Reasonable Tool Research Articles

Evaluation of the Smart Logistics Based on the SLDI Model: Evidence from China

Smart logistics (SL) reflects the digital transformation of the logistics industry, which is key for economic development. Most evaluations are based on the application of technology in SL, and few studies have evaluated SL from a comprehensive perspective. The paper builds the SL development index (SLDI) model from five dimensions based on the driving force, pressure, state, impact, and response (DPSIR) model and identifies the indicator weight by the entropy weight technique. The paper employs the ETDK method, a combined quantitative approach that incorporates entropy weight (E), the technique for order preference by similarity to an ideal solution (TOPSIS) (T), the Dagum Gini coefficient (D), and Kernel density estimation (K), to calculate the closeness degree, analyze spatial-temporal differentiation, and explain the distribution characteristics using data from China spanning 2013 to 2021. The findings show that (1) The SL evaluation is multidimensional and cannot be evaluated only based on technical indicators. A comprehensive evaluation indicator system is necessary. (2) A combined quantitative approach can measure SL development from multiple perspectives and get a clearer picture of the characteristics and regional differences of SL. (3) Influenced by economic development, infrastructure, regional clusters, location, talent, etc., the overall SL development is improving yearly, but SL development in different regions is unbalanced and has different distribution characteristics. The SLDI model developed in this paper will provide a more scientific and reasonable tool for comprehensively evaluating SL. The findings are helpful in proposing suggestions and optimization approaches for subsequent research on SL evaluation and development.

Entangled Mathematics as a Tool of Reasoning in the Mid-Twentieth-Century UK Electricity Industry

In the mid-twentieth century, the identity of those who oversaw the UK electricity grid tentatively and slowly began to shift from those who joined the electricity industry directly from secondary school to a university-educated elite with a higher level of technical education. At the same time, electricity infrastructure became increasingly centralised, leading to the creation of a national grid in 1938, meaning that control of electricity became concentrated in the hands of an ever-smaller group and increasing the stakes in debates over strategy. By using the case studies of power engineer Paul Schiller and mathematician Maurice Davies, this paper traces how the boundaries of what mathematics could or could not be used for were renegotiated between factions within the UK electricity industry. Schiller unsuccessfully attempted to use mathematics, including the authority of academic mathematicians, to reinforce controversial arguments about the strategic direction of the industry in the 1940s. Such arguments failed to resonate with a class of, as Schiller put it, “practical men” that still held considerable influence. Davies on the other hand was employed by the industry in the 1950s to improve efficiency, and was able to implement lasting measures in this effort by using the weather to forecast electricity demand, and successfully defended the usefulness of his work in the 1970s against colleagues who felt that forecasting could be done better with mathematical models without weather inputs. The contrast between these two stories shows how the influence of mathematical thinking was contingent upon existing power dynamics, and reinforce how the history of mathematics should be socially embedded.

APPROACH TO CREATION OF GEOLOGICAL AND RESERVOIR SIMULATION MODEL AND METHODS FOR HISTORY MATCHING OF RESERVOIR ENERGY STATE

Under conditions of complex geological structure and substantial share of hard-to-recover oil reserves, reservoir simulation is a key tool in reservoir management. Direct problems solved by reservoir simulation include forecasting of the production performance, control and management of reservoir development, and localization of residual oil reserves. Inverse problem solution is useful for updating the knowledge of geological structure, reservoir quality, and historical production data by means of history matching. The quality of history matching is fundamental to ensure reliable future forecasts and localization of residual oil zones. The main approaches to appropriate history matching rely on analysis and adjustment of well logging and geological parameters, as well as checking and correction of errors, inadequate historical data, application of physics-based and reasonable approaches and tools. The prerequisite for adequate history matching and predictive ability of the resultant reservoir simulation model is the compliance of simulated and actual energy state of the reservoir. In this paper, the initial stage of reservoir simulation is performed, the approach to history matching of reservoir energy state aimed at improving the quality of further predictions is described as exemplified by one of the production areas of Russian oil field. The main causes of poor history match of formation and bottomhole pressures are revealed. These causes are grouped as follows: — geological causes/reservoir quality, which include permeability field distribution, reservoir connectivity, and determination of rock and fluid compressibility;— technical causes (during reservoir simulation), that is model limitations in case of larger areas, the need to use sector models, consideration of buffer region;— technological causes, including inadequate historical data or lack of data, detection of behind-the-casing flows and production casing leaks in wellbore, etc. For each group of factors that have a substantial impact on reservoir pressure, recommendations and methods of energy state history matching on geological and reservoir simulation models are provided, examples are given.

Assessing the diagnostic accuracy of postnatal clinical scoring methods and foot length measurement for estimating gestational age and birthweight of newborns in low- and middle-income countries: a systematic review and meta-analysis

BackgroundThis study aimed to update systematic reviews and meta-analyses on the diagnostic accuracy of postnatal clinical scoring (PCS) methods and foot length (FL) measurement for assessing gestational age (GA) and...

Buckling prediction based on joint opening and safe temperature estimation in jointed plain concrete pavements

Concrete pavement buckling is a significant distress that disrupts traffic flow and results in costly repairs, issues that are increasingly exacerbated by global warming. Addressing these issues, this study develops a systematic framework for assessing jointed plain concrete pavement (JPCP) by integrating temperature and moisture gradients, pavement structures, and material properties into mechanical-based models for predicting buckling potential. Specifically, a two-stage analysis is developed to analyze buckling development based on the slab deformation and the slab-base interface, including joint closure assessment and upheaval buckling prediction. Through the established model, parametric studies are conducted to quantitatively identify key factors influencing buckling. Moreover, the developed models are applied to pavement sections in various climate regions and validated through comparative analysis with field data from the Long-Term Pavement Performance (LTPP) database to confirm model accuracy. Additionally, a case study using pavement buckling data from Wisconsin between 2014 and 2020 demonstrates the model's practical application. As the results, it is found that temperature increase, the percentage of incompressible materials, and the coefficient of thermal expansion are critical for joint opening changes, while the coefficient of thermal expansion, elastic modulus, and slab thickness are crucial to post-buckling performance. Regression equations are provided to estimate safe temperature increases as a recommended buckling temperature limit. Furthermore, the predicted joint opening shows reasonable alignment with joint gauge measurement in the field recordings from the LTPP database. Finally, the predicted buckling events are reasonably compared with field recordings for a Wisconsin pavement section from 2014 to 2020. In summary, by considering pavement structural parameters, material properties, and weather conditions, this comprehensive model provides a reasonable tool for predicting and mitigating JPCP buckling in different climate conditions.

Effect of structure tool on nano-cutting surface integrity of single crystal γ-TiAl alloy via atomic simulation

To investigate the impact of microgroove geometry at the tool's flank face on the surface integrity of the workpiece, molecular dynamics simulation is utilized to establish a model of cutting single crystal γ-TiAl alloy using various structured nanodiamond tools. The effect of groove shape on the surface integrity of single crystal γ-TiAl alloys was investigated by analyzing mechanical properties, workpiece surface quality, and subsurface damage during the cutting process. The results show that non-structured tool cuts γ-TiAl alloy with the highest cutting force, and the V-groove tool cuts with the lowest friction coefficient, which is favorable for the removal of single crystal γ-TiAl alloy. Statistical atomic phase transitions during cutting confirmed that structured tools reduce subsurface damage, especially V-grooved tool reduce the generation of defective atoms. The circular arc grooved tool effectively reduces the subsurface temperature of the single crystal γ-TiAl alloy workpiece by reducing the friction at the tool chip interface due to lower normal cutting force. In addition, the circular arc grooved tool cutting has stronger atomic flow and surface recovery ability compared with other tools, and smaller surface roughness can be obtained. Therefore, selecting a reasonable structured tool can effectively improve the machinability of single crystal γ-TiAl alloy.

A Continuity in Logical Development: Domain-General Disjunctive Inference by Toddlers.

Children grow up surrounded by opportunities to learn (the language of their community, the movements of their body, other people's preferences and mental lives, games, social norms, etc.). Here, we find that toddlers (N = 36; age range 2.3-3.2 years) rely on a logical reasoning strategy, Disjunctive Inference (i.e., A OR B, A is ruled out, THEREFORE, B), across a variety of situations, all before they have any formal education or extensive experience with words for expressing logical meanings. In learning new words, learning new facts about a person, and finding the winner of a race, toddlers systematically consider and reject competitors before deciding who must be the winner. This suggests that toddlers may have a general-purpose logical reasoning tool that they can use in any situation.

The need for research targeting the link between occupational carcinogens and hepatopancreatobiliary cancers in Africa: A systematic review

IntroductionHepatopancreatobiliary (HPB) cancers encompassing malignancies of the liver, pancreas, gall bladder, and bile ducts pose a significant health burden in Africa. While the association of certain occupational carcinogens in cancer is well established globally, their potential role in HPB cancers remains understudied, especially in an African context. AimThis systematic review delves into the association between occupational carcinogens and HPB cancer in Africa. It examines the current state of research on occupational carcinogens and HPB cancers in Africa, identifying key challenges and knowledge gaps. MethodsThis systematic review examined publications (published between 01 January 2012 and 31 May 2023) that highlight occupational carcinogens and HBP cancers in Africa. The search was conducted on electronic databases namely PubMed, Web of Science, and Africa Wide Information. ResultDue to the lack of information on the association between occupational carcinogens and HPB cancers in Africa, as a result of the paucity of published studies, only four articles were included in this study. Hepatocellular carcinoma (HCC) was the predominant cancer associated with the occupational carcinogen, aflatoxin. Agricultural workers, especially those involved in the production and processing of maize and peanuts, appear to be the most exposed to aflatoxin. ConclusionDespite the sample size limitations due to the paucity of research studies on occupational carcinogens and HPB cancers in Africa, this study provides a reasonable tool for subsequent epidemiological studies. There is a need for more research on the association of occupational carcinogens and HPB cancers in Africa, especially with the growing industrialization.

Uncertainty of microseismic sources identification and probabilistic location in underground excavation

Microseismic (MS) source location is an integral component of MS technology and essential to understanding the rock failure mechanism and avoiding potential geological hazards in underground rock excavation. However, accurate location remains challenging owing to the complex geological conditions and unknown rock failure mechanisms. In this study, a novel location framework was developed to locate the MS source positions and their uncertainties based on probabilistic programming. Probabilistic programming was utilized to determine the coordinates of the MS source and its variation using the Markov Chain Monte Carlo (MCMC) method based on the waveform equation. A classical benchmark problem was utilized to verify and illustrate the developed framework. The developed framework can not only locate the position of the MS source but also determine its variation due to the uncertainty during the monitoring and excavation. The located MS source is in agreement with the actual positions. The results show that the developed framework is a scientific, accurate, reasonable, and promising tool for the location of MS sources. Then, the developed framework was applied to locate the position of the blasting in a practical mine. This further proved that the developed framework could locate the MS source, providing an excellent uncertainty analysis tool for underground rock excavation.

Ceftobiprole quantification in human serum by HPLC-UV to implement routine TDM in clinical practice

Background and aimsCeftobiprole is a recent 5th generation parenteral cephalosporin with antibacterial activity against a large range Gram+ and Gram− bacteria. Therapeutic drug monitoring (TDM) is an essential tool for maintaining plasma concentrations of antibiotics above the MIC by the end of the dosing interval, thus preventing the resistant strain diffusion. TDM is already recommended for other cephalosporins, and it is a reasonable tool contributing to the safety and efficacy of these drugs. During the treatment of patients in real-life, a number of pharmacokinetic (PK) changes not normally seen in healthy volunteers can occur which can impair the pharmacokinetic/pharmacodynamic target attainment.We aimed to develop simple and rapid HPLC-UV method for determination of ceftobiprole in human serum to implement TDM in clinical practice and support PKs and pharmacokinetic/pharmacodynamic (PK/PD) studies. Materials and methodsSamples preparation of calibration standards, QC, and anonymous patients serum samples was performed by protein precipitation by adding 0.01 ml of sulphosalicylic acid at 30 % to 0.1 ml of each sample. Then samples were vortexed and the centrifuged at 12,000 rpm for 10 min at 4 °C. Fifty microlitres of clear supernatant were diluted 1:1 with mobile phase and transferred into HPLC autosampler held at 8 °C. Chromatographic separation was carried out in a gradient mode at 35 °C on an ultra-Biphenyl column using a Thermo Scientific chromatographic system with a Diode array. Data management was performed with Chromeleon 7.4 software. ResultsThe HPLC-UV method proved to be linear over wide concentration ranges (0.5–50.0 mg/L) and was accurate and reproducible in the absence of matrix effects, allowing for robust, specific, and rapid quantification of ceftobiprole from a low amount of serum (0.1 mL). The mean steady state Ctrough and Cend values measured in the anonymous patients’ samples were 6.26 ± 3.81 mg/L and 22.56 ± 15.69 mg/L, respectively. ConclusionsWe report a broadened simple and fast HPLC with UV detection method for quantification of ceftobiprole in human serum to implement ceftobiprole TDM as clinical routine, and support future (PK/PD) studies in special patients’ population.

Visualization or Mathematization? The London School of Economics and “Diagrammatic Economics” in the 1930s

Although the subject of numerous contributions in the history of economics, the use of theoretical diagrams by economists is still quite misunderstood, as this practice is often characterized as a basic form of mathematization, soon replaced by more rigorous techniques of demonstration or exhibition. The present article attempts to challenge this view, focusing on a period of time, the 1930s, during which “diagrammatic economics” and other techniques coexisted, and on a specific community, that of students and young researchers from the London School of Economics with a keen interest in using diagrams as tools for economic reasoning. The cosmopolitan nature of research and education at the LSE, with its insistence on reading a vast amount of literature and attending seminars by a revolving cast of local and foreign lecturers, offered a favorable environment for a form of visual analysis that helped clarify concepts and resolve definitional issues, at a time when interest in various economic traditions had not yet given way to attempts to systematize and unify economic knowledge and its standards of production.

Inductive Diagrams for Causal Reasoning

The Lamport diagram is a pervasive and intuitive tool for informal reasoning about “happens-before” relationships in a concurrent system. However, traditional axiomatic formalizations of Lamport diagrams can be painful to work with in a mechanized setting like Agda. We propose an alternative, inductive formalization — the causal separation diagram (CSD) — that takes inspiration from string diagrams and concurrent separation logic, but enjoys a graphical syntax similar to Lamport diagrams. Critically, CSDs are based on the idea that causal relationships between events are witnessed by the paths that information follows between them. To that end, we model “happens-before” as a dependent type of paths between events. The inductive formulation of CSDs enables their interpretation into a variety of semantic domains. We demonstrate the interpretability of CSDs with a case study on properties of logical clocks , widely-used mechanisms for reifying causal relationships as data. We carry out this study by implementing a series of interpreters for CSDs, culminating in a generic proof of Lamport’s clock condition that is parametric in a choice of clock. We instantiate this proof on Lamport’s scalar clock, on Mattern’s vector clock, and on the matrix clocks of Raynal et al. and of Wuu and Bernstein, yielding verified implementations of each. The CSD formalism and our case study are mechanized in the Agda proof assistant.

Evaluating Clinical Reasoning in Undergraduate Medical Education: The Value of a Virtual Oral Assessment.

Oral assessments are essential components of board certification in numerous fields, as they provide insight into problem-solving capacity and clinical reasoning. The development of clinical reasoning often begins in undergraduate medical education and remains a challenge to assess. We developed a pilot oral assessment to evaluate medical student oral presentations and systematically assess clinical reasoning. This was incorporated into a previously existing cumulative assessment at the conclusion of the third year of medical school, with the intent to demonstrate feasibility and future reliability of this exam format. This pilot oral assessment was developed using content taught during third year clerkships. A modified Assessment of Reasoning Tool (ART) was used as the evaluation metric. It was conducted virtually to include faculty members from multiple disciplines and accommodate schedules and space limitations. A total of 152 third year medical students completed the exam, with a total of 15 faculty examiners. 89% of medical students scored as complete in hypothesis directed history, 93% in problem representation, 86% in prioritized differential diagnoses, and 67% in effectively directing management. Most examiners felt an oral assessment is effective to determine a medical student's clinical reasoning ability. Virtual oral assessments of clinical reasoning can be incorporated in undergraduate medical education to identify students struggling with components of clinical reasoning, while also allowing maximum flexibility for the clinician educator workforce as examiners. Longitudinal use of these exams would be valuable to track the development of clinical reasoning across the medical school curriculum.

Design thinking for sustainable development: A bibliometric analysis and case study research

This paper describes the role of Design Thinking (DT) in the context of sustainable development (SD), based on a perceived research need to identify the features which may characterise its deployment, and identify ways via which it may be optimised, especially in the implementation of the United Nations Sustainable Development Goals (UN SDGs). The main goal of this study is to examine the connection between DT and SD and showcase examples of what has been done to deploy it, using real-case situations. From a methodological perspective, the paper deploys a set of two methods: bibliometric analysis and case studies. Among other findings, the paper shows that DT can be used to help implement the UN SDGs by providing an approach that emphasizes human-centered design. This includes identifying problems, creating user-friendly solutions, and testing them in order to ensure that they are effective. Also, by using DT, companies, organisations, and governments can create low-cost, high-impact, and sustainable solutions to help achieve SDGs such as SDG8, SDG9, SDG12, and SDG13, among others. Overall, DT provides a framework for combining creative and analytical reasoning, specific mindsets, and diverse hands-on tools and techniques to improve critical thinking abilities towards sustainability challenges. The novelty of the paper relies on the fact that the combined use of the two methods allowed the identification of some useful features of DT, which may facilitate its deployment in sustainability contexts. This may assist future studies since it provides a theoretical basis for the field.

Development of Integrated Supportive Care Nursing Competence Scale for Cancer Survivors.

Nurses play a key role in providing integrated supportive care to cancer patients for their various needs. Efforts should be made to identify the competencies required for nurses providing integrated supportive care to cancer survivors, evaluate the competence level with reliable and reasonable tools, and continuously improve them. In Phase 1, the items of the scale were developed through a literature review and by conducting a focus group interview. In Phase 2, the validity and reliability of the scale were analyzed. A total of 504 nurses participated. Data were analyzed using item analysis, exploratory factor analysis, confirmatory factor analysis, Pearson's correlation with other scales, internal consistency, and split-half reliability. The developed scale consisted of 22 items. These items were grouped into five subscales and labeled as professionalism enhancement, care coordination, comprehensive nursing needs assessment, providing tailored information and education, and recurrence surveillance and secondary cancer prevention. Confirmatory factor analysis supported good convergent and discriminant validities. The criterion validity was verified. The internal consistency of the scale measured by Cronbach's α was 0.91. The developed scale is expected to be used as an instrument to identify cancer survivor integrated supportive care competencies of nurses in practice.

Measuring Burnout: A Validation Study of The Oldenburg Burnout Inventory for The Sri-Lankan IT Sector

Burnout is a psychological syndrome emerging as a prolonged response to chronic interpersonal stressors on the job. WHO defines burnout as an “occupational phenomenon” and is included in the 11th revision of the International Classification of Diseases (ICD-11). Research reveals the existence of this burnout phenomenon across a range of occupations, such as healthcare professionals, teachers, athletes, pilots, IT professionals etc. A study conducted by Yerbo, a mental wellbeing platform revealed that 2 in 5 of the workers in the IT industry show a high risk of burnout. At present, there are few tools available to measure burnout. After the Maslach Burnout Inventory (MBI), the Oldenburg Burnout Inventory (OLBI) is considered the most widely used measure of burnout and is also freely available. The current study is aimed at determining the measurement validity of the OLBI in the local context based on IT professionals. To determine the content validity of the OLBI, an expert panel was employed. In order to examine the construct validity and concurrent criterion validity, a questionnaire-based study was conducted among 161 (n = 161) randomly chosen IT professionals. MBI and DASS-21 were used to explore the convergent and divergent validity of the OLBI. Four items were deemed not essential to measure burnout based on content validation. The MTMM analysis revealed adequate evidence of the existence of both convergent and divergent validity of the OLBI. The current study was able to provide evidence of content, concurrent criterion and construct related validity of the OLBI in the Sri Lankan context based on IT professionals. These findings suggest that OLBI can be used as a reasonable tool to measure burnout among IT professionals in Sri Lanka. Availability of such a tool will undoubtedly help organizations in ensuring their workforce is healthy and productive. KEYWORDS: Occupational burnout, Content validity, Construct validity, Criterion validity, Oldenburg Burnout Inventory, Multi Trait Multi Method Matrix

Dietary reconstruction and influencing factors of oysters cultured in a typical estuarine bay of South China

Blue carbon can be transferred from primary producers to primary consumers through oyster filter feeding. Understanding the carbon (food) sources is crucial for understanding coastal food webs and management of oyster aquaculture ecosystems. In the present study, Bayesian stable isotope mixing models (MixSIAR) were used to identify and quantify food composition within a cultured oyster ecosystem at six sites along a salinity gradient in the estuarine bay of Zhenhai (ZHB). The carbon stable isotope (δ13C) signatures of oyster Crassostrea hongkongensis ranged from −22.06 to −27.27‰, with significant spatial differences (p < 0.001), indicating variations in food resources along the salinity gradient. The primary food source for cultured oysters was suspended particle organic matter across ZHB (55.7–90.6%), with sedimentary organic matter contributing more in the mid-estuary (28.9–44.3%). Partial least squares regression (PLSR) was used to explore the effects of habitat environment and human disturbance on spatial variation in oyster diets. The results indicated that dissolved oxygen, sediment particle size, elevation, and mangrove-related landscape indices were the main factors influencing oyster diet in ZHB. The findings provide insights into the dietary composition of cultured oysters and the underlying factors in a typical shallow bay in southern China, with particular emphasis on the role of terrestrial landscape features. In addition, the findings validate PLSR as a reasonable tool for predicting the food composition of consumers in estuarine bays.

Impact of Deficit Irrigation Strategies Using Saline Water on Soil and Peach Tree Yield in an Arid Region of Tunisia

Sustainable fruit orchard development in arid areas is severely affected by the scarcity of fresh water. To mitigate the lack of fresh water, the use of low-quality water for irrigation is becoming a common practice in several margin areas. However, salinity is considered one of the most important environmental constraints limiting the successful crop production. Therefore, the effects of deficit irrigation strategies using saline water (3.1 dS m−1) on soil water content, soil salinity, and yield of commercial peach orchard were investigated. Three irrigation treatments were considered: a Control, full irrigated (FI); and partial root-zone drying (PRD50); and deficit irrigation (DI) strategies irrigated at 50% ETc. These levels of water supply allowed for contrasting watering conditions with clear distinction between irrigation treatments. The differential pattern in soil moisture was accompanied by that of soil salinity with an increase in all FI treatments (16–25%). The results indicated that soil salinity increased with increasing water supply and evaporative demand during the growing season from January (3.2 dS m−1) to August (6.6 dS m−1). Deficit irrigation strategies (DI, PRD50) induced more soil salinity along the row emitter compared to the Control due to insufficient leaching fractions. By the end of the growing season, the soil salinity under long-term saline drip irrigation remained stable (5.3–5.7 dS m−1). An efficient leaching action seemed to be guaranteed by rainfall and facilitated by sandy soil texture, as well as the high evaporative demand and the important salt quantity supplied, which maintain the deficit irrigation strategies as valuable tools for water saving and improving water productivity. The significant water saving of 50% of water requirements induced a fruit yield loss of 20%. For this reason, DI and PRD50 could be reasonable irrigation management tools for saving water and controlling soil salinity in arid areas and on deep sandy soil.

Investigating pre-service teachers’ perceptions on readability tools: a case study in Indonesia

&lt;span lang="EN-US"&gt;The readability tools allow us to measure the readability of a text. The previous studies have elaborated the use of readability tools to analyze reading materials, but it is relatively sparse regarding the teaching of readability tools especially involving the second language teaching education (SLTE) program as a context. Therefore, this study aimed to explore the acceptance of pre-service English as a foreign language (EFL) teacher upon readability text tools. It covers their acceptance towards the tools, the extent to how the pre-service teachers accept the Web-FX and Readability Analyzer as readability tools and seeks for participants’ concerns using the tools. The study was conducted at one English Language Education Study Program at in East Java, Indonesia, involving 33 third-year undergraduate students taking pre-teaching program. Having incorporated a qualitative data analysis approach on the students’ text analysis reports and interviews, the study revealed that the participants have positive acceptance of the tools for several reasons. Some final concerns from pre-service teachers after readability tools teachings are presented, including suggestions for future research related to readability tools.&lt;/span&gt;

Abstract 90: Optimizing Triage Assessments for Large and Medium Vessel Occlusions

Introduction: Stroke symptom assessment tools are used in various settings, including telestroke triage, to identify patients who may be candidates for endovascular therapy (EVT). EVT is now being offered to more patients including those with medium vessel occlusions (MeVOs). We hypothesize that triage screening tools have differing rates of detection for large vessel occlusions (LVOs) versus medium vessel occlusions (MeVOs). Methods: Using our 2021 stroke registry, we created a retrospective cohort of ischemic stroke patients with LVO, MeVO or no occlusion. Patients were treated with the standard of care (e.g., thrombolytics, EVT). Clinical and radiographic data were abstracted for each case. Patients were evaluated for hemiparesis (HP) and vision, aphasia, or neglect (VAN) using the documented presenting exam. ROC analysis was conducted to evaluate the ability of the HP + VAN screening tool to detect LVOs and MeVOs. Results: The cohort consisted of 299 patients (median age 66 years, 48% female, 36% Black, median NIHSS score 9). Among the 175 patients with recorded HP + one of the VAN signs, 81% (n=141) had an occlusion (LVO or MeVO). HP+VAN criteria was not met by 11% of LVOs and 33% of MeVOs. HP + VAN tool performed best for the combined endpoint of LVO or MeVO (sensitivity 0.83, specificity 0.74, AUC 0.786, Figure). Variations of this tool did not significantly improve performance (additional models with AUCs will be presented) with the exception of changing the score to from HP+VAN to “HP or VAN” (sensitivity 1.00, specificity 0.25). Conclusions: In our sample from a tertiary care center, HP+VAN is a reasonable tool for the detection of LVOs or MeVOs. The only variation that improved sensitivity was screening for hemiparesis or VAN. While this prevented us from missing any LVOs or MeVOs, this approach comes at a heavy cost of reduced specificity.