Search Results (4,251)

Background: price dynamics in financial markets exhibit scale-invariant volatility, quantized liquidity and collective behaviour that resist single-paradigm models; Multiscale Relativistic Quantum Finance (MRQF) reconciles these facets on an energy–entropy $(E,S)$ plane, but its translation into a deployable decision system has remained open. Methods: we propose MRQF-MAS, a cooperative multi-agent system (MAS) in which institutional, commercial and retail operators become first-class agents, each decomposed into signal, energy, entropy, risk and execution sub-agents that share beliefs through a horizontal cooperation layer and a shared knowledge base (SKB) of $(E,S)$ trajectories. The framework is benchmarked as a high-volatility regime classifier on 6978 daily EUR/USD reference rates published by the European Central Bank (ECB) over 1999–2026 against four baselines including Generalized Autoregressive Conditional Heteroscedasticity (GARCH)(1,1). Results: on the full official ECB EUR/USD series, MRQF-MAS attains 83.0% accuracy, precision 0.552 and Matthews correlation coefficient (MCC) 0.479 with 95% bootstrap CI [0.46, 0.51] and a one-day median detection latency, improving slightly on a rolling-volatility baseline while remaining below a GARCH(1,1) reference. Conclusions: MRQF-MAS delivers a structurally interpretable, agent-traceable regime decomposition complementary to scalar volatility estimators. Full article

Background: Despite evidence-based guidelines for cardiovascular risk management, many patients fail to achieve therapeutic targets. The relative contribution of medication non-adherence versus suboptimal treatment optimization to poor cardiovascular outcomes remains unclear in real-world primary care settings. The aim of this study was to describe changes in cardiovascular risk factor control following protocolized adherence reinforcement combined with physician-driven treatment optimization in high-risk patients. Methods: This multicenter, real-world longitudinal study included 789 participants with high or very high cardiovascular risk enrolled from primary care settings across 9 Spanish regions between 2023 and 2025. All participants received a protocolized intervention combining adherence reinforcement and physician-driven treatment optimization. This was a single-arm, pre–post study without a concurrent control group; observed changes therefore cannot be attributed to the intervention alone. Of 789 participants screened, all completed the baseline assessment, and 628 (79.6%) completed the 90-day follow-up. A total of 161 participants (20.4%) were lost to follow-up. Primary outcomes included changes in systolic and diastolic blood pressure, lipid parameters (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-c], high-density lipoprotein cholesterol [HDL-c], triglycerides [TG]), glucose, glycated hemoglobin (HbA1c), and body mass index (BMI) from baseline to 90-day follow-up. Changes were assessed using linear mixed models. Results: Among participants with complete paired data (n = 453–615 depending on the outcome), significant improvements were observed in most cardiovascular risk factors (HDL-c and HbA1c did not change significantly). Mean changes (95% confidence interval [CI]) were: systolic blood pressure, −9.24 mmHg (−10.41 to −8.06; p < 0.001); diastolic blood pressure, −4.75 mmHg (−5.49 to −4.01; p < 0.001); LDL-c, −22.29 mg/dL (−25.59 to −19.00; p < 0.001); TC, −23.24 mg/dL (−26.73 to −19.74; p < 0.001); TG, −16.75 mg/dL (−23.03 to −10.46; p < 0.001); fasting plasma glucose, −10.03 mg/dL (−12.61 to −7.46; p < 0.001); and BMI, −0.46 kg/m² (−0.58 to −0.35; p < 0.001). Linear mixed models including all available data (n = 628 at 90-day follow-up) confirmed these findings. No significant interactions were observed between assessment timepoint and sex, age, or overweight/obesity status for most outcomes, except for age-related differences in lipid responses. Conclusions: Protocolized adherence reinforcement combined with physician-driven treatment optimization was associated with clinically meaningful improvements in multiple cardiovascular risk factors in high-risk primary care patients. Given the single-arm pre–post design, the observed improvements are associative and cannot establish causality. Residual uncontrolled risk, particularly in lipid management and among older adults, persisted despite active treatment optimization (treatment was modified in 82.0% of participants), consistent with residual suboptimal treatment intensification even after adherence had been reinforced. These findings suggest that achieving optimal cardiovascular risk factor control requires addressing both medication adherence and treatment intensification, particularly in patients with multimorbidity. Full article

Treatment of non-small cell lung cancer (NSCLC) has been transformed by immunotherapy and targeted therapies. We aimed to characterize clinical features, treatment patterns, and healthcare resource use in patients with early and locally advanced NSCLC before incorporation of these therapies. This retrospective observational study included adults diagnosed with stage I–III NSCLC at four Spanish hospitals between 2014 and 2018, with follow-up until 2021, using artificial intelligence to extract data from electronic health records. A total of 951 patients were included (34.7% stage I, 16.7% stage II, 48.6% stage III), with a median age of 66 years and 31.9% female. Surgery was performed in 78.5% of stage I, 74.8% of stage II, and 35.5% of stage III patients. Among surgical patients, 62.5% received adjuvant chemo- and/or radiotherapy, 20.8% neoadjuvant therapy, and 15.7% both; among non-surgical patients, chemoradiotherapy was the most common treatment (50.4%). Beyond hospitalization, outpatient visits were the most frequently used healthcare resource. These findings provide a historical benchmark of NSCLC care before introduction of immunotherapy and targeted therapies in these settings, highlighting treatment variability and the need for earlier diagnosis, structured treatment pathways, and multidisciplinary management. Full article

Background: Oxidative stress and chronic inflammation contribute to the pathogenesis of obesity and type 2 diabetes (T2D), yet the effects of dietary interventions on endogenous antioxidant defences remain poorly defined. This is a non-randomized study evaluates the effects of very-low-energy ketogenic therapy (VLEKT), compared with a Mediterranean diet (MedD) and a control group, on antioxidants, metabolic, and inflammatory markers. Materials and Methods: Thirty adults with obesity and T2D were assigned to VLEKT (n = 10), MedD (n = 10), or control (n = 10) for 90 days. Metabolic parameters, inflammatory cytokines, superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were assessed. Longitudinal changes were analyzed using linear mixed models. Results: VLEKT exhibited significant reductions in body weight, fat mass, HbA1c, and HOMA-IR. SOD activity increased in the VLEKT group, whereas no significant changes were observed in MedD. Changes in SOD were inversely associated with changes in HOMA-IR. GPx showed a less consistent response pattern, while inflammatory markers did not differ between groups. Conclusions: VLEKT was associated with substantial metabolic improvement accompanied by a selective modulation of antioxidant enzyme activity. The increase in SOD activity and its association with HOMA-IR suggest a link between metabolic and redox adaptations in subjects with obesity and T2D. Full article

Background and Objectives: Persistent human papillomavirus (HPV) infection is associated with the development of cervical intraepithelial neoplasia and cervical cancer. In women with low-grade cervical lesions, a conservative management approach is commonly recommended. However, a subset of patients may experience lesion progression, which can also be accompanied by psychological distress. Adjuvant therapies during the surveillance period have gained increasing clinical interest. This consensus aims to provide multidisciplinary, expert-based recommendations on the use of a Coriolus versicolor-based vaginal gel in HPV-positive women with low-grade cervical lesions. Materials and Methods: A rapid systematic review was conducted in accordance with PRISMA guidelines, and the level of evidence was assessed using SIGN criteria. Subsequently, a multidisciplinary panel of experts formulated and evaluated consensus statements and recommendations using the nominal group technique and a voting process. Results: All statements reached consensus, with agreement levels exceeding 80%. Experts concluded that available evidence reports potential benefits of a Coriolus versicolor-based vaginal gel in HPV-positive women with low-grade cervical lesions, since it has demonstrated increased lesion regression and viral clearance rates. These benefits may be more pronounced in specific subgroups, particularly women over 40 years of age. Limited studies also suggest a positive effect on vaginal microbiota, which may contribute to both vaginal health and HPV clearance, as well as a reduction in perceived stress. The experts emphasized the importance of patient education, shared decision-making, and addressing psychosocial aspects, including emotional well-being and sexual health. Conclusions: This consensus provides a multidisciplinary perspective on the management of HPV-positive women with low-grade cervical lesions, highlighting the adjuvant role of a Coriolus versicolor-based vaginal gel during surveillance. Although current evidence suggests potential clinical benefits, further high-quality, independent studies are needed to corroborate these findings. Full article

Background. Behavioral procrastination has been increasingly recognized as a maladaptive self-regulatory pattern associated with unhealthy lifestyle behaviors, psychological stress, and adverse cardiometabolic profiles. However, its relationship with accelerated cardiovascular aging remains poorly understood. This study aimed to evaluate the association between behavioral procrastination and heart age acceleration in a large occupational cohort of Spanish workers. Methods. A multicenter cross-sectional study was conducted including 92,184 actively employed Spanish workers undergoing routine occupational health examinations between 2021 and 2024. Behavioral procrastination was assessed using the Pure Procrastination Scale-9 (PPS-9). Estimated heart age and heart age acceleration were calculated using a cardiovascular risk-factor-based algorithm. Multivariable linear and logistic regression analyses were performed to evaluate associations between procrastination score, continuous heart age acceleration, and accelerated cardiovascular aging phenotypes after adjustment for demographic, lifestyle, anthropometric, and cardiometabolic variables. Restricted cubic spline analyses and sex-stratified analyses were additionally conducted. Results. Higher procrastination levels were associated with progressively worse cardiometabolic and cardiovascular aging profiles. Mean heart age acceleration increased from −3.1 ± 6.0 years in participants with very low procrastination to 14.0 ± 6.4 years in those with very high/chronic procrastination (p < 0.001). The prevalence of accelerated cardiovascular aging (>0 years) increased from 27.2% to 94.2% across increasing procrastination categories, whereas severe accelerated cardiovascular aging (≥10 years) increased from 1.7% to 75.6% (both p < 0.001). In fully adjusted multivariable analyses, each 5-point increase in PPS-9 score was associated with a 0.50-year increase in heart age acceleration (B = 0.50; 95% CI 0.48–0.52; p < 0.001). Participants with very high/chronic procrastination exhibited significantly higher odds of accelerated cardiovascular aging (OR 1.89; 95% CI 1.65–2.18) and severe accelerated cardiovascular aging (OR 2.51; 95% CI 2.16–2.92). Associations were significantly stronger among women (p-interaction < 0.001). Findings remained robust in sensitivity analyses excluding participants with diabetes mellitus. Conclusions. Behavioral procrastination was associated with higher estimated heart age acceleration and less favorable cardiovascular aging profiles in this large occupational cohort. Higher procrastination severity was consistently related to greater estimated heart age acceleration and a higher prevalence of cardiovascular aging phenotypes, even after extensive multivariable adjustment. These findings indicate that higher procrastination levels were associated with less favorable cardiovascular aging profiles beyond traditional biomedical risk factors. However, given the cross-sectional design, no conclusions regarding causality or temporality can be drawn. Full article

Objectives: This study investigated the short- and long-term metabolic effects of two β-sitosterol with propionic acid cocrystals (CCA and CCB) compared with commercial β-sitosterol in male hamsters. Methods: Five experiments were conducted, including three acute and two chronic dietary interventions. Acute experiments evaluated the metabolic response to a single dose of commercial β-sitosterol (S) or its cocrystals (513 mg/kg) administered with a pork-fat load following 40% caloric restriction. Blood samples were collected before and 5 h after the lipid challenge. Long-term studies assessed daily supplementation with CCA (264 mg/kg) or CCB (at two doses, 114 and 342 mg/kg) during exposure to high-fat (HF) or Western diets (WD), respectively, for 21 days. Results: Acutely, CCA attenuated postprandial triglyceride increases in adult animals, while CCB induced a reduced rise in postprandial cholesterol across the three studies compared to S. Young animals treated with CCA and CCB exhibited a reduction in postprandial glucose levels. Long-term, in HF-fed hamsters, CCA lowered plasma cholesterol and triglyceride levels on day 14 and, at the endpoint, decreased liver weight and increased circulating sitosterol levels, unlike its commercial counterpart. In WD-fed animals, CCB supplementation dose-dependently elevated plasma sitosterol levels. At the low dose, CCB treatment reduced body weight gain and cholesterol increase and improved adipocyte morphology, whereas the high dose reduced diet-induced hepatic detrimental outcomes, showing a stronger hepatoprotective effect compared to S-treated animals. Together, these results indicate improved postprandial lipid handling in the short-term and a modulation of metabolic adaptation to obesogenic diets in the long-term. Conclusions: β-sitosterol with propionic acid cocrystals improved metabolic responses more effectively than commercial β-sitosterol, enhancing bioavailability and potential therapeutic value against diet-induced metabolic disturbances. Full article

Background/Objectives: The Dynamic Strength Index (DSI) has been proposed as an indicator of the ability to dynamically express maximum available strength; however, its practical significance remains unclear. This study examined the associations of the DSI with dynamic and isometric strength measures, as well as sprint performance, in female professional soccer players. Methods: Eighteen female professional soccer players were assessed during pre-season. The DSI was calculated from peak force obtained in the countermovement jump (CMJ) and the isometric mid-thigh pull (IMTP). Spearman’s correlations were analysed alongside bootstrap confidence intervals, false discovery rate (FDR) adjustment, dependent correlation comparisons, and partial correlations controlling for body mass. Results: The DSI showed moderate unadjusted associations with relative CMJ peak force (ρ = 0.59) and relative CMJ peak yank (ρ = 0.56). However, no associations remained statistically significant after FDR correction. Despite this, the overall pattern of effect sizes and confidence intervals suggested a tendency towards stronger associations with dynamic rather than isometric variables. No meaningful associations were observed with IMTP-derived variables or sprint performance. Conclusions: In this exploratory sample, the DSI showed a tendency towards stronger associations with relative dynamic force variables than with isometric measures. However, given the lack of statistical significance after correction for multiple comparisons, these findings should be interpreted cautiously. The DSI may be better considered as a complementary metric within a broader neuromuscular assessment framework rather than as a standalone indicator. Full article

Nanotechnology has emerged as a promising strategy in restorative dentistry and endodontics due to the physicochemical and biological properties of nanomaterials. This narrative review aimed to critically analyze the current applications of nanomaterials in restorative dentistry and endodontics, highlighting their mechanisms of action, biological properties, and translational potential. A literature search was performed in the PubMed/MEDLINE database using combinations of MeSH terms and free keywords related to nanomaterials and dental applications. Studies published in English within the last twenty years and addressing restorative or endodontic applications were considered. After screening and eligibility assessment, 69 studies were included in the descriptive analysis. The findings indicate that nanomaterials have been investigated in preventive strategies, adhesive systems, restorative materials, intracanal medicaments, endodontic sealers, vital pulp therapy, and regenerative formulations. In restorative dentistry, nanoparticles such as silver nanoparticles, nano-hydroxyapatite, amorphous calcium phosphate, bioactive glass nanoparticles, and chitosan-based systems showed favorable antimicrobial, remineralizing, and material-enhancing properties. In endodontics, silver and chitosan nanoparticles showed potential for intracanal disinfection and biofilm disruption, while chlorhexidine, zinc, and bioactive glass nanoparticles enhanced the antimicrobial activity and sealing ability of endodontic sealers. In addition, magnetic nanoparticles, mesoporous silica nanoparticles, and hydroxyapatite nanoparticles presented promising applications in regenerative endodontics and vital pulp therapy. However, most of the available evidence is still based on in vitro studies, with limited long-term clinical validation. Overall, nanotechnology offers potential experimental advantages for improving preventive, restorative, and endodontic therapies; however, its successful clinical translation remains strictly dependent on overcoming critical biosafety barriers and addressing long-term toxicity concerns. Full article

Urban mobility planning in smart cities requires sophisticated simulation tools, yet their complexity often creates a technical barrier for non-expert stakeholders. This paper presents a novel architecture that integrates generative artificial intelligence with digital twin technology to create an accessible and decision-support prototype. The framework employs a conversational AI agent based on Gemini 2.5 Flash Lite to interpret natural language intentions and translate them into validated simulation parameters. A critical safety layer, built using Pydantic, ensures that the agent’s stochastic outputs adhere to strict technical schemas and predefined logical bounds before execution. The underlying digital twin, developed with SimPy, NetworkX, and OSMnx, features a multi-source data integration strategy that includes demographic density (INE), tourism activity (ISTAC), and high-resolution traffic statistics (TomTom) to calibrate vehicle behavior. The architecture was technically demonstrated through a Technology Readiness Level (TRL) 4 proof-of-concept in Las Palmas de Gran Canaria, simulating multimodal scenarios including buses, the future MetroGuagua (BRT), and pedestrian flows. Results demonstrate a 96% success rate in intent recognition and configuration mapping, with end-to-end execution times under 20 min for a 19 h simulated day. This study demonstrates that LLM-driven orchestration, coupled with automated data pipelines and a decoupled microservice architecture, can lower technical barriers to urban simulation, which could support broader participation in future smart city deployments. Full article

Background/Objectives: Despite the availability of multiple pharmacological treatment options, up to one-third of patients with depressive disorders fail to achieve adequate symptom relief following first-line antidepressant therapy, representing a major unmet clinical need. Fatty acids—including short-chain (SCFAs), medium-chain (MCFAs), and long-chain polyunsaturated fatty acids (PUFAs)—are increasingly implicated in depression pathogenesis through neuroinflammation, gut–brain axis signaling, and neurotransmitter metabolism, but their potential as predictors of antidepressant response remains largely unexplored. The primary aim is to evaluate whether baseline fatty acid profiles can predict pharmacological antidepressant treatment efficacy. The secondary objective is to assess the association between blood fatty acid profile and clinical presentation of depressive disorders. Methods: Sixty adults diagnosed with depressive disorders (ICD-11) at the initiation of a new antidepressant treatment will be recruited from psychiatric settings. Fasting blood samples collected at baseline will undergo gas chromatographic analysis of fatty acid methyl esters (FAMEs) and GC-MS quantification of SCFAs (acetic, propionic, and butyric acids). Clinical outcomes will be assessed at baseline and at 3, 6, and 12 weeks using the Beck Depression Inventory-II (BDI-II) and the Depression Anxiety Stress Scales (DASS-42). The primary endpoint is the change in BDI-II total score from baseline to week 6. Treatment response, defined as a ≥50% reduction in BDI-II total score at week 6, and remission, defined as a BDI-II score ≤12 at week 6, will be examined as secondary outcomes. Dietary habits, physical activity, quality of life, and anthropometric parameters will be collected as potential confounders. Discussion: This study is among the first prospective investigations to comprehensively characterize the circulating fatty acid spectrum as potential predictors of antidepressant outcomes. Findings may support identification of metabolic phenotypes of depression and contribute to personalized treatment strategies. Full article

This in vitro study examined the influence of supersaturation level on the efficacy of different inhibitors in preventing the crystallization of calcium oxalate, uric acid, and cystine. Kinetic–turbidimetric assays were used to determine the induction time of crystallization (t_i) in the absence and presence of different inhibitors. For calcium oxalate, the inhibitory effects of citrate, hydroxycitrate, tartronate, and phytate decreased significantly as the Ca²⁺ concentration increased from 220 mg/L to 240 mg/L. The polyhydroxycarboxylic compounds (citrate, hydroxycitrate, tartronate) can form complexes with calcium ions, decreasing overall supersaturation. Even though phytate also forms complexes with calcium, its urinary concentration is much lower than that of calcium, so the decrease in supersaturation can be considered negligible. For uric acid, theobromine and two of its metabolites (3-methylxanthine and 7-methylxanthine) inhibited the formation of these crystals. For each compound, the efficacy of inhibition decreased as the supersaturation of uric acid increased. For cystine, the inhibitory effect of N-acetylcysteine was lower at pH 4.5 and 5.0 than at pH 6.0. These studies of the crystallization of calcium oxalate, uric acid, and cystine showed that the efficacy of crystallization inhibitors decreased as the level of supersaturation increased. The results demonstrate that, in patients prone to kidney stone formation, the effectiveness of crystallization inhibitors can be improved by reducing the supersaturation of the specific stone-forming compound. Full article

Background: BMI is widely used for obesity classification, yet it does not adequately reflect adiposity distribution and related metabolic risk. Normal-weight obesity (NWO), defined as excess adiposity despite normal BMI, has emerged as a clinically relevant phenotype associated with increased cardiometabolic risk. However, its prevalence and implications in young populations remain insufficiently characterized. Objective: To evaluate the prevalence of normal-weight obesity and its association with cardiometabolic risk markers in a cohort of young adults undergoing occupational health assessments. Methods: A cross-sectional study was conducted in 12,874 adults aged 22–30 years undergoing routine occupational health assessments. NWO was defined using a strict criterion (normal BMI with a waist-to-height ratio ≥ 0.5) and an expanded definition including additional adiposity markers derived from body fat percentage and visceral fat estimates. Anthropometric, adiposity-related, biochemical, and lifestyle data were collected using standardized protocols. Multivariable logistic regression models adjusted for age and sex were used to assess associations between NWO and cardiometabolic risk markers. Results: Among individuals with normal BMI (n = 9290), the prevalence of NWO was 1.79% (n = 166) using the strict definition and 2.30% (n = 214) with the expanded definition. Compared with metabolically healthy normal-weight individuals, those with NWO exhibited higher triglycerides, fasting glucose, and atherogenic lipid indices, along with lower HDL cholesterol (all p < 0.05). In multivariable analyses, NWO was independently associated with elevated triglycerides (OR 4.99; 95% CI 2.90–8.58), an unfavorable triglyceride-to-HDL ratio (OR 7.44; 95% CI 5.19–10.65), and impaired fasting glucose (OR 3.87; 95% CI 2.19–6.82). Associations were consistent across sensitivity and sex-stratified analyses. Conclusions: Normal-weight obesity is present in a measurable proportion of young adults and is associated with an unfavorable cardiometabolic profile despite normal BMI. The triglyceride-to-HDL ratio was consistently associated with normal-weight obesity and showed marked differences across adiposity-defined phenotypes. These findings highlight the limitations of BMI-based classification alone and suggest that additional anthropometric and metabolic markers may help identify individuals with less favorable cardiometabolic characteristics. Full article

Background: Obesity is a major public health concern and shows a clear social gradient, with higher prevalence among individuals with lower socioeconomic position. Educational level is a key indicator of socioeconomic status, but the extent to which lifestyle factors explain its association with obesity remains unclear. Objective: To examine the association between educational level and obesity in a working-age population and to evaluate how adjustment for lifestyle factors influences the magnitude of the association between educational level and obesity. Methods: A cross-sectional study was conducted among 3108 working-age adults undergoing occupational health assessments in Spain. Educational level was categorised into three groups (higher, intermediate, and primary or none). Obesity was defined as a body mass index ≥30 kg/m². Lifestyle variables included smoking status, physical activity assessed using the International Physical Activity Questionnaire (IPAQ-SF), and adherence to the Mediterranean diet evaluated with the MEDAS-14 score. Sequential logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CI), with progressive adjustment for demographic, behavioural, and clinical factors. Results: The overall prevalence of obesity was 16.6%, with a clear gradient across educational levels (11.5% in higher education vs. 19.8% in primary or no education). In crude analyses, individuals with the lowest educational level had higher odds of obesity (OR 1.89; 95% CI 1.46–2.45). Adjustment for age and sex attenuated the association (OR 1.72; 95% CI 1.32–2.24), with further reduction after inclusion of lifestyle factors (OR 1.63; 95% CI 1.24–2.13). In the fully adjusted model, the association remained statistically significant (OR 1.61; 95% CI 1.18–2.21), indicating that adjustment for lifestyle factors attenuated the association between educational level and obesity, although the association remained statistically significant. Conclusions: Lower educational level is associated with a higher risk of obesity. Adjustment for lifestyle factors attenuated this association, although a statistically significant relationship remained. These findings support the role of education as a fundamental determinant of health and highlight the need for strategies addressing broader social and structural determinants of obesity. Full article

Economic dispatch in grid-connected microgrids is challenged by the variability of renewable generation, the uncertainty of demand, and the need to simultaneously satisfy technical and economic constraints under different operating conditions. This study proposes an integrated predictive economic dispatch strategy for power grids with interconnected microgrids, structured as a unified optimization framework. The approach integrates nodal electrical modeling, Optimal Power Flow (OPF)-based optimization, multi-scenario analysis, and post-optimization feasibility verification based on performance indicators within a single decision-support structure. The methodology is applied to a modified 14-node power grid interconnected with a microgrid, where simulations are conducted under three representative load scenarios (100%, 70%, and 40%) and two operational configurations (hybrid and renewable-only), enabling a comprehensive assessment of system behavior. Results show that the hybrid configuration consistently outperforms the renewable-only case, achieving loss reductions of up to 7.3 MW, increases in spinning reserve exceeding 50 MW, and a transition from net power import to export of approximately 50 MW under high demand. Additionally, the microgrid plays an active operational role, dynamically switching between import and export modes based on load levels and the generation mix. The proposed framework enables identification of operationally efficient and technically feasible configurations by incorporating bidirectional power exchange, electrical constraints, and reserve requirements. The main contribution lies in integrating technical, operational, and interaction variables within a single deterministic Optimal Power Flow (OPF)-based assessment scheme to support decision-making in interconnected microgrid-based power grids. Full article