Background: Current automated cervical cytology screening systems still heavily depend on manipulation of glass slides. We developed a new system called CytoProcessorTM (DATEXIM, Caen, France), which increases sensitivity and takes advantage of virtual slide technology to simplify the workflow and save worker time. We used an approach based on artificial intelligence to identify abnormal cells among the tens of thousands in a cervical preparation. Objectives: We set out to compare the diagnostic sensitivity and specificity of CytoProcessorTM and the ThinPrep Imaging System (HOLOGIC, Marlborough, MA, USA). Methods: A representative population of 1,352 cases was selected from the routine workflow in a private laboratory. Diagnoses were established using the ThinPrep Imaging System and CytoProcessorTM. All discordances were resolved by a consensus committee. Results: Compared to the ThinPrep Imaging System, CytoProcessorTM significantly improves diagnostic sensitivity without compromising specificity. The sensitivity of detection of “atypical squamous cells of undetermined significance (ASC-US) and more severe” and “low-grade squamous intraepithelial lesion and more severe” was significantly higher using CytoProcessorTM. Considering that cases with a truth diagnosis of ASC-US or more severe required clinical follow-up, 1.5% of the cases (21/1,360) would have been missed if the CytoProcessorTM diagnosis had been used for clinical decision-making. In contrast, 4% of the cases (54/1,360) were missed when the ThinPrep Imaging System diagnosis was used for clinical decision-making. There were 2.6 times fewer false negatives using CytoProcessorTM. The CytoProcessorTM workflow was 1.5 times faster in terms of worker time. Conclusions: CytoProcessorTM is the first of a new generation of automated screening systems, demonstrating improved sensitivity and yielding significant gains in processing time. In addition, the fully digital nature of slide presentation in CytoProcessorTM allows the remote diagnosis of Papanicolaou tests for the first time.
This research project aims to evaluate the potential reduction of environmental impacts from circular economy strategies on an industrial sector at a regional scale with a case study on Greenhouse Gas (GHG) emissions in Quebec's steel industry and its value chain. To do so, an integrated model has been created based on the matrix approach, building on material flow analysis (MFA) tracking flows and stocks and on life cycle assessment (LCA) to compute direct (from the activity, e.g., combustion process) and indirect (from the supply chain, e.g., production of raw material inside or outside of region) emissions. This theoretical model is designed to be applied to any emissions or environmental impacts from a specific sector in a given region and enable to model the effects of circularity strategies to both flows and related environmental impacts. The overall mitigation potential of individual or combined circular economy strategies on a specific sector could thus be evaluated across its entire value chain. In the case study, a set of the most promising circular strategies applicable in the Quebec context were identified, and the GHG reduction potential within and outside the province is calculated and compared with actual emissions. Six circular strategies were analyzed acting at three different levers, namely, GHG/material (increase iron recycling rate, switch to hydrogen-based reduction production), material/product (reduce weight of vehicle, limit over-specification in building construction), and product/service (increase buildings and cars lifetime, increase car-sharing), and therefore impact rather direct or indirect emissions on different stages of the steel life cycle. Combining these six strategies into a consolidated scenario shows that a circular-driven economy allows to cut down GHG emissions of the cradle-to-gate steel industry value chain by −55%, i.e., 1.67 Mt CO2e. Taking into account use phase of steel, overall reductions are estimated at −6.03 Mt CO2e, i.e., −30% of the whole life cycle.
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