Selection Of Candidates Research Articles

Management of Malignant Bowel Obstruction in Patients with Gynaecological Cancer: A Systematic Review.

Objectives: This systematic review aimed to evaluate current surgical and non-surgical management strategies for malignant bowel obstruction (MBO) in patients with gynaecological cancer. Methods: Comprehensive literature searches were conducted across MEDLINE, Embase, CENTRAL, and Scopus, without restrictions on language or publication date. Following the removal of duplicates, 4866 articles were screened, with 34 meeting the inclusion criteria. Results: Surgical intervention remains the definitive treatment for MBO, offering longer symptom-free periods and improved survival, particularly when conservative methods fail. However, the selection of surgical candidates is crucial due to the high risk of morbidity and the potential for significant complications. Non-surgical treatments, such as the use of Gastrografin, Octreotide, and Dexamethasone, along with invasive procedures like nasogastric tubing, percutaneous gastrostomy, and stent placement, offer varying degrees of symptom relief and are often considered when surgery is not feasible. Conclusions: In this article we provide a potential therapeutic algorithm for the management of patients with MBO. This review underscores the urgent need for high-quality research to develop clear, evidence-based guidelines for MBO management in patients with gynaecologic cancer. Establishing standardised protocols will improve patient outcomes by aiding clinicians in making informed, individualised treatment decisions.

Diversity and selection analyses identify transmission-blocking antigens as the optimal vaccine candidates in Plasmodium falciparum

A highly effective vaccine for malaria remains an elusive target, at least in part due to the under-appreciated natural parasite variation. This study aimed to investigate genetic and structural variation, and immune selection of leading malaria vaccine candidates across the Plasmodium falciparum's life cycle. We analysed 325P.falciparum whole genome sequences from Zambia, in addition to 791 genomes from five other African countries available in the MalariaGEN Pf3k Database. Ten vaccine antigens spanning three life-history stages were examined for genetic and structural variations, using population genetics measures, haplotype network analysis, and 3D structure selection analysis. Among the ten antigens analysed, only three in the transmission-blocking vaccine category display P. falciparum 3D7 as the dominant haplotype. The antigens AMA1, CSP, MSP119 and CelTOS, are much more diverse than the other antigens, and their epitope regions are under moderate to strong balancing selection. In contrast, Rh5, a blood stage antigen, displays low diversity yet slightly stronger immune selection in the merozoite-blocking epitope region. Except for CelTOS, the transmission-blocking antigens Pfs25, Pfs48/45, Pfs230, Pfs47, and Pfs28 exhibit minimal diversity and no immune selection in epitopes that induce strain-transcending antibodies, suggesting potential effectiveness of 3D7-based vaccines in blocking transmission. These findings offer valuable insights into the selection of optimal vaccine candidates against P.falciparum. Based on our results, we recommend prioritising conserved merozoite antigens and transmission-blocking antigens. Combining these antigens in multi-stage approaches may be particularly promising for malaria vaccine development initiatives. Purdue Department of Biological Sciences; Puskas Memorial Fellowship; National Institute of Allergy and Infectious Diseases (U19AI089680).

White matter microstructural integrity as a key to effective propagation of gamma entrainment in humans.

Gamma entrainment through sensory stimulation has the potential to reduce the pathology of Alzheimer's disease in mouse models. However, clinical trials in Alzheimer's disease (AD) patients have yielded inconsistent results, necessitating further investigation. This single-center pre-post intervention study aims to explore the influence of white matter microstructural integrity on gamma rhythm propagation from the visual cortex to AD-affected regions in 31 cognitively normal volunteers aged ≥ 65. Gamma rhythm propagation induced by optimal FLS was measured. Diffusion tensor imaging was employed to assess the integrity of white matter tracts of interest. After excluding 5 participants with a deficit in steady-state visually evoked potentials, 26 participants were included in the final analysis. In the linear regression analyses, gamma entrainment was identified as a significant predictor of gamma propagation (p < 0.001). Furthermore, the study identified white matter microstructural integrity as a significant predictor of gamma propagation by flickering light stimulation (p < 0.05), which was specific to tracts that connect occipital and temporal or frontal regions. These findings indicate that, despite robust entrainment of gamma rhythms in the visual cortex, their propagation to other regions may be impaired if the microstructural integrity of the white matter tracts connecting the visual cortex to other areas is compromised. Consequently, our findings have expanded our understanding of the prerequisites for effective gamma entrainment and suggest that future clinical trials utilizing visual stimulation for gamma entrainment should consider white matter tract microstructural integrity for candidate selection and outcome analysis.

Sport as a Pathway to Political Office and its Gendered Effects

ABSTRACT This paper finds that a background in competitive, organised sports is common among those active in electoral politics. Unique data collected through surveys of federal election candidates and local party association presidents together with the examination of candidate and MP biographies establish that many have a sporting background. This sporting experience offers the opportunity for individuals to acquire skills beneficial to political candidacy and makes them more attractive to party gatekeepers. This paper then connects this, and the significantly lower sports participation rates among women/girls, to their consistent under-representation in the pool of election candidates presented by Canada’s political parties and at every level of our elected legislatures. Women/girls participate in sports at significantly lower levels than men/boys. Men thus benefit disproportionately from both the personal skills developed through sports that lead to formal political participation and the local notoriety desired by party candidate search committees that sports participation offers.

Open Legal Primaries in Chile: Reflections Ten (Turbulent and Convulsive) Years after Their Formal Enactment

Objective/context: This paper examines the open legal primary rule in Chile for the selection of the presidential candidate, established in 2012 through Law 20640. This rule contains elements shared with similar legislation in the region as well as specific characteristics. Methodology: Through a case study, we will investigate the results and consequences of the application of primaries on the three occasions they were implemented (2013, 2017, and 2021). We will review the formal changes adopted and the political events that occurred in the interim, considering the main variables that typically intervene in electoral events of this nature, drawn from the existing debate and literature. Conclusions: The case of Chile shows that the combination of an open legal primary system with voluntary internal voting, incomplete simultaneity, and the absence of stable political groupings produces effects that do not align with either the general aspirations for the implementation of primaries or the theoretical purposes outlined by the ideologists of Chilean legislation. Originality: This study contributes to the emerging literature addressing open legal primaries in their dual aspect, both as a nomination mechanism and as an electoral rule.

Planning improvements through data envelopment analysis (DEA) benchmarking based on a selection of peers

Incorporating preferences on suitable peers into benchmarking analyses may ensure the setting of appropriate targets, which enable designing plans for improving performance that are aligned with management. This paper deals with target setting in situations where decision makers (DMs) have previously made a selection of peer candidates for the benchmarking of a given organization. A first approach is developed within the framework of conventional Data Envelopment Analysis (DEA), which is the technology mostly used in non-parametric frontier analysis. It provides targets from reference sets consisting of peer candidates that span a face of the strong efficient frontier of the production possibility set (PPS). These targets result from solving a DEA-like model, thus preventing from the need to identify all of the maximal efficient faces (MEFs) of the DEA frontier. We also propose a second approach where the convexity in DEA is somehow relaxed to allow additionally for reference sets consisting of candidates that are Pareto-efficient, provided that their convex hull is not dominated by other units. In that sense, the targets found can be seen as representing best practices. This approach broadens the range of alternatives when planning improvements, and may eventually provide closer targets.

Appraisal of Students Admission on Service Delivery in the Directorate of Undergraduate Studies (DUS) Federal College of Education (FCE), Yola

Establishment of relationship between policy issues and service delivery in tertiary institution of learning requires to encourage policy implementations to relate to policy formulation that would address rather than dismal service delivery in tertiary educational institutions across the country. Precisely the research intends to establish if policy issues on students’ admission affect service delivery in DUS FCE, Yola. The main instruments used for data collection were the Questionnaires, Focus Group Discussion (FGD), observation check list and Semi Structured Interview (SSI) formats. This paper proposes Analysis of Variance (ANOVA) test statistic as a measurement tool for the study. The findings show that consideration of only first choice for JAMB Admission affect students intake in DUS and cut off marks for admission into DUS poses a threat to intake in some programmes. Post JAMB screening of applicants ensures selection of better candidates. Also, clearly stated memorandum of understanding (MoU) with portal managers and memorandum of understanding (MoU) with ICT facility managers would enhance service delivery in DUS. The study recommends that admission guidelines/policies of regulatory bodies like JAMB and affiliate institution need to be carefully studied and regularly incorporated in the students’ guide book.

In Search of the Missing Link: Election Law Infractions and Candidate Sanctions

In contrast to the extensive literature on the determinants of campaign spending and its effect on candidates’ electoral performance, comparatively less literature exists on the legal and sanctioning characteristics of political finance systems. Though some contributions have analyzed and compared the institutional designs of these financing systems, limited literature has empirically examined infractions and sanctions of electoral laws, categorized as either a crime or a misdemeanor, by the candidates. Limited knowledge exists about the political and sociodemographic profile of candidates who commit such offenses or misdemeanors, a gap this study addresses by empirically analyzing electoral law infractions. Using the case of Chile and an unpublished database of infractions of 38,246 candidates in the local elections of 2008, 2012, and 2016, as well as the legislative elections of 2009, 2013, and 2017, we present four conclusions. First, only about one-fifth of candidates commit such infractions. Second, such infractions are more common during first-tier elections, especially in deputy and senatorial elections. Third, the candidates most likely to commit such infractions are independent candidates who compete in regions remote from large urban centers, especially in rural areas. Fourth, the rise in infractions is linked to a new law that more strictly regulates candidates’ campaign spending. The study enhances our understanding of the efficacy of political finance systems and the enforcement of electoral sanctions.

Implementation of Decision Support System for New Employee Selection at PT Triotech Solution Indonesia using SAW Method

The new employee selection process is one of the important activities in human resource management at PT Triotech Solution Indonesia. The selection of the right candidate determines the quality and performance of the company in the future. This research aims to develop and implement a Decision Support System (SPK) that can assist in the selection process of new employees using the Simple Additive Weighting (SAW) method. The SAW method was chosen because it is able to integrate various assessment criteria by giving appropriate weights to each criterion, resulting in a final ranking of candidates that best suits the company's needs. The system is built by collecting candidate data, which includes criteria such as education, work experience, technical skills, and soft skills. The weight for each criterion is determined based on the priorities set by the company management. After that, the SAW method is applied to calculate the total score of each candidate, which is then used to determine the priority order of the best candidates.

The The Relationship between the Media Agenda and the Public Agenda on the Electability of Presidential Candidates

Facing the 2024 election, two big figures have emerged who have been nominated as Indonesian presidential candidates for the 202-2029 period, namely Anies Bawesdan from the Nasdem Party and Ganjar Pranowo from PDIP. These two figures then became targets of the media by sharing information and activities carried out. Every report in the mass media is essentially a construction of events by the mass media based on the reality that occurred. The ability to construct this discourse will have a major influence on the opinions, decision making and political attitudes of readers. By understanding the work of media reality construction, people will be wise and appropriate in utilizing any information from the mass media. Solopos.com's media agenda setting regarding the two presidential candidates Anies Bawesdan and Ganjar Pranowo certainly greatly influences the level of electability of readers, especially among FISH Univet Bantara students who were respondents to this research. This research aims to determine the influence of the Solopos.com media agenda setting on the electability level of students in the candidacy of Anies Bawesdan and Ganjar Pranowo in the 2024 election and to analyze the influence of the public agenda on the electability level of students in the candidacy of Anies Bawesdan and Ganjar Pranowo in the 2024 election. The method used is a quantitative research approach. Data collection techniques use questionnaires, observation, documentation. Data is measured using a Linkert scale with a range of 5 options. Statistical analysis uses multiple linear regression analysis techniques. The respondents of this research are students of the Communication Science Study Program, Even Semester, Academic Year 2022-2023. The research results show that there is a relationship between the Solopos.com media agenda and the public agenda regarding the electability of presidential candidates. The political situation leading up to the 2024 election is an important moment for the Solopos.com media which is directly or indirectly participating in branding candidates Anies Bawesdan and Ganjar Pranowo as presidential candidates.

Multimodality imaging for the evaluation and management of patients with long-term (durable) left ventricular assist devices.

Left ventricular assist devices (LVADs) are gaining increasing importance as therapeutic strategy in advanced heart failure (HF), not only as bridge to recovery or to transplant but also as destination therapy. Even though long-term LVADs are considered a precious resource to expand the treatment options and improve clinical outcome of these patients, these are limited by peri-operative and post-operative complications, such as device-related infections, haemocompatibility-related events, device mis-positioning, and right ventricular failure. For this reason, a precise pre-operative, peri-operative, and post-operative evaluation of these patients is crucial for the selection of LVAD candidates and the management LVAD recipients. The use of different imaging modalities offers important information to complete the study of patients with LVADs in each phase of their assessment, with peculiar advantages/disadvantages, ideal application, and reference parameters for each modality. This clinical consensus statement sought to guide the use of multimodality imaging for the evaluation of patients with advanced HF undergoing LVAD implantation.

A recipe for an effective selection of promising candidates for high-temperature superconductors among binary hydrides

Recent research on compressed binary hydrides have unveiled the potential for achieving superconductivity at near-room-temperature. Nevertheless, the available decision-making procedures standing behind the selection of constituent elements that may potentially exhibit high values of critical temperature (Tc) are far from optimal. In other words, a lot of experimental and numerical effort is wasted on exploring unpromising compounds. By conducting a deep study of a database containing over 580 binary hydride superconductors, we were able to observe some interesting relationships between Tc and selected physico-chemical properties of examined compounds. Among studied parameters, the ratio of the sum of the molecular weight of heavier atoms to the total mass of all hydrogen atoms in the chemical formula of hydride (MX/MH) was found to be the most valuable indicator that can help to screen for new promising superconductor candidates. This is because the highest Tc requires the lowest MX/MH ratio. Statistical analysis indicates a 28% chance of finding Tc > 200 K within 0 <MX/MH < 15. It is expected that these findings will not only allow for more efficient use of resources by improving future superconductor candidates selection but also they will accelerate ongoing experimental and numerical research that should bring new exciting discoveries in a much shorter time.

Social Opportunity Structures in Hacktivism: Exploring Online and Offline Social Ties and the Role of Offender Convergence Settings in Hacktivist Networks

ABSTRACT Hacktivism represents the promotion in the cyber landscape of ideologically motivated agendas using hacking techniques. Despite research on the topic has provided some clues on how hacktivist networks develop, the processes behind their evolution remain mostly unknown. This gap in the literature prompted us to research the role of online/offline social relationships and of the offender convergence settings in the creation, recruitment process and development of hacktivist networks. This study is based on 30 interviews with hacktivists, and it uses the social opportunity structures framework to analyze the development of 21 hacktivist networks. The results show that said networks can be divided in sub-categories based on the type of connections used to create them. Online social relationships and online convergence settings (particularly social media platforms and IRC channels) seem to play a key role in the development of hacktivist networks, while offline contacts are limited. For the recruitment process, hacktivists use comparable strategies to any organization, but three different categories were identified when discussing the level of sophistication applied to the selection of new candidates.

Mexican State’s interpretation of indigenous self-determination in the age of democracy (1992-2022)

This article charts how Mexican authorities have interpreted and implemented indigenous peoples’ constitutional right to self-determination since it was first adopted in a 1992 constitutional reform. “Self determination” can mean many things, and the constitution gives stakeholders ample discretion to define and negotiate the content of this right. Most state legislatures initially passed “indigenous culture laws” starting in the late 1990s. The state of Oaxaca also amended its electoral procedure code to allow municipalities with a majority of indigenous residents to elect the members of their local governments through community assemblies (instead of the “political party system”). In the last five years, courts have further expanded electoral protections for indigenous communities by mandating that federal and state electoral Institutes implement quotas reserved for indigenous candidates in legislative elections. The application of indigenous self-determination has thus gone from being handled by state legislatures to being the province of federal electoral courts. The prevailing interpretation of self-determination has shifted from self-determination as self-government to it being understood as special legislative representation.

Definition of the effector landscape across 13 phytoplasma proteomes with LEAPH and EffectorComb.

'Candidatus Phytoplasma' genus, a group of fastidious phloem-restricted bacteria, can infect a wide variety of both ornamental and agro-economically important plants. Phytoplasmas secrete effector proteins responsible for the symptoms associated with the disease. Identifying and characterizing these proteins is of prime importance for expanding our knowledge of the molecular bases of the disease. We faced the challenge of identifying phytoplasma's effectors by developing LEAPH, a machine learning ensemble predictor composed of four models. LEAPH was trained on 479 proteins from 53 phytoplasma species, described by 30 features. LEAPH achieved 97.49% accuracy, 95.26% precision and 98.37% recall, ensuring a low false-positive rate and outperforming available state-of-the-art methods. The application of LEAPH to 13 phytoplasma proteomes yields a comprehensive landscape of 2089 putative pathogenicity proteins. We identified three classes according to different secretion models: 'classical', 'classical-like' and 'non-classical'. Importantly, LEAPH identified 15 out of 17 known experimentally validated effectors belonging to the three classes. Furthermore, to help the selection of novel candidates for biological validation, we applied the Self-Organizing Maps algorithm and developed a Shiny app called EffectorComb. LEAPH and the EffectorComb app can be used to boost the characterization of putative effectors at both computational and experimental levels, and can be employed in other phytopathological models.

The Future of Artificial Intelligence in Surgery.

Until recently, innovations in surgery were largely represented by extensions or augmentations of the surgeon's perception. This includes advancements such as the operating microscope, tumor fluorescence, intraoperative ultrasound, and minimally invasive surgical instrumentation. However, introducing artificial intelligence (AI) into the surgical disciplines represents a transformational event. Not only does AI contribute substantively to enhancing a surgeon's perception with such methodologies as three-dimensional anatomic overlays with augmented reality, AI-improved visualization for tumor resection, and AI-formatted endoscopic and robotic surgery guidance. What truly makes AI so different is that it also provides ways to augment the surgeon's cognition. By analyzing enormous databases, AI can offer new insights that can transform the operative environment in several ways. It can enable preoperative risk assessment and allow a better selection of candidates for procedures such as organ transplantation. AI can also increase the efficiency and throughput of operating rooms and staff and coordinate the utilization of critical resources such as intensive care unit beds and ventilators. Furthermore, AI is revolutionizing intraoperative guidance, improving the detection of cancers, permitting endovascular navigation, and ensuring the reduction in collateral damage to adjacent tissues during surgery (e.g., identification of parathyroid glands during thyroidectomy). AI is also transforming how we evaluate and assess surgical proficiency and trainees in postgraduate programs. It offers the potential for multiple, serial evaluations, using various scoring systems while remaining free from the biases that can plague human supervisors. The future of AI-driven surgery holds promising trends, including the globalization of surgical education, the miniaturization of instrumentation, and the increasing success of autonomous surgical robots. These advancements raise the prospect of deploying fully autonomous surgical robots in the near future into challenging environments such as the battlefield, disaster areas, and even extraplanetary exploration. In light of these transformative developments, it is clear that the future of surgery will belong to those who can most readily embrace and harness the power of AI.

Unexpected identification of peak systolic velocity in the radial artery as a risk factor for functional primary patency of radiocephalic fistulas

ObjectiveAs radiocephalic fistula is not necessarily appropriate for all patients with advanced kidney disease, our aim was to investigate the sensitive indicators that affect the functional primary patency of radiocephalic fistulas. MethodsThis prospective observational study included consecutive patients referred to the Second Hospital of Dalian Medical University for initial creation of radiocephalic fistula from July 2017 to December 2019. Preoperative ultrasound parameters, demographic characteristics, serum indicators and comorbidities were recorded. The functionality of radiocephalic fistulas would be assessed every 6 months until March 2023, following their unassisted maturation, unless AVF dysfunction, kidney transplantation, mortality or loss to follow-up occurred. Kaplan–Meier analysis was employed to illustrate differences in functional primary patency of radiocephalic fistulas, while log-rank tests were utilized to compare survival curves. Univariate and multivariable Cox proportional hazard models were performed, yielding hazard ratios and 95% confidence intervals. The significance level was set at 5% for a two-sided test. ResultsThe studies included a total of 182 patients who successfully underwent radiocephalic fistulas with primary unassisted maturation. The mean age of the study population was 58 years, with 66 percent being male. All AVFs were placed on the forearm, with 84% located on the left side.The primary patency rates of eleven parameters exhibited significant differences between groups stratified by cut-off values at different time points. Notably, the group with a peak systolic velocity of the radial artery near the elbow ≤59cm/s demonstrated a higher primary patency rate compared to the >59cm/s group at 2 years (78.4% vs 57.5%, P=0.026).In the univariate Cox proportional hazard models, the P values for gender, the diameter of radial artery near the elbow, the peak systolic velocity of radial artery near the elbow, the diameter of brachial artery near the elbow were less than 0.1. The multivariable Cox proportional hazard model revealed that only the peak systolic velocity of radial artery near the elbow exhibited a significant impact on the functional primary patency of radiocephalic fistula (HR=1.017, 95%CI 1.002–1.031, P=0.021). ConclusionsThe peak systolic velocity of the radial artery near the elbow is a significant risk factor for functional primary patency of radiocephalic fistula. Preoperative evaluation of the peak systolic velocity could allow to identify patients with a lower likelihood of long-term radiocephalic fistula patency, facilitating improved selection of candidates for radiocephalic fistula creation.

Metallicities for more than 10 million stars derived from Gaia BP/RP spectra

Context. The third Gaia Data Release, which includes BP/RP spectra for 219 million sources, has opened a new window into the exploration of the chemical history and evolution of the Milky Way. The wealth of information encapsulated in these data is far greater than their low resolving power (R ~ 50) would suggest at first glance, as shown in many studies. We zeroed in on the use of these data for the purpose of the detection of “new” metal-poor stars, which are hard to find yet essential for understanding several aspects of the origin of the Galaxy, star formation, and the creation of the elements, among other topics. Aims. We strive to refine a metal-poor candidate selection method that was developed with simulated Gaia BP/RP spectra with the ultimate objective of providing the community with both a recipe to select stars for medium and high resolution observations, and a catalog of stellar metallicities. Methods. We used a dataset comprised of GALAH DR3 and SAGA database stars in order to verify and adjust our selection method to real-world data. For that purpose, we used dereddening as a means to tackle the issue of extinction, and then we applied our fine-tuned method to select metal-poor candidates, which we thereafter observed and analyzed. Results. We were able to infer metallicities for GALAH DR3 and SAGA stars with color excesses up to E(B − V) &lt; 1.5 and an uncertainty of σ[Fe/H]inf ∼ 0.36, which is good enough for the purpose of identifying new metal-poor stars. Further, we selected 26 metal-poor candidates via our method for observations. As spectral analysis showed, 100% of them had [Fe/H] &lt; −2.0, 57% had [Fe/H] &lt; −2.5, and 8% had [Fe/H] &lt; −3.0. We inferred metallicities for these stars with an uncertainty of σ[Fe/H]inf ∼ 0.31, as was proven when comparing [Fe/H]inf to the spectroscopic [Fe/H]. Finally, we assembled a catalog of metallicities for 10 861 062 stars.

A World Update of Progress in Lower Extremity Transplantation: What's Hot and What's Not.

The field of vascularized composite allotransplantation (VCA) is the new frontier of solid organ transplantation (SOT). VCA spans life-enhancing/life-changing procedures such as upper extremity, craniofacial (including eye), laryngeal, tracheal, abdominal wall, penis, and lower extremity transplants. VCAs such as uterus transplants are life giving unlike any other SOT. Of all VCAs that have shown successful intermediate- to long-term graft survival with functional and immunologic outcomes, lower extremity VCAs have remained largely underexplored. Lower extremity transplantation (LET) can offer patients with improved function compared to the use of conventional prostheses, reducing concerns of phantom limb pain and stump complications, and offer an option for eligible amputees that either fail prosthetic rehabilitation or do not adapt to prosthetics. Nevertheless, these benefits must be carefully weighed against the risks of VCA, which are not trivial, including the adverse effects of lifelong immunosuppression, extremely challenging perioperative care, and delayed nerve regeneration. There have been 5 lower extremity transplants to date, ranging from unilateral or bilateral to quadrimembral, progressively increasing in risk that resulted in fatalities in 3 of the 5 cases, emphasizing the inherent risks. The advantages of LET over prosthetics must be carefully weighed, demanding rigorous candidate selection for optimal outcomes.

Weakly Supervised Lesion Detection and Diagnosis for Breast Cancers With Partially Annotated Ultrasound Images.

Deep learning (DL) has proven highly effective for ultrasound-based computer-aided diagnosis (CAD) of breast cancers. In an automatic CAD system, lesion detection is critical for the following diagnosis. However, existing DL-based methods generally require voluminous manually-annotated region of interest (ROI) labels and class labels to train both the lesion detection and diagnosis models. In clinical practice, the ROI labels, i.e. ground truths, may not always be optimal for the classification task due to individual experience of sonologists, resulting in the issue of coarse annotation to limit the diagnosis performance of a CAD model. To address this issue, a novel Two-Stage Detection and Diagnosis Network (TSDDNet) is proposed based on weakly supervised learning to improve diagnostic accuracy of the ultrasound-based CAD for breast cancers. In particular, all the initial ROI-level labels are considered as coarse annotations before model training. In the first training stage, a candidate selection mechanism is then designed to refine manual ROIs in the fully annotated images and generate accurate pseudo-ROIs for the partially annotated images under the guidance of class labels. The training set is updated with more accurate ROI labels for the second training stage. A fusion network is developed to integrate detection network and classification network into a unified end-to-end framework as the final CAD model in the second training stage. A self-distillation strategy is designed on this model for joint optimization to further improves its diagnosis performance. The proposed TSDDNet is evaluated on three B-mode ultrasound datasets, and the experimental results indicate that it achieves the best performance on both lesion detection and diagnosis tasks, suggesting promising application potential.