Catch-up growth in children with chronic kidney disease started on enteral feeding after 2 years of age

BACKGROUND: Enteral feeding by tube in chronic kidney disease (CKD) before 2 years of age improves growth. Whether it is effective after this age is unknown. We assessed whether height and weight SDS changed after tube feeding was started in children with CKD above 2 years of age. METHODS: Retrospective study of pre-transplant, pre-pubertal children (< 11 years) with CKD stages 2–5 started on nasogastric tube or gastrostomy feeds for the first time after age 2 years. Children were identified by searching dietetic records and the renal database. Children on growth hormone were excluded. Height, weight, and BMI were documented 1 year prior to and at the start of tube feeds, and after 1 and 2 years. Data collection ceased at transplantation. RESULTS: Fifty children (25 male) were included. The median (range) age at start of tube feeds was 5.6 (2.1–10.9) years. Sixteen children were dialysed (1 haemodialysis, 15 peritoneal dialysis); 34 predialysis patients had a median (range) eGFR of 22 (6–88) ml/min/1.73 m2. Overall height SDS (Ht SDS) improved from − 2.39 to − 2.27 at 1 year and − 2.18 after 2 years (p = 0.02). BMI SDS improved from − 0.72 to 0.23 after 1 year and was 0.09 after 2 years of enteral feeding (p < 0.0001). Height SDS improved more in children aged 2–6 years (− 2.13 to − 1.68, p = 0.03) and in children not on dialysis (− 2.33 to − 1.99, p = 0.002). CONCLUSIONS: Enteral tube feeding commenced after 2 years of age in prepubertal children with CKD improves height and weight SDS, with stability of BMI during the second year. Younger children and those not on dialysis had the greatest benefit

Mechanical Response of Fuel Cell Membranes Subjected to a Hygro-Thermal Cycle

The mechanical response of fuel cell proton exchange membranes subjected to a single hygro-thermal duty cycle in a fuel cell assembly is investigated through numerical means. To this end, the behavior of the membrane with temperature and humidity dependent material properties is simulated under temperature and humidity loading and unloading conditions. The stress-evolution during a simplified operating cycle is determined using finite element analysis for two clamping methods and two alignments of the bipolar plates. It is shown that compressive, plastic deformation occurs during the hygro-thermal loading, resulting in tensile residual stresses after unloading. These residual in-plane stresses in the membrane may explain the occurrence of cracks and pinholes in the membrane under cyclic loading

Mechanical Behavior of Fuel Cell Membranes under Humidity Cycles and Effect of Swelling Anisotropy on the Fatigue Stresses

The mechanical response of proton exchange membranes in a fuel cell assembly is investigated under humidity cycles at a constant temperature (85°C). The behavior of the membrane under hydration–dehydration cycles is simulated by imposing a humidity gradient from the cathode to the anode. Linear elastic, plastic constitutive behavior with isotropic hardening and temperature and humidity dependent material properties are utilized in the simulations for the membrane. The evolution of the stresses and plastic deformation during the humidity cycles are determined using finite element analysis for two clamping methods and various levels of swelling anisotropy. The membrane response strongly depends on the swelling anisotropy where the stress amplitude decreases with increasing anisotropy. These results suggest that it may be possible to optimize a membrane with respect to swelling anisotropy to achieve better fatigue resistance, potentially enhancing the durability of fuel cell membranes

Mechanical Behavior of Fuel Cell Membranes under Humidity Cycles and Effect of Swelling Anisotropy on the Fatigue Stresses

The mechanical response of proton exchange membranes in a fuel cell assembly is investigated under humidity cycles at a constant temperature (85°C). The behavior of the membrane under hydration–dehydration cycles is simulated by imposing a humidity gradient from the cathode to the anode. Linear elastic, plastic constitutive behavior with isotropic hardening and temperature and humidity dependent material properties are utilized in the simulations for the membrane. The evolution of the stresses and plastic deformation during the humidity cycles are determined using finite element analysis for two clamping methods and various levels of swelling anisotropy. The membrane response strongly depends on the swelling anisotropy where the stress amplitude decreases with increasing anisotropy. These results suggest that it may be possible to optimize a membrane with respect to swelling anisotropy to achieve better fatigue resistance, potentially enhancing the durability of fuel cell membranes

Mechanical Response of Fuel Cell Membranes Subjected to a Hygro-Thermal Cycle

The mechanical response of fuel cell proton exchange membranes subjected to a single hygro-thermal duty cycle in a fuel cell assembly is investigated through numerical means. To this end, the behavior of the membrane with temperature and humidity dependent material properties is simulated under temperature and humidity loading and unloading conditions. The stress-evolution during a simplified operating cycle is determined using finite element analysis for two clamping methods and two alignments of the bipolar plates. It is shown that compressive, plastic deformation occurs during the hygro-thermal loading, resulting in tensile residual stresses after unloading. These residual in-plane stresses in the membrane may explain the occurrence of cracks and pinholes in the membrane under cyclic loading

Stresses in Proton Exchange Membranes Due to Hygro-Thermal Loading

Durability of the proton exchange membrane (PEM) is a major technical barrier to the commercial viability of polymer electrolyte membrane fuel cells (PEMFC) for stationary and transportation applications. In order to reach Department of Energy objectives for automotive PEMFCs, an operating design lifetime of at least 5000 h over a broad temperature range is required. Reaching these lifetimes is an extremely difficult technical challenge. Though good progress has been made in recent years, there are still issues that need to be addressed to assure successful, economically viable, long-term operation of PEM fuel cells. Fuel cell lifetime is currently limited by gradual degradation of both the chemical and hygro-thermomechanical properties of the membranes.Eventually the system fails due to a critical reduction of the voltage or mechanical damage. However, the hygro-thermomechanical loading of the membranes and how this effects the lifetime of thefuel cell is not understood. The long-term objective of the research is to establish a fundamental understanding of the mechanical processes in degradation and how they influence the lifetime of PEMFCs based on perfluorosulfuric acid membrane. In this paper, we discuss the finite element models developed to investigate the in situ stresses in polymer membranes

Numerical Investigation of Mechanical Durability in Polymer Electrolyte Membrane Fuel Cells

The relationship between the mechanical behavior and water transport in the membrane electrode assembly (MEA) is numerically investigated. Swelling plays a key role in the mechanical response of the MEA during fuel cell operation because swelling can be directly linked to the development of stresses. Thus, in the model introduced here, the stresses and the water distribution are coupled. Two membranes are studied: unreinforced perfluorosulfonic acid (PFSA) and an experimental reinforced composite membrane. The results suggest that open-circuit voltage operations lead to a uniform distribution of stresses and plastic deformation, whereas under current-load operation, the stresses and the plastic deformation are generally lower and localized at the cathode side of the MEA. For the experimental reinforced membrane investigated, the in-plane swelling and, consequently, the stresses and plastic deformation are lower than in an unreinforced PFSA membrane. This reduction is a favorable outcome for improving durability. The model also suggests that the mechanical constraints due to the clamping of the cell may limit the swelling of the membrane and consequently change the water distribution

Stresses in Proton Exchange Membranes Due to Hygro-Thermal Loading

Durability of the proton exchange membrane (PEM) is a major technical barrier to the commercial viability of polymer electrolyte membrane fuel cells (PEMFC) for stationary and transportation applications. In order to reach Department of Energy objectives for automotive PEMFCs, an operating design lifetime of at least 5000 h over a broad temperature range is required. Reaching these lifetimes is an extremely difficult technical challenge. Though good progress has been made in recent years, there are still issues that need to be addressed to assure successful, economically viable, long-term operation of PEM fuel cells. Fuel cell lifetime is currently limited by gradual degradation of both the chemical and hygro-thermomechanical properties of the membranes.Eventually the system fails due to a critical reduction of the voltage or mechanical damage. However, the hygro-thermomechanical loading of the membranes and how this effects the lifetime of thefuel cell is not understood. The long-term objective of the research is to establish a fundamental understanding of the mechanical processes in degradation and how they influence the lifetime of PEMFCs based on perfluorosulfuric acid membrane. In this paper, we discuss the finite element models developed to investigate the in situ stresses in polymer membranes

Numerical Investigation of Mechanical Durability in Polymer Electrolyte Membrane Fuel Cells

The relationship between the mechanical behavior and water transport in the membrane electrode assembly (MEA) is numerically investigated. Swelling plays a key role in the mechanical response of the MEA during fuel cell operation because swelling can be directly linked to the development of stresses. Thus, in the model introduced here, the stresses and the water distribution are coupled. Two membranes are studied: unreinforced perfluorosulfonic acid (PFSA) and an experimental reinforced composite membrane. The results suggest that open-circuit voltage operations lead to a uniform distribution of stresses and plastic deformation, whereas under current-load operation, the stresses and the plastic deformation are generally lower and localized at the cathode side of the MEA. For the experimental reinforced membrane investigated, the in-plane swelling and, consequently, the stresses and plastic deformation are lower than in an unreinforced PFSA membrane. This reduction is a favorable outcome for improving durability. The model also suggests that the mechanical constraints due to the clamping of the cell may limit the swelling of the membrane and consequently change the water distribution

Mechanical Properties of a Reinforced Composite Polymer Electrolyte Membrane and its Simulated Performance in PEM Fuel Cells

The hygro-thermo-mechanical properties and response of a class of reinforced perfluorosulfonic acid membranes (PFSA), that has potential application as an electrolyte in polymer fuel cells, are investigated through both experimental and numerical modeling means. A critical set of material properties, including Young’s modulus, proportional limit stress, break stress and break strain, is determined for a range of temperature and humidity levels in a custom-built environmental test apparatus. The swelling strains are also determined as functions of temperature and humidity level. To elucidate the mechanical response and the potential effect these properties have on the mechanical durability, mechanics-based simulations are performed using the finite element method (ABAQUS). The results indicate that the relatively high strength of the experimental membrane, in combination with its relatively low in-plane swelling due to water absorption, should have a positive influence on membrane durability, potentially leading to longer life times for polymer electrolyte membrane fuel cells (PEMFC)