A wellness program for cardiac surgery improves clinical outcomes

Objective: To evaluate the efficacy of an Integrative Cardiac Wellness Program (ICWP) for cardiothoracic surgery patients on postoperative recovery, bleeding risk, satisfaction and participation in rehabilitation programs. Design: An open label study whereby ICWP participants were compared to a historical control group that received usual care at the same hospital. Methods: Patients enrolled at pre-admission clinics took metabolic supplements (CoQ10, magnesium orotate, alpha lipoic acid, omega 3 fatty acids) three times daily from enrolment until surgery and for 4 weeks afterwards. Between postoperative days 3–7, patients received individualised health education from a naturopath followed by a phone call post-discharge. The control group consisted of elective cardiothoracic patients receiving usual care prior to the ICWP commencing. Data was collected from medical records, a survey and interviews. Results: Data from 922 patients were analysed. ICWP participants (n = 337) were well matched with controls (n = 585) for age, gender and history of hypertension, hypercholesterolaemia, diabetes and smoking. Multivariate analysis found that CABG ICWP patients had a relative reduction of 42% for postoperative inotrope (cardiac stimulants) support compared to controls (p < 0.001). Similarly, the ICWP valve surgery patients had 40% relative reduction in the incidence of postoperative inotrope support compared to controls (p = 0.02). There was no significant difference between the treatment and control groups in the incidence of serious bleeding events, defined as return to theatre due to haemorrhage or blood transfusion requirements. ICWP patients gave positive feedback of their experience and there was a 46% increase in attendance at rehabilitation programs compared to controls (p = 0.033). Conclusions: The ICWP is safe, improves postoperative heart function, is well accepted by patients and has long-term patient benefits by improving attendance at rehabilitation

Very high-energy gamma-ray follow-up program using neutrino triggers from IceCube

We describe and report the status of a neutrino-triggered program in IceCube that generates real-time alerts for gamma-ray follow-up observations by atmospheric-Cherenkov telescopes (MAGIC and VERITAS). While IceCube is capable of monitoring the whole sky continuously, high-energy gamma-ray telescopes have restricted fields of view and in general are unlikely to be observing a potential neutrino-flaring source at the time such neutrinos are recorded. The use of neutrino-triggered alerts thus aims at increasing the availability of simultaneous multi-messenger data during potential neutrino flaring activity, which can increase the discovery potential and constrain the phenomenological interpretation of the high-energy emission of selected source classes (e.g. blazars). The requirements of a fast and stable online analysis of potential neutrino signals and its operation are presented, along with first results of the program operating between 14 March 2012 and 31 December 2015