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Researchers Use AI to Detect Wrist Fractures

By MedImaging International staff writers
Posted on 27 Apr 2021

An automated system that uses artificial intelligence (AI) is effective at detecting a common type of wrist fracture on X-rays, according to a study.

Researchers at the Jeroen Bosch Hospital ('s-Hertogenbosch, The Netherlands) and Jheronimus Academy of Data Science ('s-Hertogenbosch, The Netherlands) who developed the AI-derived algorithm said that it could help speed diagnosis and allow earlier treatment.

Scaphoid fractures are injuries to one of the small bones of the wrist that typically occur when people try to break a fall with their hands. They comprise up to 7% of all skeletal fractures. Prompt diagnosis is important, as the fracture may fail to heal properly if untreated, leading to a host of problems like arthritis and even loss of function. Conventional X-ray is the imaging technique of choice for diagnosing scaphoid fractures, but it is often limited by overlap of the scaphoid with the surrounding bones of the wrist. Variations in wrist positioning and X-ray technique can also limit the visibility of fractures.

To overcome this, the researchers studied a system that could aid radiologists in detecting these common fractures. The system is based on deep learning with a convolutional neural network, a sophisticated type of AI that is capable of discerning subtle patterns in images beyond the capabilities of the human eye. While previous research has found that a convolutional neural network was inferior to human observers at identifying scaphoid fractures on X-rays, the new study used larger datasets and further algorithm refinements to improve detection. It also employed class activation maps, which are AI tools that help users understand what region of the image is influencing the network’s predictions. The researchers used thousands of conventional X-rays of the hand, wrist and scaphoid to develop the system.

They tested it on a dataset of 190 X-rays and compared its performance to that of 11 radiologists. The system had a sensitivity of 78% for detecting fractures with a positive predictive value of 83%, which refers to the likelihood that patients the AI identifies as having a fracture really do have one. Analysis showed that the system performed comparably to the 11 radiologists. The class activation maps were found to overlap with fracture lines in the scaphoid, suggesting they could be used for localizing potential fractures. The researchers plan to expand the scaphoid fracture detection system so that it can combine multiple X-ray views for its predictions. They are also conducting an experimental study in which radiologists are asked to identify scaphoid fractures on X-rays with and without the aid of the fracture detection system. The researchers hope to extend the system to fracture detection in other bone structures.

The system has significant potential in clinical use as it could reduce the incidence and costs of additional imaging exams and unnecessary therapy, speed up diagnosis and allow earlier treatment. The system may be able to assist residents, radiologists or other physicians by acting either as a first or second reader, or as a triage tool that helps prioritize worklists, potentially reducing the risk of missing a fracture. Such assistance could prevent delayed therapy and reduce complications that may lead to a subpar clinical outcome, according to the researchers.

“The convolutional neural network may also reduce unnecessary wrist immobilization, performed out of precaution, in more than half of the patients with clinical suspicion for having a scaphoid fracture,” said study lead author Nils Hendrix.

Related Links:
Jeroen Bosch Hospital
Jheronimus Academy of Data Science

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63 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

64 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

65 (!!!!! 3951.0726928711): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

66 (628.94821166992): SELECT fid FROM jos_deeppockets WHERE id=294788027 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294788027 AND published='1' LIMIT 1

67 (299.93057250977): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=217 ORDER BY `ordering`

68 (51.021575927734): select jos_twitters.link from jos_twitters where cat=10

69 (28.133392333984): select jos_facebook.link from jos_facebook where cat=10

70 (31.948089599609): select jos_google_plus.link from jos_google_plus where cat=10

71 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

72 (30.994415283203): SELECT fid FROM jos_deeppockets WHERE id=294788027 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294788027 AND published='1' LIMIT 1

73 (30.994415283203): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=217 ORDER BY `ordering`

74 (328.06396484375): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294788027 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (245.80955505371): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294788027 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

76 (48.160552978516): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

77 (!!!!! 1703.9775848389): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (87.976455688477): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (127.07710266113): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (501.87110900879): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (668.04885864258): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294788027 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

92 (35.04753112793): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294788027 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

93 (35.04753112793): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

94 (398.87428283691): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (141.14379882812): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (202.17895507812): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (114.20249938965): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (194.07272338867): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (110.86463928223): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (499.96376037598): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

109 (329.97131347656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

110 (54.836273193359): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294788027 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (542.87910461426): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294788027 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (976.8009185791): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

113 (!!!!! 1950.0255584717): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

114 (51.021575927734): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294788027 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (540.97175598145): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294788027 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (!!!!! 3700.0179290771): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

117 (682.11555480957): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

118 (358.10470581055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

119 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

120 (!!!!! 1142.0249938965): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

121 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

122 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

123 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

124 (308.99047851562): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 43219.089508057): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

126 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

127 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

128 (416.04042053223): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294788027 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294788027 AND type='deeppockets_item' AND published='1' LIMIT 1

129 (!!!!! 880944.9672699): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

130 (456.09474182129): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

131 (318.05038452148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

132 (37.908554077148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

133 (372.88665771484): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

134 (80.108642578125): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

135 (379.08554077148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

136 (80.108642578125): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

137 (342.84591674805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (267.02880859375): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (119.92454528809): SELECT name FROM jos_deeppockets WHERE id=217

140 (30.040740966797): SELECT name FROM jos_deeppockets WHERE id=217

141 (475.88348388672): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))217((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

142 (416.04042053223): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))217((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

144 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

145 (!!!!! 11783.123016357): TRUNCATE TABLE jos_trademed_module

146 (214.0998840332): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294788027 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (93.936920166016): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294788027 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (334.02442932129): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (162.83988952637): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

151 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

152 (967.97943115234): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

153 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

154 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

155 (36.001205444336): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294788027 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294788027 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (30.994415283203): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=217 or channel_id is null)

157 (27.179718017578): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=217 or channel_id is null)

158 (28.848648071289): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (!!!!! 3365.0398254395): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

160 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294788027 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294788027 AND published='1' LIMIT 1

161 (558.13789367676): select jos_twitters.link from jos_twitters where cat=10

162 (231.98127746582): select jos_facebook.link from jos_facebook where cat=10

163 (850.91590881348): select jos_google_plus.link from jos_google_plus where cat=10

164 (301.12266540527): select jos_linkedin.link from jos_linkedin where cat=10

165 (451.08795166016): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

166 (!!!!! 2078.0563354492): insert into jos_banners_delta values (14615,'2025-05-01 03:01:27','3.22.242.110','view'),(14202,'2025-05-01 03:01:27','3.22.242.110','view'),(14203,'2025-05-01 03:01:27','3.22.242.110','view')

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