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Game-Changing AI Software That Helps Diagnose Breast and Thyroid Cancers Receives US FDA Clearance

By MedImaging International staff writers
Posted on 20 Dec 2021

A new artificial intelligence (AI) enabled software that improves cancer detection with fewer false positives and avoidable procedures has been cleared for use by physicians interpreting ultrasound exams.

Koios Medical, Inc. (New York, NY, USA) has received FDA clearance for Koios DS, its AI-based software platform used to diagnose thyroid and breast cancer. The new system, built using ultrasound data from a network of 48 sites around the world, aids physicians in accurately diagnosing disease and improves speed to treatment while reducing avoidable surgical procedures.

Breast cancer is the second most diagnosed cancer in women worldwide. An ultrasound exam is the standard of care for women with dense breast tissue. Thyroid disease is one of the most complex and challenging radiological interpretations. Diagnostic uncertainty drives a high level of variability across physicians and results in surgical procedures, downstream cost, risk of complication and physician burn-out.

The company performed studies that proved physicians using Koios DS software dramatically improved accuracy, consistency, and efficiency. Physicians’ thyroid cancer detection rates jumped by up to 14% while simultaneously reducing false positive biopsy orders by over 35%. Interpretation variability was lowered by over 50% and time spent per case dropped by 24%.

The patented AI software aligns Koios DS AI generated findings directly to the American College of Radiology’s BI-RADS and TI-RADS rating systems as well as the American Thyroid Association’s system for tissue classification, scoring and patient management. The AMA recently announced new CPT Category 3 codes for whenever Koios DS software is utilized interpreting, classifying and reporting traditional ultrasound exams.

The rigor of the FDA clearance process required that Koios DS be proven to accurately interpret images from all major ultrasound hardware manufacturers. The software is compatible with major PACS workstation viewers and integrated into GE Healthcare’s LOGIQ E10 ultrasound scanner. The system enables real-time decision-making with results that can be exported directly into a patient's record and all major reporting systems, reducing errors and saving time.

“The typical decision-making paradigm relies on tradeoffs; trading sensitivity for specificity, efficiency for thoroughness, but the only thing enforcing this paradigm is the inability to shift off of these tradeoff curves in place of shifting along them,” said Dr. Lev Barinov, VP of Clinical Excellence. “This novel software demonstrates that using AI for decision support physicians can make clinically meaningful shifts in performance improving interpretation efficacy and diagnostic performance, improving sensitivity and reducing false positives. It is exciting to bring these innovations to physicians and ultimately their patients to elevate the level of care broadly.”

“The ability of physicians and health systems to now code and bill for the use of this innovative and effective technology will most certainly accelerate adoption, putting the software into the hands of physicians for the benefit of patients nationwide,” added Graham Anderson, Koios Medical CFO.

“The loss of life globally to cancers found too late, or misdiagnosed, is tragic. When combined with the millions wasted on avoidable procedures we are compelled to relentlessly innovate, building powerful AI models directly into easy-to-use software,” said Koios Medical CEO Chad McClennan. “This new FDA clearance means physicians are now poised to save tens of thousands of lives while freeing up precious time and resources that can be used more effectively and elevate quality of life.”

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63 (133.99124145508): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

64 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

65 (98.943710327148): 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 (494.95697021484): SELECT fid FROM jos_deeppockets WHERE id=294790995 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294790995 AND published='1' LIMIT 1

67 (49.114227294922): 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=215 ORDER BY `ordering`

68 (42.915344238281): select jos_twitters.link from jos_twitters where cat=10

69 (69.141387939453): select jos_facebook.link from jos_facebook where cat=10

70 (30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10

71 (53.882598876953): select jos_linkedin.link from jos_linkedin where cat=10

72 (30.994415283203): SELECT fid FROM jos_deeppockets WHERE id=294790995 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294790995 AND published='1' LIMIT 1

73 (32.186508178711): 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=215 ORDER BY `ordering`

74 (359.05838012695): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294790995 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

75 (356.91261291504): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294790995 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

76 (104.90417480469): 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 (92.029571533203): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (44.107437133789): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (41.007995605469): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294790995 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=294790995 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

93 (32.901763916016): 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 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (53.882598876953): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

109 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

110 (72.956085205078): 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=294790995 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (67.949295043945): 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=294790995 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

113 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

114 (96.08268737793): 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=294790995 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (971.07887268066): 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=294790995 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (725.98457336426): 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 (406.02684020996): 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 (89.168548583984): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

119 (123.02398681641): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

120 (110.14938354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

121 (74.863433837891): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

122 (94.175338745117): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

123 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

124 (294.92378234863): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 28280.973434448): 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 (99.897384643555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

127 (92.029571533203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

128 (435.82916259766): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294790995 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294790995 AND type='deeppockets_item' AND published='1' LIMIT 1

129 (!!!!! 453508.85391235): ( 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 (88.930130004883): ( 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 (41.961669921875): 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 (29.087066650391): 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 (46.968460083008): 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 (28.848648071289): 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 (27.894973754883): 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 (32.901763916016): 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 (458.0020904541): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (423.90823364258): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (41.007995605469): SELECT name FROM jos_deeppockets WHERE id=215

140 (29.087066650391): SELECT name FROM jos_deeppockets WHERE id=215

141 (488.9965057373): 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 '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

142 (381.9465637207): 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 '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

143 (59.127807617188): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

144 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

145 (!!!!! 8866.0717010498): TRUNCATE TABLE jos_trademed_module

146 (84.877014160156): 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=294790995 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (57.220458984375): 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=294790995 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (797.03330993652): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (92.029571533203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

151 (39.815902709961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

152 (!!!!! 1053.8101196289): 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 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

154 (40.769577026367): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

155 (36.954879760742): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294790995 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294790995 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=215 or channel_id is null)

157 (27.894973754883): 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=215 or channel_id is null)

158 (27.894973754883): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

160 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294790995 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294790995 AND published='1' LIMIT 1

161 (41.007995605469): select jos_twitters.link from jos_twitters where cat=10

162 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

163 (31.232833862305): select jos_google_plus.link from jos_google_plus where cat=10

164 (30.994415283203): select jos_linkedin.link from jos_linkedin where cat=10

165 (309.94415283203): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

166 (!!!!! 1566.1716461182): insert into jos_banners_delta values (14615,'2025-05-02 12:24:42','18.191.169.138','view'),(14202,'2025-05-02 12:24:42','18.191.169.138','view'),(14203,'2025-05-02 12:24:42','18.191.169.138','view')

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