Nimbus cm2 Pulse BAND: Erythrocyte De-aggregation. Influencing Zeta Potential of Cell Membrane for Improved Gas Exchange - Nimbus Performance
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JM Global Research Nimbus cm2 Pulse BAND: Erythrocyte De-aggregation. Influencing Zeta Potential of Cell Membrane for Improved Gas Exchange. Dale C. Gledhill, Gregory Anderson D.P.M. and Kade T. Huntsman, M.D. Researchers Note: The basis and foundation of the science, principles and physiological assumptions cited herein are based upon the research articles, medical studies found at the conclusion of this paper and the data gathered as part of this research study. © Copyright 2018, Dale C. Gledhill. All rights reserved.
The erythrocyte, commonly referenced as a red blood cell (RBC), is by far the most common formed element in the human body. A single drop of blood contains millions of erythrocytes. The primary medically accepted functions of an erythrocyte is gas exchange, to pick up inhaled oxygen molecules from the lungs and transport it to the body’s tissues, and to pick up carbon dioxide waste at the tissues and transport it to the lungs for exhalation. This article describes the physiological requirement and need for free-suspended RBCs. A method to improve disaggregation of RBCs and the potential impact RBC separation may have an impact on health and particularly athletic performance. ABSTRACT Rouleaux RBC Background: Aggregated and/or Rouleaux stacked RBCs may have a direct impact upon health in general. • Aggregated erythrocytes are defined a physiological phenomenon that takes places in normal blood under low-flow conditions or at stasis. The presence or increased concentrations of acute phase proteins, particularly fibrinogen, results in enhanced erythrocyte aggregation. Surface properties of erythrocytes, such as surface Free-Suspended RBC  charge density or membrane zeta potential strongly influence the extent and time course of aggregation. In addition, only limited research has been pursued to access the potential influence on health and performance. • Rouleaux erythrocytes are stacks or linear aggregations of red blood cells (RBCs) which form partially because of the unique discoid shape of the cells. The flat surface of the RBCs provides a large surface area to make contact with and attract each other primarily due to dissimilar membrane zeta potential; thus forming a rouleaux. This event often occurs when the plasma protein concentration is high, which also increases the ESR erythrocyte sedimentation rate,. This is a non-specific 2 © Copyright 2018, Dale C. Gledhill. All rights reserved.
indicator of the presence of disease, a common factor in diet deficiencies and highly prevalent under inflammatory conditions. • Conversely, the presence of RBC aggregation and rouleaux is a potential cause of disease because of the restrictive flow of blood throughout the body because capillaries can only accept free flowing singular and independent red blood cells. The aggregations, also known as “clumping”, can form as an allergic reaction or a response to elevated fibrinogens effecting the cell membrane zeta potential. • Free flow into micro-capillaries is dependent upon shear force when these conditions are present. Aim: To describe and demonstrate the rationale for assisting Free flow into the human body’s ability to separate RBCs and a method to assess the short and long term impact on athletic performance. micro-capillaries is dependent upon Method: Fifty highly skilled athletes participating in shear force when sanctioned college athletics provided a live blood smear where these conditions a visual RBC condition was photographed and documented. The recipient was then provided a Nimbus cm2 Pulse BAND, are present. a small wrist device that generates a dynamic toroidal .030 gauss magnetic pulse. Each recipient was asked to wear the device for a minimum of 8 hours per day. At a minimum of 21 days and a maximum of 30 days, the recipients then provided a second live blood smear and again it was photographically documented. The pre and post recipient smear photographs were then visually compared and contrasted. In addition, an unstructured open ended questions was posed regarding any personal physiological changes after the second blood sample was obtained. There was no compensation provided to the athlete and the testing program was under the supervision of the athletic training department. Conclusion: This article describes the strategies, rationale, efforts and outcomes from the evidence-based test as performed on the 50 selected athletes. The outcomes, as demonstrated by visual documentation and interview, demonstrate the effectiveness of a low intensity dynamic toroidal magnetic pulse on RBCs and initial physiological effect. Study outcome warrants further research in creating additional methods of measuring improved performance in athletes with free-suspended RBCs or absence 3 © Copyright 2018, Dale C. Gledhill. All rights reserved.
of aggregation or rouleaux, a common condition of athletes under intense physical training and performance demands. Background The erythrocyte, commonly known as a red blood cell (RBC), is by far the most common formed element in the human body. The primary functions of erythrocytes are to accept oxygen rich hemoglobin from the lungs and transport it to the body’s tissues, organs, brain etc and to pick up carbon dioxide waste at the tissues and transport it to the lungs for exhalation. Mature, circulating erythrocytes have few internal cellular structural components. Lacking mitochondria, for example, they rely solely on anaerobic respiration. This means that they do not utilize any of the oxygen they are transporting, so they can deliver it all to the tissues, further demonstrating their potential impact. They also lack endoplasmic reticula and do not synthesize proteins. Erythrocytes do, however, contain some structural proteins that help the blood cells maintain their unique structure and enable them to change their shape to squeeze through capillaries for oxygen delivery and waste deletion at a controlled pace for optimal efficiency. Erythrocytes are biconcave discs with very shallow centers. This shape optimizes the ratio of surface area to volume, facilitating gas exchange. It also enables flexibility to fold and bend as they move through narrow capillaries. Erythrocytes are plump at their periphery and very thin in the center. Since they lack most organelles, there is more interior space for the presence of the hemoglobin molecules to maximize the transport of gases. The biconcave shape also provides a greater surface area across which gas exchange can occur, relative to its volume; a sphere of a similar diameter would have a lower surface area-to-volume ratio. This unique shape, additionally demonstrates the intended efficiency of erythrocyte gas exchange. The numeric count and physiological condition of the erythrocyte will impact the transport of gases, both oxygen and carbon dioxide. Athletic performance can be limited or enhanced and dependent upon the count and condition of the erythrocyte. Referencing the University of Minnesota School of Medicine, “What do normal red blood cells look like (in a live blood smear)? First, the cells are nicely spread across the field. They are sometimes touching or even slightly overlapping, but they’re not all 4 © Copyright 2018, Dale C. Gledhill. All rights reserved.
piled up on top of each other. There are occasional small empty spaces, but there are not vast barren areas the size of several red cells”. The reference to a “normal” erythrocyte clearly describes a free suspended erythrocyte with circumferal exposure allowing for maximum surface area to uptake and dispose oxygen and carbon dioxide. In the capillaries, the oxygen carried by the erythrocytes can diffuse into the plasma and then through the capillary walls to reach the cells, whereas some of the carbon dioxide produced by the cells as a waste product diffuses into the capillaries to be picked up by the erythrocytes. Capillary beds are extremely narrow by design, slowing the movement of the erythrocytes and providing maximum opportunity for gas exchange to occur. The capillary diameter can be so minute that erythrocytes may have to fold in on themselves to make their way through. By design, their structural proteins are flexible, allowing them to bend to a surprising degree, then reshape when they enter a wider vessel. Each iron ion in the erythrocyte can bind to one oxygen molecule. Each hemoglobin molecule can transport four oxygen molecules. An individual erythrocyte may contain about 300 million hemoglobin molecules, and therefore can bind to and transport up to 1.2 billion oxygen molecules. An adult male is estimated to have 33 trillion RBCs within his circulatory system. Changes in the quantity or separation of RBCs can have significant effects on the body’s ability to effectively deliver oxygen to tissues. In addition, gas exchange of oxygen (O2) and carbon dioxide (CO2) by erythrocytes can be affected by ineffective hemopoiesis as well as aggregation. A balance of these conditions impact erythrocyte gas exchange capabilities and therefore performance. Erythrocyte Creation: When hypoxemia or a low concentration of oxygen exists, fibroblasts within the kidney secrete EPO, thereby increasing erythrocyte production intending to restore oxygen levels with increased erythrocytes. Operating in a negative response loop, as oxygen saturation rises, EPO secretion falls, thereby maintaining 5 © Copyright 2018, Dale C. Gledhill. All rights reserved.
homeostasis. As an example, populations dwelling at Improving gas exchange high elevations, with inherently lower levels of oxygen efficiency seems a in the atmosphere, naturally maintain a hematocrit higher than people living at sea level. Consequently, promising method of people traveling to high elevations may experience developing a safe and symptoms of hypoxemia, such as fatigue, headache, and effective method of shortness of breath, for a few days after their arrival. As previously discussed, in response to the hypoxemia, improved athletic and the kidneys secrete EPO to step up the production of cognitive performance. erythrocytes until homeostasis is achieved once again. Although staggering to consider, marrow can produce up to 2 million cells per second to attempt homeostasis of the fragile 120 day lifecycle of erythrocytes. This erythrocyte capacity, unless  manipulated by artificially doping, is maintained naturally by hematopoiesis. Therefore, improving gas exchange efficiency seems a promising method of Rouleaux Formation developing a safe and effective method of improved athletic and cognitive performance. Rouleaux Formation: Erythrocytes often stack like a roll of coins, forming a rouleaux. When rouleaux formation is truly present in blood, it is often caused by an increase in cathodal proteins, such as immunoglobulins and fibrinogen. Red blood cells are Aggultination Formation thought to form rouleaux because they have decreased or imbalanced negative charge (altered zeta potential) on the membrane of the erythrocyte, primarily a factor of high levels of fibrinogen. This can be a common finding in the blood of healthy individuals, athletes or the compromised. Rouleaux can also be a marker of underlying disease, especially those with an autoimuume disorder. Fibrinogen, thought to be the one of the main causes of altered RBC zeta potential is a β-2 globulin, a reactantant value increase associated with inflammation. In athletes that are involved with intense training and extended physical performance, 6 © Copyright 2018, Dale C. Gledhill. All rights reserved.
potential for inflammation associated with these activities commonly produce added proteins in the blood, creating rouleaux. Agglutination versus rouleaux formation: Agglutination can be distinguished from rouleaux by their characteristic appearance on blood smears, wherein agglutination forms three-dimensional clusters, whereas rouleaux forms stacks. This condition can also be caused by reduced zeta potential of a RBC and from many of the same conditions as detailed in the rouleaux section previously cited. Blood Doping Dangers: The performance value of a high erythrocyte count has been brought to the forefront of the medical community by the abuse, attempts and achievements of professional and amateur athlete’s effort to enhance performance by manipulating hematopoiesis. Blood doping has been achieved by either infusing ones own red blood cells or Blood doping is by administering the drug erythropoietin to artificially increase red blood cell mass. Blood doping has shown associated with risks to improve an athlete’s ability to perform in a maximal that can be serious endurance exercise. Blood doping has also shown to reduce physiologic strain during exercise in the heat and altitude. and impair athletic Conversely, blood doping is associated with risks that can performance. be serious and impair athletic performance. These known risks are exacerbated by lack of medical supervision, as well as the imbalance created by dehydration and blood pressure. The medical risks associated with blood doping has been documented from many carefully controlled research studies. The position of the American College of Sports Medicine is “that any blood doping procedure used in an attempt to improve athletic performance is unethical, unfair, and exposes the athlete to unwarranted and potentially serious health risks”. The researchers involved in this study do not condone doping or any other dangerous manipulative or chemical performance enhancements. Study Premise The research committee conducting the study has extensively reviewed the literature from PubMed, Science Direct and multiple data bases that address erythrocyte conditions, cause and effect, and potential effects on gas exchange based upon such conditions. [see attached studies] This search yielded over 100 studies or articles addressing the potential implications of erythrocyte condition as it relates to gas exchange and therefore health and performance. The vast research supported the committee’s hypothesis that regardless of a the physiological cause, if the zeta potential of an erythrocyte (RBC) could be restored to a “like charge”, then Coulomb’s law, or 7 © Copyright 2018, Dale C. Gledhill. All rights reserved.
Coulomb’s inverse-square law, of physics would induce disaggregation or separation of erythrocytes. Coulomb’s law states, “electrically charged particles will repel or attract each other. The force of the interaction between the charges is attractive if the charges have opposite signs and repulsive if like-signed.” In summary and premise; Can a device assist the body in naturally separating erythrocytes and safely free suspend single RBCs in plasma to allow for maximum surface area for optimum gas exchange, and to access capillaries capable of only single cell mass, therefore safely improving physiological and athletic performance? Test Device Delivering cm2 The Nimbus cm2 Pulse BAND is a wrist worn device that emits a unique toroidal magnetic pulse that has shown via blood tests to influence the zeta potential of a erythrocyte. The pulse is a dynamic toroidal .030 gauss magnetic pulse. The BAND is designed to be worn between 8 and 12 hours per 24 hour cycle. The device emits a micro pulse for seven minutes and then rests for twenty-three. The science of the cm2 Pulse BAND foundation is upon the scientific principle of Faraday’s law of induction and Lenz’s law, which are basic laws of electromagnetism, predicting how a magnetic field will interact and produce a current in the receiving conductor. It is similar to the common technology being used today with wireless charging systems. In this case, an erythrocyte is the receiving conductor upon which the dynamic field has been induced. This is the phenomenon called electromagnetic induction. It is the fundamental operating principle of all transformers and equally applies as designed, for influencing erythrocyte membrane charge. Study Method The athletic training department from a select Division One collegiate school selected 50 of their top female and male athletes to participate in this investigative research study. Participants were from the following programs: football, basketball, cross country, volleyball and soccer. The research team was provided the athlete list and was unable to accept or deny any of the recipients. The following was the research protocol for testing of each athlete: 1. Blood draw area cleaned and disinfected. 2. Single lance to obtain a one-drop specimen direct to a glass slide. 3. Specimen covered with cover slide and 1 drop of oil applied on top of slide for ease of scanning slide under a light field microscope. 8 © Copyright 2018, Dale C. Gledhill. All rights reserved.
4. Specimen viewed 1,000 magnification. Olympus cx41 light field scope. 5. Specimen scanned for predominant erythrocyte condition 6. Photo of predominant condition documented. 7. Recipient issued a Nimbus cm2 BAND and provided operational instructions. 8. Recipient requested to use the BAND daily for a minimum 8 hours per day. 9. Recipient was then retested after a minimum of 14 days of BAND use, utilizing the same specimen acquisition protocol and documentation. 10. Recipient was asked three exit questions after second blood test. 11. The recipient was allowed to keep the BAND and no further contact has been initiated at the time of this writing. 12. There is additional new athlete testing with the same protocol as of the time of this writing. Ongoing and additional testing results and data forthcoming in a follow- up study to be published in 2019. Follow-up Testing Statistics Initial blood test and a BAND was issued to a total of 50 recipients. Of this treatment group, the following statistical information of this group is as follows: • 40 recipients returned for a follow-up blood test. • 1 recipient damaged the BAND and had not used the technology. • 11 recipients were unable to return for their follow-up blood test. • 1 recipient had not used the band within four days of the second test. For qualifying purposes, the actual sample size of those that stated they met the test criteria is thirty eight (38) total recipients. Follow-up Blood Smear Results All conditions of blood sampling were identical between the pre and post events. When each study recipient’s initial blood smear was compared visually side by side via a high resolution photo with the identical post BAND blood smear photo, the following observations 9 © Copyright 2018, Dale C. Gledhill. All rights reserved.
became discernible and measurable: • 38 of 38 compliant users showed distinguishable visual erythrocyte separation. • 3 of 38 showed only fair separation or absence of rouleaux or aggregation. • 35 of 38 showed clear measurable and distinguishable separation or absence of rouleaux or aggregation. • 0 of 38 showed no noticeable change in erythrocyte appearance. • 35 of 38 showed results of a text book description and documentation on healthy erythrocytes within a body. Follow-up Open Ended Interview Results Immediately upon completion of the second blood smear specimen, each recipient was privately queried with the following open ended questions: • How often did you wear the BAND? • How many hours per day on average did you wear the BAND? • Have you noticed any changes since using the BAND? The following indicators were conveyed. Although anecdotal, the feedback was not controlled and the information gleaned is deemed genuine and unfiltered. The following outlines a complete feedback summary regarding question 3: • 13 of the 38 recipients or 34% stated they had felt no noticeable difference within the first two weeks of use. • 25 of the 38 recipients or 66% stated they experienced at least one or more of the following; improved energy, improved sleep, faster recovery and extended endurance in the first two weeks of use. • Improved energy and sleep were the two most frequent comments. • 0 of 38 expressed a negative side effect. 10 © Copyright 2018, Dale C. Gledhill. All rights reserved.
Discussion To the best of our knowledge, this is the first investigative study intended to understand potential performance effects of separated or free suspended erythrocytes as defined by hematology as normal or healthy condition or RBCs. For years the athletic performance world has been plagued by the dangerous practice of blood doping in an effort to improve gas exchange, therefore improved aerobic endurance, recovery and performance. This practice has been deemed dangerous, unethical and banned by most sports federations. Therefore, one is left to query is there a safe method of improving erythrocyte gas exchange by assisting the body’s natural ability to return and maintain blood conditions that one would consider as, “healthy and normal blood”. It is indisputable the impact RBCs have on gas exchange, therefore performance. Based upon the initial testing outlined herein and positive health and performance impact, further study and research is warranted. This study has limitations. Firstly, it did not have control over the amount of active BAND use time by each athlete. Verification was based only upon verbal confirmation. Secondly, further study will be required to determine the optimal amount of time required for erythrocyte separation. Thirdly, the long term benefits are still yet to be determined. Fourth, the perceived or actual physiological changes are not quantifiable at this stage, although visual improvements were significant and consistent enough to warrant additional investigation. The researcher notes that the improved levels of recovery, energy and sleep exceeded expectations and validated the research hypothesis. Additional research and data will be forthcoming. Conclusion This initial study was initiated after years of similar findings from hundreds of random samples under similar testing parameters. This structured environment and study confirmed to the research team with actual visual data that demonstrated that changing erythrocyte zeta potential will improve RBC separation. Furthermore, the post test feedback interview confirmed that an athletic and performance benefit, primarily improved energy and endurance is directly affected with improved gas exchange, the result of separated or non aggregated RBCs. 11 © Copyright 2018, Dale C. Gledhill. All rights reserved.
Blood Sample Data Before 1 After Before 2 After Before 3 After Before 4 After Before 5 After Before 6 After 12 © Copyright 2018, Dale C. Gledhill. All rights reserved.
Before 7 After Before 8 After Before 9 After Before 10 After Before 11 After Before 14 After 13 © Copyright 2018, Dale C. Gledhill. All rights reserved.
Before 15 After Before 16 After Before 17 After Before 18 After Limited Use Before 20 After Before 21 After 14 © Copyright 2018, Dale C. Gledhill. All rights reserved.
Before 22 After Before 24 After Before 25 After Before 26 After Before 27 After Before 28 After 15 © Copyright 2018, Dale C. Gledhill. All rights reserved.
Before 30 After Before 31 After Before 32 After Before 33 After Before 34 After Before 35 After 16 © Copyright 2018, Dale C. Gledhill. All rights reserved.
Before 37 After Before 38 After Before 39 After Before 41 After Before 43 After Before 44 After 17 © Copyright 2018, Dale C. Gledhill. All rights reserved.
Before 45 After Before 46 After Did not use. Before 47 After Before 49 After 18 © Copyright 2018, Dale C. Gledhill. All rights reserved.
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