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Lung Ultrasound could be used as a safe and Effective Substitute for Chest X-Rays for the Diagnosis of Pneumonia in Children

By MedImaging International staff writers
Posted on 26 Apr 2016

The results of a randomized controlled trial in the pediatric emergency department of a leading medical school in the US suggest that lung ultrasound is highly effective, and safe, for diagnosing pneumonia in children, and could potentially be used as a substitute for standard chest X-Ray exams.

According to the World Health Organization (WHO) pneumonia is the leading cause of death in children worldwide. While chest X-Rays exams are currently the standard choice for diagnosis, the WHO estimates that 75% of the world’s population does not have access to radiography.

The results of the study were published in the March, 2016 issue of the journal Chest. The study included 191 children aged 0 to 21 years. The children were randomly assigned to receive either a lung ultrasound and if necessary also a chest X-ray, and a control group that underwent a chest X-ray followed by a lung ultrasound. The study was conducted by researchers at the Mount Sinai hospital Icahn School of Medicine (ISMMS; New York, NK, USA).

The researchers found that 38.8% less chest X-Rays were performed in the group that underwent an initial ultrasound exam, compared to no reduction in the control group. No pneumonia cases were missed and there was no increase in any other adverse events. The replacement of X-Ray exams by ultrasound resulted in overall cost savings of USD 9,200, and reduced the time the children spent in the emergency ward by an average of 26 minutes. The results suggest that lung ultrasound could become the best option for the diagnosis of pneumonia in children, although further research is required.

Dr. Tsung, associate professor at Mount Sinai, and leader of the research team, said, “Ultrasound is portable, cost-saving and safer for children than an X-ray because it does not expose them to radiation. Our study could have a profound impact in the developing world where access to radiography is limited. In the era of precision medicine, lung ultrasound may also be an ideal imaging option in children who are at higher risk for radiation-induced cancers or have received multiple radiographic or CT imaging studies.

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65 (49.114227294922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

66 (66.995620727539): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

67 (529.05082702637): SELECT fid FROM jos_deeppockets WHERE id=294763834 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294763834 AND published='1' LIMIT 1

68 (41.007995605469): 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`

69 (36.954879760742): select jos_twitters.link from jos_twitters where cat=10

70 (28.848648071289): select jos_facebook.link from jos_facebook where cat=10

71 (29.087066650391): select jos_google_plus.link from jos_google_plus where cat=10

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

73 (30.040740966797): SELECT fid FROM jos_deeppockets WHERE id=294763834 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294763834 AND published='1' LIMIT 1

74 (42.915344238281): 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`

75 (284.91020202637): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294763834 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

76 (247.00164794922): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294763834 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

77 (46.014785766602): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

78 (52.928924560547): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (52.928924560547): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294763834 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

93 (29.087066650391): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294763834 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

94 (31.948089599609): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

95 (!!!!! 1304.1496276855): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (50.067901611328): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (33.855438232422): 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 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

107 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

108 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

109 (80.82389831543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

110 (57.93571472168): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

111 (215.05355834961): 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=294763834 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (270.12825012207): 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=294763834 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (!!!!! 1096.0102081299): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

114 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

115 (863.07525634766): 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=294763834 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (401.97372436523): 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=294763834 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

117 (619.88830566406): 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 (513.07678222656): 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 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

120 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

121 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

122 (77.009201049805): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

123 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

124 (36.954879760742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

125 (338.07754516602): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

126 (!!!!! 19792.079925537): 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 (291.82434082031): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

128 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

129 (556.94580078125): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294763834 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294763834 AND type='deeppockets_item' AND published='1' LIMIT 1

130 (!!!!! 412837.98217773): ( 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 (95.129013061523): ( 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 (40.054321289062): 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 (30.040740966797): 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 (28.848648071289): 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 (27.894973754883): 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 (28.133392333984): 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 (27.894973754883): 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 (654.93583679199): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (547.88589477539): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (53.167343139648): SELECT name FROM jos_deeppockets WHERE id=214

141 (30.994415283203): SELECT name FROM jos_deeppockets WHERE id=214

142 (450.13427734375): 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

143 (371.93298339844): 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

144 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

145 (45.061111450195): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

146 (!!!!! 10047.197341919): TRUNCATE TABLE jos_trademed_module

147 (106.0962677002): 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=294763834 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (56.982040405273): 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=294763834 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

149 (452.99530029297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (53.882598876953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

151 (82.015991210938): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

152 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

153 (!!!!! 1214.0274047852): 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 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

155 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

156 (44.107437133789): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294763834 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294763834 AND type='deeppockets_item' AND published='1' LIMIT 1

157 (41.007995605469): 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)

158 (39.100646972656): 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)

159 (36.001205444336): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

160 (142.81272888184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

161 (73.19450378418): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294763834 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294763834 AND published='1' LIMIT 1

162 (46.014785766602): select jos_twitters.link from jos_twitters where cat=10

163 (52.928924560547): select jos_facebook.link from jos_facebook where cat=10

164 (36.954879760742): select jos_google_plus.link from jos_google_plus where cat=10

165 (30.994415283203): select jos_linkedin.link from jos_linkedin where cat=10

166 (416.99409484863): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

167 (!!!!! 1224.9946594238): insert into jos_banners_delta values (14615,'2025-04-29 21:35:44','3.145.109.97','view'),(14202,'2025-04-29 21:35:44','3.145.109.97','view'),(14203,'2025-04-29 21:35:44','3.145.109.97','view')

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