Metastatic cutaneous melanoma has poor prognosis with 2-year survival rate of 10–20%. Melanoma cells express various antigens including gp100, melanoma antigen recognized by T cells 1 (MART-1), and tyrosinase, which can induce immune-mediated anticancer response via T cell activation. Cytotoxic T-lymphocyte associated antigen-4 (CTLA-4) is an immune check point molecule that negatively regulates T cell activation and proliferation. Accordingly, recent phase III clinical trials demonstrated significant survival benefit with ipilimumab, a human monoclonal antibody (IgG1) that blocks the interaction of CTLA-4 with its ligands. Since the efficacy of ipilimumab depends on T cell activation, it is associated with substantial risk of immune mediated adverse reactions such as colitis, hepatitis, thyroiditis, and hypophysitis. We report the first case of late onset pericarditis and cardiac tamponade associated with ipilimumab treatment in patient with metastatic cutaneous melanoma.
This paper explores how fuzzy features' number and reasoning rules can influence the rate of emotional speech recognition. The speech emotion signal is one of the most effective and neutral methods in individuals' relationships that facilitate communication between man and machine. This paper introduces a novel method based on mind inference and recognition of speech emotion recognition. The foundation of the proposed method is the inference of rules in Fuzzy Petri-net (FPN) and the learning automata. FPN is a new method of classification which is introduced for the first time on emotion speech recognition. This method helps to analyze different rules in a dynamic environment like human's mind. The input of FPN is computed by learning automata. Therefore learning automata has been used to adjust the membership functions for each feature vector in the dynamic environment. The proposed algorithm is divided into different parts: preprocessing; feature extraction; learning automata; fuzzification; inference engine and defuzzification. The proposed model has been compared with different models of classification. Experimental results show that the proposed algorithm outperforms other models.
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