Cathode fall voltage of TIG arcs from a non-equilibrium arc model

This work presents modelling results concerning a tungsten inert gas (TIG) welding arc. The model provides a consistent description of the free burning arc, the arc attachment and the electrodes. Thermal and chemical non-equilibrium is considered in the whole arc area, and a detailed model of the cathode space-charge sheath is included. The mechanisms in the cathode pre-sheath are treated in the framework of a non-equilibrium approach which is based on a two-fluid description of electrons and heavy particles and a simplified plasma chemistry of argon. A consistent determination of the electrode fall voltages and temperature distributions is achieved. The model is applied to arcs in pure argon at currents up to 250 A, whereby welding of a workpiece made of mild steel with a fixed burner is considered. Arc voltages in the range from 12 to 17 V are obtained at 50 at 250 A, respectively. The space-charge sheath voltage is found to be about 7 V and almost independent of the current. The corresponding temperatures of the cathode tip are in the range from 3,000 K to about 3,800 K. The results obtained are in a good agreement with measurements

Development, implementation and outcome analysis of semi-automated alerts for metformin dose adjustment in hospitalized patients with renal impairment

PURPOSE Overdosing of the oral antidiabetic metformin in impaired renal function is an important contributory cause to life-threatening lactic acidosis. The presented project aimed to quantify and prevent this avoidable medication error in clinical practice. METHODS We developed and implemented an algorithm into a hospital's clinical information system that prospectively identifies metformin prescriptions if the estimated glomerular filtration rate is below 60 mL/min. Resulting real-time electronic alerts are sent to clinical pharmacologists and pharmacists, who validate cases in electronic medical records and contact prescribing physicians with recommendations if necessary. RESULTS The screening algorithm has been used in routine clinical practice for 3 years and generated 2145 automated alerts (about 2 per day). Validated expert recommendations regarding metformin therapy, i.e., dose reduction or stop, were issued for 381 patients (about 3 per week). Follow-up was available for 257 cases, and prescribers' compliance with recommendations was 79%. Furthermore, during 3 years, we identified eight local cases of lactic acidosis associated with metformin therapy in renal impairment that could not be prevented, e.g., because metformin overdosing had occurred before hospitalization. CONCLUSIONS Automated sensitive screening followed by specific expert evaluation and personal recommendations can prevent metformin overdosing in renal impairment with high efficiency and efficacy. Repeated cases of metformin-associated lactic acidosis in renal impairment underline the clinical relevance of this medication error. Our locally developed and customized alert system is a successful proof of concept for a proactive clinical drug safety program that is now expanded to other clinically and economically relevant medication errors