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To Whom It Concerns, Sigma Tactical Wellness, a Telemed2U Company, has pioneered a new system of cardiac/ metabolic screening correlating known risk factors, genetics, and occupational stressors that are characteristic of law-enforcement. Over the last five years, we have shown massive potential in eliminating the catastrophic effects of cardiovascular disease amongst first responders. Sigma Tactical Wellness is the only company to use this approach AND deliver the results in an on-site manner, free from the encumbrance of insurers that would financially complicate the patient experience via deductibles, co-pays, and unforeseen out of pocket expenses. Sigma Tactical Wellness maintains exclusive rights to any and all intellectual property, methodologies, and care plans associated with services highlighted in this document. There are no other outlets, distributors, or representatives of Sigma Tactical Wellness, and at this time, there are no licensees of products/services designed by Sigma Tactical Wellness. Our primary points of differentiation along with their brief descriptions of those items are as follows: Advanced Lipidology/Carotid Intima Media Thickness Ultrasound (CIMT): Sigma Wellness has developed a comprehensive cardiac laboratory screening evaluation along with an individualized nutritional and exercise prescription. The screening consists of non-invasive imaging as well as advanced lipid panel testing to evaluate the early stages of the development of coronary disease and the inflammatory markers (PLA2) that can be used to predict the development of a heart attack. We then perform a cardiopulmonary/EKG exercise stress test on a stationary bicycle. This test measures functional capacity, the presence of any ischemia (lack of blood flow to the heart muscle) and allows us to use indirect calorimetry to develop a personalized diet and exercise component given to the officer at the time of physician consultation. The resultant occupational risk defined by our in-house specialty providers correlates known stressors along with three diagnostics (bio inflammatory markers, 12-lead ECG, and carotid intima-media thickness [CIMT]). The clinical “report" delivered to each officer includes current risk, risk derived from a career in public safety, and risk defined by certain genetic characteristics promoting the development of arterial plaque. Sigma Tactical Wellness is the only organization operating in the sphere of public safety that uses cardiac inflammatory markers (Lp-PLA2 and OxLDL) along with carotid ultrasound to isolate patients (often in the 30s) that show genetic predisposition towards arterial plaque development. This approach is not only vetted via peer-reviewed data, but it has served over 25,000 officers nationwide in every vertical of law-enforcement (municipal, county, state, and federal agencies). Sigma Tactical Wellness partners with Cleveland Heart Lab of Quest Diagnostics, one of the largest providers of laboratory analysis in the world. Because of the volume of specimens submitted by Sigma Tactical Wellness each year, Quest Diagnostics has opened their extensive network of Patient Service Centers which allows officers to participate even if they are unable to attend their scheduled on-site phlebotomy visit at the host agency or department. Sigma Tactical Wellness is the only known mobile partner of Quest Diagnostics with access to this resource. Metabolic Analysis: Sigma’s unique approach uses Advanced Metabolic Testing (AMP) to assess precise nutritional status of each individual and prescribe key nutritional changes based on each patient’s individual goals. For law enforcement officers, nutritional status underwrites on-duty performance and can be the deciding factor between a routine arrest and a situation where the officer must rely on the use of excessive force to overpower an assailant. Sigma’s unique methodology gives each officer a perfect understanding of their nutritional needs, leading to increased focus, alertness, less fatigue, and, in general, higher competency to perform the duties of an agent of public safety. Sigma Tactical Wellness is the only source for on-site cardio-metabolic exercise testing using respiratory gas analysis. Additionally, Sigma Tactical Wellness uses proprietary data to generate a model from raw data specific to each patient’s macromolecule (carbohydrate and fat) utilization. This data is designed to pinpoint specific intensities where intramuscular fat utilization is highest during exercise (Exhibit 1). Exercise and Nutritional Modification: Because the demands of law enforcement are so extreme, studies have shown that each decade of law enforcement effectively doubles each officer’s risk for heart attack or stroke. With Sigma’s approach, officers are provided information specific to lifestyle modifications, based on results from Sigma’s metabolic analysis, that are most effective in decreasing BMI, fatigue, and hypertension. Additionally, because 46% of law-enforcement officers are obese, a strong emphasis on weight optimization will be included within the consultation. Medical Evaluation: Unlike every other screening program in existence, SIGMA offers a complete solution to the number one medical issue affecting police officers today - heart disease. Once an individual is identified as being at high risk for a cardiac event, an immediate follow up appointment is scheduled. The individual next meets with a provider from our highly trained and licensed cardiology team and a treatment plan is initiated. This plan includes prescription medication, lifestyle modification (diet and exercise pattern changes), and the correction of nutrition deficiencies. The risk of a cardiac event in thus mitigated at multiple levels. This treatment component differentiates SIGMA from every other screening company in existence. By treating our patients immediately, we do not leave the engaged agency with a simple list of how many of its personnel are at risk for heart disease. We identify risk and then quickly and decisively act to eliminate it. EXHIBIT 1. Please contact me directly with any questions arising from statements contained within this document. My contact details are below in my signature. We look forward to working with you. BENJAMIN STONE | Founder - Sigma Division of Telemed2U phone | 501 358 2112 e-mail | bstone@telemed2u.com iamsigma.com