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AR-Based Surgical Visualization and Navigation System Sees First Inpatient Utilization

By MedImaging International staff writers
Posted on 10 Nov 2023

Image: The FDA-cleared XR90 AR-based visualization and navigation platform has witnessed its first clinical use (Photo courtesy of MediView XR)

Current medical imaging tools have limitations, notably flat panel monitors that confine doctors to 2D imagery and require looking away from the patient during procedures, possibly affecting outcomes. To overcome these challenges, an innovative augmented reality (AR) surgical visualization and navigation system has been adopted for clinical use for the first time. This system is designed for minimally invasive ultrasound and CT-guided needle-based procedures for soft tissue and bone.

MediView XR’s (Cleveland, OH, USA) XR90 AR-based surgical visualization and navigation system integrates Microsoft's HoloLens2 AR headset, enabling clinicians to view holographic ultrasound images which enhances their workflow. The system transcends traditional 2D imaging limits by offering 3D internal anatomical visualization, including bones, tissues, organs, and blood vessels, right beneath the patient’s skin. Utilizing the patient's CT data, XR90 merges this with live ultrasound for conducting minimally invasive procedures, such as biopsies and tumor ablations.

The XR90 system's AR features include a Holographic Light Ray, which visualizes the path of the surgical instrument, a 3D holographic display of the patient’s anatomy based on CT imaging, and a live ultrasound projection that works similarly to a flashlight beam on the patient’s body. This technology aids clinicians in pre-operative planning, enhances procedural workflow, and improves ergonomics by providing a heads-up display of medical images during ultrasound-guided needle procedures. Additionally, it facilitates real-time remote collaboration, allowing clinicians in different locations to share visualizations, communicate effectively, and provide guidance during procedures.

In the first worldwide clinical case since its 510(k) clearance from the U.S. Food and Drug Administration, the XR90 was used to perform a mediastinal lymph node biopsy. The system proved instrumental when the tumor was not clearly visible through ultrasound alone. Using XR90's holographic anatomy, surgeons could locate the target area and then plan their approach with the holographic needle tracking feature, corroborating with standard care techniques. This initial clinical use highlights the system’s practical value, particularly in correlating CT-identified anomalies with live ultrasound displays.

"We are pleased at the successful utilization of our holographic visualization and navigation system," said Mina Fahim, President and CEO of MediView. “This is an incredible milestone for MediView and the medical AR space, marking just the beginning of the potential impact of MediView's AR ecosystem on disrupting – and democratizing healthcare."

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60 (!!!!! 7300.1384735107): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

61 (!!!!! 2366.0659790039): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

62 (!!!!! 7943.868637085): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

63 (!!!!! 5636.9304656982): 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

64 (893.11599731445): SELECT fid FROM jos_deeppockets WHERE id=294799253 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294799253 AND published='1' LIMIT 1

65 (!!!!! 8733.0341339111): 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`

66 (!!!!! 1671.0758209229): select jos_twitters.link from jos_twitters where cat=10

67 (211.95411682129): select jos_facebook.link from jos_facebook where cat=10

68 (56.028366088867): select jos_google_plus.link from jos_google_plus where cat=10

69 (30.994415283203): select jos_linkedin.link from jos_linkedin where cat=10

70 (43.153762817383): SELECT fid FROM jos_deeppockets WHERE id=294799253 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294799253 AND published='1' LIMIT 1

71 (33.140182495117): 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`

72 (313.99726867676): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294799253 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

73 (295.87745666504): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294799253 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

74 (42.915344238281): 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`

75 (53.167343139648): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (39.815902709961): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (32.901763916016): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (33.855438232422): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (54.836273193359): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (62.942504882812): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294799253 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

90 (37.908554077148): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294799253 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

91 (45.061111450195): 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`

92 (!!!!! 1150.1312255859): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (106.8115234375): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (!!!!! 4251.0032653809): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (496.86431884766): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (55.789947509766): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (195.02639770508): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

105 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

106 (!!!!! 1183.9866638184): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

107 (182.15179443359): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

108 (385.04600524902): 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=294799253 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

109 (!!!!! 1183.9866638184): 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=294799253 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

110 (!!!!! 2929.9259185791): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

111 (!!!!! 2454.9961090088): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

112 (928.87878417969): 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=294799253 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

113 (!!!!! 1424.0741729736): 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=294799253 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

114 (!!!!! 1030.9219360352): 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=294799248 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

115 (!!!!! 2779.0069580078): 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=294799248 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

116 (814.91470336914): 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

117 (635.86235046387): 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 (195.98007202148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

119 (75.817108154297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

120 (92.029571533203): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

121 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

122 (87.02278137207): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

123 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

124 (416.04042053223): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

125 (!!!!! 159751.17683411): 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

126 (143.05114746094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

127 (74.863433837891): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

128 (!!!!! 1718.9979553223): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294799253 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294799253 AND type='deeppockets_item' AND published='1' LIMIT 1

129 (!!!!! 1914276.1230469): ( 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

130 (!!!!! 1213.0737304688): ( 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 (!!!!! 6423.9501953125): 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

132 (365.9725189209): 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 (633.00132751465): 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

134 (164.98565673828): 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 (55.074691772461): 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

136 (43.153762817383): 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 (!!!!! 3645.8969116211): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

138 (!!!!! 1157.0453643799): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

139 (!!!!! 1202.8217315674): SELECT name FROM jos_deeppockets WHERE id=214

140 (!!!!! 2501.0108947754): SELECT name FROM jos_deeppockets WHERE id=214

141 (!!!!! 1481.0562133789): 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

142 (!!!!! 1770.01953125): 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 (!!!!! 2223.014831543): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

144 (!!!!! 1070.0225830078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

145 (!!!!! 39390.802383423): TRUNCATE TABLE jos_trademed_module

146 (644.92225646973): 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=294799253 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

147 (!!!!! 3686.9049072266): 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=294799253 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

148 (473.0224609375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

149 (!!!!! 1163.0058288574): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

150 (!!!!! 1436.2335205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

151 (!!!!! 16252.040863037): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

152 (!!!!! 1919.0311431885): 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

153 (269.17457580566): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

154 (459.19418334961): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

155 (634.90867614746): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294799253 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294799253 AND type='deeppockets_item' AND published='1' LIMIT 1

156 (!!!!! 1779.7946929932): 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)

157 (275.1350402832): 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 (!!!!! 1110.0769042969): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

159 (!!!!! 7133.960723877): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

160 (421.04721069336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294799253 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294799253 AND published='1' LIMIT 1

161 (!!!!! 3454.9236297607): select jos_twitters.link from jos_twitters where cat=10

162 (616.07360839844): select jos_facebook.link from jos_facebook where cat=10

163 (56.028366088867): select jos_google_plus.link from jos_google_plus where cat=10

164 (33.855438232422): select jos_linkedin.link from jos_linkedin where cat=10

165 (414.84832763672): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

166 (!!!!! 2572.0596313477): insert into jos_banners_delta values (14615,'2025-04-29 21:00:19','18.222.218.204','view'),(14202,'2025-04-29 21:00:19','18.222.218.204','view'),(14203,'2025-04-29 21:00:19','18.222.218.204','view')

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