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1T6-215 testing - Sniffer Portable Switch Expert Analysis and Troubleshooting Updated: 2023

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Exam Code: 1T6-215 Sniffer Portable Switch Expert Analysis and Troubleshooting testing June 2023 by Killexams.com team
Sniffer Portable Switch Expert Analysis and Troubleshooting
Network-General Troubleshooting testing

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1T6-215 Sniffer Portable Switch Expert Analysis and Troubleshooting
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1T6-303 TCP/IP Network Analysis and Troubleshooting
1T6-323 Microsoft Windows 2000 Network Analysis and Troubleshooting
1T6-510 Troubleshooting with Sniffer Portable/Sniffer Distributed
1T6-511 Network Analysis and Troubleshooting
1T6-520 Application Performance Analysis and Troubleshooting
1T6-521 Application Performance Analysis and Troubleshooting
1T6-530 TCP/IP Network Analysis and Troubleshooting
1T6-540 Advanced Troubleshooting with InfiniStream Network Mgmt

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Network-General
1T6-215
Sniffer Portable Switch Expert Analysis and Troubleshooting
https://killexams.com/pass4sure/exam-detail/1T6-215
A loop has a similar effect on a network as:
A. A poorly written application
B. packet corruption
C. CRC error
D. A broadcast storm
Answer: D
Question: 65
The loss of BPDU packets causes a ________ port to start ___________--
A. Forwarding/Blocking
B. Listening/Learning
C. Blocking/Forwarding
D. Forwarding/Learning
Answer: C
Question: 66
Choose all that apply. Which of the following can result in a port/switch failing to
receive BPDU packets?
A. A duplex mismatch on a point-to point link
B. Aggressive STP value changes
C. A unidirectional link
D. Packet corruption
Answer: A, B, C, D
Question: 67
Loops cannot occur with spanning Tree protocol enabled
A. True
B. False
19
Answer: B
Question: 68
The BPDU Forward Delay timer has a maximum value of ____________ seconds.
A. 10
B. 20
C. 30
D. 40
Answer: C
Question: 69
The BPDU Message Age timer has a maximum value of __________ seconds.
A. 10
B. 20
C. 30
D. 40
Answer: A
20
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Network-General Troubleshooting testing - BingNews https://killexams.com/pass4sure/exam-detail/1T6-215 Search results Network-General Troubleshooting testing - BingNews https://killexams.com/pass4sure/exam-detail/1T6-215 https://killexams.com/exam_list/Network-General Why Can’t I Connect to a Network is a tool to Diagnose Network Problems

Network problems? What could be the reason? It is just like being a detective and solve a mystery case – but who wants to be a James Bond when you’ve got a software like Why Can’t I Connect. WCIC is an easy and handy tool that lets you diagnose network issues and even helps you resolve TCP/IP connection errors. This tool will let you connect to various kinds of servers and would perform an incoming and outgoing test to diagnose the network for any problems and related issues.

WCIC is an open-sourced utility licensed under GNU public license. It is easy to use and operate the utility. It has basic and essential features that are very useful while diagnosing network problems in different types of servers.

Why Can't I Connect to a Network

Using this software you can connect to the following types of servers:

Microsoft SQL Server: WCIC would create a TCP/IP connection to any Microsoft SQL Server you want. What you simply need to enter is IP Address and Port of the server. But remember WCIC would not verify the server username or password, it would only make a connection to the server.

MySQL Server: It would make a similar connection as it made with Microsoft MySQL Server.

FTP and SFTP: WCIC can even diagnose network problems with FTP and Secure FTP servers. Simply you need to enter the IP address and the port only!

FTP

POP3 and IMAP: Email protocols like POP3 and IMAP can even be diagnosed using this wonderful software, for these you need to enter the server IP address and choose between STARTTLS and SSL/TLS and enter the corresponding port numbers. But remember it would not attempt to verify the username and password.

It can even diagnose other servers like IRC, LDAP and Usenet. Why Can’t I connect to create a complete log of performed operations and you can export the log by copying everything, and you can save it as a record for the future.

Overall Why Can’t I Connect is a must-have utility, as it has the essential features that are required while diagnosing the network problems experienced in different servers – and it is even useful for various testing features like if you want to test whether a server is live or not. It is easy to use and doesn’t require any geeky configuration and commands.

Click here to download Why Can’t I Connect.

The built-in Network & Internet Diagnostic & Repair Tool is another tool that you may want to have a look at.

Why Can't I Connect to a Network
Thu, 03 Feb 2022 20:15:00 -0600 en-US text/html https://www.thewindowsclub.com/why-cant-i-connect-network
Chapter 19: Testing and Troubleshooting Just a moment...
Mon, 12 Mar 2018 11:32:00 -0500 en-US text/html https://www.globalspec.com/reference/82682/203279/chapter-19-testing-and-troubleshooting
6.1: GENERAL TROUBLESHOOTING SAFETY PRACTICES Just a moment...
Tue, 20 Feb 2018 20:39:00 -0600 en-US text/html https://www.globalspec.com/reference/79717/203279/6-1-general-troubleshooting-safety-practices
Wi-Fi problems? Here’s how to diagnose your router issues

Whenever someone sends me a question about how to fix their Wi-Fi, I wince. It’s not that I dislike helping people with their router problems. In fact, there are few geeky endeavors I find more rewarding than fixing Wi-Fi connection issues at a friend or family member’s home.

But Wi-Fi has always felt more like a dark art than a science, and it’s an art that’s hard to conjure without being physically present. Potential points of failure are everywhere, and what works well in one home might not in another. Even the reviewers of networking gear can reach drastically different conclusions about the very same product.

Wi-Fi is fundamentally at odds, then, with my desire to answer questions with specific recommendations. The best I can do is walk your through how I diagnose Wi-Fi problems myself. That way, you can make better decisions on whether (and how) to upgrade your own gear.

Further reading: The best mesh Wi-Fi routers

Size up the Wi-Fi problem

The first step to solving Wi-Fi issues is to see if the slowdown is coming from your cable modem (which brings internet service into the home) or from the router (which distributes Wi-Fi connectivity throughout the home).

Start by plugging a computer directly into your modem with an ethernet cable and running a speed test. (The easiest way is to do a Google search for “speed test,” then hit the blue “Run Speed Test” button atop the search results.) A USB-to-Ethernet adapter will be necessary for testing on computers that don’t have an ethernet port, but if that’s too much trouble or you don’t have a proper computer at all, you can also try calling your internet provider and asking them to test your internet speed remotely.

Google speed test tool

Running speed tests throughout the house can help you figure out where the Wi-Fi trouble spots are.

Jared Newman / Foundry

If wired connection speeds are on par with your internet provider’s advertised speeds, the next step is to start running speed tests throughout the house. Measure speeds around the area where connectivity feels slow, then work your way back to where the router is located, running multiple tests in each area as you go.

The goal here is to figure out where your connection troubles are occurring. Consistently slow speeds throughout the house may be a sign of an outdated router, while dead zones or range issues may require a more powerful router or mesh Wi-Fi system. (More on that shortly.)

Find your Wi-Fi router’s 802.11 version

To figure out whether a router needs replacing, it helps to know how old it is. One way to do this to locate the router’s model number—it’s likely printed on the router itself—then search the web for info about which version of Wi-Fi it supports. Here are the major Wi-Fi versions to know about:

  • 802.11a/b/g: Extremely old and almost certainly the source of all your Wi-Fi problems.
  • 802.11a/b/g/n (or just 802.11n): Outdated at this point and a solid candidate for replacement. Many of these routers only support a single frequency band that’s slower and more congestion-prone, and “dual-band” variants have limited range on the faster 5 GHz frequency band.
  • 802.11ac (also marketed as Wi-Fi 5): Not the latest standard, but still widely available even in some high-performance routers.
  • 802.11ax (or Wi-Fi 6): Routers using this standard started shipping in late 2020, so your router is likely quite new.
  • Wi-Fi 6E: Congrats, you probably just bought a new router.

Wi-Fi versions alone aren’t an indicator of quality—a cheap Wi-Fi 6 router can be worse than a high-end mesh system with Wi-Fi 5—but each successive version has introduced new features that Strengthen connectivity, and we’ve generally seen a push toward better performance over time.

Try some smaller router fixes

Just to rehash a tip I discussed back in July, sometimes changing your router’s channel and bandwidth settings can work wonders for reducing Wi-Fi interference, especially if you’re seeing inconsistent speeds on devices that aren’t too far from the router. By digging into your router’s settings, you can bypass automatic channel selection and find a channel that might be less congested.

You can also try some other little tweaks, like getting your router off the ground and clearing some space around it—but I wouldn’t start rearranging your room for the router’s sake. Chances are the improvements will be minimal. Of course, moving your router to a more central location in the home can help, but that would likely require having the cable company rewire your home internet connection.

Wi-Fi extenders: a last resort

TP-Link extender
An extender can help squeeze more range out of your router, but it’s not a panacea.

TP-Link

Because replacing a router is a pain, a lot of folks wonder if they can just solve their problems with a Wi-Fi extender or repeater, which take the wireless signal from a router and rebroadcast it farther away. (“Extender” sometimes refers to a device with a wired connection to the router, though I often see both terms used interchangeably.)

My experience with Wi-Fi extenders is hit or miss. Wireless repeaters will always degrade whatever signal they receive, so the benefits can cancel out if you’re trying to address a dead zone or interference from other nearby wireless devices. The same is true with powerline adapters, which send a wired ethernet connection from your router to another part of the house through your wall outlets. Depending on how your house is wired, this approach can provide you a weak connection or not work at all.

I don’t tell people to avoid extenders outright, because they can work in some scenarios, but keep your expectations low and be prepared to return the device if it doesn’t help. Here’s how to set up a Wi-Fi extender if you decide to go that route.

Picking a new Wi-Fi router

Once you’ve concluded that it’s time to replace your router, then what?

A mesh Wi-Fi system will be the surest way to solve your Wi-Fi problems, especially in larger homes or ones with lots of dead zones. These systems let you plug in multiple access points throughout the house, creating one big network. They’re better at managing connections than a router with an extender, and systems advertised as “Tri-Band” can connect each access point without congesting the rest of the network.

Such systems might not be necessary, though. If you haven’t replaced your router in a while, even a new standalone router might be enough to power through dead zones if they’re not too far away. Standalone routers are generally less expensive than mesh systems, and some have features that mesh systems lack, such as USB storage support or a large number of ethernet ports.

Ultimately, though, there’s no way to tell for sure if a new router will work without trying it yourself. You can read all sorts of reviews—PCWorld reviews both Wi-Fi mesh systems and the latest Wi-Fi 6E routers—but even the best advice isn’t one-size-fits-all. Buying a new router will always involve a leap of faith.

A note on modem/router combos

Finally, there’s one more complicating factor: Although cable companies used to distribute internet modems and routers separately—the former bringing in the internet from outside the house, and the latter to distributing Wi-Fi through the home—it’s increasingly common now to get both functions in one box. That makes installation easier for the cable company, but makes router replacement trickier for you.

If you have a combo box and are paying for it in rental fees, consider replacing it with two devices: A new router and a separate cable modem. But be aware that some companies—particularly fiber-optic internet providers such as AT&T and Verizon—make replacing the modem component difficult or impossible.

If replacing the modem isn’t possible or necessary, you can just disable its Wi-Fi features so they don’t interfere with your new router. The instructions for doing so can vary by provider, so expect to do some Googling of “modem mode” or “bridge mode” plus the name of your internet provider.

And if you’re still having Wi-Fi problems after all that, send me an email and I’ll do my best to help. You can also check out my Advisorator newsletter—where a version of this story first appeared—to get more practical tech advice every week.

Editor’s note: This article has been updated with up-to-date product recommendations.

Sat, 13 May 2023 08:44:00 -0500 Author: Jared Newman en text/html https://www.pcworld.com/article/695032/how-to-fix-wifi-router-issues.html
Racial bias in testing likely led to underdiagnosing Black men with lung problems, study suggests FILE - An 8-year-old student blows into a spirometer held by a nurse outside an elementary school in Bel Nor, Mo., in May 2009. Racial bias built into a common medical test for lung function is likely leading to fewer Black patients getting care for breathing problems, researchers said in a study published in JAMA Network Open on Thursday, June 1, 2023. (Christian Gooden/St. Louis Post-Dispatch via AP, File) ((Christian Gooden / Associated Press)) © (Christian Gooden / Associated Press) FILE - An 8-year-old student blows into a spirometer held by a nurse outside an elementary school in Bel Nor, Mo., in May 2009. Racial bias built into a common medical test for lung function is likely leading to fewer Black patients getting care for breathing problems, researchers said in a study published in JAMA Network Open on Thursday, June 1, 2023. (Christian Gooden/St. Louis Post-Dispatch via AP, File) ((Christian Gooden / Associated Press))

Racial bias built into a common medical test for lung function is likely leading to fewer Black patients getting care for breathing problems, a study published Thursday suggests.

As many as 40% more Black male patients in the study might have been diagnosed with breathing problems if current diagnosis-assisting computer software was changed, the study said.

Doctors have long discussed the potential problems caused by race-based assumptions that are built into diagnostic software. This study, published in JAMA Network Open, offers one of the first real-world examples of how the the issue may affect diagnosis and care for lung patients, said Dr. Darshali Vyas, a pulmonary care doctor at Massachusetts General Hospital.

The results are “exciting” to see published but it's also "what we'd expect” from setting aside race-based calculations, said Vyas, who was an author of an influential 2020 New England Journal of Medicine article that catalogued examples of how race-based assumptions are used in making doctors' decisions about patient care.

For centuries, some doctors and others have held beliefs that there are natural racial differences in health, including one that Black people's lungs were innately worse than those of white people. That assumption ended up in modern guidelines and algorithms for assessing risk and deciding on further care. Test results were adjusted to account for — or “correct” for — a patient’s race or ethnicity.

One example beyond lung function is a heart failure risk-scoring system that categorizes Black patients as being at lower risk and less likely to need referral for special cardiac care. Another is an equation used in determining kidney function that creates estimates of higher kidney function in Black patients.

The new study focused on a test to determine how much and how quickly a person can inhale and exhale. It’s often done using a spirometer — a device with a mouthpiece connected to a small machine.

After the test, doctors get a report that has been run through computer software and scores the patient's ability breathe. It helps indicate whether a patient has restrictions and needs further testing or care for things like asthma, chronic obstructive pulmonary disorder or lung scarring due to air pollutant exposure.

Algorithms that adjust for race raise the threshold for diagnosing a problem in Black patients and may make them less likely to get started on certain medications or to be referred for medical procedures or even lung transplants, Vyas said.

While physicians also look at symptoms, lab work, X-rays and family histories of breathing problems, the pulmonary function testing can be an important part of diagnoses, “especially when patients are borderline,” said Dr. Albert Rizzo, the chief medical officer at the American Lung Association.

The new study looked at more than 2,700 Black men and 5,700 white men tested by University of Pennsylvania Health System doctors between 2010 and 2020. The researchers looked at spirometry and lung volume measurements and assessed how many were deemed to have breathing impairments under the race-based algorithm as compared to under a new algorithm.

Researchers concluded there would be nearly 400 additional cases of lung obstruction or impairment in Black men with the new algorithm.

Earlier this year, the American Thoracic Society, which represents lung-care doctors, issued a statement recommending replacement of race-focused adjustments. But the organization also put a call out for more research, including into the best way to modify software and whether making a change might inadvertently lead to overdiagnosis of lung problems in some patients.

Vyas noted some other algorithms have already been changed to drop race-based assumptions, including one for pregnant women that predicts risks of vaginal delivery if the mom previously had a cesarean section.

Changing the lung-testing algorithm may take longer, Vyas said, especially if different hospitals use different versions of race-adjusting procedures and software.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

This story originally appeared in San Diego Union-Tribune.

Thu, 01 Jun 2023 05:58:42 -0500 en-US text/html https://www.msn.com/en-us/health/medical/racial-bias-in-testing-likely-led-to-underdiagnosing-black-men-with-lung-problems-study-suggests/ar-AA1c09nb
Black men were likely underdiagnosed with lung problems

NEW YORK — Racial bias built into a common medical test for lung function is likely leading to fewer Black patients getting care for breathing problems, a study published June 1 suggests.

As many as 40% more Black male patients in the study might have been diagnosed with breathing problems if current diagnosis-assisting computer software were changed, the study said.

Doctors have long discussed the potential problems caused by race-based assumptions that are built into diagnostic software. This study, published in JAMA Network Open, offers one of the first real-world examples of how the issue may affect diagnosis and care for lung patients, said Dr. Darshali Vyas, a pulmonary care doctor at Massachusetts General Hospital.

The results are “exciting” to see published but it’s also “what we’d expect” from setting aside race-based calculations, said Vyas, who was an author of an influential 2020 New England Journal of Medicine article that catalogued examples of how race-based assumptions are used in making doctors’ decisions about patient care.

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For centuries, some doctors and others have held beliefs that there are natural racial differences in health, including one that Black people’s lungs were innately worse than those of white people. That assumption ended up in modern guidelines and algorithms for assessing risk and deciding on further care. Test results were adjusted to account for — or “correct” for — a patient’s race or ethnicity.

One example beyond lung function is a heart failure risk-scoring system that categorizes Black patients as being at lower risk and less likely to need referral for special cardiac care. Another is an equation used in determining kidney function that creates estimates of higher kidney function in Black patients.

The new study focused on a test to determine how much and how quickly a person can inhale and exhale. It’s often done using a spirometer — a device with a mouthpiece connected to a small machine.

After the test, doctors get a report that has been run through computer software and scores the patient’s ability breathe. It helps indicate whether a patient has restrictions and needs further testing or care for things like asthma, chronic obstructive pulmonary disorder or lung scarring due to air pollutant exposure.

Algorithms that adjust for race raise the threshold for diagnosing a problem in Black patients and may make them less likely to get started on certain medications or to be referred for medical procedures or even lung transplants, Vyas said.

While physicians also look at symptoms, lab work, X-rays and family histories of breathing problems, the pulmonary function testing can be an important part of diagnoses, “especially when patients are borderline,” said Dr. Albert Rizzo, the chief medical officer at the American Lung Association.

The new study looked at more than 2,700 Black men and 5,700 white men tested by University of Pennsylvania Health System doctors between 2010 and 2020. The researchers looked at spirometry and lung volume measurements and assessed how many were deemed to have breathing impairments under the race-based algorithm as compared to under a new algorithm.

Researchers concluded there would be nearly 400 additional cases of lung obstruction or impairment in Black men with the new algorithm.

Earlier this year, the American Thoracic Society, which represents lung-care doctors, issued a statement recommending replacement of race-focused adjustments. But the organization also put a call out for more research, including into the best way to modify software and whether making a change might inadvertently lead to overdiagnosis of lung problems in some patients.

Vyas noted some other algorithms have already been changed to drop race-based assumptions, including one for pregnant women that predicts risks of vaginal delivery if the mom previously had a cesarean section.

Changing the lung-testing algorithm may take longer, Vyas said, especially if different hospitals use different versions of race-adjusting procedures and software.

Sun, 04 Jun 2023 10:00:00 -0500 en text/html https://dailyprogress.com/ap/national/black-men-were-likely-underdiagnosed-with-lung-problems/article_2d61fd0f-b4fe-5ca3-bbf8-b78a967a4fa9.html
The Learning Network No result found, try new keyword!By The Learning Network Middle and high school students ... By Katherine Schulten The United States surgeon general issued an extraordinary public warning that could bring changes to how young ... Sun, 04 Jun 2023 20:02:00 -0500 en text/html https://www.nytimes.com/section/learning Dutch Survey Data Shows Significant Increase In Memory And Concentration Problems Among Adults Since Start Of Covid-19 Pandemic

From the outset of the Covid-19 pandemic, a growing contingent of Covid-19 patients whose symptoms were initially mild began facing mysterious neurological problems, both short- and long-term. These include memory and sleep disturbances, dizziness, nerve pain, and what people often refer to as “brain fog.”

Recently published data from the Netherlands suggests that among people ages 25 and up, memory and concentration problems have risen by 24% since the beginning of the Covid-19 pandemic. According to an ongoing large-scale research survey conducted by the Dutch National Institute for Public Health and the Environment (RIVM) and the Netherlands Institute for Health Care Research (NIVEL), there has been a 31% increase in primary care visits by adults ages 25 to 44 for “memory and concentration problems” in the past three years. Among the 45 to 74 year-old group, there was a 40% jump in visits to the doctor for these specific complaints. And, in the 75 and up age group, there was an 18% rise in physician visits.

The data was released as part of the latest quarterly research update (the seventh round of an ongoing study) from the GOR Network, which since 2021, in partnership with the RIVM and NIVEL, has been tracking the short- and long-term effects of the Covid-19 pandemic in the Netherlands. The quarterly survey is based on both questionnaires sent to patients and primary care physician records. Between March 13th and 27th of this year, 7,838 adults (25 and older) completed a questionnaire about their mental and physical health. Respondents included adults with and without a history of a confirmed coronavirus infection. Further, the GOR Network examined data gathered from 380 primary care physician clinics with approximately 1.6 million registered patients (9% of the Dutch population). Physicians recorded data on all symptoms and conditions for which patients presented at their practice. After being uploaded to a database, this information was analyzed by researchers at the GOR Network.

Under normal circumstances, people ages 75 and above would be most likely to go to their doctor with complaints about their memory or inability to concentrate. And adults in the age group of, say, 25 to 44, would be relatively unlikely to visit their primary care physician for such symptoms. What’s remarkable is that the findings showed the opposite of what one would have expected. While the number of physician visits for memory and concentration problems increased in all age groups among adults ages 25 years and up, the smallest increase was seen among adults 75 and older: 18%. And researchers observed no increase in visits among “young people,” or those under 25.

Professor Dückers, who leads the research on behalf of RIVM and NIVEL, says it’s a “worrying development … We still don’t know much about the long-term effects, but the picture is now emerging that the pandemic can lead to faster aging on a significant scale.”

The possible causes of the increase in memory and concentration problems are unclear. A plausible explanation is that the isolation brought about by Covid-19 restrictions contributed to accelerated cognitive decline among people who were already starting to have problems with memory and concentration.

Experts posit, however, that long Covid is likely to blame for the majority of sufferers. Since 2020, numerous investigations have shown that memory and concentration problems are common post-Covid symptoms. Other infectious diseases, such as flu, can also cause these symptoms. But studies have demonstrated that long-term memory and concentration problems are much more common after being infected with Covid-19 than following a bout with influenza. Specifically, people struggling with the effects of long Covid can exhibit problems with attention, memory, and executive function.

What is referred to in everyday parlance as “brain fog” includes cognitive problems such as remembering and concentrating, but also performing daily tasks. Working memory, which is a form of short-term memory, allows people to store and retrieve information while doing daily activities, such as problem solving, memorizing or having a conversation.

Last year, in a U.K.-based examination, researchers found that being infected with Covid negatively impacted working memory function, but only in adults ages 25 and up. The study findings indicate that memory function can recover over time after a Covid infection, but people with persistent symptoms may continue to have difficulty with their working memory.

In parallel with the GOR Network quarterly survey, the Dutch RIVM had been conducting a long-term investigation on long Covid. The RIVM collected data, both to characterize the syndrome and attempt to figure out what’s causing symptoms.

It’s evident from the work carried out by the RIVM from 2020 to 2022 that a large number of people who contract the coronavirus struggle for months with lingering Covid-19 symptoms which can be debilitating. These include memory and concentration issues, among a wide array of symptoms.

Last year, RIVM posted results derived from a health survey questionnaire taken by a total of 14,572 participants. 9,166 people took the survey shortly after testing positive for SARS-CoV-2. The control group consisted of 5,406 people who tested negative for the coronavirus and applied to take part in the survey or were invited by letter from the general population. RIVM requested that all survey participants fill out questionnaires about their health at intervals of three months.

Fifteen percent of respondents had ongoing “brain fog” which consists of a mixture of memory and concentration problems. What’s striking is that the reported symptoms, including brain fog, are 1.5 times more common among those who had tested positive for Covid-19 than among those who have had other (non Covid-19) respiratory infections, such as influenza.

The most exact Dutch data from the GOR Network point to an alarming increase since the beginning of the Covid-19 pandemic of nearly a quarter in memory and concentration problems among people ages 25 and up. Brain fog is one of many long Covid symptoms. While there continue to challenges regarding how to precisely define long Covid and how to determine cause and effect, the syndrome isn’t going away. The Dutch Minister of Health Kuipers will soon announce whether (and how much) additional budget will be allocated to government-funded biomedical research into the causes of long Covid.

Sun, 04 Jun 2023 01:18:00 -0500 Joshua Cohen en text/html https://www.forbes.com/sites/joshuacohen/2023/06/04/dutch-survey-data-shows-significant-increase-in-memory-and-concentration-problems-among-adults-since-start-of-covid-19-pandemic/
Black men were likely underdiagnosed with lung problems because of bias in software, study suggests

Racial bias built into a common medical test for lung function is likely leading to fewer Black patients getting care for breathing problems, a study published Thursday suggests.

As many as 40% more Black male patients in the study might have been diagnosed with if current diagnosis-assisting computer software was changed, the study said.

Doctors have long discussed the potential problems caused by race-based assumptions that are built into diagnostic software. This study, published in JAMA Network Open, offers one of the first real-world examples of how the the issue may affect diagnosis and care for patients, said Dr. Darshali Vyas, a pulmonary care doctor at Massachusetts General Hospital.

The results are "exciting" to see published but it's also "what we'd expect" from setting aside race-based calculations, said Vyas, who was an author of an influential 2020 New England Journal of Medicine article that catalogued examples of how race-based assumptions are used in making doctors' decisions about .

For centuries, some doctors and others have held beliefs that there are natural racial differences in health, including one that Black people's lungs were innately worse than those of . That assumption ended up in modern guidelines and algorithms for assessing risk and deciding on further care. Test results were adjusted to account for—or "correct" for—a patient's race or ethnicity.

One example beyond is a heart failure risk-scoring system that categorizes Black patients as being at lower risk and less likely to need referral for special cardiac care. Another is an equation used in determining that creates estimates of higher kidney function in Black patients.

The new study focused on a test to determine how much and how quickly a person can inhale and exhale. It's often done using a spirometer—a device with a mouthpiece connected to a small machine.

After the test, doctors get a report that has been run through computer software and scores the patient's ability breathe. It helps indicate whether a patient has restrictions and needs further testing or care for things like asthma, chronic obstructive pulmonary disorder or lung scarring due to air pollutant exposure.

Algorithms that adjust for race raise the threshold for diagnosing a problem in Black patients and may make them less likely to get started on certain medications or to be referred for or even lung transplants, Vyas said.

While physicians also look at symptoms, lab work, X-rays and family histories of breathing problems, the pulmonary function testing can be an important part of diagnoses, "especially when patients are borderline," said Dr. Albert Rizzo, the chief medical officer at the American Lung Association.

The new study looked at more than 2,700 Black men and 5,700 white men tested by University of Pennsylvania Health System doctors between 2010 and 2020. The researchers looked at spirometry and lung volume measurements and assessed how many were deemed to have breathing impairments under the race-based algorithm as compared to under a new algorithm.

Researchers concluded there would be nearly 400 additional cases of lung obstruction or impairment in Black men with the new algorithm.

Earlier this year, the American Thoracic Society, which represents lung-care doctors, issued a statement recommending replacement of race-focused adjustments. But the organization also put a call out for more research, including into the best way to modify software and whether making a change might inadvertently lead to overdiagnosis of lung problems in some patients.

Vyas noted some other algorithms have already been changed to drop race-based assumptions, including one for that predicts risks of vaginal delivery if the mom previously had a cesarean section.

Changing the lung-testing algorithm may take longer, Vyas said, especially if different hospitals use different versions of race-adjusting procedures and software.

More information: Alexander T. Moffett et al, Global, Race-Neutral Reference Equations and Pulmonary Function Test Interpretation, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2023.16174

Adam Gaffney, Pulmonary Function Prediction Equations—Clinical Ramifications of a Universal Standard, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2023.16129

Lundy Braun et al, Race, Lung Function, and the Historical Context of Prediction Equations, JAMA Network Open (2023). DOI: 10.1001/jamanetworkopen.2023.16128

© 2023 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.

Citation: Black men were likely underdiagnosed with lung problems because of bias in software, study suggests (2023, June 2) retrieved 5 June 2023 from https://medicalxpress.com/news/2023-06-black-men-underdiagnosed-lung-problems.html

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