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Scientific Developments, Broader Imaging Role Drive U.S. Utilization

By HospiMedica staff writers
Posted on 01 Aug 2006

Rapid increases in utilization of medical imaging take place from new scientific advances that allow clinicians to see inside the human body and that have brought about a major transformation in how clinicians practice medicine and how healthcare is structured, according to Donald Rucker, chief medical officer, Siemens Medical Solutions USA (Malvern, PA, USA), testifying on behalf of the U.S. National Electrical Manufacturers Association (NEMA; Rosslyn, VA, USA) at a hearing of the U.S. House Energy and Commerce Health Subcommittee held on July 18, 2006.

"The power of imaging to offer more precise and less-invasive care has sparked what can only be described as a fundamental transformation in medicine,” said Mr. Rucker in a prepared statement. "Physicians can now use imaging for more conditions, for more patients, and for a much broader array of purposes than ever before.”

According to Mr. Rucker, scientific and technical developments, driven by computing power that doubles every 18 months, have allowed clinicians to provide new kinds of care and in new ways, such as positron emission tomography (PET) scans that reduce guesswork in assessing the effect of cancer drugs on a tumor. Imaging has also given clinicians huge amounts of new information to better diagnose and treat patients, such as the ability of computed tomography (CT) and magnetic resonance imaging (MRI) to visualize and target brain tumors and aneurysms, according to Mr. Rucker. Furthermore, imaging is no longer used only for diagnosis, but also for treating and managing medical conditions.

"In fact, imaging has become a standard of modern care for virtually all major medical conditions and disease,” said Mr. Rucker. "This includes cancer, stroke, heart disease, trauma, and abdominal and neurological conditions.”

Mr. Rucker reported that these broad, patient-centered changes that are driving increased utilization are frequently overlooked in policy discussions. Instead, the assumption is that financial incentives of providers lie at the heart of rapid utilization growth. "No one can doubt that financial incentives play a role in the use of imaging. But the impact of these incentives pales in comparison to these broader, patient-centered changes,” he said.

Mr. Rucker said that NEMA encouraged the U.S. Congress to support public policies that recognize this broader context of utilization growth. Payment reductions such as those recently passed by Congress in the Deficit Reduction Act of 2005 would harm patient access to imaging technologies.

NEMA is the world's largest association representing manufacturers of medical imaging equipment

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61 (646.82960510254): 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=198950000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

62 (!!!!! 1213.0737304688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

63 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

64 (106.8115234375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

65 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

66 (118.97087097168): 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

67 (646.11434936523): SELECT fid FROM jos_deeppockets WHERE id=198950000 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=198950000 AND published='1' LIMIT 1

68 (383.13865661621): 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`

69 (66.995620727539): select jos_twitters.link from jos_twitters where cat=10

70 (36.954879760742): select jos_facebook.link from jos_facebook where cat=10

71 (41.961669921875): select jos_google_plus.link from jos_google_plus where cat=10

72 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

73 (38.862228393555): SELECT fid FROM jos_deeppockets WHERE id=198950000 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=198950000 AND published='1' LIMIT 1

74 (41.961669921875): 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`

75 (370.97930908203): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=198950000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

76 (247.00164794922): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=198950000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

77 (42.915344238281): 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`

78 (68.902969360352): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (79.870223999023): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=198950000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

93 (39.100646972656): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=198950000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

94 (46.014785766602): 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`

95 (57.93571472168): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

109 (119.92454528809): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

110 (60.796737670898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

111 (95.844268798828): 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=198950000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (69.856643676758): 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=198950000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (!!!!! 1428.1272888184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

114 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

115 (634.19342041016): 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=198950000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (571.96617126465): 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=198950000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

117 (75.101852416992): 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=198940000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

118 (498.05641174316): 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=198940000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

119 (771.04568481445): 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

120 (572.91984558105): 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

121 (249.14741516113): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

122 (422.00088500977): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

123 (178.09867858887): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

124 (214.0998840332): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

125 (146.86584472656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

126 (131.84547424316): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

127 (131.84547424316): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

128 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

129 (936.03134155273): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

130 (!!!!! 68368.911743164): 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

131 (649.92904663086): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=198950000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=198950000 AND type='deeppockets_item' AND published='1' LIMIT 1

132 (!!!!! 17510.890960693): ( 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

133 (100.13580322266): ( 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

134 (75.101852416992): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

135 (43.869018554688): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

136 (59.127807617188): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

137 (34.809112548828): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

138 (391.00646972656): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

139 (39.815902709961): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

140 (46.968460083008): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

141 (42.915344238281): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

142 (514.03045654297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

143 (414.13307189941): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

144 (275.85029602051): SELECT name FROM jos_deeppockets WHERE id=217

145 (39.100646972656): SELECT name FROM jos_deeppockets WHERE id=217

146 (698.08959960938): 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

147 (472.06878662109): 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

148 (!!!!! 4256.010055542): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

149 (108.00361633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

150 (!!!!! 20615.816116333): TRUNCATE TABLE jos_trademed_module

151 (!!!!! 2992.8684234619): 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=198950000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

152 (847.10121154785): 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=198950000 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

153 (503.0632019043): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

154 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

155 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

156 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

157 (!!!!! 1512.0506286621): 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

158 (124.93133544922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

159 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

160 (51.975250244141): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=198950000 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=198950000 AND type='deeppockets_item' AND published='1' LIMIT 1

161 (824.92828369141): 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=0 or channel_id is null)

162 (56.028366088867): 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=0 or channel_id is null)

163 (56.982040405273): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

164 (477.79083251953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

165 (94.175338745117): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=198950000 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=198950000 AND published='1' LIMIT 1

166 (77.962875366211): select jos_twitters.link from jos_twitters where cat=10

167 (41.007995605469): select jos_facebook.link from jos_facebook where cat=10

168 (41.961669921875): select jos_google_plus.link from jos_google_plus where cat=10

169 (39.815902709961): select jos_linkedin.link from jos_linkedin where cat=10

170 (380.9928894043): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14202,14203)

171 (!!!!! 1456.9759368896): insert into jos_banners_delta values (14202,'2025-08-19 23:28:35','216.73.216.0','view'),(14203,'2025-08-19 23:28:35','216.73.216.0','view')

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