the System outperformed the nonexpert physicians and 2) it performed as well as the expert physicians did. This learning and prediction approach, as well as our original FDESs theory, is general purpose and can be applied to other medical or nonmedical problems.