Digital Commons Network^™

Short-Term Preeclampsia Prediction: Cutoff Variations For Sflt-1/Plgf In U.S. Patients With Or Without Hypertensive Disorders, Yaxin Li, Kristen Cagino, Jim Yee, Caroline Andy, Dajana Borova, Ayush Shah, Isla Racine, Tracy Grossman, Zhen Zhao

Student Papers, Posters & Projects

BACKGROUND: Preeclampsia (PE) is a complex disorder with significant maternal and fetal risks. The soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) ratio shows promise as a diagnostic tool, but its adoption in the U.S. remains limited due to the lack of accessible testing platforms, U.S.-based studies, and evidence-based implementation guidelines.

PATIENTS/MATERIALS AND METHODS: We conducted a cohort study to evaluate the sFlt-1/PlGF ratio for predicting PE within two weeks among pregnant individuals ≥18 years, ≥20 weeks gestation. Serum samples were obtained from routine prenatal visits or triage evaluations. sFlt-1/PlGF ratios were measured using Roche Elecsys assays, and …

Enhancing Learning Path Recommendation Via Multi-Task Learning, Afsana Nasrin

All Theses

Personalized learning is a student-centered educational approach that acknowledges and adapts to the unique characteristics of each learner by customizing content, pacing, and assessments to meet individual needs. Key components include learner profiles, cognitive styles, learning objectives, adjustable pacing, and enabling technologies such as intelligent learning environments, intelligent tutoring systems, and data mining.

A key strategy for implementing personalized learning is learning path recommendation, a technique that guides learners through tailored sequences of content. This approach sequentially recommends personalized learning items, such as lectures, exercises, to address each student’s specific needs. Recent advances in deep learning, particularly deep reinforcement learning, …

Twim #286: Integrons And Invasion, Andrea Ayala-Lopez, Brittney Heist,, Thomas Salazar, Rebecca Seipelt-Thiemann, Mel Melendrez-Vallard, Angela Wilson

School of Medical Diagnostics & Translational Sciences Publications

Podcast annotation TWiM #286: Integrons and Invasion from the weekly podcast series "This Week in Microbiology" (TWiM), a podcast where experts in microbiology discuss academic papers in their field in an informal way.

Experimental Measurement Demonstration Of Initial And Steady-State Heights Of A Co2 Vertical Jet Fountain In Still Air, Brock Mcrae

Chemical Engineering Undergraduate Honors Theses

Atmospheric releases of heavier-than-air gases pose acute near-field hazards in low wind, yet the near-source behavior of vertical dense-gas jets in still air is sparsely documented. This thesis demonstrates a repeatable laboratory method for measuring the initial and steady-state rise heights of a carbon dioxide (CO₂) jet issued vertically from a floor nozzle in the CHRC ultra-low-speed wind tunnel under still-air conditions. Controlled mixtures (pure CO₂, 50/50 CO₂-air, 25/75 CO₂-air) were released at four flow rates (75, 100, 125, 150 LPM) with five repeats per condition. A fixed camera and tape-measure scale enabled video extraction of jet height using Kinovea …

Calibration And Validation Of Cyclic Stretching Platform For Stiffness Testing Of Engineered Heart Tissue, Jillian Welsh

Chemical Engineering Undergraduate Honors Theses

Cardiac fibrosis (CF) is a major contributor to the high mortality rate of heart failure which affects over 23 million people worldwide. CF involves cardiac fibroblasts depositing extracellular matrix, made primarily of collagen type I, which stiffens the heart walls over time. As testing new drugs for CF is deterred by the high cost and time required for animal and clinical trials, this research helps to solve the problem by providing an in vitro platform to study fibrosis.

The work involved creating tissues containing human cardiac fibroblast (HCFB) cells. Spring testing was conducted to determine the force applied by the …

Undergraduate Awareness Of Sexual Harassment Law In Tanzania's Higher Learning Institutions: Case Studies Of Two Universities, Salma Ramadhan Fundi Phd Candidate

Tanzania Journal of Sociology

This study examines undergraduate students' awareness of legal provisions and guidelines concerning sexual harassment in Tanzanian higher education, focusing on the University of Dar es Salaam (UDSM) and the Open University of Tanzania (OUT) as case studies. Sexual harassment significantly impacts students’ well-being, safety, and academic success. Despite the existence of legal frameworks, students' knowledge of these provisions is often limited. The study employed a qualitative approach with a phenomenological research design to explore students’ experiences and perceptions of harassment policies. This design allowed participants to share the meanings they attach to their experiences and how such policies are understood …

Editorial – Dec 2025, Edwin Van Teijlingen, Rafat Jan

Journal of Asian Midwives (JAM)

No abstract provided.

Factors Associated With Preterm Premature Rupture Of Membranes: A Case-Control Study In A Tertiary Hospital In Kabul, Afghanistan, Atia Sharif Nadi, Freshta Sharif Tawakkuli, Zainab Sharif Ezadi, Sayed Murtaza Sadat Hofiani, Shoaib Murtaza Sadat Naeemi, Ahmad Komail Frogh

Journal of Asian Midwives (JAM)

Background: It is essential to identify preterm premature rupture of membranes (PPROM) and its associated risk factors to reduce its impact. This study aims to find the demographic, reproductive, and obstetric factors associated with PPROM among women in Kabul, Afghanistan.
Methods: This case-control study was conducted over six months in 2023 at a tertiary hospital in Kabul, Afghanistan. We included 40 cases of PPROM and 80 controls without PPROM in this study. We used structured questionnaires to collect demographic, reproductive, and obstetric characteristics of the participants. To find the factors associated with PPROM, Logistic regression was performed using IBM SPSS …

Transcriptional Coregulator Zmiz1 Modulates Estrogen Responses That Are Essential For Healthy Endometrial Function, Myeongjin Yi, Cynthia J Willson, Mark Y Chiang, Yong Song, Goutham Venkata Naga Davuluri, Christopher Day, Ramakrishna Kommagani, Joseph Rodriguez, Asgerally T Fazleabas, John P Lydon, Francesco J Demayo

Faculty, Staff and Students Publications

Estrogen is a critical regulator of endometrial health. Aberrant estrogen stimulation can result in infertility, endometrial cancer, and endometriosis. Here, we identified Zinc Finger MIZ-Type Containing 1 (Zmiz1) as a coregulator of uterine estrogen signaling. ZMIZ1 is colocalized with an estrogen receptor α–binding (ESR1-binding) super enhancer. ZMIZ1 mutations are found in endometrial cancer and its RNA levels trend toward reduction in endometrium of patients with endometriosis. ZMIZ1 is dynamically expressed in human endometrial tissues during the menstrual cycle. Disrupting ZMIZ1 in cultured human endometrial stromal cells resulted in impaired cell proliferation and decidual differentiation. Ablation of Zmiz1 using …

Education Research: Eeg Instruction: Findings From A Scoping Review, Alexis Peedin, Jeffrey B Ratliff, Urvashi Vaid, Swati A Karmarkar, Moushumi Sur, Vivianne Van Kranen-Mastenbroek, Dimitrios Papanagnou, Marian H J M Majoie, Dorene F Balmer, Satid Thammasitboon

Faculty, Staff and Students Publications

Background and objectives: Although EEG interpretation is a key skill in neurology, EEG instruction is variable and its landscape remains underexplored. Thus, we conducted a scoping review to expand the literature by providing a structured mapping of the EEG instruction literature and a foundation for future research in EEG instruction.

Methods: We followed a structured methodological framework for scoping reviews and report the findings in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Research questions explored theoretical frameworks, methodologies, learner populations, instructional methods, and assessment approaches. Eligibility criteria were iteratively modified to focus …

Fibroblasts Are The Primary Contributors To A Disrupted Micro-Environment In End-Stage Pediatric Hypertrophic Cardiomyopathy, Chang-Ru Tsai, Iki A Adachi, Xiao Li, James F Martin

Faculty, Staff and Students Publications

Background: Hypertrophic cardiomyopathy (HCM) is a relatively rare but debilitating diagnosis in the pediatric population, and patients with end-stage HCM require heart transplantation. Here, we have examined the transcriptome in ventricular tissue from this patient group to identify cell states and underlying cellular processes unique to pediatric HCM.

Methods: We performed single-nucleus RNA sequencing (snRNA-seq) on explanted hearts at transplant in 3 pediatric patients with end-stage HCM and compared findings to pediatric control and adult HCM.

Results: We identified distinct underlying cellular processes in cardiomyocytes, fibroblasts, endothelial cells, and myeloid cells compared with controls. Pediatric HCM was enriched in cardiomyocytes …

Insights From A Survey Of School Nurses: Assessing The Challenges Of Constipation In Schools

Faculty, Staff and Students Publications

Objectives: School nurses are key responders to students with constipation, yet their experiences are underreported. This study surveyed their observations regarding constipation, identified barriers to student restroom access, and assessed educational needs.

Methods: In this descriptive, cross-sectional survey study, an anonymous online survey was distributed to school nurses participating in a virtual education series. The survey assessed nurse demographics, frequency of encounters with constipation and encopresis, school restroom policies, barriers to restroom use, accommodation requests, and training in constipation management.

Findings: Of 125 respondents, 95% encountered students with constipation at least monthly and 55% reported ≥ 6 encounters monthly. Commonly …

Characteristics Associated With Eurolupus Versus Modified National Institutes Of Health Cyclophosphamide Regimen Use In Children And Young Adults With Lupus Nephritis, Kristen R Miller, Stacy P Ardoin, Christine Bearer, Emily Hause, Joyce Hui-Yuen, Nicole Ling, Maria Pereira, Meredith Riebschleger, Kelly Rouster-Stevens, Aliese Sarkissian, Julia Shalen, William Daniel Soulsby, Marinka Twilt, Eveline Y Wu, Laura B Lewandowski, Scott E Wenderfer, Jennifer C Cooper

Faculty, Staff and Students Publications

Objective: To determine the demographic and clinical characteristics associated with use of the EuroLupus or modified National Institutes of Health (NIH) cyclophosphamide (CYC) regimen for treatment of lupus nephritis (LN) at North American pediatric centers.

Methods: A retrospective cohort study was conducted at 11 North American centers. Patients < 22 years of age with active LN treated with CYC using the EuroLupus or NIH regimen between July 2014 and June 2021 were included. Data were extracted via electronic medical record review. Demographic and clinical characteristics were compared at CYC initiation. A multivariable generalized estimating equation with logit link was fit to model EuroLupus use. An exchangeable correlation structure was used to account for correlation within centers. Independent variables were chosen using elastic net regression.

Results: The cohort consisted of 191 patients (85 EuroLupus, 106 NIH) with a median age of 15.3 years at CYC initiation. In multivariable analysis, characteristics significantly associated with EuroLupus regimen use (vs NIH regimen use) included more recent year of CYC initiation, longer disease duration, Hispanic ethnicity and Asian race (as compared …

Phenotypic Variability And Paternal Inheritance Of A Chd8 Variant Causing Intellectual Developmental Disorder With Autism And Macrocephaly Confirmed By Epigenetic And Structural Analyses, Yutaka Furuta, Jonathan H Sheehan, Et Al.

2020-Current year OA Pubs

BACKGROUND: Intellectual developmental disorder with autism and macrocephaly (IDDAM, OMIM #615032) is an autosomal dominant neurodevelopmental disorder characterized primarily by intellectual disability, autism spectrum disorder, macrocephaly, tall stature, gastrointestinal symptoms, and variable neurological manifestations. Most cases result from de novo pathogenic variants in CHD8.

METHODS: We conducted genome sequencing through the Undiagnosed Diseases Network (UDN) in a female proband harboring a CHD8 variant of uncertain significance (VUS), whose clinical presentation was consistent with IDDAM but included atypical features such as ptosis and hearing loss. Variant pathogenicity was further evaluated using EpiSign DNA methylation analysis and structural biology modeling.

RESULTS: Genome …

Assessment Of Knowledge And Attitudes Of Undergraduate Students On Trichomoniasis In Ghana, Christopher Yaw Dumevi, Ezekiel Kofi Vicar, Lorie Christla Quansah, Rhoda Oklu, Smith Joshua, Joyce Junior Asiamah, James-Paul Kretchy, George Boateng Kyei, Patience B Tetteh-Quarcoo, Nicholas T K D Dayie, Irene Ayi, Patrick F Ayeh-Kumi

2020-Current year OA Pubs

BACKGROUND: Trichomoniasis is a non-viral neglected sexually transmitted disease of public health importance. Undergraduate students, often experiencing newfound freedom from family oversight, may engage in risky sexual behaviors, predisposing them to trichomoniasis and other sexually transmitted infections (STIs). This study aimed to assess the knowledge, attitudes, and practices towards trichomoniasis and associated factors among the Central University students in the Greater Accra Region of Ghana.

METHODS: An institutional cross-sectional study was conducted between March and July 2024, involving 387 undergraduate students from Central University who were selected using a simple random sampling technique. Data were collected using a structured researcher-led …

A Roadmap To Scale Up Person-Centred Care In The Hiv Response: Recommendations From A Global Consensus-Building Process, Lina Golob, Elvin H Geng, Et Al.

2020-Current year OA Pubs

INTRODUCTION: World Health Organization global normative guidance recommends person-centred care (PCC) approaches to reduce HIV-related mortality and morbidity and to improve health-related quality of life (HrQoL). However, consensus on the priority PCC elements and guidance on how different stakeholders can realize PCC principles at the health systems, service delivery and individual client-healthcare worker (HCW) levels are lacking. We conducted a global consensus-building process to define core PCC elements and develop recommendations for implementation at scale.

METHODS: We used a multi-phase process to build consensus and prioritize recommendations, consisting of a literature review, five stakeholder consultations (34-43 participants each) between July …

Current Practices And Trends In Surgical Decision-Making For Children With Lennox-Gastaut Syndrome: A Cross-Sectional Survey By The Pediatric Epilepsy Research Consortium, Michelle Y Chiu, Renée A Shellhaas, Et Al.

2020-Current year OA Pubs

OBJECTIVE: The objective of this study is to characterize contemporary surgical management practices and factors influencing surgical decision-making in the management of Lennox-Gastaut Syndrome (LGS) across pediatric epilepsy centers in the United States.

METHODS: A 45-item cross-sectional survey was developed and distributed to Pediatric Epilepsy Research Consortium centers. Domains included institutional demographics, surgical evaluation timing and goals, presurgical workup, procedural utilization and outcomes, and barriers to surgery. Descriptive statistics and thematic analysis were performed.

RESULTS: Thirty-two pediatric epilepsy centers participated (38% response), the majority comprising pediatric epileptologists at Level 4 National Association of Epilepsy Centers. Most centers (66%) considered surgery …

A Multi-Center Retrospective Cohort Study Of Neurosarcoidosis Myelitis: Current Observations And Future Directions, Giovanna S Manzano, David B Clifford, Steven Richard Dunham, Masoud Majed, Et Al.

2020-Current year OA Pubs

OBJECTIVE: The optimal treatment for neurosarcoidosis myelitis is uncertain. We characterize incident neurosarcoidosis myelitis and assess treatment response by MRI and clinical scales.

METHODS: Incident probable or definite neurosarcoidosis myelitis in adults was retrospectively identified from 13 academic medical centers. Cases were analyzed by initial treatment. The primary outcome was T1 post-contrast gadolinium enhancement resolution at 6 months post-treatment. Secondary outcomes were changes in modified Rankin scale (mRS) and Expanded Disability Status Scale (EDSS) from nadir to final follow-up.

RESULTS: Two hundred two patients were identified (median diagnosis age: 47 years (IQR 39-55); male: female 1.3:1). Median nadir mRS and …

Fast And Accurate Measurement Of Small Field Dosimetry Using A Novel Scintillation Detector, Yiding Han, Jingzhu Xu, Yao Hao, Baozhou Sun

2020-Current year OA Pubs

BACKGROUND: The most used instruments for small-field dosimetry have notable limitations, including the need for correction of output factors, limited scanning speeds, and challenges in alignment for percentage depth dose (PDD) measurements, particularly for extremely small fields. However, plastic scintillation detectors (PSDs) are an attractive alternative for small-field dosimetry due to their correction-free nature, linear dose response, and fast response time.

PURPOSE: This study evaluates the robustness and accuracy of the dosimetric measurements using a new water-equivalent PSD in small-field dosimetry. The study also aims to report accurate measurements of output factors, profiles, and an indirect method for measuring PDD …

Reply To Chaïbi And Tandjaoui-Lambiotte And To Young And Scott

Faculty, Staff and Students Publications

No abstract provided.

A Β-Lactamase Inhibitory Protein Mutant Displays High Potency And A Broad Inhibition Profile Due To An Altered Binding Mode With Β-Lactamases, Banumathi Sankaran, Bidadi Venkataram Prasad, Timothy Palzkill

Faculty, Staff and Students Publications

β-lactamase enzymes inactivate β-lactam antibiotics, leading to drug resistance. The β-lactamase inhibitory protein (BLIP) is a naturally occurring inhibitor of β-lactamases, with inhibition constants (Ki) ranging from picomolar to micromolar values. For example, BLIP inhibits CTX-M-14 β-lactamase with a Ki of 330 nM, whereas the Ki for CTX-M-15 is 3 nM, despite CTX-M-14 and CTX-M-15 sharing 83% sequence identity. We used a genetic screen to identify a BLIP mutant, E73W, that potently inhibited CTX-M-14. Subsequent purification and testing of BLIP E73W revealed that it is a potent, broad-spectrum inhibitor of class A β-lactamases. We determined …

Managing Conflict Case: The Difficult Consultant, Daniela Ortiz, David Fernandez, Shagun Berry, Colleen Donovan, Nicole Novotny, Stephanie Cohen, Stephanie Stapleton, Tiffany Moadel

Faculty, Staff and Students Publications

Audience: This communication case is intended for emergency medicine (EM) resident physicians and junior faculty preparing for the ABEM Certifying Exam.

Introduction: Conflict management is a common and significant challenge in the emergency department (ED), with potential negative impact on both physicians and patients. At the individual level, hospital-based conflicts can lead to emotional stress, impaired concentration, decreased trust among providers, and feelings of dehumanization.1 For patients, conflicts between physicians can compromise the quality of care and contribute to delays in treatment.1 In the ED, conflict often arises between emergency physicians (EPs) and various stakeholders, including patients, family members, nursing …

Patient-Centered Communication Case: Threatened Miscarriage, Colleen Donovan, Nicole Novotny, Stephanie Cohen, Charles Lei, Alaa Aldalati, Stephanie Stapleton, David Fernandez

Faculty, Staff and Students Publications

Audience: This communication case is intended for EM residents of all levels.

Introduction: Patient-centered communication is a necessary skill in the practice of emergency medicine. This style of communication is crucial for promoting high-quality healthcare by prioritizing patient needs, perspectives, and values. This patient-centered communication case centers on miscarriage, a diagnosis where patient-centered communication is requisite. Approximately one in six or 17.1% of patients with a final diagnosis of miscarriage, also known as early pregnancy loss, present initially to the emergency department.1 Advising a patient of the diagnosis of miscarriage requires excellent communication skills including facile rapport building, empathy, nonverbal …

Difficult Conversation Case: Death Notification, Amrita Vempati, David Fernandez, Daniela Ortiz, Anita Rohra, Stephanie Stapleton, Hillary Moss

Faculty, Staff and Students Publications

Audience: This case is meant for senior emergency medicine (EM) resident physicians as a preparatory tool for the American Board of Emergency Medicine Certifying Exam. However, it is applicable for EM residents at all levels of training.

Introduction: Difficult conversations are an integral part of the practice of emergency medicine. Competent EM physicians routinely engage in challenging conversations with patients and their families (eg, delivering bad news, disclosing medical errors, providing death notifications).1 Despite their importance, communication skills are often not formally taught in residency training.2 Instead, learners frequently rely on role modeling to develop the skills necessary to navigate …

Rationale And Design Of The Rembrandt Trial: A Phase 3 Study To Evaluate The Effect Of Obicetrapib/Ezetimibe On Coronary Plaque Characteristics, Matthew J Budoff, Marc Ditmarsch, C Michael Gibson, John J P Kastelein, Ann Marie Navar, Stephen J Nicholls, Kausik K Ray, Cheerag Shirodaria, Michelle C Williams, James L Januzzi

Faculty, Staff and Students Publications

Background: Obicetrapib is a potent, selective cholesteryl ester transfer protein (CETP) inhibitor that significantly lowers low-density lipoprotein cholesterol (LDL-C). Additive reductions in LDL-C occur when obicetrapib is combined with ezetimibe. The impact of obicetrapib and ezetimibe fixed-dose combination (FDC) on coronary plaque burden is unknown. Favorable changes in noncalcified coronary atherosclerotic plaque volume (NCPV) may indicate a potential beneficial effect on atherosclerotic cardiovascular disease (ASCVD) events.

Methods: REMBRANDT is a placebo-controlled, double-blind, randomized trial designed to assess the efficacy of obicetrapib and ezetimibe FDC on coronary plaque burden. Individuals aged 45 years or older with ASCVD (imaging evidence of vascular …

Newsletter 2025.12.01, Fcrh Honors Program

What's Going On, Honors? (2025-26)

No abstract provided.

Halo Gravity Traction And Temporary Internal Distraction, Nicholas D. Fletcher, Anson G. Bautista, Joshua S. Murphy, K Aaron Shaw

Manuscripts, Articles, Book Chapters and Other Papers

Severe pediatric spinal deformities may require staged correction strategies to mitigate neurologic risk and optimize cardiopulmonary outcomes. This paper reviews two adjunctive techniques—halo gravity traction (HGT) and temporary internal distraction (TID)—used in the management of rigid scoliosis. HGT enables gradual preoperative spinal elongation and coronal/sagittal realignment, improving pulmonary function and nutritional status while reducing the need for three-column osteotomies. TID offers an internal, staged distraction approach for patients contraindicated for external traction, allowing incremental correction via posterior instrumentation followed by definitive fusion. Clinical studies report Cobb angle reductions of 30–80 %, with low rates of neurologic complications when neuromonitoring and …

Performance Study Of A Woody Downdraft Gasifier: Numerical Investigation And Experimental Validation, Md Sanowar Hossain, Showmitro Bhowmik, Mujahidul Islam Riad, Md Golam Kibria, Barun K. Das, Sanjay Paul

Research outputs 2022 to 2026

Biomass gasification is an established and widely utilized renewable energy system. The research work aims to develop and construct a downdraft gasifier to investigate gasifier performance. The gasifier’s performance and cold gas efficiency were calculated for three volumetric airflow rates: 7.16 m3/h, 5.97 m3/h, and 4.78 m3/h. The efficiency was found maximum of 69.6% for an airflow rate of 7.16 m3/h. The oxidation zone and neck region of the gasifier reactor had the maximum recorded temperatures of 845 °C and 823 °C for Swietenia macrophylla (SM) and Mangifera indica (MI), respectively. A two-dimensional computational fluid dynamics (CFD) model for a …

A Thematic Analysis Of What Australians State Would Change Their Minds On Climate Change, Amy S.G. Lee, Kelly Kirkland, Samantha K. Stanley, Abby Robinson, Zoe Leviston, Iain Walker

Research outputs 2022 to 2026

What do Australians believe would change their current opinions about climate change? In this study, we used audience segmentation analysis through the Six Americas Short Survey to identify groups of climate opinion holders within a representative sample of Australians. We had 4857 participants tell us what it would take to change their current opinions about climate change and leveraged OpenAI’s Generative Pre-Trained Transformer (GPT) to identify the presence or absence of themes (Nothing, Evidence and Information, Trusted Sources, Action, and Unsure) and subthemes in their responses. GPT performed at near-human levels, proving to be a highly useful tool for thematic …

Bio-Inspired Computational Intelligence Metaheuristic-Based Optimization And Sensitivity Analysis Approach To Determine Techno-Economic Feasibility Of Hydrogen Refueling Stations For Fuel Cell Vehicles, Paul C. Okonkwo, Samuel Chukwujindu Nwokolo, Saad S. Alarifi, Stephen E. Ekwok, Rita Orji, Sunday O. Udo, Ahmed M. Eldosouky, El Manaa Barhoumi, Barun Kumar Das, David Gomez-Ortiz, Kamal Abdelrahman, Anthony E. Akpan

Research outputs 2022 to 2026

This study presents a comprehensive economic and technological evaluation of renewable hybrid power systems for hydrogen refueling stations (HRS) in Nizwa, Oman, leveraging cutting-edge optimization algorithms to determine the most cost-effective and efficient hybrid energy system configurations. Three hybrid energy systems of photovoltaic-wind turbine-battery (PV-WT-B), photovoltaic-wind-fuel cell-battery (PV-WT-FC-B), and wind turbine-battery (WT-B) were evaluated based on net present cost (NPC), levelized cost of energy (LCOE), and levelized cost of hydrogen (LCOH). The study employs advanced optimization techniques, including the Mayfly Algorithm, Genetic Algorithm, CUKO Search, Gray Wolf Optimizer (GWO), Constrained Particle Swarm Optimization (CPSO), Harmony Search (HS), and Flower Pollination …