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Machine Learning Shows Promise for Supporting Medical Decisions

By MedImaging International staff writers
Posted on 05 Apr 2018
A number of studies presented at the 67th Annual Scientific Session of the American College of Cardiology (Washington, DC, USA) demonstrated how machine learning can be used to accurately predict clinical outcomes in patients with known or potential heart problems. The findings of these studies indicate that machine learning can usher in a new era in digital health care tools capable of enhancing healthcare delivery by aiding routine processes and helping physicians to assess the patients’ risk.

Clinical scoring systems and algorithms have been used in medical practice since a long time now, although there has recently been a visible increase in the application of machine learning to improve these tools. While traditional algorithms require all calculations to be pre-programmed, machine-learning algorithms deduce the optimal set of calculations by searching for patterns in large collections of patient data. New studies presented at ACC.18, which took place on March 10-12 in Orlando, USA, demonstrated how machine learning can be used to predict outcomes such as diagnosis, death or hospital readmission; improve upon standard risk assessment tools; elucidate factors that contribute to disease progression; or to advance personalized medicine by predicting a patient’s response to treatment.

For instance, in one study, researchers used machine learning to predict which patients would eventually be diagnosed with a heart attack after visiting a hospital emergency department for chest pain. Although chest pain is among the most common complaints in patients visiting the emergency department, only a fraction of such patients are ultimately diagnosed with a heart attack. In a pilot test, the algorithm was able to accurately predict a heart attack diagnosis 94% of the time in the validation data set. Researchers also ran the validation data through a standard clinical model (the hsTnT model, which incorporates only a patient’s age, sex and high-sensitivity troponin levels), which showed an accuracy of 88%. These results suggest that machine learning can offer a substantial improvement over current decision support tools.

“In a broad sense, machine-learning methods have been around for quite some time, but it’s just in the last few years that we have gained the large data sets and computational capabilities to use them for clinical applications,” said Daniel Lindholm, MD, PhD, postdoctoral research fellow at Uppsala University in Sweden and the study’s lead author. “I think that we will see more and more decision support systems based on machine learning. But even as machine learning can enhance medical practice, I do not think these algorithms will ultimately replace physicians but, rather, provide decision support based on the data at hand. Other things, such as empathy, human judgment and the patient-doctor relationship are crucial.”

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(70.810317993164): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
46
(44.822692871094): select journal.name,journal.id,dpcat.livesite,journal.code
				from jos_dp_categories dpcat
				join jos_journal journal
				on journal.id=dpcat.journalid
				where dpcat.id=10
47
(78.201293945312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
48
(51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
49
(56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
50
(41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
51
(55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
52
(38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
53
(79.154968261719): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
54
(48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
55
(402.92739868164): SELECT name FROM jos_deeppockets WHERE id=294773079 LIMIT 1
56
(427.9613494873): SELECT name FROM jos_deeppockets_archive WHERE id=294773079 LIMIT 1
57
(71.048736572266): SELECT a.*
 FROM jos_components AS a
 WHERE ( a.admin_menu_link = 'option=com_syndicate' OR a.admin_menu_link = 'option=com_syndicate&hidemainmenu=1' )
 AND a.option = 'com_syndicate'
58
(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=294773079
							AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
							AND dp.published='1' LIMIT 1
59
(611.0668182373): 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=294773079
								AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
								AND dp.published='1' LIMIT 1
60
(!!!!! 1105.0701141357): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
61
(94.175338745117): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
62
(82.969665527344): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
63
(46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
64
(120.16296386719): 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
65
(486.13548278809): SELECT fid FROM jos_deeppockets WHERE id=294773079 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294773079 AND published='1'  LIMIT 1
66
(277.04238891602): 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=216
                    ORDER BY `ordering`
67
(83.208084106445): select jos_twitters.link from jos_twitters where cat=10
68
(30.040740966797): select jos_facebook.link from jos_facebook where cat=10
69
(30.994415283203): select jos_google_plus.link from jos_google_plus where cat=10
70
(27.894973754883): select jos_linkedin.link from jos_linkedin where cat=10
71
(31.948089599609): SELECT fid FROM jos_deeppockets WHERE id=294773079 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294773079 AND published='1'  LIMIT 1
72
(31.948089599609): 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=216
                    ORDER BY `ordering`
73
(272.98927307129): SELECT fid FROM jos_deeppockets
								WHERE cat=10
								AND id=294773079
								AND (type='deeppockets_item' OR type='deeppockets_item_link') 
								AND published='1' 
								LIMIT 1
74
(214.0998840332): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294773079 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1
75
(38.14697265625): 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`
76
(52.213668823242): SELECT show_live FROM jos_com_show_setting LIMIT 1
77
(30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1
78
(28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1
79
(28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1
80
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1
81
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1
82
(28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1
83
(28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1
84
(28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1
85
(28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1
86
(27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1
87
(27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1
88
(26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1
89
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1
90
(42.915344238281): SELECT fid FROM jos_deeppockets
								WHERE cat=10
								AND id=294773079
								AND (type='deeppockets_item' OR type='deeppockets_item_link') 
								AND published='1' 
								LIMIT 1
91
(30.040740966797): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294773079 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1
92
(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`
93
(103.95050048828): SELECT show_live FROM jos_com_show_setting LIMIT 1
94
(58.174133300781): SELECT show_live FROM jos_com_show_setting LIMIT 1
95
(66.995620727539): SELECT show_live FROM jos_com_show_setting LIMIT 1
96
(57.93571472168): SELECT show_live FROM jos_com_show_setting LIMIT 1
97
(68.187713623047): SELECT show_live FROM jos_com_show_setting LIMIT 1
98
(55.074691772461): SELECT show_live FROM jos_com_show_setting LIMIT 1
99
(72.956085205078): SELECT show_live FROM jos_com_show_setting LIMIT 1
100
(35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1
101
(29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1
102
(28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1
103
(49.829483032227): SELECT show_live FROM jos_com_show_setting LIMIT 1
104
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1
105
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1
106
(27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1
107
(71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
108
(56.028366088867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
109
(57.93571472168): 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=294773079
							AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
							AND dp.published='1' LIMIT 1
110
(42.915344238281): 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=294773079
								AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
								AND dp.published='1' LIMIT 1
111
(98.943710327148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
112
(50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
113
(370.97930908203): 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=294773079
							AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
							AND dp.published='1' LIMIT 1
114
(401.02005004883): 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=294773079
								AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
								AND dp.published='1' LIMIT 1
115
(53.167343139648): 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=294772694
							AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
							AND dp.published='1' LIMIT 1
116
(336.88545227051): 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=294772694
								AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
								AND dp.published='1' LIMIT 1
117
(566.95938110352): 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
(324.01084899902): 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
119
(66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
120
(43.153762817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
121
(50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
122
(38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
123
(109.19570922852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
124
(72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
125
(238.18016052246): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`
126
(!!!!! 20511.150360107): 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
127
(113.01040649414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
128
(47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
129
(408.17260742188): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294773079 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294773079 AND type='deeppockets_item' AND published='1'  LIMIT 1
130
(!!!!! 559307.09838867): (
				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
(118.01719665527): (
				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
132
(87.976455688477): 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
(66.995620727539): 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
134
(58.889389038086): 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
(34.093856811523): 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
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
(39.100646972656): 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
138
(550.0316619873): SELECT *
                            FROM jos_deeppockets
                            WHERE 1=1 
                              AND id=294773079
                              AND (type='deeppockets_item' OR type='deeppockets_item_link')
                              AND published='1'
                            LIMIT 1
139
(355.00526428223): SELECT *
                            FROM jos_deeppockets_archive
                            WHERE 1=1 
                              AND id=294773079
                              AND (type='deeppockets_item' OR type='deeppockets_item_link')
                              AND published='1'
                            LIMIT 1
140
(215.05355834961): SELECT name FROM jos_deeppockets WHERE id=216
141
(38.14697265625): SELECT name FROM jos_deeppockets WHERE id=216
142
(464.91622924805): 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 '((;)|(^))216((;)|($))' AND catid IN (0,110) 
    ORDER BY publish_up ASC LIMIT 3
143
(408.17260742188): SELECT *,
    DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up,
    DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down
    FROM jos_events
    WHERE state=1
    AND publish_up > NOW()
    and extra_info REGEXP '((;)|(^))216((;)|($))' AND catid IN (0,110) 
    ORDER BY publish_up ASC LIMIT 3
144
(61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
145
(43.153762817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
146
(!!!!! 9173.8700866699): TRUNCATE TABLE jos_trademed_module
147
(117.06352233887): 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=294773079
							AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
							AND dp.published='1' LIMIT 1
148
(55.074691772461): 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=294773079
								AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link')
								AND dp.published='1' LIMIT 1
149
(844.00177001953): SELECT *
   FROM jos_deeppockets
   WHERE 1=1 
   AND id=294773079
   AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1
150
(58.174133300781): SELECT *
   FROM jos_deeppockets
   WHERE 1=1 
   AND id=294773079
   AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1
151
(52.213668823242): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
152
(43.153762817383): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
153
(!!!!! 1115.7989501953): 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
154
(51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
155
(43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
156
(45.061111450195): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294773079 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294773079 AND type='deeppockets_item' AND published='1'  LIMIT 1
157
(31.948089599609): 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)
158
(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=0 or channel_id is null)
159
(36.001205444336): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1
160
(174.99923706055): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
161
(78.201293945312): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294773079 AND published='1'
				union
		SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294773079 AND published='1'
		LIMIT 1
162
(62.942504882812): select jos_twitters.link from jos_twitters where cat=10
163
(76.055526733398): select jos_facebook.link from jos_facebook where cat=10
164
(42.915344238281): select jos_google_plus.link from jos_google_plus where cat=10
165
(41.961669921875): select jos_linkedin.link from jos_linkedin where cat=10
166
(365.01884460449): update jos_bannersmanager_banner
			set impmade=impmade+1
			where id in(14615,14202,14203)
167
(!!!!! 1388.7882232666): insert into jos_banners_delta values (14615,'2025-04-29 21:19:35','18.218.161.96','view'),(14202,'2025-04-29 21:19:35','18.218.161.96','view'),(14203,'2025-04-29 21:19:35','18.218.161.96','view')