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Increases in Pediatric Radiation Dose from CT Scans Scrutinized

By MedImaging International staff writers
Posted on 24 Jun 2013

According to a study of seven US healthcare systems, the use of computed tomography (CT) scans of the abdomen/pelvis, head, chest, or spine, in children younger than age 14 more than doubled from 1996 to 2005, and this associated radiation is projected to potentially increase the risk of radiation-induced cancer in these children in the future.

The study’s findings were published online June 2013 by JAMA Pediatrics. The use of CT in pediatrics has increased over the last 20 years. Children are more sensitive to radiation-induced carcinogenesis and have many years of life left for cancer to develop, according to the investigators. The ionizing radiation doses delivered by the imaging modalities are higher than traditional radiography and are in ranges that have been tied to an increased risk of cancer. “The increased use of CT in pediatrics, combined with the wide variability in radiation doses, has resulted in many children receiving a high-dose examination,” the scientists noted.

Diana L. Miglioretti, PhD, of the Group Health Research Institute and University of California, Davis (USA), and colleagues quantified trends in the use of CT in pediatrics in addition to the associated radiation exposure and estimated potential cancer risk using data from seven US healthcare systems.

The investigators noted the use of CT doubled for children younger than five years old and tripled for children five to 14 years of age between 1996 and 2005 before remaining stable between 2006 and 2007 and then starting to decline. The projected lifetime attributable risks of solid tumors were higher for younger patients and girls than for older patients and boy. The risks were also higher for patients who underwent CT scans of the abdomen/pelvis or spine than for patients who underwent other types of CT scans, according to the results.

The estimates also suggest that for girls, a radiation-induced solid cancer is projected to potentially result from every 300 to 390 abdomen/pelvis scans, 330 to 480 chest scans, and 270 to 800 spine scans, depending on age. The potential risk of leukemia was highest from head scans for children younger than five years of age at a rate of 1.9 cases per 10,000 CT scans, the results show.

The researchers estimate that 4,870 future cancers could be caused by the four million pediatric CT scans conducted yearly. The authors, based on their calculations, also suggest that reducing the highest 25% of doses to the median may prevent 43% of these cancers.

“Thus, more research is urgently needed to determine when CT in pediatrics can lead to improved health outcomes and whether other imaging methods [or no imaging] could be as effective. For now, it is important for both the referring physician and the radiologist to consider whether the risks of CT exceed the diagnostic value it provides over other tests, based on current evidence,” the study authors concluded.

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66 (58.889389038086): select jos_google_plus.link from jos_google_plus where cat=10

67 (43.153762817383): select jos_linkedin.link from jos_linkedin where cat=10

68 (593.90068054199): SELECT fid FROM jos_deeppockets WHERE id=294746926 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294746926 AND published='1' LIMIT 1

69 (176.90658569336): 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=211 ORDER BY `ordering`

70 (!!!!! 1230.9551239014): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746926 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (274.8966217041): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746926 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (534.0576171875): 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`

73 (654.93583679199): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (58.889389038086): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (287.05596923828): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (144.95849609375): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (221.96769714355): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (343.08433532715): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 5249.0234375): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746926 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (184.05914306641): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746926 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (67.949295043945): 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`

90 (166.89300537109): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (!!!!! 4004.0016174316): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (98.228454589844): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (166.89300537109): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (303.03001403809): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (175.95291137695): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (386.95335388184): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (82.015991210938): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (!!!!! 2124.0711212158): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (!!!!! 3723.14453125): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (89.168548583984): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (56.982040405273): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (183.10546875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

105 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

106 (91.075897216797): 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=294746926 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (74.148178100586): 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=294746926 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (123.97766113281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

109 (68.902969360352): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

110 (113.01040649414): 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=294746926 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (821.11358642578): 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=294746926 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (828.02772521973): 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

113 (591.99333190918): 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

114 (!!!!! 5845.0698852539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

115 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

116 (158.07151794434): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

117 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

118 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

119 (59.843063354492): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

120 (128.98445129395): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

121 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

122 (494.95697021484): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 56979.894638062): 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

124 (958.91952514648): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746926 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746926 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 18744.230270386): ( 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

126 (81.062316894531): ( 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

127 (69.856643676758): 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

128 (128.98445129395): 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

129 (557.89947509766): 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

130 (391.96014404297): 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

131 (401.02005004883): 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

132 (859.97581481934): 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

133 (61.988830566406): 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

134 (34.093856811523): 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

135 (612.97416687012): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (359.05838012695): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (190.01960754395): SELECT name FROM jos_deeppockets WHERE id=211

138 (53.882598876953): SELECT name FROM jos_deeppockets WHERE id=211

139 (838.04130554199): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (704.05006408691): 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 '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

142 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

143 (!!!!! 14225.959777832): TRUNCATE TABLE jos_trademed_module

144 (134.94491577148): 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=294746926 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (!!!!! 3283.9775085449): 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=294746926 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (525.95138549805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (74.863433837891): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (98.943710327148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

149 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

150 (!!!!! 1461.9827270508): 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

151 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

152 (58.174133300781): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

153 (119.92454528809): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294746926 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294746926 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (52.213668823242): 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=211 or channel_id is null)

155 (41.961669921875): 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=211 or channel_id is null)

156 (66.041946411133): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (87.976455688477): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

158 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294746926 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294746926 AND published='1' LIMIT 1

159 (55.074691772461): select jos_twitters.link from jos_twitters where cat=10

160 (30.994415283203): select jos_facebook.link from jos_facebook where cat=10

161 (31.948089599609): select jos_google_plus.link from jos_google_plus where cat=10

162 (29.087066650391): select jos_linkedin.link from jos_linkedin where cat=10

163 (309.94415283203): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 1316.0705566406): insert into jos_banners_delta values (14615,'2025-08-19 07:56:41','216.73.216.0','view'),(14202,'2025-08-19 07:56:41','216.73.216.0','view'),(14203,'2025-08-19 07:56:41','216.73.216.0','view')

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