Indiana University-Purdue University Indianapolis (IUPUI) / Hospital readmission is of growing importance in the healthcare industry because of associated patient and system costs, impact to the quality of patient care, and hospital Medicare payment penalties. The increasing interest in sepsis readmission prevention has highlighted the uniqueness of severe sepsis or septic shock survivors. The results of this study provide insight into the relationship between index hospital length of stay (LOS) and 30-day readmissions for older adults (> 65 years) who discharged home from an index hospital with a principle or secondary discharge diagnosis of severe sepsis or septic shock. The purpose of this study was to investigate the relationship between index hospital LOS and 30-day readmissions in older adults (> 65 years) whose expected primary payer was Medicare and who discharged home with a principle or secondary diagnosis of severe sepsis or septic shock. Data used to answer the proposed research questions consisted of older adult discharge records from the 2014 Nationwide Readmissions Database (NRD), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. Differences in 30-day readmissions between older adult age groups, gender, and older adult location were examined. The number of days to readmission since discharge was evaluated for the subset of older adults with a readmission. Approximately 15.6% of older adults were readmitted within 30 days of their discharge. Readmissions were statistically different based on the older adult’s age, gender, and LOS. Location did not have a significant effect on readmissions. Mean LOS among readmitted older adults was 10.1 days. Analysis indicates that an older adult’s LOS had a significant effect on readmissions, although models performed poorly. Findings suggest that there are certain factors that can predict older adults who are at risk for being readmitted after being discharged with a principle or secondary discharge diagnosis of severe sepsis or septic shock.

The Word Association Test has been less frequently used in recent years with the advent and popularization of many new projective techniques. From a clinical viewpoint the method is limited in that it gives insufficient material for a description of the personality as a meaningful whole, individual administration is time consuming, and the tendency is to indicate the presence of an emotional disturbance without denoting the exact nature of that disturbance. A look at the Word Association Tests's long and respectable history will find that this test has been used clinically and experimentally by many prominent men. A survey of the history reveals no research has been done with this test and patients receiving electric shock treatment. It was for this reason that this project was undertaken.

This thesis is composed of two distinct parts. The first part of this work addresses the problem of critical ignition behind a decaying shock wave in the context of cellular detonations. Low-pressure (4.1 kPa) shock tube experiments were performed in a thin rectangular channel using the highly-unstable mixture of CH4 + 2O2 and the weakly-unstable mixture of 2H2 + O2 + 7Ar, with Schlieren visualization of the flow field. The dynamics of the lead shock in a detonation cell was reconstructed from measurements of the lead shock position and curvature. The post-shock state and the expansion rate along the path of a Lagrangian particle crossing the lead shock at any given point in the cell cycle were evaluated with the shock jump and shock change equations. The chemical evolution behind the shock was then integrated using a detailed chemistry model. Quenching of the post-shock reaction zone was found within the first half of the detonation cell for both mixtures, with quenching occurring earlier in the highly unstable mixture. Simplified models derived from 1-step and 2-step chemistry models very accurately predict the quenching of the post-shock reactions and the evolution of the ignition delay through the cell. The second part describes the assembly and characterization of a fibre-optic probe hydrophone (FOPH) for the measurement of shock waves associated with blast-induced neuro-trauma. Compared to traditional polyvinylidene difluoride (PVDF) hydrophones, the assembled FOPH has a higher bandwidth and smaller active diameter, which are comparable to the characteristic time and thickness of shock waves associated with blast-induced neuro-trauma. However, the sensitivity of FOPHs are substantially lower than traditional hydrophones. We assemble a FOPH and provide detailed calculations and measurements of its sensitivity (0.66 mV/MPa) , noise floor, and spatial resolution. The 150 MHz bandwidth, limited by the photodetector, is sufficient for resolving shock waves with over-pressures of up to 174 kPa with 3 measurement points. Experimental measurements of the system noise gives a floor of 260 Pa/√Hz . A detailed noise analysis finds that the system is limited by photodetector noise (215 Pa/√Hz), which is 4x the fundamental shot noise limit, closely followed by a laser noise of 150 Pa/√Hz. We conclude that the system noise floor is insufficient for resolved measurements of the post-shock pressure in the range associated with blast-induced neuro-trauma. From our noise analysis, we quantify the sensitivity enhancement required for resolving this regime, and we conclude that sensitivity-enhancing fibre-coatings could provide a sufficient increase in sensitivity.

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Rapid consumption of energy storage and serious environmental pollution demand more advanced combustion strategies and more renewable fuels. Development of chemical kinetic models and suitable selection of fuels are key factors in evolving and optimizing new engine and combustion concepts. Alkenes are typical composition of gasoline as well as typical intermediates in the oxidation of larger alkanes and alcohol, while isoprene is one of the important alkenes impacting both the atmospheric pollution and energy depletion. Isoprene is one of the most important species in the atmosphere chemistry, dominating the carbon flux emitted by vegetation and accounting for forty percent of non-methane biogenic emissions globally. Isoprene has been recognized not only as a noteworthy precursor to polycyclic aromatic hydrocarbons but also as a promising fuel additive. Isoprene has been extensively investigated in the atmosphere chemistry, but its role as a critical diolefin in combustion chemistry has received less attention. Only A few researchers studied isoprene chemistry by carrying out pyrolysis experiments and theoretical calculations. To better understand the combustion chemistry of isoprene, this work presents a detailed experimental and kinetic modeling investigation. This study explored the chemical kinetics of isoprene oxidation in ignition delay times and speciation measurements. Our shock tube experiments for ignition delay times covered the temperatures of 680 – 1470 K, pressures of 1 – 30 bar, and equivalence ratios of 0.5 – 2. We measured laser-based time-resolved CO speciation in a low-pressure shock tube at temperatures of 900 – 1470 K, pressures of 1 and 4 bar, and equivalence ratios of 0.5 and 1. Major species concentrations were measured in a jet-stirred reactor at 680 – 1280 K, 1 bar, and φ = 0.5 – 2. Afterwards, we used 1,3-butadiene as a basis to develop fuel-specific isoprene sub-mechanism and coupled it with a C0-C5 core sub-mechanism. Finally we developed a comprehensive kinetic model including 1585 species and 6884 reactions and achieved a good agreement between the model’s predictions and the experiments. To our knowledge, this study is the first comprehensive effort to describe the process and provides valuable insights into isoprene oxidation. The work reported in the thesis also facilitates the better understanding of combustion chemistry of diolefins.

This thesis describes the simulation of ERDC’s Blast Load Simulator (BLS) using MSU’s Loci/BLAST. The BLS was created to replicate waveforms found in blast scenarios. Loci/BLAST is an explicit, unstructured CFD code that specializes in moving waveforms. ERDC conducted various tests, and a grid for each scenario was created using the SolidMesh tool. Each grid was simulated, and the results were displayed as time history plots and spatial plots. Simulations were also performed that compared 2D and 3D grids and determined the effect of the grate and striker components. There was a strong correlation between the experimental and simulation results for each case, demonstrating that Loci/BLAST is fully capable of modeling the BLS waveforms. A 2D grid produced results comparable to those on a full 3D grid. The grate and striker were critical in the simulation because they significantly affected the waveform.

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With the growing demand of renewable wind energy, logistics and operations associated with a wind turbine makes for compelling study and analysis. The study entails understanding of transporting a wind turbine nacelle from Denmark till Australia. The methods of transporting the wind turbine nacelle and the modes of transportation that are currently in use have been studied. Factors that are detrimental to efficient shipping have been reviewed with existing literature and analysed for a wind turbine nacelle. The two key factors that influence transportation namely humidity and G-force have been identified. Simple and cost effective solutions such as use of insulation material, use of desiccants to overcome the effects of humidity, use of shock absorber pallets to reduce shock and vibration have been proposed. For the damages caused to a wind turbine nacelle due to random causes, some suggestions to prevent such damages have also been provided.

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<p>Hypersonic flow over two generic missile configurations was investigated using CFD meth-</p> <p>ods. CFD results were compared with experimental results obtained by the hypersonic flight</p> <p>lab at Texas A&M University. Baseline RANS computations involving the missile configurations at a zero deg angle-of-attack were performed, along with computations at higher angles-of-attack. As the angle-of-attack was increased, complex vortex interactions were observed in the region between the fins. Increasing the angle-of-attack generally increased heating on the windward side of the missile geometries, especially on wall surface regions</p> <p>adjacent to the fin-root vortices. The results presented highlight observed fin region vortices and regions of intense heating on the body surface. DES simulations methods were also used to explore unsteady aspects of flow around the two generic missile configurations through time-accurate CFD simulations. Power spectral plots were generated to quantify the dominant frequencies of large-scale unsteadiness.</p>