C2090-930 Braindumps

Killexams.com Practice Questions of C2090-930 Exam. | cheat sheets | stargeo.it

Download Killexams.com C2090-930 practice questions - VCE - examcollection - braindumps and exam prep They are added to our Killexams.com exam test framework to best set you up for the certifiable test - cheat sheets - stargeo.it

Pass4sure C2090-930 dumps | Killexams.com C2090-930 actual questions | http://www.stargeo.it/new/

C2090-930 IBM SPSS Modeler Professional v3

Study usher Prepared by Killexams.com IBM Dumps Experts

Exam Questions Updated On :

Killexams.com C2090-930 Dumps and actual Questions

100% actual Questions - Exam Pass Guarantee with tall Marks - Just Memorize the Answers

C2090-930 exam Dumps Source : IBM SPSS Modeler Professional v3

Test Code : C2090-930
Test denomination : IBM SPSS Modeler Professional v3
Vendor denomination : IBM
: 60 actual Questions

So immaculate questions in C2090-930 exam! i used to live already sufficient organized.
The precise solutions occupy been now not difficult to sustain in brain. My data of emulating the killexams.com modified intowithout a doubt attractive, as I made entire right replies within the exam C2090-930. Lots preferred to the killexams.com for the help. I advantageously took the exam preparation internal 12 days. The presentation mode of this aide occupy become smooth without any lengthened answers or knotty clarifications. A number of the topic which can live so toughand difficult as well are discipline so highly.

am i able to locate actual exam Q & A modern C2090-930 examination?
i was looking to assemble ready for my C2090-930 check that became across the nook, i discovered myself to live lost within the books and wandering far far from the actual point. I didnt grasp a unique phrase and that turned into virtually concerningdue to the fact I had to prepare as soon as feasible. Giving up on my books I decided to register myself in thiskillexams.com and that changed into the pleasant decision. I cruised through my C2090-930 test and became capable of assemble a respectable score so thanks very an terrible lot.

a gross lot much less effort, top notch information, assured success.
The crew in the back of killexams.com requisite to severely pat their returned for a activity well achieved! I occupy no doubts whilst pronouncing that with killexams.com, there is no threat which you dont assemble to live a C2090-930. virtually recommending it to the others and entire of the top class for the future you guys! What a notable examine time has it been with the wait on for C2090-930 available at the internet site. You had been dote a chum, a unfeigned buddy indeed.

notable supply modern exquisite actual exam questions, correct answers.
I passed, and very delighted to report that killexams.com adhere to the claims they make. They provide actual exam questions and the exam simulator works perfectly. The bundle contains everything they promise, and their customer service works well (I had to assemble in handle with them since first my online payment would not travel through, but it turned out to live my fault). Anyways, this is a very noble product, much better than I had expected. I passed C2090-930 exam with nearly top score, something I never thought I was capable of. Thank you.

I requisite actual test questions of C2090-930 exam.
After a few days of C2090-930 training with this killexams.com set, I passed the C2090-930 exam. I occupy to admit, I am relieved to depart it in the back of, yet pleased that I located killexams.com to wait on me assemble through this exam. The questions and solutions they encompass in the package deal are correct. The solutions are right, and the questions had been taken from the actual C2090-930 exam, and I were given them while taking the exam. It made matters plenty easier, and I were given a marks fairly better than I had hoped for.

Do you requisite actual pick a watch at qustions brand new C2090-930 examination?
I got 76% in C2090-930 exam. thanks to the team of killexams.com for making my pains so easy. I counsel to new customers to establish together via killexams.com as its very complete.

wherein occupy to I quest to assemble C2090-930 actual pick a watch at questions?
C2090-930 Exam was my purpose for this yr. A very lengthy New Years resolution to position it in plenary C2090-930 . I without a doubt thought that analyzing for this exam, making ready to skip and sitting the C2090-930 exam would live simply as loopy because it sounds. Thankfully, I discovered a few critiques of killexams.com online and decided to apply it. It ended up being absolutely really worth it as the package had protected each question I got on the C2090-930 exam. I passed the C2090-930 definitely pressure-unfastened and came out of the trying out headquarters joyful and comfortable. Definitely worth the money, I suppose this is the exceptional exam bask in viable.

i establish an super supply for C2090-930 question fiscal institution.
Tried a lot to pellucid my C2090-930 exam taking assist from the books. But the intricate motives and difficult instance made things worse and I skipped the test twice. Finally, my pleasant buddy suggested me the question & solution by means of killexams.com. And harmonize with me, it worked so well! The much contents were brilliant to undergo and recognize the subjects. I could effortlessly cram it too and replied the questions in slightly a hundred and eighty mins time. Felt elated to pass well. Thanks, killexams.com dumps. Thanks to my adorable buddy too.

Prepare C2090-930 Questions and Answers otherwise live prepared to fail.
I thanks killexams.com braindumps for this excellent achievement. yes, its far your question and solution which helped me pass the C2090-930 exam with ninety one% marks. That too with best 12 days preparation time. It changed into past my imagination even three weeks before the test until i establish the product. thank you lots on your invaluable usher and wish entire the exceptional to you team individuals for entire of the destiny endeavors.

i establish the entirety had to bypass C2090-930 exam here.
killexams.com questions and answers helped me to know what exactly is expected in the exam C2090-930. I prepared well within 10 days of preparation and completed entire the questions of exam in 80 minutes. It accommodate the topics similar to exam point of view and makes you memorize entire the topics easily and accurately. It besides helped me to know how to manage the time to finish the exam before time. It is best method.

IBM IBM SPSS Modeler Professional

IBM SPSS Modeler client knowledgeable - application Subscription and uphold Renewal series | killexams.com actual Questions and Pass4sure dumps

No outcomes found, are attempting new key phrase!IBM SPSS Modeler client knowledgeable - software Subscription and uphold Renewal e09qillae IBM SPSS Modeler client knowledgeable - application Subscription and wait on Renewal e09qmllae IBM SPSS Modeler ...

MOL to disburse IBM SPSS Modeler for safety evaluation | killexams.com actual Questions and Pass4sure dumps

 Mitsui O.S.okay. lines and its thoroughly-owned consolidated subsidiary MOL tips systems, (MOLIS) to birth multi-dimensional evaluation of the explanations for incidents and complications on its operated vessels, the usage of IBM's statistical evaluation utility, "IBM SPSS Modeler".

IBM SPSS Modeler is an superior information analysis software that offers potential analysis from mass volume of records and supports superior resolution making to resolve traffic considerations.

The MOL neighborhood has conventionally aggregated incidents and issues statistics pronounced by using its operated vessels to "visualize" protected operation. And any more, the neighborhood will promote more positive measures to steer pellucid of incidents and verify the results through examining correlations and causal relationship of facts from dissimilar sources (for example, operation information, crewmember records, vessel inspection statistics, and so on).

 additionally, it will construct a brand new evaluation mode the usage of the text mining function, for some elements of unstructured records, equivalent to near misses gathered from crewmembers.

prior to this evaluation, the community held a 3-month tribulation birth in July 2017 and constructed analysis fashions that examine causal relationship of counsel on crewmembers, comparable to downtime complications and years of onboard event.

The MOL group constantly makes disburse of and applies ICT technology in a proactive method, with the end ensuring protected, strong cargo transport and fitting the realm leader in secure operation.

IBM sends Cognos, SPSS to the cloud | killexams.com actual Questions and Pass4sure dumps

Two of IBM’s most universal evaluation products, the Cognos traffic Intelligence and the SPSS predictive analytics kit, are headed for the cloud, the newest in an ongoing shove by using IBM to port its giant utility portfolio to the cloud.

gaining access to this benevolent of utility from a hosted atmosphere, as opposed to purchasing the package outright, provides a number of merits to clients.

“We manage the infrastructure, and this allows you to scale extra without problems and assemble entire started with much less upfront funding,” spoke of Eric Sall, IBM vice chairman of global analytics advertising.

IBM announced these additions to its cloud services, as well as a few new choices, at its insight user convention for information analytics, held this week in Las Vegas.

by 2016, 25 percent of recent traffic evaluation deployments may live executed in the cloud, in line with Gartner.

Analytics may uphold groups in many methods, according to IBM. It may give extra perception in the buying habits of customers, in addition to insight into how well its personal operations are performing. It could aid safeguard techniques from assaults and makes an attempt at fraud, in addition to assure that enterprise departments are assembly compliance necessities.

the new online version of Cognos, IBM Cognos company Intelligence on Cloud, can at the minute live demonstrated in a preview mode. IBM plans to proffer Cognos as a plenary commercial service early subsequent year. users can elope Cognos in opposition t records they hold within the IBM cloud, or in opposition t statistics they sustain on premises.

A plenary commercial version of the online IBM SPSS Modeler may live obtainable inside 30 days. This package will consist of entire the SPSS add-ons for records primarily based predictive modeling, reminiscent of a modeler server, analytics altenative administration utility and a facts server.

past this 12 months, IBM pledged to present much of its utility portfolio as cloud functions, many through its Bluemix set of platform functions.

moreover Cognos and SPSS, IBM additionally unveiled a few new and updated offerings at the conference.

One new carrier, DataWorks, offers a few strategies for refining and cleaning information so it is able for evaluation. The enterprise has launched a cloud-based mostly records warehousing provider, referred to as dashDB. a new Watson-based mostly service, called Watson Explorer, gives a way for users to quiz herbal language questions on assorted units of inside records.

To comment on this text and different PCWorld content material, dispute with their facebook web page or their Twitter feed.

Whilst it is very difficult chore to pick reliable exam questions / answers resources regarding review, reputation and validity because people assemble ripoff due to choosing incorrect service. Killexams. com accomplish it sure to provide its clients far better to their resources with respect to exam dumps update and validity. Most of other peoples ripoff report complaint clients approach to us for the brain dumps and pass their exams enjoyably and easily. They never compromise on their review, reputation and attribute because killexams review, killexams reputation and killexams client self self-confidence is indispensable to entire of us. Specially they manage killexams.com review, killexams.com reputation, killexams.com ripoff report complaint, killexams.com trust, killexams.com validity, killexams.com report and killexams.com scam. If perhaps you contemplate any bogus report posted by their competitor with the denomination killexams ripoff report complaint internet, killexams.com ripoff report, killexams.com scam, killexams.com complaint or something dote this, just sustain in understanding that there are always depraved people damaging reputation of noble services due to their benefits. There are a big number of satisfied customers that pass their exams using killexams.com brain dumps, killexams PDF questions, killexams practice questions, killexams exam simulator. Visit Killexams.com, their test questions and sample brain dumps, their exam simulator and you will definitely know that killexams.com is the best brain dumps site.

Back to Braindumps Menu

000-061 braindumps | 202-400 practice exam | NPTE cheat sheets | 300-135 dumps | HP0-J63 cram | 1Z0-416 sample test | VCS-323 test prep | 650-179 test prep | LOT-404 practice test | 000-J02 braindumps | HP2-N51 brain dumps | 9A0-702 study guide | COBIT5 braindumps | 000-341 examcollection | C2030-284 practice Test | 920-336 exam prep | 156-706 free pdf | E20-070 questions answers | M2040-642 practice questions | 642-278 dumps questions |

Real C2090-930 questions that showed up in test today
On the off random that you are occupied with effectively finishing the IBM C2090-930 exam to inaugurate acquiring, killexams.com has driving edge created IBM SPSS Modeler Professional v3 exam questions that will guarantee you pass this C2090-930 exam! killexams.com conveys you the most precise, present and latest refreshed C2090-930 exam questions and accessible with a 100% unconditional promise.

IBM C2090-930 Exam has given a new direction to the IT industry. It is now required to certify as the platform which leads to a brighter future. But you requisite to establish extreme pains in IBM IBM SPSS Modeler Professional v3 exam, beAs there is no shun out of reading. But killexams.com occupy made your toil easier, now your exam preparation for C2090-930 IBM SPSS Modeler Professional v3 is not tough anymore. Click http://killexams.com/pass4sure/exam-detail/C2090-930 killexams.com is a reliable and trustworthy platform who provides C2090-930 exam questions with 100% success guarantee. You requisite to practice questions for one day at least to score well in the exam. Your actual journey to success in C2090-930 exam, actually starts with killexams.com exam practice questions that is the excellent and verified source of your targeted position. killexams.com Huge Discount Coupons and Promo Codes are as under;
WC2017 : 60% Discount Coupon for entire exams on website
PROF17 : 10% Discount Coupon for Orders greater than $69
DEAL17 : 15% Discount Coupon for Orders greater than $99
DECSPECIAL : 10% Special Discount Coupon for entire Orders

killexams.com facilitates a awesome many candidates pass the tests and assemble their certifications. They occupy a big quantity of efficacious surveys. Their dumps are solid, reasonable, updated and of truly best much to overcome the issues of any IT certifications. killexams.com exam dumps are most recent updated in rather outflank way on criterion premise and cloth is discharged intermittently. Most recent killexams.com dumps are reachable in trying out focuses with whom they are retaining up their dating to assemble maximum recent material.

The killexams.com exam questions for C2090-930 IBM SPSS Modeler Professional v3 exam is essentially in view of two to live had arrangements, PDF and practice software program. PDF file conveys entire of the exam questions, solutions which makes your making plans less hardworking. While the practice software program are the complimentary detail within the exam object. Which serves to self-survey your strengthen. The evaluation paraphernalia additionally functions your feeble areas, where you occupy to positioned more attempt with the train that you may enhance each one among your concerns.

killexams.com hint you to must strive its free demo, you will contemplate the natural UI and moreover you will speculate that its smooth to modify the prep mode. In any case, accomplish sure that, the actual C2090-930 exam has a bigger wide variety of questions than the tribulation shape. On the off random that, you are placated with its demo then you could purchase the actual C2090-930 exam object. killexams.com offers you 3 months free updates of C2090-930 IBM SPSS Modeler Professional v3 exam questions. Their grasp group is constantly reachable at returned give up who updates the material as and whilst required.

killexams.com Huge Discount Coupons and Promo Codes are as below;
WC2017 : 60% Discount Coupon for entire exams on internet site
PROF17 : 10% Discount Coupon for Orders extra than $69
DEAL17 : 15% Discount Coupon for Orders greater than $99
DECSPECIAL : 10% Special Discount Coupon for entire Orders

C2090-930 Practice Test | C2090-930 examcollection | C2090-930 VCE | C2090-930 study guide | C2090-930 practice exam | C2090-930 cram

Killexams 000-559 sample test | Killexams 00M-622 questions and answers | Killexams 000-206 actual questions | Killexams 010-111 test prep | Killexams P2040-052 brain dumps | Killexams HP2-B88 braindumps | Killexams VCS-323 pdf download | Killexams ICDL-EXCEL practice test | Killexams 090-600 free pdf | Killexams 000-235 cheat sheets | Killexams 000-277 braindumps | Killexams ST0-075 free pdf download | Killexams C2040-407 brain dumps | Killexams 050-SEPROGRC-01 test prep | Killexams 000-N31 practice exam | Killexams 650-325 exam prep | Killexams A8 dumps | Killexams S90-19A test questions | Killexams 310-230 braindumps | Killexams ACSM-GEI dump |

killexams.com huge List of Exam Braindumps

View Complete list of Killexams.com Brain dumps

Killexams 922-104 brain dumps | Killexams 648-375 brain dumps | Killexams CAT-380 test prep | Killexams 310-044 cheat sheets | Killexams 1Z0-477 test prep | Killexams 400-201 practice test | Killexams 201-400 braindumps | Killexams 9L0-408 bootcamp | Killexams 000-026 exam prep | Killexams 00M-229 braindumps | Killexams P2080-088 dumps | Killexams 1Z0-561 practice test | Killexams 920-270 braindumps | Killexams 1Z0-132 free pdf | Killexams VCS-257 test questions | Killexams 000-M80 actual questions | Killexams HP5-K01D practice exam | Killexams HPE2-E69 test prep | Killexams BH0-004 study guide | Killexams 4A0-109 free pdf |

IBM SPSS Modeler Professional v3

Pass 4 sure C2090-930 dumps | Killexams.com C2090-930 actual questions | http://www.stargeo.it/new/

Impact of HIV and type 2 diabetes on Gut Microbiota Diversity, Tryptophan Catabolism and Endothelial Dysfunction | killexams.com actual questions and Pass4sure dumps

Baseline characteristics

Baseline characteristics are given in Table 1. There was more disburse of ACE-inhibitors, angiotensin 2 blockers and statins in patients with T2D irrespective of HIV-status, whereas disburse of beta-blockers was more prevalent in HIV-infected patients with T2D. HIV-infected patients with T2D were more often treated with non-nucleoside transpose transcriptase inhibitors (NNRTIs) and less often with protease inhibitors (PIs) compared to HIV-infected patients without T2D. Those with combined T2D and HIV infection had the highest levels of triglycerides and the lowest levels of high-density lipoprotein (HDL) cholesterol, but there was no inequity in HbA1c in patients with T2D according to HIV status. Furthermore, low-density lipoprotein (LDL) cholesterol was lower in patients with T2D irrespective of HIV status, probably reflecting higher disburse of statins. Finally, there was a higher balance of sedentary individuals (exercising <once/week) in the HIV+T2D group compared to controls.

Impact of HIV, T2D and both on endothelial dysfunction, tryptophan metabolism, and inflammation

As previously described, HIV-infected patients with T2D had higher concentration of ADMA as a marker of endothelial dysfunction compared with controls and HIV-infected patients without T2D10 (Table 1). In addition, HIV-infected patients had higher plasma KT-ratio as a marker of increased IDO-1 induced tryptophan metabolism and higher levels of the pro-inflammatory marker neopterin, with the highest levels in those with accompanying T2D (Fig. 1A,B). In contrast, T2D lonely was not associated with increased KT-ratio or neopterin levels.

Figure 1

The repercussion of HIV, T2D and both (HIV + T2D) on (A) tryptophan catabolism (KT-ratio), (B) inflammation (neopterin), (C and D) gut microbiota diversity (number of observed bacterial species and Shannon diversity index). Controls (red), HIV only (blue), T2D only (green) and HIV-infected with T2D (orange). *p < 0.05 vs. controls, #p < 0.05 vs. T2D only, †p < 0.05 vs. HIV only.

HIV-infected patients with T2D occupy an altered gut microbiota with reduced alpha diversity

As depicted in Fig. 1C and D, the lowest alpha diversity (number of observed bacterial species) was establish in HIV-infected patients with T2D, followed by T2D alone, HIV alone, and hale controls. Of note, there was no significant inequity between HIV lonely and hale controls whereas HIV + T2D had a significantly lower number of observed bacterial species compared to both HIV lonely and controls. The identical pattern was seen when applying the Shannon diversity index, with the lowest alpha diversity in HIV + T2D, significantly lower than HIV lonely and controls (p for trend = 0.003).

Diabetes treatment, Framingham score and mode of HIV transmission are associated with alpha diversity

Factors associated with alpha diversity measures are given in Table 2, including physical activity and HDL cholesterol which were associated with higher alpha diversity measures, and smoking and Framingham risk score being associated with lower alpha diversity. With respect to diabetes treatment, metformin was associated with higher alpha diversity, as previously reported13. Concerning HIV transmission, there was a higher alpha diversity in men who occupy sex with men (MSM), besides in line with a recent report23. In contrast, BMI, time on ART, CD4+ T cell count, type of technique (PI/NNRTI) or disburse of statins were not associated with alpha diversity measures (data not shown).

Table 2 Association between covariates and gut microbiota diversity. HIV-infected patients with T2D occupy altered gut microbiota composition and increased fecal calprotectin levels

Looking at microbiota composition in more detail, no significant differences were observed between the groups among the major bacterial phyla. Significantly different taxa on order and genus plane are summarized in Supplementary Table S1 showing differences in HIV + T2D as compared with the other groups. On order level, there was an expansion of Enterobacteriales and Lactobacillales in the HIV + T2D group, the latter being driven by an multiply in Streptococcus on genus levels. Among the more abundant taxa on the genus level, microbes from the family of Lachnospiracea (Lachnospira, Lachnobacterium, Anaerostipes) were depleted in the HIV + T2D group. Although the Lachnospiracea family is known for its capacity to bear butyrate, the overall capacity for butyrate metabolism as predicted by a PICRUSt analysis, did not disagree between the groups (p = 0.70).

Of note, not any of the bacterial taxa were significantly different between the groups after FDR adjustment, and differences in individual bacterial taxa should therefore live interpreted with caution. In order to capture the overall local inflammation in the gut, they measured fecal calprotectin levels, finding a higher fraction of individuals with elevated calprotectin levels (>100 mg/kg feces) in HIV + T2D (43%) compared to the other groups (HIV only 22%, T2D 13%, controls 17%, p for trend = 0.048). However, log-transformed fecal calprotectin levels did not correlate with soluble markers, including ADMA (r = 0.11, p = 0.308), L-arginin/ADMA ratio (r = −0.09, p = 0.439), KT-ratio (r = 0.12, p = 0.281), neopterin (r = 0.11, p = 0.307) or log-transformed C-reactive protein (CRP) levels (r = 0.09, p = 0.440).

Tryptophan catabolizing bacteria are associated with KT-ratio and plasma neopterin but not with endothelial dysfunction

We next examined the potential repercussion of tryptophan metabolizing microbes in the gut microbiota by performing a PICRUSt analysis. Bacterial taxa contributing to tryptophan metabolism belonged mainly to the phylum Proteobacteria, including Burkholderia, Pseudomonas, and Bacillus, as previously reported19 (Supplementary Table S2). Bacterial genes related to tryptophan metabolism correlated with KT-ratio and neopterin in the total population (r = 0.33, p = 0.002 and r = 0.38, p < 0.001) and particularly in HIV-infected patients with T2D (r = 0.52, p = 0.015 and r = 0.57, p = 0.007). Furthermore, tryptophan metabolizing microbes correlated negatively with gut microbiota diversity and again, these correlations were stronger in HIV-infected with T2D (Table 3).

Table 3 Correlations between alpha diversity measures, endothelial dysfunction and bacterial genes related to tryptophan metabolism, KT-ratio and inflammation in the total study population (n = 84) and the HIV-infected individuals with type 2 diabetes (n = 21).

Among the factors potentially confounding alpha diversity (as shown in Table 2), MSM status was associated with lower predicted abundance of tryptophan metabolizing microbes (median 4609 [IQR 897] vs. 5473 [IQR 499], p = 0.002). Of note, these factors, including MSM status, were not associated with KT-ratio. Tryptophan metabolizing microbes, although being correlated with KT-ratio and neopterin, did not correlate with endothelial dysfunction (Table 3). CRP levels correlated inversely with alpha diversity measures but not with markers of endothelial dysfunction (Table 3).

Increased tryptophan catabolism is associated with endothelial dysfunction in multivariate analyses

As shown in Table 3, KT-ratio and neopterin were positively correlated with ADMA and negatively correlated with L-arginine/ADMA-ratio, suggesting an association between systemic inflammation, altered tryptophan metabolisms and endothelial dysfunction. Notably, these correlations were stronger in HIV-infected with T2D (Table 3).

To further investigate potential predictors of endothelial dysfunction, they performed a stepwise multivariate linear regression analysis with ADMA as relative variable, and KT-ratio, group, traditional cardiovascular risk factors, gut microbiota diversity and factors affecting the gut microbiota (Table 2) as covariates. KT-ratio, log-transformed CRP, group, observed bacterial species, physical activity, diabetes treatment (insulin, oral), mode of HIV transmission (MSM, others), and Framingham 10 year CVD score were included in the multivariate model. Neopterin was excluded from the model due to the near correlation with KT-ratio (r = 0.78, p < 0.001). KT-ratio was associated with ADMA in multivariate analyses (Fig. 2). Hence, higher KT-ratio was associated with higher ADMA reflecting increased endothelial dysfunction (β = 4.58 [95% CI 2.53–6.63], p < 0.001) besides after adjusting for confounders.

Figure 2

Association (Pearson correlation) between tryptophan catabolism (KT-ratio) and endothelial dysfunction assessed by ADMA in the total study population; controls (red), HIV only (blue), T2D only (green) and HIV-infected with T2D (orange).

Technology Infrastructure, Graphics and Visualization, and Adaptive Technologies | killexams.com actual questions and Pass4sure dumps

Technology Infrastructure, Graphics and Visualization, and Adaptive Technologies

Technology Infrastructure: Servers

Acer Altos Servers

Designed for workgroup networking, the Altos server series supports systems for file management, a department, or a LAN or WAN. Features comprise multiple processor support, big remembrance and cache possibilities, hot-swappable power supplies and storage modules, and uphold for multiple operating systems, including Windows NT, Novell Netware, or SCO OpenServer environments. A broad selection of scalable configurations, from basic add-in cards to key-activated Internet, Intranet, or RAID solutions, is besides available. Contact: Acer America, San Jose, CA; (800) SEE-ACER; www.acer.com.

Dell PowerEdge Servers

The PowerEdge Server line has three different models, the PE300, PE2400, and PE4400. The PE300 has up to two Pentium III 800MHz processors and up to 1GB of ECC SDRAM. The PE2400 has up to two Pentium III 1GHz processor, 2 GB of ECC SDRAM and 144 GB of sweltering Swap internal disk capacity. The PE 4400 has up to two Pentium III 1GHz processors, 4GB of PC133 SDRAM and 252GB of sweltering plug ultra-3SCSI internal disk capacity. Contact: Dell, Round Rock, TX; (888) 560-8324; www.dell.com.

Gateway Ultra-Thin Server

Gateway offers a full-featured server in a compact design, for companies with growing server requirements but limited physical space. The 7450-R supports Intel's two latest processors, 4CG of RAM and three hot-plug SCSI drives, optional RAID configurations, and two full-length 64-bit PCI slots. The components are designed for durability. Two high-powered blowers control the unit's temperature, and a tool-free chassis makes servicing convenient. Contact: Gateway, North Sioux City, IA; (800) 846-2000; www.gateway.com.

IBM RS/6000 Model 43P-140

The 43P-140 is an entry-level desktop/deskside system that provides a orbit of performance options, from drafting, design, and software evolution to high-definition 3D graphics and technical simulations. It includes the altenative of processor speed, storage devices, and communications features, allowing users to configure the system for particular needs. With the selection of 2D or 3D graphics accelerators or 3D graphics input devices, the 43P-140 provides the necessary capability for demanding 2D or high-function 3D applications. Contact: International traffic Machines, Inc., Armonk, NY; (914) 499-1900; www.ibm.com.

Informix Dynamic Server 2000

The Dynamic Server 2000 delivers a transaction engine for mission-critical applications while providing an upgrade path to the Internet. Capable of supporting thousands of concurrent users, it is scalable to power even the largest transaction processing systems. Features comprise enhanced Virtual Table Interface (VTI), which provides the capacity to integrate and view legacy data from a variety of disparate systems, databases, and formats, and smooth migration from previous Informix database products. Contact: Informix Software, Menlo Park, CA; (650) 926-6300; http://www-3.ibm.com/software/data/informix/ids/.

Professional dietary coaching within a group chat using a smartphone application for weight loss: a randomized controlled tribulation | killexams.com actual questions and Pass4sure dumps

Kiyoji Tanaka,1,2 Hiroyuki Sasai,3 Kyohsuke Wakaba,4 Shin Murakami,4,5 Miyuki Ueda,5 Fumio Yamagata,6 Masao Sawada,6 Kazuhiro Takekoshi7

1Faculty of Health and Sport Sciences, University of Tsukuba, Tsukuba, Japan; 2THF Co., Ltd, Tsukuba, Japan; 3Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan; 4Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; 5Life Science Department, FiNC Inc., Tokyo, Japan; 6Genki Plaza Medical headquarters for Health Care, Tokyo, Japan; 7Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

Purpose: To test the effectiveness of professional dietary coaching via group chat using a smartphone application (app) for weight loss.Methods: This study was a 12-week, assessor-blind, parallel-group, waitlist-controlled randomized tribulation that included a 4-week follow-up term (trial registration, UMIN000025340). Data were collected between October 2016 and May 2017 and were analyzed between July 2017 and January 2018. Participants were 112 overweight, obese, or abdominally obese Japanese adults, aged 20 to 64 years, with at least one cardiometabolic risk factor. Participants were randomized to the coaching group (n=75) or control group (n=37), with a ratio of 2:1. The coaching group received a commercial weight loss program characterizing dietary coaching by a certified nutrition professional via group chat delivered on a smartphone app. Participants posted photos of every meal into the group chat, and the certified professional gave immediate direct feedback and encouragement. The primary outcome was an 8-week weight change. Secondary outcomes included 8-week changes in cardiometabolic risk factors. The frequency of meal photo uploads was recorded as a measure of adherence.Results: Of the 112 randomized participants, 93 (83.0%) and 81 (72.3%) completed 8-week and 12-week visits, respectively. Intention-to-treat analysis demonstrated significantly larger 8-week weight loss in the coaching group (−1.4 kg; 95% self-confidence interval [CI]: −2.0, −0.8 kg) than that in the control group (−0.1 kg; 95% CI: −0.6, 0.4 kg). Significantly larger improvements in triglyceride and glycated hemoglobin A1c levels were besides obtained in the coaching group. These benefits, except for the triglyceride level, were maintained until week 12. The frequent upload of meal photos was associated with a larger 8-week weight loss in a dose–response mode (P-value for trend <0.001).Conclusion: This smartphone-delivered commercial weight loss program characterized as dietary coaching via group chat resulted in modest but significant weight loss. Facilitating participants’ lively involvement in the program is necessary to achieve greater health benefits.

Keywords: specific health guidance, technology-enhanced program, meal photo upload


Body weight loss and its maintenance remain indispensable challenges in clinical and public health settings.1,2 Most of the clinical guidelines for obesity recommend dietary restriction as a first-line treatment option before proceeding to more intensive modalities such as pharmacotherapy and bariatric surgery.2–5 In public health practices, weight control via dietary modification is besides highly recommended. In April 2008, the Japanese Ministry of Health, Labour and Welfare launched a nationwide health check-up and interventional program for targeting metabolic syndrome.1,6 The program is aimed at early identification of high-risk individuals through efficacious health check-ups, with an chance for lifestyle (mainly dietary) modification to obviate the evolution of cardiovascular disease.1,5 However, traditional weight control programs with frequent visits in face-to-face settings are often time-consuming, and labor- and cost-intensive, require big client efforts, and thus circumscribe the widespread application to a big balance of the target population.

With these issues in mind, technology-enhanced weight loss programs occupy attracted much attention in the past two decades.7,8 The technology in this context includes the disburse of landline phones, mobile phones, personal digital assistants, the Internet-based tools, gregarious media, smartphone and its applications (apps), and other smart devices such as the tablet.8 Of these, the smartphone has much potential for health promotion programs because of its various functions including behavior monitoring with a built-in camera and an accelerometer as well as the convenience of the Internet connectivity, portability, and a tall dissemination rate. Although numerous smartphone apps that can track food intake, physical activity, and body weight are available in the commercial app databases, such as the iOS App Store and Google Play,9 the effectiveness of the disburse of these smartphone apps on weight loss has rarely been tested by well-designed randomized controlled trials.10 In fact, a systematic review on smartphone-delivered weight loss interventions included a total of six trials (publications were retrieved from April 2015), but only one of them adopted an appropriately controlled trial.10 Sutton and Redman besides identified remarkably few active, completed, and published trials designed to aid weight loss using a smartphone in the clinical tribulation registry of ClinicalTrial.gov (accessed February 5, 2016).11

There exist several other issues to live tackled in this field. Khaylis et al reported five key behavioral techniques for technology-enhanced weight loss interventions (ie, self-monitoring, counselor feedback and communication, gregarious support, disburse of a structured program, and disburse of an individually tailored program).12 However, no study assesses fully the advantages of the smartphone apps and how to integrate the key behavioral techniques into weight loss programs. In addition, Coughlin et al indicated the requisite for culturally tailored smartphone apps for weight management since most currently available apps were offered in English.13 Thus, the evolution and testing of non-English smartphone apps for weight loss would live valuable to widely disseminate a scientifically proven weight loss program.

One of Japan’s health tech start-up companies, FiNC Inc., developed a Japanese smartphone app called “FiNC” that can upload meal photos by users who then receive immediate direct feedback by certified nutrition professionals within a group chatroom. This randomized controlled tribulation tested the effectiveness of a weight loss program delivered on a smartphone app among overweight or obese Japanese adults. The findings from this tribulation would enable us to achieve a big portion of high-risk individuals at lower costs and contribute to improving population health.


Design and setting

This study was an assessor-blind, parallel-group, waitlist-controlled, randomized tribulation comprised of an 8-week intervention and a 4-week non-intervention follow-up periods. The tribulation was implemented at a preventive medical custody clinic in Tokyo, Japan, between October 2016 and May 2017, and data were analyzed between July 2017 and January 2018. The Ethics Review Board of the Faculty of Health and Sport Sciences at the University of Tsukuba reviewed and approved the study protocol (approval number: 28-65) on October 17, 2016. The study protocol was placed in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN000025340) on December 20, 2016. This article followed the Consolidated Standards of Reporting Trials 2010 guidelines.14 entire participants gave written informed consent prior to eligibility assessment. No compensation was offered to any of the participants upon completion of this study.

Our target for enrollment was 90 participants, which allowed us to detect an result size (Cohen’s d) of 0.64 with a two-tailed alpha plane of 5% and a power of 80%.15 The result size was determined according to their previously collected data when they provided the identical weight loss program to a different group of customers. The data used for the sample size estimation are designated as confidential company information, and they are therefore unable to disclose this. Considering that some would decline to provide the informed consent or would live unable to fulfill the eligibility criteria, they attempted to invite 120 candidates for the initial eligibility assessment.

Participants and randomization

Participants were recruited from employees of several companies mainly in transportation or actual estate industries in Tokyo, Japan. Through e-mail and verbal outreach, the human resources department of these companies encouraged employees who met the study eligibility listed below, validated by a recent health check-up result, to participate in this trial. The candidates were enrolled if they met entire the following criteria: 1) Japanese adults aged 20–64 years, 2) body mass index (BMI) ≥25 kg/m2 or waist perimeter ≥85 cm for manly and ≥90 cm for female, 3) having at least one of the cardiometabolic risk factors such as elevated blood pressure (systolic blood pressure ≥130 mm Hg and/or diastolic blood pressure ≥85 mm Hg), dyslipidemia (triglyceride ≥150 mg/dL and/or high-density lipoprotein cholesterol <40 mg/dL), and mild hyperglycemia (fasting plasma glucose ≥100 mg/dL and/or glycated hemoglobin A1c ≥5.2% [National Glycohemoglobin Standardization Program]16) according to risk stratification criteria for the Japanese nationwide health check-ups.1,6 Since Japanese are reported to live susceptible to evolution of type 2 diabetes at a low plane of obesity,17 the lower cutoff value of glycated hemoglobin A1c was used for early identification and intervention for high-risk individuals with type 2 diabetes. They excluded candidates if they intended to participate in or were enrolled in other clinical trials. Although those with current disease status were not excluded, they excluded candidates if they had contraindications to intentional weight loss through dietary modification judged by a physician.

After stratifying by recruitment waves, eligible participants were randomized to the coaching group or control group, with a ratio of 2:1. This weighted allocation ratio toward the coaching group was designed to minimize the number of control group who cannot receive dietary advices until the study halt for an ethical reason. An investigator who lacked direct contact with the participants and assessors generated a random number sequence using a validated computer program.


Participants in the coaching group received a commercial weight loss program called “Wellness Coach” developed and provided by FiNC Inc. The participants in the control group did not receive any intervention for 8 weeks or during the 4-week follow-up period. After the 12-week study period, the control participants were offered the identical weight loss program for ethical considerations.

The Wellness Coach is a weight loss program that gives users dietary uphold by connecting them with nutrition professionals for advice, instruction, and encouragement through the FiNC smartphone app. This weight loss program adopted four out of five established behavioral techniques for a technology-based health promotion program, ie, self-monitoring, counselor feedback and communication, gregarious support, and considered an individually tailored program.12 First, the participants were asked to download the app on their own smartphones and were assigned to a group with up to six members (14 groups in total) with a nutrition professional. Participants were instructed to measure their body weight twice a day in the morning and at night, according to a randomized tribulation of self-weighing for Japanese,18 and to pick photos of their meals three times a day. Then, they uploaded the photos to a group chat system within the app which can allow users to self-monitor their weight and meals (self-monitoring). The certified nutrition professional used the group chat to give immediate and direct feedback to each participant on things such as meal choices or answers to dietary questions (counselor feedback and communication, and individually tailored program). The nutrition professionals replied to a participant’s post within 3 hours during the day or by noon the next day if participants posted their photo or comment after midnight. This removed time constraints and the requisite for a Place to receive professional dietary counsel and community support. They recorded the total number of meal photo uploads as a proxy measure of study adherence and used it for sub-analyses described later. Participants were besides able to communicate with other participants within their own group, but not between groups (social support). The weight monitoring records for each participant were not visible to other members due to privacy reasons. Whereas, the meal photos uploaded by the participant, the advice, comments and encouragement by the nutrition professional were disclosed to entire other members for their learning purposes. The Wellness Coach program is now available primarily for corporate customers such as national, local, and corporate health insurance societies. A similar weight loss program with a one-to-one online chat system, rather than a group chatroom, is available for individual customers. This is because the effectiveness of gregarious (peer) uphold on behavior change would live possibly smaller for individuals than corporate customers.

The Wellness Coach program adopted a unique diet principle called the “FiNC Method”, which encouraged participants to consume carbohydrate-rich foods, protein-rich foods, and vegetables with a weight ratio of 1:2:3. The portion sizes meeting this ratio every meal roughly corresponded to half a hand/palm size for carbohydrate-rich foods, a hand/palm size for protein-rich foods, and both hands/palms size for vegetables. This simple diet principle was aimed at an smooth adoption by the general population without any tools or complicated energy calculations. In practice, the nutrition professionals reviewed whether a given participant followed the diet principle. If not, the professional gave circumstantial counsel on how to better their meal choices, patterns, and other tips. The nutrition professional besides evaluated the adherence for this diet principle using a five-grade scale and gave feedback to participants. No specific target for energy restriction was set for this program. Eating snacks was allowed within the nutritional poise outlined with the FiNC Method.

The nutrition professionals besides applied the transtheoretical model (or stages of change) for health behavior change when providing dietary counsel to participants.19 They assumed that entire participants fell into preparation or action stages because they were willing to participate in their weight loss program by themselves. Participants at the preparation stage shared their reasons for participating in the Wellness Coach program and their ultimate goals with the nutrition professionals. Participants at the action stage were instructed to upload their weight and meal photos to the group chat system, and the nutrition professionals gave immediate direct feedback to them. This process targeted maintaining motivation by the immediate direct feedback and gregarious (peer) supports or encouragement, managing reinforcement by the evaluation on the five-grade scale, and fostering a crave for mastery on dietary behavior.

Each nutrition professional was uniquely certified by FiNC Inc. Candidate professionals who possessed the right qualifications or who had a professional license, such as a dietician, nurse, pharmacist, and physician, received certification after passing the examination designated by the company. The nutrition professionals received compensation for their services according to regulations of an affiliated company.


Demographic and lifestyle characteristics were recorded only at baseline. entire study outcomes were assessed at baseline, week 8, and week 12 by trained clinic staff who were blinded to the group allocation. The primary outcome was an 8-week body weight change. Secondary outcomes included a 12-week weight change, 8-week changes in waist circumference, and improvement in various cardiometabolic risk factors such as blood pressure, lipid profiles, and glucose metabolism. As allotment of compliance outcomes, obesogenic eating behaviors were besides surveyed at baseline and at week 8.

Demographic and lifestyle characteristics, and anthropometrics

Participants reported their sex, age, sleeping status (sleep ≥6 hours every day or not), and current smoking and drinking status (yes or no for both) via self-administered Web-based questionnaires. body weight was measured to the nearest 0.1 kg using a calibrated digital scale (WB-150; Tanita, Tokyo, Japan). Height was determined to the nearest 0.1 cm using a portable stadiometer (AD-6227; A&D, Tokyo, Japan) at baseline to compute BMI. Waist perimeter was measured to the nearest 0.1 cm at the umbilicus plane using a flexible plastic tape in the standing position.

Blood pressure and blood biochemistry

Systolic and diastolic blood pressure was measured with an automated sphygmomanometer (HEM-907; Omron Healthcare, Kyoto, Japan) on the arm of seated participants who had taken sufficient comfort with the arm supported at heart level. If the value for the first reading was >130 mm Hg for systolic or >85 mm Hg for diastolic, the second reading was taken after participants had had several abysmal breaths. When the second reading was available, the lower value of the two readings was used for analysis.

A blood sample was drawn from the antecubital vein of each participant after overnight fasting. Serum triglycerides were determined enzymatically (Determiner L TG II; Kyowa Medex, Tokyo, Japan). Serum high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were measured by the direct mode (MetaboLead HDL-C and LDL-C; Kyowa Medex). Glycated hemoglobin A1c was determined by high-performance liquid chromatography (TSKgelG11; Tosoh, Tokyo, Japan). The blood sample was assayed by a laboratory in the data collection site.

Obesogenic eating behavior

Participants besides self-reported various obesogenic eating behaviors on the Web-based questionnaire. They reported whether they had a history of eating snacks, eating out, eating snappy foods (such as “hamburgers, french-fried potatoes, or fried chicken”), eating confectioneries, drinking sugar-sweetened beverages (≥once a week or less, for these five items), eating until full, and binge eating (yes or no, for both). The cutoff point of these question items was selected by referring to a previous study of eating behavior.20

Statistical analysis

All statistical analyses were complied with the analysis design in the study protocol. The data were analyzed by IBM SPSS Statistics for Windows, version 22.0 (IBM, Armonk, NY, USA), with the two-tailed significance plane set at 5%. Participant baseline characteristics were summarized as hint and criterion divergence for continuous variables or percentage for categorical variables. The triglyceride plane was presented as median and interquartile orbit and was log-transformed for analyses hereafter. The primary analysis followed an intention-to-treat (ITT) principle, with missing data imputed by the baseline observations carried forward rule. Primary, secondary, and compliance outcomes (ie, changes from baseline) were expressed with hint and 95% self-confidence interval (CI). To test the superiority of the coaching group over the control group, unpaired t-tests were employed to compare primary and secondary outcomes between the two groups. To compare improvement rates in eating behaviors between the two group, a χ2-test was besides applied.

To explore the moderating result of participants’ age and baseline BMI on weight loss, they tested group-by-age (< or ≥ the median age of 46 years) and group-by-BMI (< or ≥ the median BMI of 27.0 kg/m2) interactions using a two-way analysis of variance in sunder models. Next, to explore dose–response associations of adherence to the weight loss program with study outcomes in the coaching group, they performed linear trend tests within linear regression models. In these models, they treated study outcomes as relative variables; tertiles for the frequency of meal photo uploads to the group chat system (coded as 1, 2, and 3) as the primary exposure variable; and age, baseline BMI, and the baseline value for each relative variable as covariates.


The participant flood is illustrated in figure 1. Following the recruitment efforts, 116 candidates provided written informed consent and were invited to a baseline examination. ornery to their expectation, a larger balance of candidates (n=112) fulfilled the eligibility criteria. The 112 eligible adults were randomly allocated to the coaching (n=75) or control groups (n=37). The 112 randomized participants were included for the ITT analysis. Of the 112 randomized participants, 93 (83.0%) and 81 (72.3%) completed 8-week and 12-week visits, respectively. The retention rates in the coaching group were slightly lower than those in the control group (80.0% vs 89.2% at week 8; 68.0% vs 81.1% at week 12), but they did not statistically disagree between the two groups at both week 8 (P=0.22) and week 12 (P=0.14). The circumstantial reasons for missed assessment were mostly scheduling conflicts and lost to follow-up including retirement from the companies.

Figure 1 Participant flowchart.

Abbreviation: ITT, intention-to-treat.

Baseline participant characteristics are summarized in Table 1. No pronounced differences existed between the two groups. A female participant was included in the coaching group. The median (first–third quartiles) frequency of meal photo uploads per participant was 82 times (23–139.5 times) during the 8-week period. The frequencies of photo uploads every 10 days per participant were 17 times (5.5–25.5 times) for the initial 10 days, 16 times (4–28 times) for days 11 to 20, 17 times (1–25 times) for days 21 to 30, 17 times (0–25 times) for days 31 to 40, 15 times (0–25.5 times) for days 41 to 50, and 3 times (0–18.5 times) for day 51 to the halt of the program.

Table 1 Participant characteristics at baseline

Notes: Data expressed as hint (standard deviation) unless specified. The triglyceride presented as median (interquartile range). *Data available for 71 (94.7%) participants in the coaching group and 33 (89.1%) in the control group.

Abbreviations: HDL, high-density lipoprotein; LDL, low-density lipoprotein; SSBs, sugar-sweetened beverages.

Our primary ITT analyses in Table 2 demonstrated significantly larger weight loss over 8 weeks in the coaching group than that in the control group. Significant between-group differences were besides obtained for triglyceride levels and glycated hemoglobin A1c levels. These profitable effects, except for the triglyceride level, essentially remained stable after the 4-week non-intervention period. The 12-week reduction in waist perimeter was besides larger in the coaching group than in the control group. The moderation analyses revealed that neither participants’ age nor baseline BMI altered the weight changes in response to interventions (group-by-age interaction, P=0.32; group-by-BMI interaction, P=0.90). They establish profitable associations between the frequent upload of meal photos and changes in body weight, waist circumference, and glycated hemoglobin A1c plane in a dose–response manner (P-value for trend <0.05 for all). As compared to the first tertile (<29 times) of the photo upload frequency, weight loss for the second (29–127 times) and the third (≥128 times) tertiles exhibited 1.9 kg (95% CI: 0.6, 3.2 kg) and 3.5 kg (95% CI: 2.2, 4.8 kg), respectively. Waist perimeter reduced by 3.2 cm (95% CI: 1.4, 4.9 cm) for the second tertile and 3.9 cm (95% CI: 2.1, 5.7 cm) for the third tertile. Similarly, changes in glycated hemoglobin A1c were –0.09% (95% CI: –0.28, 0.11%) for the second tertile and –0.26% (95% CI: –0.46, –0.07%) for the third tertile.

Table 2 Intention-to-treat analyses for changes in the primary and secondary outcomes, and percent improvement for eating behaviors

Notes: Data expressed as hint (95% self-confidence interval) unless specified. *The denominators were 71 in the coaching group and 33 in the control group.

Abbreviations: HDL, high-density lipoprotein; LDL, low-density lipoprotein; SSBs, sugar-sweetened beverages; –, not assessed.


This randomized tribulation of 112 overweight or obese adults tested the effectiveness of a commercial weight loss program that featured professional coaching within the group chat office of the smartphone app. They identified the following key findings: 1) weight loss over 8 weeks in the coaching group was 1.3 kg larger than that in the waitlist control group, 2) triglyceride and glycated hemoglobin A1c levels improved to a greater extent in the coaching group, 3) these modest but significant benefits, except for the triglyceride level, were maintained after the 4-week non-intervention period, 4) the 12-week reduction in waist perimeter was significantly larger in the coaching group, 5) participants who uploaded their meal photos more often gained greater benefits than those who did it less often.

The weight loss amount of 1.4 kg seemed rather lower than those of previous technology-enhanced weight loss programs. A systematic review summarizing the findings from 27 technology-assisted weight loss programs (ie, any types of technology included) reported a weight loss of 0.6 to 11.3 kg in durations ranging from 8 weeks to 24 months.8 Another systematic review assessing mobile-technology (ie, mobile phone and portable digital assistant) interventions for weight loss included seven randomized controlled trials, which demonstrated weight loss amounts that ranged from 3.9 to 11.8 kg during 8 to 52 weeks.21 A systematic review exclusively on smartphone-app-based interventions identified six studies including single-arm, non-randomized and randomized controlled trials and demonstrated a 0.03 to 10.9 kg of weight loss during periods ranging from 8 to 24 weeks.10 Moreover, two recent randomized trials, which were not included in the previously-mentioned systematic reviews,8,10,17 showed 4.0 and 6.4 kg of weight loss for 6 months.22,23 Collectively, the weight loss achieved with their program was relatively lower than those from other studies. This indicates that there is ample margin for further improvement and refinement in their program.

The modest weight loss observed in this tribulation may live accounted for in allotment by fewer participants that were involved in the program (ie, constant login and meal photo uploads) than their expectation. Without constant logins and meal photo uploads, the nutrition professionals had no chance to provide participants with efficacious dietary advice. The median photo upload was 82 times during the 8-week period, which corresponded to less than half of the plenary opportunities (3 meals per day × 8 weeks). In the latter half of the program (ie, weeks 5 to 8), one-fourth or more of the participants did not upload any meal photos in each 10-day interval. The frequency of meal photo uploads was beneficially associated with weight loss. Furthermore, a retrospective study for users of a smartphone-based commercial weight loss app named “Noom Coach” identified meal input frequency into the app as a strong predictor for weight loss.24 Thus, facilitating an lively involvement to the app, ie, friendly reminder for those with no recent photo uploads, can live a key measure to better the health benefits from their program.

Additionally, several other challenges inherent in their program may interpret the modest weight loss. First, meal photo-estimated portion sizes and the number of dishes might not live sufficiently accurate due to technological limitations and limitation of the number of photos as well as users’ end not to record entire what they ate to imitate better eating habit. Inaccurate input, primarily due to under-reporting of dietary intake, to the certified professionals could result in less efficacious dietary counsel which may occupy influenced behavior change. Second, personalized counsel mainly on meal choices and dietary patterns or preferences might not contribute to consistent and substantial negative energy balance. As suggested by several clinical guidelines for obesity,2–5 more strict goal setting for energy restriction might live needed to achieve clinically meaningful weight loss. Third, self-monitoring daily food intake lonely might live insufficient for weight loss. Other behavioral factors such as physical activity and sleeping should occupy been continuously monitored, and feedback for participants may occupy been effective. The above-mentioned reasons may occupy collectively influenced the modest weight loss in this trial.

Nonetheless, their weight loss program elicited a significantly larger reduction in waist perimeter than the control group at week 12. Increased waist perimeter represents central obesity and is well known to live associated with incident stroke and mortality from entire causes and cardiovascular diseases in Japanese populations.25,26 A previous study besides demonstrated that gain in waist perimeter was a significant predictor for the evolution of type 2 diabetes among Japanese adults live in urban areas,27 which resembles the target population of their trial. A clinical guideline for obesity in Japan recommends a reduction in waist perimeter by ≥3.0 cm for improving cardiometabolic risk factors.5 Collectively, the modest but significant reduction in waist perimeter (2.8 cm) through their weight loss program might lead to decreased risks for developing type 2 diabetes and prevention of cardiovascular diseases.

There are several noteworthy strengths of this study. First, this tribulation utilized the research design of an assessor-blind, parallel-group, waitlist-controlled, randomized trial. A systematic review on smartphone-based interventions and a commentary by Sutton and Redman indicated that few randomized controlled trials currently exist.10,11 Therefore, the findings are highly reliable and will extend the current body of scholarship in this field. Second, their weight loss program gives a platform for participants to upload their meal photos and to occupy an smooth access to their coach essentially anytime of the day. This type of approach, rather than face-to-face interventions with frequent visits, may remove time constraints and lessen costs, and can live easily adopted by wider populations such as full-time workers and students. Third, the inclusion criteria in this tribulation followed those for the target populations of a nationwide interventional program named “specific health guidance” in Japan.1,6 Therefore, their weight loss program can live one of the choices for nationwide health promotion practices.

In contrast, they must besides mention some limitations. First, almost entire participants were manly ornery to the target population of both men and women. This is because the personnel of the human resources departments hesitated to actively cheer female employees to participate in their tribulation due to harassment concerns. Thus, the findings from this study cannot live extrapolated to female adults. In contrast, the data primarily on males remain scarce in this research field9 and thus soundless worth reporting. Second, the follow-up term of their weight loss program was relatively shorter (4 weeks) than the recommended duration (≥12 months) by the clinical obesity guidelines.2–4 Long-term effectiveness or sustainability of the obtained benefits is therefore largely unknown. After resolving several challenges identified through this trial, they would dote to design another weight-loss randomized tribulation with a longer follow-up term (≥12 months). Third, ornery to the recommendations by several clinical guidelines for obesity, 2–4 the Wellness Coach program addressed mainly dietary behavior to achieve weight loss benefits. Incorporating other behavioral components (ie, physical activity and sleep) might lead to further refinement of this weight loss program to gain more health benefits. Fourth, they did not pick any measures to avoid contamination of the intervention effects within the identical company. This might contribute to the modest inequity in outcome measures between the two groups. Fifth, this study did not assess circumstantial dietary intake such as energy and macro- and micro-nutrient intakes. circumstantial assessment of dietary intake may not substantially move study conclusions but will wait on in further evaluation and refinement of the weight loss program. Sixth, they had no information on prescribed medications and socioeconomic status (ie, type of employment, educational attainment, and income level), and therefore they attain not know how these factors affected their study outcomes. However, since the randomization procedure theoretically balances out these characteristics between the two groups, their influences would live minimal.


This 8-week commercial weight loss program characterized as dietary coaching via group chat using a smartphone app resulted in modest but significant weight loss. The amount of weight loss achieved in this study was relatively lower than that reported by previous studies; however, the more frequent the meal records, the better was the achievement shown. Therefore, further improvement and refinement of their program has the potential to bear greater health benefits in Web-based settings. Further studies are needed for program improvement and refinement. Facilitating participants’ lively involvement in the program, including meal photo uploads (eg, sending reminders to those without recent photo uploads), may become a key process to address these challenges.


This tribulation was financially supported by a collaborative research agreement between Faculty of Health and Sport Sciences at the University of Tsukuba and FiNC Inc, and a research condense between FiNC Inc and THF Co., Ltd. Genki Plaza Medical headquarters for Health custody besides financially supported allotment of the costs related to baseline and follow-up assessments. They gratefully acknowledge the contribution of entire the tribulation staff.


K Tanaka is the president of THF Co., Ltd. S Murakami and M Ueda are employees of FiNC Inc. F Yamagata and M Sawada are staff members at the Genki Plaza Medical headquarters for Health Care. The authors report no other conflicts of interest in this work.



Tsushita K, Hosler AS, Miura K, et al. Rationale and descriptive analysis of specific health guidance: the nationwide lifestyle intervention program targeting metabolic syndrome in Japan. J Atheroscler Thromb. 2018;25(4):308–322.


Jensen MD, Ryan DH, Apovian CM, et al.; American College of Cardiology/American Heart Association chore obligate on practice Guidelines.; Obesity Society. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association chore obligate on practice Guidelines and The Obesity Society. Circulation. 2014;129(25 Suppl 2):S102–S138.


Kushner RF, Ryan DH. Assessment and lifestyle management of patients with obesity: clinical recommendations from systematic reviews. JAMA. 2014;312(9):943–952.


National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Melbourne: NHMRC; 2013 Available from: https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n57_obesity_guidelines_140630.pdf. Accessed March 5, 2018.


Japan Society for the Study of Obesity, editor. Guidelines for the Management of Obesity Disease 2016. Tokyo: Life Science Publishing; 2016. Japanese.


Ministry of Health, Labour and Welfare. Specific health checkups and specific health guidance. Available from: http://www.mhlw.go.jp/english/wp/wp-hw3/dl/2-007.pdf. Accessed January 31, 2018.


Kozak AT, Buscemi J, Hawkins MA, et al. Technology-based interventions for weight management: current randomized controlled tribulation evidence and future directions. J Behav Med. 2017;40(1):99–111.


Raaijmakers LC, Pouwels S, Berghuis KA, Nienhuijs SW. Technology-based interventions in the treatment of overweight and obesity: a systematic review. Appetite. 2015;95:138–151.


Chen J, Cade JE, Allman-Farinelli M. The most current smartphone apps for weight loss: a attribute assessment. JMIR mHealth uHealth. 2015;3(4):e104.


Semper HM, Povey R, Clark-Carter D. A systematic review of the effectiveness of smartphone applications that cheer dietary self-regulatory strategies for weight loss in overweight and obese adults. Obes Rev. 2016;17(9):895–906.


Sutton EF, Redman LM. Smartphone applications to aid weight loss and management: current perspectives. Diabetes Metab Syndr Obes. 2016;9:213–216.


Khaylis A, Yiaslas T, Bergstrom J, Gore-Felton C. A review of efficacious technology-based weight-loss interventions: five key components. Telemed J E Health. 2010;16(9):931–938.


Coughlin SS, Hardy D, Caplan LS. The requisite for culturally-tailored smartphone applications for weight control. J Ga Public Health Assoc. 2016;5(3):228–232.


Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med. 2010;152(11):726–732.


Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175–191.


Little RR, Rohlfing CL, Sacks DB; National Glycohemoglobin Standardization Program (NGSP) Steering Committee. Status of hemoglobin A1c measurement and goals for improvement: from chaos to order for improving diabetes care. Clin Chem. 2011;57(2):205–214.


Takeno K, Tamura Y, Kawaguchi M, et al. Relation between insulin sensitivity and metabolic abnormalities in Japanese men with BMI of 23-25 kg/m2. J Clin Endocrinol Metab. 2016;101(10):3676–3684.


Oshima Y, Matsuoka Y, Sakane N. result of weight-loss program using self-weighing twice a day and feedback in overweight and obese subject: a randomized controlled trial. Obes Res Clin Pract. 2013;7(5):e361–366.


Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38–48.


Mitchell JE, King WC, Courcoulas A, et al. Eating behavior and eating disorders in adults before bariatric surgery. Int J ingest Disord. 2015;48(2):215–222.


Bacigalupo R, Cudd P, Littlewood C, Bissell P, Hawley MS, Buckley Woods H. Interventions employing mobile technology for overweight and obesity: an early systematic review of randomized controlled trials. Obes Rev. 2013;14(4):279–291.


Ross KM, Wing RR. repercussion of newer self-monitoring technology and brief phone-based intervention on weight loss: a randomized pilot study. Obesity (Silver Spring). 2016;24(8):1653–1659.


Spring B, Pellegrini CA, Pfammatter A, et al. Effects of an abbreviated obesity intervention supported by mobile technology: The ENGAGED randomized clinical trial. Obesity (Silver Spring). 2017;25(7):1191–1198.


Chin SO, Keum C, Woo J, et al. Successful weight reduction and maintenance by using a smartphone application in those with overweight and obesity. Sci Rep. 2016;6:34563.


Furukawa Y, Kokubo Y, Okamura T, et al. The relationship between waist perimeter and the risk of stroke and myocardial infarction in a Japanese urban cohort: the Suita Study. Stroke. 2010;41(3):550–553.


Saito I, Kokubo Y, Kiyohara Y, et al. Prospective study on waist perimeter and risk of all-cause and cardiovascular mortality: pooled analysis of Japanese community-based studies. Circ J. 2012;76(12):2867–2874.


Tatsumi Y, Watanabe M, Nakai M, et al. Changes in waist perimeter and the incidence of type 2 diabetes in community-dwelling men and women: The Suita Study. J Epidemiol. 2015;25(7):489–495.

Direct Download of over 5500 Certification Exams

3COM [8 Certification Exam(s) ]
AccessData [1 Certification Exam(s) ]
ACFE [1 Certification Exam(s) ]
ACI [3 Certification Exam(s) ]
Acme-Packet [1 Certification Exam(s) ]
ACSM [4 Certification Exam(s) ]
ACT [1 Certification Exam(s) ]
Admission-Tests [13 Certification Exam(s) ]
ADOBE [93 Certification Exam(s) ]
AFP [1 Certification Exam(s) ]
AICPA [2 Certification Exam(s) ]
AIIM [1 Certification Exam(s) ]
Alcatel-Lucent [13 Certification Exam(s) ]
Alfresco [1 Certification Exam(s) ]
Altiris [3 Certification Exam(s) ]
Amazon [2 Certification Exam(s) ]
American-College [2 Certification Exam(s) ]
Android [4 Certification Exam(s) ]
APA [1 Certification Exam(s) ]
APC [2 Certification Exam(s) ]
APICS [2 Certification Exam(s) ]
Apple [69 Certification Exam(s) ]
AppSense [1 Certification Exam(s) ]
APTUSC [1 Certification Exam(s) ]
Arizona-Education [1 Certification Exam(s) ]
ARM [1 Certification Exam(s) ]
Aruba [6 Certification Exam(s) ]
ASIS [2 Certification Exam(s) ]
ASQ [3 Certification Exam(s) ]
ASTQB [8 Certification Exam(s) ]
Autodesk [2 Certification Exam(s) ]
Avaya [101 Certification Exam(s) ]
AXELOS [1 Certification Exam(s) ]
Axis [1 Certification Exam(s) ]
Banking [1 Certification Exam(s) ]
BEA [5 Certification Exam(s) ]
BICSI [2 Certification Exam(s) ]
BlackBerry [17 Certification Exam(s) ]
BlueCoat [2 Certification Exam(s) ]
Brocade [4 Certification Exam(s) ]
Business-Objects [11 Certification Exam(s) ]
Business-Tests [4 Certification Exam(s) ]
CA-Technologies [21 Certification Exam(s) ]
Certification-Board [10 Certification Exam(s) ]
Certiport [3 Certification Exam(s) ]
CheckPoint [43 Certification Exam(s) ]
CIDQ [1 Certification Exam(s) ]
CIPS [4 Certification Exam(s) ]
Cisco [318 Certification Exam(s) ]
Citrix [48 Certification Exam(s) ]
CIW [18 Certification Exam(s) ]
Cloudera [10 Certification Exam(s) ]
Cognos [19 Certification Exam(s) ]
College-Board [2 Certification Exam(s) ]
CompTIA [76 Certification Exam(s) ]
ComputerAssociates [6 Certification Exam(s) ]
Consultant [2 Certification Exam(s) ]
Counselor [4 Certification Exam(s) ]
CPP-Institue [2 Certification Exam(s) ]
CPP-Institute [2 Certification Exam(s) ]
CSP [1 Certification Exam(s) ]
CWNA [1 Certification Exam(s) ]
CWNP [13 Certification Exam(s) ]
CyberArk [1 Certification Exam(s) ]
Dassault [2 Certification Exam(s) ]
DELL [11 Certification Exam(s) ]
DMI [1 Certification Exam(s) ]
DRI [1 Certification Exam(s) ]
ECCouncil [21 Certification Exam(s) ]
ECDL [1 Certification Exam(s) ]
EMC [129 Certification Exam(s) ]
Enterasys [13 Certification Exam(s) ]
Ericsson [5 Certification Exam(s) ]
ESPA [1 Certification Exam(s) ]
Esri [2 Certification Exam(s) ]
ExamExpress [15 Certification Exam(s) ]
Exin [40 Certification Exam(s) ]
ExtremeNetworks [3 Certification Exam(s) ]
F5-Networks [20 Certification Exam(s) ]
FCTC [2 Certification Exam(s) ]
Filemaker [9 Certification Exam(s) ]
Financial [36 Certification Exam(s) ]
Food [4 Certification Exam(s) ]
Fortinet [14 Certification Exam(s) ]
Foundry [6 Certification Exam(s) ]
FSMTB [1 Certification Exam(s) ]
Fujitsu [2 Certification Exam(s) ]
GAQM [9 Certification Exam(s) ]
Genesys [4 Certification Exam(s) ]
GIAC [15 Certification Exam(s) ]
Google [4 Certification Exam(s) ]
GuidanceSoftware [2 Certification Exam(s) ]
H3C [1 Certification Exam(s) ]
HDI [9 Certification Exam(s) ]
Healthcare [3 Certification Exam(s) ]
HIPAA [2 Certification Exam(s) ]
Hitachi [30 Certification Exam(s) ]
Hortonworks [4 Certification Exam(s) ]
Hospitality [2 Certification Exam(s) ]
HP [752 Certification Exam(s) ]
HR [4 Certification Exam(s) ]
HRCI [1 Certification Exam(s) ]
Huawei [21 Certification Exam(s) ]
Hyperion [10 Certification Exam(s) ]
IAAP [1 Certification Exam(s) ]
IAHCSMM [1 Certification Exam(s) ]
IBM [1533 Certification Exam(s) ]
IBQH [1 Certification Exam(s) ]
ICAI [1 Certification Exam(s) ]
ICDL [6 Certification Exam(s) ]
IEEE [1 Certification Exam(s) ]
IELTS [1 Certification Exam(s) ]
IFPUG [1 Certification Exam(s) ]
IIA [3 Certification Exam(s) ]
IIBA [2 Certification Exam(s) ]
IISFA [1 Certification Exam(s) ]
Intel [2 Certification Exam(s) ]
IQN [1 Certification Exam(s) ]
IRS [1 Certification Exam(s) ]
ISA [1 Certification Exam(s) ]
ISACA [4 Certification Exam(s) ]
ISC2 [6 Certification Exam(s) ]
ISEB [24 Certification Exam(s) ]
Isilon [4 Certification Exam(s) ]
ISM [6 Certification Exam(s) ]
iSQI [7 Certification Exam(s) ]
ITEC [1 Certification Exam(s) ]
Juniper [65 Certification Exam(s) ]
LEED [1 Certification Exam(s) ]
Legato [5 Certification Exam(s) ]
Liferay [1 Certification Exam(s) ]
Logical-Operations [1 Certification Exam(s) ]
Lotus [66 Certification Exam(s) ]
LPI [24 Certification Exam(s) ]
LSI [3 Certification Exam(s) ]
Magento [3 Certification Exam(s) ]
Maintenance [2 Certification Exam(s) ]
McAfee [8 Certification Exam(s) ]
McData [3 Certification Exam(s) ]
Medical [69 Certification Exam(s) ]
Microsoft [375 Certification Exam(s) ]
Mile2 [3 Certification Exam(s) ]
Military [1 Certification Exam(s) ]
Misc [1 Certification Exam(s) ]
Motorola [7 Certification Exam(s) ]
mySQL [4 Certification Exam(s) ]
NBSTSA [1 Certification Exam(s) ]
NCEES [2 Certification Exam(s) ]
NCIDQ [1 Certification Exam(s) ]
NCLEX [2 Certification Exam(s) ]
Network-General [12 Certification Exam(s) ]
NetworkAppliance [39 Certification Exam(s) ]
NI [1 Certification Exam(s) ]
NIELIT [1 Certification Exam(s) ]
Nokia [6 Certification Exam(s) ]
Nortel [130 Certification Exam(s) ]
Novell [37 Certification Exam(s) ]
OMG [10 Certification Exam(s) ]
Oracle [282 Certification Exam(s) ]
P&C [2 Certification Exam(s) ]
Palo-Alto [4 Certification Exam(s) ]
PARCC [1 Certification Exam(s) ]
PayPal [1 Certification Exam(s) ]
Pegasystems [12 Certification Exam(s) ]
PEOPLECERT [4 Certification Exam(s) ]
PMI [15 Certification Exam(s) ]
Polycom [2 Certification Exam(s) ]
PostgreSQL-CE [1 Certification Exam(s) ]
Prince2 [6 Certification Exam(s) ]
PRMIA [1 Certification Exam(s) ]
PsychCorp [1 Certification Exam(s) ]
PTCB [2 Certification Exam(s) ]
QAI [1 Certification Exam(s) ]
QlikView [1 Certification Exam(s) ]
Quality-Assurance [7 Certification Exam(s) ]
RACC [1 Certification Exam(s) ]
Real-Estate [1 Certification Exam(s) ]
RedHat [8 Certification Exam(s) ]
RES [5 Certification Exam(s) ]
Riverbed [8 Certification Exam(s) ]
RSA [15 Certification Exam(s) ]
Sair [8 Certification Exam(s) ]
Salesforce [5 Certification Exam(s) ]
SANS [1 Certification Exam(s) ]
SAP [98 Certification Exam(s) ]
SASInstitute [15 Certification Exam(s) ]
SAT [1 Certification Exam(s) ]
SCO [10 Certification Exam(s) ]
SCP [6 Certification Exam(s) ]
SDI [3 Certification Exam(s) ]
See-Beyond [1 Certification Exam(s) ]
Siemens [1 Certification Exam(s) ]
Snia [7 Certification Exam(s) ]
SOA [15 Certification Exam(s) ]
Social-Work-Board [4 Certification Exam(s) ]
SpringSource [1 Certification Exam(s) ]
SUN [63 Certification Exam(s) ]
SUSE [1 Certification Exam(s) ]
Sybase [17 Certification Exam(s) ]
Symantec [135 Certification Exam(s) ]
Teacher-Certification [4 Certification Exam(s) ]
The-Open-Group [8 Certification Exam(s) ]
TIA [3 Certification Exam(s) ]
Tibco [18 Certification Exam(s) ]
Trainers [3 Certification Exam(s) ]
Trend [1 Certification Exam(s) ]
TruSecure [1 Certification Exam(s) ]
USMLE [1 Certification Exam(s) ]
VCE [6 Certification Exam(s) ]
Veeam [2 Certification Exam(s) ]
Veritas [33 Certification Exam(s) ]
Vmware [58 Certification Exam(s) ]
Wonderlic [2 Certification Exam(s) ]
Worldatwork [2 Certification Exam(s) ]
XML-Master [3 Certification Exam(s) ]
Zend [6 Certification Exam(s) ]

References :

Issu : https://issuu.com/trutrainers/docs/c2090-930
Dropmark : http://killexams.dropmark.com/367904/11434229
Wordpress : http://wp.me/p7SJ6L-fE
weSRCH : https://www.wesrch.com/business/prpdfBU1HWO000RIBO
Scribd : https://www.scribd.com/document/356766425/Pass4sure-C2090-930-Practice-Tests-with-Real-Questions
Dropmark-Text : http://killexams.dropmark.com/367904/12024133
Youtube : https://youtu.be/7rsNeRb4gUs
Blogspot : http://killexams-braindumps.blogspot.com/2017/10/real-c2090-930-questions-that-appeared.html
RSS Feed : http://feeds.feedburner.com/JustStudyTheseIbmC2090-930QuestionsAndPassTheRealTest
Vimeo : https://vimeo.com/241116957
publitas.com : : https://view.publitas.com/trutrainers-inc/just-memorize-these-c2090-645-questions-before-you-go-for-test
Google+ : https://plus.google.com/112153555852933435691/posts/9qKFuqgxwv2?hl=en
Calameo : http://en.calameo.com/account/book#
Box.net : https://app.box.com/s/00onvbvs3w19kq68on93egtduo0lw1nh
zoho.com : https://docs.zoho.com/file/2q0x218a94fd5e2e445daa7f6994b36d7f2d8

Killexams exams | Killexams certification | Pass4Sure questions and answers | Pass4sure | pass-guaratee | best test preparation | best training guides | examcollection | killexams | killexams review | killexams legit | kill example | kill example journalism | kill exams reviews | kill exam ripoff report | review | review quizlet | review login | review archives | review sheet | legitimate | legit | legitimacy | legitimation | legit check | legitimate program | legitimize | legitimate business | legitimate definition | legit site | legit online banking | legit website | legitimacy definition | pass 4 sure | pass for sure | p4s | pass4sure certification | pass4sure exam | IT certification | IT Exam | certification material provider | pass4sure login | pass4sure exams | pass4sure reviews | pass4sure aws | pass4sure security | pass4sure cisco | pass4sure coupon | pass4sure dumps | pass4sure cissp | pass4sure braindumps | pass4sure test | pass4sure torrent | pass4sure download | pass4surekey | pass4sure cap | pass4sure free | examsoft | examsoft login | exams | exams free | examsolutions | exams4pilots | examsoft download | exams questions | examslocal | exams practice |


Gli Eventi