Search results for: large claims

Authors: Mansi Chinchanikar

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Homoeopathy is the second most widely used medical system in the world, yet the homoeopaths of India and around the world are sick of reading or hearing about how homoeopathy is only a placebo effect and cannot cure or even manage any disease. However, individuals making such unfounded claims should explain to the group how a homoeopathic placebo, particularly one for a neurodevelopmental disease like Attention Deficit Hyperactivity Disorder (ADHD), can be effective in children, with studies to back it up their skeptics. This literary review work exhibits how homoeopathy with a multimodal approach may show a considerable proportion of ADHD patients in India and throughout the world successfully manageable and treatable according to growing study evidence, ruling out the hazardous conventional medicines. Indeed, homeopathy can help cure ADHD symptoms either on its own or in combination with other types of integrative systems.

Keywords: ADHD, adult ADHD, homoeopathy, integrative approach

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Authors: Zina Benouaret, Djamil Aissani

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In this work, we introduce the qualitative and quantitative concept of the strong stability method in the risk process modeling two lines of business of the same insurance company or an insurance and re-insurance companies that divide between them both claims and premiums with a certain proportion. The approach proposed is based on the identification of the ruin probability associate to the model considered, with a stationary distribution of a Markov random process called a reversed process. Our objective, after clarifying the condition and the perturbation domain of parameters, is to obtain the stability inequality of the ruin probability which is applied to estimate the approximation error of a model with disturbance parameters by the considered model. In the stability bound obtained, all constants are explicitly written.

Keywords: Markov chain, risk models, ruin probabilities, strong stability analysis

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Authors: Lu Si, Jie Yu, Shasha Li, Jun Ma, Lei Luo, Qingbo Wu, Yongqi Ma, Zhengji Liu

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Instance selection (IS) technique is used to reduce the data size to improve the performance of data mining methods. Recently, to process very large data set, several proposed methods divide the training set into some disjoint subsets and apply IS algorithms independently to each subset. In this paper, we analyze the limitation of these methods and give our viewpoint about how to divide and conquer in IS procedure. Then, based on fast condensed nearest neighbor (FCNN) rule, we propose a large data sets instance selection method with MapReduce framework. Besides ensuring the prediction accuracy and reduction rate, it has two desirable properties: First, it reduces the work load in the aggregation node; Second and most important, it produces the same result with the sequential version, which other parallel methods cannot achieve. We evaluate the performance of FCNN-MR on one small data set and two large data sets. The experimental results show that it is effective and practical.

Keywords: instance selection, data reduction, MapReduce, kNN

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Authors: Eunice Chiamaka Allen-Ngbale

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Cargo claims are brought by cargo interests against carriers when the goods are not delivered or delivered short or mis-delivered or delivered damaged. The objective of the cargo claimant is to seek recovery for the loss suffered through the award of damages against the carrier by a court of competent jurisdiction. Moreover, whether the vessel on which the goods were carried is or is not under charter, the bill of lading plays a central role in the cargo claim. Since the bill of lading is an important international transport document, this paper examines, by chronicling the progress of a cargo claim as governed by the English law of contract. It finds that other than by contract, there are other modes of recovery available to a consignee or endorsee of a bill of lading to obtain a remedy under the sui generis contract of carriage contained in or evidenced by a bill of lading.

Keywords: bill of lading, cargo interests, carriage contract, transfer of right of suit

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Authors: Youssef Abdelli, Rachid Nasri

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The large amplitude free vibration analysis of three-layered symmetric sandwich beams is carried out using two different approaches. The governing nonlinear partial differential equations of motion in free natural vibration are derived using Hamilton's principle. The formulation leads to two nonlinear partial differential equations that are coupled both in axial and binding deformations. In the first approach, the method of multiple scales is applied directly to the governing equation that is a nonlinear partial differential equation. In the second approach, we discretize the governing equation by using Galerkin's procedure and then apply the shooting method to the obtained ordinary differential equations. In order to check the validity of the solutions obtained by the two approaches, they are compared with the solutions obtained by two approaches; they are compared with the solutions obtained numerically by the finite difference method.

Keywords: finite difference method, large amplitude vibration, multiple scales, nonlinear vibration

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Authors: Haneffa M. G.

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Retirement preparedness among Malaysian working individuals found to be poor. Prior research proven women consistently have lower retirement confidence as compared to men. Retirement planning still become the vague issues due to saving for the golden years are being stepsided by many people. Most of them think that their contributions in companies and government retirement plan is enough to comfort them in their golden years. The Employee Provident Fund (EPF) claims that most of nearly retired person have inadequate fund to retire. Therefore, this paper aims to discuss the saving behavior of younger cohort of working individuals towards retirement planning in Malaysia. A theoretical framework is developed to understand the relationship between demographic characteristics, financial education, goal clarity, perceived religiosity and retirement savings behavior.

Keywords: retirement planning, savings behavior, perceived religiosity, goal clarity, Malaysia

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Authors: Gangmin Li, Fan Yang

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Personalized recommendation is crucial for any recommendation system. One of the techniques for personalized recommendation is to identify the intention. Traditional user intention identification uses the user’s selection when facing multiple items. This modeling relies primarily on historical behaviour data resulting in challenges such as the cold start, unintended choice, and failure to capture intention when items are new. Motivated by recent advancements in Large Language Models (LLMs) like ChatGPT, we present an approach for user intention identification by embracing LLMs with Chain-of-Thought (CoT) prompting. We use the initial user profile as input to LLMs and design a collection of prompts to align the LLM's response through various recommendation tasks encompassing rating prediction, search and browse history, user clarification, etc. Our tests on real-world datasets demonstrate the improvements in recommendation by explicit user intention identification and, with that intention, merged into a user model.

Keywords: personalized recommendation, generative user modelling, user intention identification, large language models, chain-of-thought prompting

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Authors: Teerada Apibunyopas, Nithinant Thammakoranonta

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Many organizations bring e-Learning to use as a tool in their training and human development department. It is getting more popular because it is easy to access to get knowledge all the time and also it provides a rich content, which can develop the employees skill efficiently. This study focused on the factors that affect using e-Learning efficiently, so it will make job satisfaction increased. The questionnaires were sent to employees in large commercial banks, which use e-Learning located in Bangkok, the results from multiple linear regression analysis showed that employee’s characteristics, characteristics of e-Learning, learning and growth have influence on job satisfaction.

Keywords: e-Learning, job satisfaction, learning and growth, Bangkok

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Authors: E. Behmanesh, J. Pannek

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The distribution-allocation problem is known as one of the most comprehensive strategic decision. In real-world cases, it is impossible to solve a distribution-allocation problem in traditional ways with acceptable time. Hence researchers develop efficient non-traditional techniques for the large-term operation of the whole supply chain. These techniques provide near-optimal solutions particularly for large scales test problems. This paper, presents an integrated supply chain model which is flexible in the delivery path. As the solution methodology, we apply a memetic algorithm with a novelty in population presentation. To illustrate the performance of the proposed memetic algorithm, LINGO optimization software serves as a comparison basis for small size problems. In large size cases that we are dealing with in the real world, the Genetic algorithm as the second metaheuristic algorithm is considered to compare the results and show the efficiency of the memetic algorithm.

Keywords: integrated logistics network, flexible path, memetic algorithm, genetic algorithm

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Authors: Eun-Jun Yoon

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Deniable authentication protocol is a new security authentication mechanism which can enable a receiver to identify the true source of a given message, but not to prove the identity of the sender to a third party. In 2013, Kar proposed a secure ID-based deniable authentication protocol whose security is based on computational infeasibility of solving Elliptic Curve Diffie-Hellman Problem (ECDHP). Kar claimed that the proposed protocol achieves properties of deniable authentication, mutual authentication, and message confidentiality. However, this paper points out that Kar's protocol still suffers from sender spoofing attack and message modification attack unlike its claims.

Keywords: deniable authentication, elliptic curve cryptography, Diffie-Hellman problem, cryptanalysis

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Authors: Noman Shabbir, Roheel Nawaz, Muhammad N. Iqbal, Junaid Zafar

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This paper focuses on the performance evaluation of routing protocols in WLAN based Wireless Sensor Networks (WSNs). A comparative analysis of routing protocols such as Ad-hoc On-demand Distance Vector Routing System (AODV), Dynamic Source Routing (DSR) and Optimized Link State Routing (OLSR) is been made against different network parameters like network load, end to end delay and throughput in small, medium and large-scale sensor network scenarios to identify the best performing protocol. Simulation results indicate that OLSR gives minimum network load in all three scenarios while AODV gives the best throughput in small scale network but in medium and large scale networks, DSR is better. In terms of delay, OLSR is more efficient in small and medium scale network while AODV is slightly better in large networks.

Keywords: WLAN, WSN, AODV, DSR, OLSR

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Authors: Libin Ouyang

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China has experienced a very fast urbanization process in the past two decades. Due to the uncoordinated characteristics of regional development in China, a large number of people from rural areas or small towns have flooded into regional central cities, which are building new cities around them due to the shortage of construction land or the need for urban development. However, the construction of some new cities has not achieved the expected effect, the absorption capacity of industry and population is limited, and the phenomenon of capital and land waste is obvious. This paper takes the Xixian New Area in Shaanxi Province, an inland region in Northwest China, as an example, and tries to analyse the reasons for the lack of vitality in the current situation of the Xixian New Area from the perspective of site layout and urban design, analyses the practical experience of the construction of new city cores in developed countries and regions, and studies how to optimise at the level of site layout planning and urban design to improve the vitality and attractiveness of the new city, decongest the population of large cities, effectively solve the problems of large cities, and promote The study will also examine how to optimise land use planning and urban design to enhance the vitality and attractiveness of new cities, relieve the population of large cities, effectively solve the problems of large cities and promote sustainable development of new cities. The study can serve as a reference for urban planners and policy makers, provide theoretical assistance for new city construction in other less developed regions of China, and provide some case references for urban construction in other developing countries undergoing rapid urbanisation.

Keywords: new city, land use layout, urban design, attraction

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Authors: Alvaro Javier Ortega

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A large number of companies face the challenge of matching highly-skilled professionals to high-end positions by human resource deployment professionals. However, when the professional list and tasks to be matched are larger than a few dozens, this process result is far from optimal and takes a long time to be made. Therefore, an automated assignment algorithm for this workforce management problem is needed. The majority of companies are divided into several sectors or departments, where trained employees with different experience levels deal with a large number of tasks daily. Also, the execution order of all tasks is of mater consequence, due to some of these tasks just can be run it if the result of another task is provided. Thus, a wrong execution order leads to large waiting times between consecutive tasks. The desired goal is, therefore, creating accurate matches and a near-optimal execution order that maximizes the number of tasks performed and minimizes the idle time of the expensive skilled employees. The problem described before can be model as a mixed-integer non-linear programming (MINLP) as it will be shown in detail through this paper. A large number of MINLP algorithms have been proposed in the literature. Here, genetic algorithm solutions are considered and a comparison between two different mutation approaches is presented. The simulated results considering different complexity levels of assignment decisions show the appropriateness of the proposed model.

Keywords: employees, genetic algorithm, industry management, workforce

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Authors: Yilei Song, Linlin Tian, Ning Zhao

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Turbulence energetics and structures in the wake of large-scale wind turbines under the stably-stratified atmospheric boundary layer (SABL) can be complicated due to the presence of low-level jets (LLJs), a region of higher wind speeds than the geostrophic wind speed. With a modified one-k-equation, eddy viscosity model specified for atmospheric flows as the sub-grid scale (SGS) model, a realistic atmospheric state of the stable ABL is well reproduced by large-eddy simulation (LES) techniques. Corresponding to the precursor stably stratification, the detailed wake properties of a standard 5-MW wind turbine represented as an actuator line model are provided. An engineering model is proposed for wake prediction based on the simulation statistics and gets validated. Results confirm that the proposed wake model can provide good predictions for wind turbines under the SABL.

Keywords: large-eddy simulation, stably-stratified atmospheric boundary layer, wake model, wind turbine wake

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Authors: Andrey A. Chernousov, Ben Y. B. Chan

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The thermal behavior of a large-scale, phase change material (PCM) enhanced building envelope system was studied in regard to the need for pre-fabricated construction in subtropical regions. The proposed large-scale envelope consists of a reinforced aluminum skin, insulation core, phase change material and reinforced gypsum board. The PCM impact on an energy efficiency of an enveloped room was resolved by validation of the Energy Plus numerical scheme and optimization of a smart material location in the core. The PCM location was optimized by a minimization method of a cooling energy demand. It has been shown that there is good agreement between the test and simulation results. The optimal location of the PCM layer in Hong Kong summer conditions has been then recomputed for core thicknesses of 40, 60 and 80 mm. A non-dimensional value of the optimal PCM location was obtained to be same for all the studied cases and the considered external and internal conditions.

Keywords: thermal performance, phase change material, energy efficiency, PCM optimization

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Authors: Tugba Ayas Onol

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The paper revisits Jean-François Lyotard’s interpretation of the Kantian Sublime as a tool for understanding politics after modernity. In 1985 Lyotard announces the end of rational politics based on consensus and claims that new strategies are urged to recognize the political imperatives of marginalized groups. The charm of the sublime as a reflective judgment is grounded on the fact that the judgment of sublime is free from any notion of consensus or common sense in particular. Lyotard interprets this feature of the sublime as a respect for heterogeneity and for him aesthetic judgments can be a model for understanding justice in postmodern times, in which it seems hard to follow a single universal law among different phrase regimes. More importantly, the Kantian sublime speaks to what Lyotard addresses as the incommensurability of phase genres. The present paper shall try to evaluate Lyotard’s employment of the Kantian notion of the sublime in relation to its possible political import.

Keywords: Kant, Lyotard, sublime, politics

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Authors: Siwapong Dheera-Aumpon

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Resource misallocation is known to be prevalent in many countries. Such misallocation in the manufacturing sector is large and has a considerable negative effect on aggregate productivity. Thailand is one of the countries having large resource misallocation in the manufacturing sector. Resource misallocation is also known to be widespread in the agricultural sector. It is, therefore, likely that resource misallocation exists in the agricultural sector of Thailand as well. This study aims to evaluate the extent of resource misallocation in Thai rice farming. Using household-level data from 2013 Thai Agricultural Census, this study calculates farm total factor productivity (TFP) controlling for land quality and rain. Similar to the case of Malawi, marginal products of land and capital are found to be related to farm TFP implying large resource misallocation. The output gain from a reallocation of resources to their best use is 67 percent. The gain from reallocation is highest for farms in the southern region and followed by the northeastern region.

Keywords: agriculture, misallocation, productivity, rice

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Authors: Ellen Van Den Oord, Julien Marie Jan Ferdinand Van Campen

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This article introduces a computationally efficient method for stacking sequence blending of composite structures. The computational efficiency makes the presented method especially interesting for composite structures with a large number of design regions. Optimization of composite structures with an unequal load distribution may lead to locally optimized thicknesses and ply orientations that are incompatible with one another. Blending constraints can be enforced to achieve structural continuity. In literature, many methods can be found to implement structural continuity by means of stacking sequence blending in one way or another. The complexity of the problem makes the blending of a structure with a large number of adjacent design regions, and thus stacking sequences, prohibitive. In this work the local stacking sequence optimization is preconditioned using a method found in the literature that couples the mechanical behavior of the laminate, in the form of lamination parameters, to blending constraints, yielding near-optimal easy-to-blend designs. The preconditioned design is then fed to the scheme using cellular automata that have been developed by the authors. The method is applied to the benchmark 18-panel horseshoe blending problem to demonstrate its performance. The computational efficiency of the proposed method makes it especially suited for composite structures with a large number of design regions.

Keywords: composite, blending, optimization, lamination parameters

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Authors: Intan Izafina Idrus, Mardina Abdullah, Alina Marie Hasbi, Asnawi Husin

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This paper presents the result of large-scale traveling ionospheric disturbance (LSTID) observation during moderate magnetic storm event on 25 October 2011 with SYM-H ~ -160 nT and Kp ~ 7 over Peninsular Malaysia at equatorial region using vertical total electron content (VTEC) from the Global Positioning System (GPS) observation measurement. The propagation of the LSTID signatures in the TEC measurements over Peninsular Malaysia was also investigated using VTEC map. The LSTID was found to propagate equator-ward during this event. The results showed that the LSTID propagated with an average phase velocity of 526.41 m/s and average periods of 140 min. The occurrence of this LSTID was also found to be the subsequent effects of substorm activities in the auroral region.

Keywords: Global Positioning System (GPS), large-scale traveling ionospheric disturbance (LSTID), moderate geomagnetic storm, vertical total electron content (VTEC)

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Authors: A. L. Agarwal, D. A. Mahajan

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Construction industry tumbled along with other industry/sectors during recent economic crash. Construction business could not regain thereafter and still pass through slowdown phase, resulted many real estate as well as infrastructure projects not completed on schedule and within budget. There are many theories, tools, techniques with software packages available in the market to analyze construction schedule. This study focuses on the construction project schedule and uncertainties associated with construction activities. The infrastructure construction project has been considered for the analysis of uncertainty on project activities affecting project duration and analysis is done using @RISK software. Different simulation results arising from three probability distribution functions are compiled to benefit construction project managers to plan more realistic schedule of various construction activities as well as project completion to document in the contract and avoid compensations or claims arising out of missing the planned schedule.

Keywords: construction project, distributions, project schedule, uncertainty

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Authors: Ramin Mirzada, Takuya Maruyama

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Kabul is the heart of political, commercial, cultural, educational and social life in Afghanistan and the fifth fastest growing city in the world. Minimum income inclined most of Kabul residents to use public transport, especially buses, although there is no proper bus system, beside that there is no proper fare exist in Kabul city Due to wars. From 1992 to 2001 during civil wars, Kabul suffered damage and destruction of its transportation facilities including pavements, sidewalks, traffic circles, drainage systems, traffic signs and signals, trolleybuses and almost all of the public transport system (e.g. Millie bus). This research is mainly focused on Kabul city’s transportation system. In this research, the data used have been gathered by Japan International Cooperation Agency (JICA) in 2008 and this data will be used to find demand and fare structure, additionally a survey was done in 2016 to find satisfaction level of Kabul residents for fare structure. Aim of this research is to observe the demand for Large Buses, compare to the actual supply from the government, analyze the current fare structure and compare it with the proposed fare (distance based fare) structure which has already been analyzed. Outcome of this research shows that the demand of Kabul city residents for the public transport (Large Buses) exceeds from the current supply, so that current public transportation (Large Buses) is not sufficient to serve public transport in Kabul city, worth to be mentioned, that in order to overcome this problem, there is no need to build new roads or exclusive way for buses. This research proposes government to change the fare from fixed fare to distance based fare, invest on public transportation and increase the number of large buses so that the current demand for public transport is met.

Keywords: transportation, planning, public transport, large buses, Kabul, Afghanistan

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Authors: Bilal Wajid, Erchin Serpedin

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The health industry is aiming towards personalized medicine. If the patient’s genome needs to be sequenced it is important that the entire analysis be completed quickly. This paper explores use of parallel computing to analyze very large sequences. Two cases have been considered. In the first case, the sequence is kept constant and the effect of increasing the number of MPI-based processes is evaluated in terms of execution time, speed and efficiency. In the second case the number of MPI-based processes have been kept constant whereas, the length of the sequence was increased.

Keywords: parallel computing, alignment, genome assembly, alignment

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Authors: Wasse Uddin Ahmed Saleh, Nawreenbinte Anwar

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A well-written operating note is crucial as a teaching tool for providing patients with high-quality medical care and fending off medico-legal claims. In this review article, some adjustments have been advised to the operative note guidelines by the Royal College of Surgeons (RCS) for different methods of ocular anesthesia and ophthalmic procedures like cataract surgeries, kerato-refractive surgeries, glaucoma surgeries, oculoplastic surgeries, etc. Some modifications of the WHO Surgical Safety Checklist have also been mentioned, including pre-operative responsibilities of the nurses, operative assistants and operating ophthalmologists. It has become essential to assemble globally accepted structured operative note guidelines modified for each ocular surgery.

Keywords: ocular surgeries, operation notes, cataract surgery, kerato-refractive surgery, Oculoplastic surgeries, guidelines

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Authors: Zaheer A. Ali, George Szabo

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SCRUM has roots in software and web development and works very well on that in that space. However, any technical person who has watched a typical waterfall managed project spiral out of control or into an abyss, has thought: "there must be a better way". I will discuss how that thought leads naturally to adopting Agile principles and SCRUM, as well as how Agile and SCRUM can be implemented in large institutions with long histories via a method I developed: Bubble Scrum. We will also see how SCRUM can be implemented in interesting places outside of the technical sphere and also discuss where and how to subtly bring Agility and SCRUM into large, rigid, institutions.

Keywords: agile, enterprise-agile, agile at scale, agile transition, project management, scrum

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Authors: Riad

Abstract:

As present world needs more and more energy in a low cost way, it needs to find out the optimal way of power generation. In the sense of low cost, renewable energy is one of the greatest sources of power generation. Water vapour of sea/river/lake can be used for power generation by using the greenhouse effect in a large flat type water chamber floating on the water surface. The water chamber will always be kept half filled. When water evaporates by sunlight, the high pressured gaseous water will be stored in the chamber. By passing through a pipe and by using aerodynamics it can be used for power generation. The water level of the chamber is controlled by some means. As a large amount of water evaporates, an estimation can be highlighted, approximately 3 to 4 thousand gallons of water evaporates from per acre of surface (this amount will be more by greenhouse effect). This large amount of gaseous water can be utilized for power generation by passing through a pipe. This method can be a source of power generation.

Keywords: renewable energy, greenhouse effect, water chamber, water vapour

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Authors: Asim Shabir, Ruqia Shaikh

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Supersized pricing is an effective strategy often used by marketers to make consumers buy more. However, such a strategy also results in more purchases and consumption, especially of hedonic food products. This study brings interesting insights about supersized pricing as it provides value-based justification to consumers; as a result, the guilt associated with the purchase and consumption of hedonic products diminishes, which mediates the impact between supersized pricing and size choice. Interestingly, there is a three-way interaction between pricing, product type, and health goal prime. Health prime diminishes the impact of supersized pricing in the case of more hedonic products (unhealthy) compared to less hedonic (perceived as healthy) products.

Keywords: supersized pricing, anticipated consumption guilt, health claim, product type

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Authors: Arun Prasad

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Introduction: Laparoscopic surgery of hernia started in early 1990 and has had a mixed acceptance across the world, unlike laparoscopic cholecystectomy that has become a gold standard. Laparoscopic hernia repair claims to have less pain, less recurrence, and less wound infection compared to open hernia repair leading to early recovery and return to work. Materials and Methods: Laparoscopic hernia repair has been done in 2100 patients from 1995 till now with a follow-up data of 1350 patients. Data was analysed for results and satisfaction. Results: There is a recurrence rate of 0.1%. Early complications include bleeding, trocar injury and nerve pain. Late complications were rare. Conclusion: Laparoscopic inguinal hernia repair has a steep learning curve but after that the results and patient satisfaction are very good. It should be the procedure of choice in all bilateral and recurrent hernias.

Keywords: laparoscopy, hernia, mesh, surgery

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Authors: S. Werrlich, E. Eichstetter, K. Nitsche, G. Notni

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Augmented Reality (AR) is a strong growing research topic in different training domains such as medicine, sports, military, education and industrial use cases like assembly and maintenance tasks. AR claims to improve the efficiency and skill-transfer of training tasks. This paper gives a comprehensive overview of evaluations using AR for assembly and maintenance training tasks published between 1992 and 2017. We search in a structured way in four different online databases and get 862 results. We select 17 relevant articles focusing on evaluating AR-based training applications for assembly and maintenance tasks. This paper also indicates design guidelines which are necessary for creating a successful application for an AR-based training. We also present five scientific limitations in the field of AR-based training for assembly tasks. Finally, we show our approach to solve current research problems using Design Science Research (DSR).

Keywords: assembly, augmented reality, survey, training

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Authors: Kuznetsova Tamara, Sametova Fauziya

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Modern period of educational development is characterized by various attempts in higher quality and effective result provision. Having acquired the modernized educational paradigm, our academic community placed the personality development through language and culture under the focus of primary research. The competency-based concept claims for professionally ready specialists who are capable of solving practical problems. In this sense, under the circumstances of the current development of Kazakhstani society, it is inevitable to form the ability to conduct argumentative discourse as the crucial element of intercultural communicative competence. This article particularly states the necessity of the culture of argumentative discourse formation presents theoretical background of its organization and aims at identifying important argumentative skills within educational process.

Keywords: argumentative discourse, teaching process, skills, competency

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Authors: Angelis P. Barlampas

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PURPOSE: The purpose of this paper is to demonstrate the important role of taking an appropriate and detailed history, in order to reach the best possible diagnostic conclusion. MATERIAL: A patient presented to the emergency department due to the sudden onset of continuous abdominal pain, during the last hour and with the clinical symptoms of an acute abdomen. During the clinical examination, signs of peritoneal irritation and diffuse abdominal tenderness were found. The rest of the clinical and laboratory tests did not reveal anything important. From the reported medical history, nothing of note was found, except for the report of a large liver cyst, for which he was advised not to take any further action, except from regular ultrasound examination . METHOD: A computed tomography examination was performed after per os administration of gastrografin, which revealed a hyperdense ascitic effusion, similar in density to that of gastrografin within the intestinal tract. The presence of a large cyst of the left hepatic lobe was confirmed, contacting and pushing against the stomach. In the area of the contact between the liver cyst and the pylorus, there were extraluminal air bubbles and local opacity of the peritoneal fat, with a small hyperdense effusion. Result : The above, as well as the absence of a history of stomach ulcer or recent trauma, or other pathology, argue in favor of acute pyloric perforation, due to mural necrosis, in response to chronic external pressure from the pre-existing large liver cyst.

Keywords: perforation, stomach, large liver cyst, CT abdomen, acute abdominal pain, intraperitoneal leakage, constrast leakage

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