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AI Improves Emergency-Related Chest X-Ray Interpretation by Non-Radiologist Practitioners

By MedImaging International staff writers
Posted on 30 Jan 2024

Image: AI has been shown to improve the performance of non-radiologists in chest imaging (Photo courtesy of 123RF)

Chest X-rays are frequently used to decide if a disease needs immediate attention. However, making this determination is hardly easy. It requires experts to identify things like projection phenomena, superimpositions, and other complex representations in the images. This can be especially difficult for non-radiologists who do not regularly analyze diagnostic imaging. Nevertheless, in emergencies, they might need to make clinical decisions based on these images, often without a radiologist present. Previous research has looked into how AI can help interpret chest X-rays, aiming to make clinical processes more efficient and enhance patient care. In a new study, a team of researchers investigated whether an AI system, based on a convolutional neural network (CNN) and designed for interpreting chest X-rays, could be beneficial in emergency units (EUs). Their study showed that AI can indeed improve chest X-ray interpretation by non-radiologists, which can be particularly valuable in settings with limited resources.

In the study, researchers at the University of Munich Hospital in Germany evaluated an AI algorithm trained on both publicly available and expert-annotated chest imaging data. They examined 563 chest X-rays, each reviewed twice by three certified radiologists, three radiology residents, and three non-radiology residents with emergency unit experience. The study also involved testing non-radiologists on their ability to diagnose four specific conditions: pleural effusion, pneumothorax, pneumonia-like consolidations, and nodules. In its internal validation, the AI algorithm showed an impressive performance, with area under the curve (AUC) scores ranging from 0.95 for nodules to 0.995 for pleural effusion. The researchers noted that non-radiologist accuracy improved for all four conditions when using AI.

Furthermore, the study found that AI assistance notably enhanced agreement among non-radiologist readers in identifying pneumothorax, including a significant increase in the AUC score and improvements in both sensitivity and accuracy. Similarly, nodule detection saw the greatest improvement with AI help, marked by increases in sensitivity, accuracy, and AUC score. When the radiologists used the AI algorithm, they saw smaller improvements in performance, sensitivity, and accuracy, most of which were not significant. These results led the researchers to conclude that AI support could be particularly helpful for less experienced physicians in situations where experienced radiologists or emergency physicians are unavailable.

“In an emergency unit setting without 24/7 radiology coverage, the presented AI solution features an excellent clinical support tool to non-radiologists, similar to a second reader, and allows for a more accurate primary diagnosis and thus earlier therapy initiation,” stated the team.

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63 (651.12113952637): 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`

64 (!!!!! 1775.0263214111): select jos_twitters.link from jos_twitters where cat=10

65 (543.83277893066): select jos_facebook.link from jos_facebook where cat=10

66 (316.85829162598): select jos_google_plus.link from jos_google_plus where cat=10

67 (230.07392883301): select jos_linkedin.link from jos_linkedin where cat=10

68 (!!!!! 1414.0605926514): SELECT fid FROM jos_deeppockets WHERE id=294800080 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294800080 AND published='1' LIMIT 1

69 (484.94338989258): 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 (!!!!! 1996.9940185547): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294800080 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 1281.9766998291): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294800080 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (458.95576477051): 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 (!!!!! 7473.9456176758): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (!!!!! 7976.0551452637): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (!!!!! 7863.9984130859): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (!!!!! 7948.8754272461): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (!!!!! 3852.1289825439): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (!!!!! 7987.9760742188): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (!!!!! 7852.0774841309): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (!!!!! 7979.154586792): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (!!!!! 7858.0379486084): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (!!!!! 7973.9093780518): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (!!!!! 7871.150970459): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (!!!!! 7977.0088195801): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (!!!!! 8126.974105835): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (!!!!! 7795.0954437256): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 7330.1792144775): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294800080 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (!!!!! 5010.1280212402): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294800080 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (!!!!! 1930.9520721436): 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 (!!!!! 2151.0124206543): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (67.949295043945): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (!!!!! 4667.9973602295): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (!!!!! 1049.0417480469): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (65.088272094727): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (313.04359436035): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (282.04917907715): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (576.01928710938): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (245.80955505371): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (54.836273193359): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (440.83595275879): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (602.96058654785): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 3739.8338317871): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

105 (363.82675170898): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

106 (686.1686706543): 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=294800080 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 1088.8576507568): 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=294800080 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 4769.0868377686): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

109 (633.95500183105): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

110 (!!!!! 1182.7945709229): 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=294800080 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (!!!!! 1387.1192932129): 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=294800080 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 1394.0334320068): 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 (!!!!! 1485.1093292236): 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 (885.009765625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

115 (115.87142944336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

116 (494.95697021484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

117 (90.122222900391): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

118 (!!!!! 1046.895980835): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

119 (86.069107055664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

120 (!!!!! 2063.0359649658): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

121 (827.07405090332): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

122 (607.01370239258): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 80157.995223999): 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 (!!!!! 3211.0214233398): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294800080 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294800080 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (87.976455688477): ( 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 (105.85784912109): ( 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 (76.055526733398): 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 (50.067901611328): 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 (66.995620727539): 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 (48.160552978516): 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 (56.982040405273): 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 (44.107437133789): 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 (56.982040405273): 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 (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

135 (!!!!! 7616.0430908203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (!!!!! 2728.9390563965): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (!!!!! 1536.1309051514): SELECT name FROM jos_deeppockets WHERE id=211

138 (!!!!! 4837.9898071289): SELECT name FROM jos_deeppockets WHERE id=211

139 (!!!!! 2564.9070739746): 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 (!!!!! 1019.0010070801): 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 (!!!!! 1524.9252319336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

142 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

143 (!!!!! 46635.150909424): TRUNCATE TABLE jos_trademed_module

144 (535.96496582031): 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=294800080 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (499.01008605957): 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=294800080 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (494.95697021484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (196.93374633789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (!!!!! 1610.9943389893): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

149 (!!!!! 3327.8465270996): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

150 (!!!!! 1985.7883453369): 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 (148.05793762207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

152 (75.817108154297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

153 (!!!!! 8111.0000610352): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294800080 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294800080 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (328.06396484375): 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 (77.009201049805): 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 (!!!!! 2318.1438446045): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (!!!!! 3479.9575805664): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

158 (!!!!! 8017.0631408691): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294800080 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294800080 AND published='1' LIMIT 1

159 (529.05082702637): select jos_twitters.link from jos_twitters where cat=10

160 (53.167343139648): select jos_facebook.link from jos_facebook where cat=10

161 (45.061111450195): select jos_google_plus.link from jos_google_plus where cat=10

162 (41.961669921875): select jos_linkedin.link from jos_linkedin where cat=10

163 (734.09080505371): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

164 (!!!!! 2336.0252380371): insert into jos_banners_delta values (14615,'2025-08-02 15:05:01','216.73.216.210','view'),(14202,'2025-08-02 15:05:01','216.73.216.210','view'),(14203,'2025-08-02 15:05:01','216.73.216.210','view')

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