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POC AI Tool Helps Novice Users Accurately Estimate Gestational Age from Blind Ultrasound Sweeps

By MedImaging International staff writers
Posted on 02 Aug 2024

Image: Obstetrical care in low-resource settings may benefit from reliable gestational age assessment using AI integration with POC ultrasonography (Photo courtesy of 123RF)

Obstetrical sonography plays a vital role in modern pregnancy care, notably for accurately measuring fetal structures to estimate gestational age (GA). This measurement is essential for guiding antenatal care decisions, such as the timing for gestational diabetes screening and vaccine administration to maximize benefits for both mother and baby. GA is also crucial for determining the need for interventions like corticosteroids or neuroprotective magnesium sulfate in cases of expected preterm delivery and for deciding the appropriateness of clinician-initiated delivery. Despite its importance, ultrasonography is often inaccessible in many low- and middle-income countries (LMICs). However, recent developments in ultrasonography technology and artificial intelligence (AI)-enabled medical image analysis are promising to extend the reach of this vital diagnostic tool. Researchers have now introduced a deep learning AI model integrated into the software of an affordable, battery-operated device that can estimate GA from blind ultrasonography sweeps.

A study led by researchers from the UNC School of Medicine (Chapel Hill, NC, USA) assessed the accuracy of GA estimation using this AI-enhanced ultrasonography tool by novice operators without prior sonography training. The study involved 400 pregnant participants whose due dates were confirmed by first-trimester ultrasonography. During randomly scheduled follow-up visits across their pregnancies, these novice clinicians were able to estimate gestational age as reliably as experienced sonographers using traditional ultrasonography equipment.

Specifically, from 14 to 27 weeks’ gestation, these novice clinicians matched the accuracy of credentialed sonographers performing standard biometry on advanced machines, using the low-cost, point-of-care AI tool. Published in JAMA Network, these findings have significant implications for obstetrical care in resource-limited settings, aligning with the World Health Organization's goal to make ultrasonography-based gestational age estimation accessible to all pregnant individuals.

“Our study demonstrates that an AI-enabled, portable ultrasound device can estimate gestational age as accurately as an expert sonographer using an expensive, high-specification machine. This high degree of accuracy was obtained even though the users of the device had no formal training in sonography,” said corresponding author Jeffrey S. A. Stringer, MD. “The most important takeaway is the potential democratization of a critical prenatal diagnostic tool. By enabling accurate gestational age estimation without the need for expensive equipment or specialized training, this technology could significantly expand access to quality prenatal care in resource-limited settings worldwide.”

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61 (!!!!! 8480.0720214844): 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

62 (!!!!! 7894.0391540527): SELECT fid FROM jos_deeppockets WHERE id=294802062 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294802062 AND published='1' LIMIT 1

63 (!!!!! 8027.0767211914): 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=214 ORDER BY `ordering`

64 (!!!!! 6128.0727386475): select jos_twitters.link from jos_twitters where cat=10

65 (!!!!! 5116.9395446777): select jos_facebook.link from jos_facebook where cat=10

66 (!!!!! 5362.9875183105): select jos_google_plus.link from jos_google_plus where cat=10

67 (!!!!! 6868.839263916): select jos_linkedin.link from jos_linkedin where cat=10

68 (!!!!! 7230.0434112549): SELECT fid FROM jos_deeppockets WHERE id=294802062 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294802062 AND published='1' LIMIT 1

69 (!!!!! 7916.9273376465): 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=214 ORDER BY `ordering`

70 (!!!!! 5236.8640899658): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294802062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (!!!!! 1539.945602417): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294802062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (!!!!! 1143.9323425293): 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 (!!!!! 1814.1269683838): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (255.10787963867): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (483.98971557617): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (372.88665771484): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (53.167343139648): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (682.83081054688): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (442.9817199707): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (268.22090148926): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (438.92860412598): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (296.83113098145): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (!!!!! 2012.9680633545): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294802062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (!!!!! 3380.0601959229): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294802062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (!!!!! 1160.8600616455): 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 (!!!!! 3245.1152801514): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (559.09156799316): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (!!!!! 1049.0417480469): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (421.04721069336): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (53.882598876953): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (43.153762817383): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (543.83277893066): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (!!!!! 1518.0110931396): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (764.84680175781): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (61.988830566406): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (574.11193847656): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 1466.0358428955): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

105 (294.20852661133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

106 (!!!!! 1847.9824066162): 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=294802062 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (!!!!! 2220.1538085938): 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=294802062 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (!!!!! 3968.9540863037): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

109 (238.18016052246): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

110 (!!!!! 1374.0062713623): 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=294802062 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (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.id=294802062 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (856.16111755371): 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 (!!!!! 1321.0773468018): 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 (!!!!! 1258.1348419189): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

115 (254.86946105957): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

116 (!!!!! 1206.1595916748): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

117 (475.88348388672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

118 (!!!!! 1101.9706726074): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

119 (542.16384887695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

120 (560.04524230957): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

121 (63.896179199219): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

122 (275.1350402832): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 60268.16368103): 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 (!!!!! 1081.9435119629): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294802062 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294802062 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1559.0190887451): ( 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 (68.902969360352): ( 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 (436.06758117676): 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 (101.08947753906): 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 (985.86082458496): 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 (178.09867858887): 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 (96.08268737793): 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 (!!!!! 1395.9407806396): 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 (167.8466796875): 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 (921.96464538574): 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 (!!!!! 1029.0145874023): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (780.10559082031): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (!!!!! 1137.9718780518): SELECT name FROM jos_deeppockets WHERE id=214

138 (501.15585327148): SELECT name FROM jos_deeppockets WHERE id=214

139 (!!!!! 1214.0274047852): 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 '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (!!!!! 2323.1506347656): 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 '((;)|(^))214((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (602.96058654785): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

142 (64.849853515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

143 (!!!!! 44487.953186035): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 2038.9556884766): 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=294802062 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (173.80714416504): 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=294802062 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (664.94941711426): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (105.85784912109): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

149 (73.909759521484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

150 (!!!!! 1777.8873443604): 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 (!!!!! 3345.0126647949): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

152 (!!!!! 4723.7873077393): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

153 (276.08871459961): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294802062 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294802062 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (!!!!! 6109.9529266357): 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=214 or channel_id is null)

155 (955.82008361816): 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=214 or channel_id is null)

156 (!!!!! 1612.9016876221): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (602.00691223145): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

158 (111.81831359863): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294802062 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294802062 AND published='1' LIMIT 1

159 (87.976455688477): select jos_twitters.link from jos_twitters where cat=10

160 (34.093856811523): select jos_facebook.link from jos_facebook where cat=10

161 (30.040740966797): select jos_google_plus.link from jos_google_plus where cat=10

162 (26.941299438477): select jos_linkedin.link from jos_linkedin where cat=10

163 (323.05717468262): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14202,14203)

164 (!!!!! 10411.024093628): insert into jos_banners_delta values (14202,'2025-08-02 18:40:45','216.73.216.210','view'),(14203,'2025-08-02 18:40:45','216.73.216.210','view')

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