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Nowadays, the increase in the number of devices using local and global networks has made it very challenging to manage network traffic, especially during epidemics and natural disasters. Traffic must be analyzed and routed efficiently while managing the network in these situations. The proposed approach focuses on effective routing by detecting elephant flows. In this study, the Deep Learning method has been utilized for elephant flow detection. In flow detection, 11 different features are extracted for each flow, and elephant flows are accurately detected. Additionally, the Grid Search method determines the parameters that yield the best results in classifying elephant and mice flows. As a result, elephant flows that have been classified are routed using the Discrete-Particle Optimization method, whereas mice flows are routed using traditional Round Robin or Random methods. The experimental results show that the proposed approach achieves a high level of accuracy in detecting elephant flows and routing them effectively while also maintaining the overall network performance.

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In the rapidly expanding landscape of medical data, the need for innovative approaches to maximize classification performance has become increasingly critical. As data volumes grow, ensuring that diagnostic systems work with accurate and relevant data is paramount for effective and generalizable classification. This study introduces a novel gradient-based sample selection method, the first of its kind in the literature, specifically designed to enhance classification accuracy by removing redundant and non-informative data. Unlike traditional methods that focus solely on feature selection, this approach integrates an advanced sample selection technique to optimize the input data, leading to more accurate and efficient diagnostics. The method is validated on multiple disease datasets, including the Wisconsin Diagnostic Breast Cancer (WDBC) dataset and the Cleveland Coronary Artery Disease (CAD) dataset, demonstrating its broad applicability and effectiveness. To address dataset imbalance, the Adaptive Synthetic Sampling (ADASYN) method is employed, followed by Particle Swarm Optimization (PSO) for feature selection. The refined datasets are then classified using a Support Vector Machine (SVM), showing that even traditional classifiers can achieve substantial improvements when enhanced with advanced sample selection. The results underscore the critical importance of precise sample selection in boosting classification performance, setting a new standard for computer-aided diagnostics and paving the way for future innovations in handling large and complex medical datasets., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Background: Esophagogastroduodenoscopy is an often-used and safe diagnostic method in gastroenterology. Transnasal esophagogastroduodenoscopy is now an established addition to the endoscopic instrumentarium. Although the two examination methods can be used alongside each other, there is a lack of studies on the comparability of the localization data obtained with the transoral and transnasal methods., Methods: In 135 adult patients presenting for routine outpatient esophagogastroduodenoscopy, transoral esophagogastroduodenoscopy (TOG) was carried out after transnasal esophagogastroduodenoscopy (TNG), and the distance from the naris or incisors, respectively, to the esophagogastric junction was measured., Results: The data for 135 patients were analyzed. With the transoral access route, the distance from the upper incisors to the cardia was a mean of 40.5 cm (SD ± 3.4 cm). In the transnasal examinations, the mean distance between the naris and the cardia was 45.6 cm (SD ± 3.5 cm). The correlation analysis showed a very close correlation between the peroral and transnasal data, with a correlation coefficient of r = 0.925. On the basis of the regression line calculated using these data, the formula TNG (cm) = 1.1 × TOG (cm) was developed. Using this formula, localization details obtained with one method can be converted into those for the other method., Conclusions: There is a strong correlation between the localization details obtained with the transnasal and transoral examination methods. The formula for converting localization details from one method to the other, presented here for the first time, is practicable for everyday use and allows rapid conversion.

The so-called buried bumper syndrome is characterised by a pathological alteration of the percutaneous endoscopic gastrostomy (PEG) in the form of a tissue overgrowth of the internal bumper of the tube. A lack of mobilisation of the tube and/or continuous traction on the PEG causes the bumper to be impacted by stomach mucosa. The consequence is a local chronic inflammatory process that may result in the occlusion of the feeding tube. As of now, different therapeutic methods exist: the surgical technique based on common laparotomy, the local invasive removal by cutting along the tube and inner flange from the outside and pulling it out (pull method) and the endoscopic recovery from inside the stomach. The authors have developed and evaluated a new endoscopic, minimally invasive technique (push method). In eight of nine patients the inner bumper could be freed by cutting with a papillotome which is brought into the stomach through the shortened PEG from the outside while maintaining endoscopic control. Afterwards the bumper is pushed to the inside with a dilatator and the patients are provided with a balloon system using the persisting stoma. The subsequent healing process proved to yield no further complications.

Diagnosis of and therapy for small bowl disease is a new challenge for modern endoscopy. Following the development of capsule endoscopy it is possible to inspect the whole small intestine. Therefore one needs adequate endoscopes in order to take tissue samples and perform the corresponding therapeutic measures. Today, the technical procedure of double-ballon enteroscopy is established and is available for routine clinical use. Double-ballon enteroscopy is usable both perorally and peranally, and can be used to inspect the entire small intestine. However, there are a few difficulties with the handling, which are time-consuming. Recently, the new single-ballon enteroscopy system SIF-Q180 was introduced which consists of a dedicated endoscope without an attached balloon, an overtube with a balloon, and an air controller to inflate or deflate the balloon of the overtube. We report the case of a patient admitted to our hospital in order to to detect the reason for an iron deficiency anaemia.

The incidence of adenocarcinoma of the esophago-gastric junction is constantly increasing. Curative treatment is no longer possible at the time of diagnosis in more than 50% of patients with esophageal carcinoma, and palliative treatment focusing on eliminating dysphagia is required. Endoscopic therapy with stent implantation is an established method of achieving this. It can be carried out quickly, with a low rate of early complications, and leads to fast symptomatic improvement, assessed using the dysphagia score. The relatively high rate of late complications such as stent migration, hemorrhage, and gastroesophageal mucosal prolapse has led to recent debate on the role of metal stents in palliative therapy. We present here a new type of stent design for transcardial application, which is intended to prevent bleeding due to mechanical mucosal lesions caused by the distal end of the stent extending into the stomach. The further intention of this case report is to force the discussion on individually designed nitinol stents in special anatomic conditions.

Background and Purpose: Patients with ulcerative colitis have a higher rate of tubular nephropathies. Data concerning the cause of these lesions is rare and inconsistent, the occurrence may be part of the disease itself or a side effect of 5-aminosalicylates (5-ASA). This study investigated proteinuria and eosinophiluria in patients with moderate ulcerative colitis under treatment with 5-ASA., Patients and Methods: Urine specimens (microelectrophoresis and eosinophiluria) of 34 patients with acute onset of moderate ulcerative colitis who were treated only with 5-ASA as active drug were analyzed., Results: Data of 27 patients could be evaluated. Twelve patients had tubular proteinuria previous to treatment. By the end of the study, urine specimens normalized in six, in further six the proteinuria remained unaltered, two patients developed proteinuria under treatment. In 14 patients, proteinuria was not detectable at any time. Eosinophiluria was found in none of the specimens., Conclusion: Under treatment with 5-ASA no toxic or allergic nephropathy developed. One initially pathologic urine specimen normalized under treatment coming along with remission of the intestinal symptoms and histological findings. This indicates an association between the activity of the ulcerative colitis and might be caused by renal excretion of pro-inflammatory cytokines.