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AI Model Detects Diabetes Using Chest X-Rays

By MedImaging International staff writers
Posted on 04 Aug 2023

Image: Chest X-rays could provide an ‘opportunistic’ alternative to universal diabetes testing (Photo courtesy of Freepik)

Present guidelines recommend screening individuals aged between 35 and 70 years who are overweight to obese, as indicated by their Body Mass Index (BMI), for type 2 diabetes. Nonetheless, numerous studies indicate that this approach fails to identify a significant number of cases, especially among racial and ethnic minorities for whom BMI is a less reliable indicator of diabetes risk. Undiagnosed diabetes patients are at a much higher risk of developing complications, including irreversible organ damage and even death. Now, a new artificial intelligence (AI) model has demonstrated that X-ray images taken during routine medical care can reveal signs of diabetes in individuals who do not meet the criteria for increased risk. This could aid doctors in detecting the disease earlier, preventing complications.

Using deep learning on images and electronic health record data, a multi-institutional team has developed a model that successfully flagged heightened diabetes risk in a retrospective analysis, often years before the disease was diagnosed. The AI model was trained on over 270,000 X-ray images from around 160,000 patients, with deep learning identifying the image features that best predicted a future diabetes diagnosis. As chest X-rays are not typically used for diabetes detection, the researchers utilized explainable AI techniques to understand the reasoning behind the model's predictions. The methods identified the location of fatty tissue as crucial in determining risk, which aligns with recent medical research linking visceral fat in the upper body and abdomen to type 2 diabetes, insulin resistance, hypertension, and other conditions.

Due to the groundbreaking nature of the approach and its remarkable results, the initial team enlisted researchers from Emory University (Atlanta, GA, USA) to externally validate the model. When applied to an independent group of nearly 10,000 patients, the model outperformed a basic model based on non-image clinical data in predicting diabetes risk. In certain cases, the chest X-ray flagged high diabetes risk up to three years before an eventual diagnosis. The model also provides a numerical risk score that could potentially aid clinicians in personalizing treatment plans for patients.

Annually, millions of chest X-rays are taken due to chest pain, difficulty breathing, injury, or as a pre-surgery procedure. While radiologists are not specifically looking for diabetes when examining these X-rays, such images become part of a patient's medical history and could be analyzed later for diabetes or other conditions. The researchers now plan to validate the model further and integrate it into electronic health record systems to alert physicians to conduct traditional diabetes screening for patients identified as high-risk based on X-ray findings. Their next focus will be to investigate the effectiveness of chest X-rays in diagnosing other conditions, such as vascular disease, congestive heart failure, and chronic obstructive pulmonary disease.

“Chest X-rays provide an ‘opportunistic’ alternative to universal diabetes testing,” said Judy Wawira Gichoya, MD, assistant professor of radiology and imaging sciences, and the lead researcher from Emory. “This is an exciting potential application of AI to pull out data from tests used for other reasons and positively impact patient care.”

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69 (363.11149597168): 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 (!!!!! 3342.866897583): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798173 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (724.07722473145): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798173 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (669.95620727539): 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 (496.14906311035): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (270.84350585938): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (92.983245849609): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (582.93342590332): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (174.99923706055): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (133.99124145508): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (129.93812561035): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (124.93133544922): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (123.97766113281): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (123.02398681641): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (124.93133544922): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (522.13668823242): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (575.06561279297): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (257.96890258789): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (473.97613525391): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798173 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (677.10876464844): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798173 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (327.11029052734): 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 (159.02519226074): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (68.902969360352): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (80.82389831543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

105 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

106 (47.922134399414): 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=294798173 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (44.822692871094): 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=294798173 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

109 (50.783157348633): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

110 (287.05596923828): 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=294798173 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (606.06002807617): 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=294798173 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (!!!!! 8746.1471557617): 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 (!!!!! 6603.0025482178): 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 (!!!!! 8188.009262085): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

115 (!!!!! 8158.9221954346): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

116 (!!!!! 7915.9736633301): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

117 (!!!!! 8191.8239593506): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

118 (!!!!! 7966.9952392578): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

119 (!!!!! 8581.8767547607): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

120 (!!!!! 6525.993347168): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 121393.91899109): 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

122 (103.95050048828): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

123 (58.174133300781): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

124 (409.84153747559): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798173 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798173 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 1115844.9649811): ( 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 (79.154968261719): ( 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 (308.03680419922): 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

128 (39.100646972656): 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

129 (640.869140625): 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

130 (324.01084899902): 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

131 (!!!!! 1226.1867523193): 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

132 (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

133 (434.87548828125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (!!!!! 3373.8613128662): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (!!!!! 1559.0190887451): SELECT name FROM jos_deeppockets WHERE id=211

136 (!!!!! 1276.0162353516): SELECT name FROM jos_deeppockets WHERE id=211

137 (854.9690246582): 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

138 (!!!!! 1003.9806365967): 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

139 (379.08554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

140 (497.10273742676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

141 (!!!!! 14008.99887085): TRUNCATE TABLE jos_trademed_module

142 (440.12069702148): 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=294798173 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (697.13592529297): 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=294798173 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (365.9725189209): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (171.89979553223): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (465.86990356445): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

147 (133.03756713867): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

148 (!!!!! 1235.0082397461): 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

149 (!!!!! 1188.9934539795): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

150 (575.78086853027): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

151 (!!!!! 1419.0673828125): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798173 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798173 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (!!!!! 1900.9113311768): 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)

153 (912.90473937988): 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)

154 (!!!!! 1837.9688262939): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (!!!!! 2614.9749755859): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

156 (513.07678222656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798173 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798173 AND published='1' LIMIT 1

157 (156.16416931152): select jos_twitters.link from jos_twitters where cat=10

158 (102.99682617188): select jos_facebook.link from jos_facebook where cat=10

159 (61.03515625): select jos_google_plus.link from jos_google_plus where cat=10

160 (58.174133300781): select jos_linkedin.link from jos_linkedin where cat=10

161 (!!!!! 3103.0178070068): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 3110.1703643799): insert into jos_banners_delta values (14615,'2025-04-29 21:05:49','18.116.118.216','view'),(14202,'2025-04-29 21:05:49','18.116.118.216','view'),(14203,'2025-04-29 21:05:49','18.116.118.216','view')

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