Search Results (2,176)

Academic dropout is costly for students and institutions, and support actions are most effective early, when little information beyond enrollment records is available. However, the most informative predictors are derived from academic trajectory data, such as grades and course progression, which only become available after students have completed one or more terms. This study investigates dropout prediction using supervised machine learning (ML) applied to records of 66,820 students across 45 undergraduate programs of the State University of Maringá, Brazil (2002–2022), trained exclusively on static enrollment-time variables, since these were the only institutional data available. Although this restricts the information the models can use, it also allows students who may be at risk to be flagged very early. Decision Tree, Random Forest, and eXtreme Gradient Boosting (XGBoost) models were evaluated in ten training configurations, covering the complete dataset, the complete-generations subset, a temporal cohort split, academic centers, individual programs, and resampled variants. Evaluation was based on per-class precision, recall, and F1-score, together with threshold-free and calibration measures (PR-AUC, ROC-AUC, and Brier score). XGBoost performed best in the institution-wide configurations, reaching a dropout recall of 0.64 at a precision of 0.51 with undersampling and, without resampling, a PR-AUC of 0.586 against a dropout prevalence of 0.364, which corresponds to 1.61 times the performance of random ranking. Under the temporal split, recall at the default threshold fell from 0.37 to 0.18, while ROC-AUC changed little (0.708 to 0.679); this loss reflects miscalibration under changing dropout prevalence and can be corrected without retraining the model. The main contributions are an evaluation methodology for enrollment-time dropout prediction that controls information leakage and includes temporal validation, and a deployment protocol that uses the model outputs to prioritize student support when follow-up capacity is limited. Full article

Background/Objectives: The period between 12 and 16 years of age coincides with peak pubertal change, declining habitual physical activity, and the consolidation of lifelong behavioral patterns, making it a critical window for understanding how fitness develops and how stable (or unstable) it is over time. This review aims to synthesize longitudinal evidence addressing how HRPF changes and tracks in adolescents aged approximately 12 to 16 years, the sex- and maturation-related modifiers of these patterns, the methodological approaches used to assess them, and the secular and behavioral context within which they occur. Methods: A structured narrative review was conducted searching four electronic databases—Google Scholar, PubMed, Web of Science, and Scopus—using terms combining concepts of adolescence, health-related physical fitness, and longitudinal study design published up to April 2026. Reference lists of retrieved systematic reviews and meta-analyses were snowball-searched. Eligible studies employed longitudinal or repeated-measures designs in samples overlapping the 12–16-year age range; no formal risk-of-bias appraisal or quantitative pooling was undertaken, consistent with the narrative-review design. Findings were synthesized narratively by HRPF component and thematic domain. Results: Cardiorespiratory fitness rises through early adolescence before plateauing or declining from approximately age 15 in one longitudinal cohort, more markedly in boys; muscular power and strength diverge increasingly by sex, a pattern consistent with androgen-mediated gains in lean mass in boys, although this mechanism was not directly tested here; flexibility remains the most stable component; and body composition acts as both an outcome and a determinant of other fitness test performance. Within-adolescence tracking is moderate-to-high for most components in the single available 3-year cohort of adolescent girls that reported component-specific tracking coefficients (e.g., lower-limb power β = 0.98, aerobic endurance β = 0.75, trunk muscular endurance β = 0.51), and substantially stronger than tracking from childhood into adolescence. Secular trends indicate population-level fitness has declined in many countries over recent decades, with adolescents showing greater decline than children. Conclusions: Early-to-mid adolescence appears to be a critical and time-limited opportunity to consider for fitness-promoting intervention: fitness rank is still somewhat malleable, but shows progressively stronger tracking with age—a pattern of rank stability that should not itself be read as evidence about responsiveness to intervention. Methodological heterogeneity in test batteries, follow-up duration, and tracking statistics limits direct comparability across studies. Future research should incorporate maturity-status indicators, multi-wave designs, and harmonized assessment protocols. Full article

Background/Objectives: Symptomatic irreversible pulpitis (SIP) is conventionally treated with pulp tissue removal via root canal treatment, pulpectomy, or pulpotomy. This case series introduces the Pulpitis Restorative Protocol (PRP), a novel method used to treat SIP without pulp removal, relieve pain, and maintain a positive pulp sensibility response. Methods: In this retrospective case series (March 2022–March 2025), 17 SIP patients (plus 10 reversible pulpitis [RP] control cases) were treated with the PRP utilizing a bioactive glutaraldehyde (GA)-resin-modified glass ionomer (RMGI) solid matrix. Follow-up to 36 months (average 17.37 ± 9.61 months) included clinical examination, cold sensibility testing, and radiographs. Results: Treatment was successful in 15/17 SIP cases, an 88.2% success rate, and 9/10 RP cases, a 90.0% success rate. Overall, a total of 24 of 27 cases were successful, a rate of 88.89%. Success criteria were the absence of pain, no soft-tissue abnormality, a positive cold test response, and no radiographic apical lesions. No failures occurred in the first year; two cases failed in the second year and one in the third year. The PRP provided favorable pain relief: 74.1% of patients reported minimal post-operative pain (0–1/10 VAS) the evening of treatment, and 96.3% of patients reported no pain at 24 h without analgesics. All 24 successful cases maintained a positive pulp sensibility response at their final visit. Radiographs were stable in 24 cases. In vitro experiments showed that the GA-RMGI solid matrix exhibits contact-independent bactericidal activity. Conclusions: The PRP provides a promising approach to SIP management, offering a conservative, cost-effective, and efficient alternative to conventional endodontic treatments alongside favorable pain relief. Its clinical significance warrants further verification in various clinical settings and randomized clinical trials. Full article

Background: Chronic pain syndromes such as fibromyalgia have been associated with worsening health-related quality of life and increased incidence of comorbid psychiatric disorders, underscoring the need for targeted interventions. Transcutaneous spinal direct-current stimulation (tsDCS) and exercise therapy (ET) have been identified as promising non-pharmacological tools due to their capacity to inhibit pain transmission. However, empirical evidence regarding a combined efficacy remains limited. The aim of this work was, therefore, to test the effects of a multimodal treatment protocol on pain and psychological symptoms. Methods: Forty-five patients with fibromyalgia were recruited and randomly assigned to the tsDCS, ET, or combined tsDCS + ET group for a three-week period. Participants were assessed at baseline, one week after the start of treatment, at the end of the treatment (T2), and at 3-month follow-up (T3) using the Visual Analogue Scale (VAS), Brief Pain Inventory (BPI), Short-Form Health Survey (SF-12), and Hospital Anxiety and Depression Scale (HADS). Results: Analysis of variance applied to linear mixed-effect models showed significant group-by-time interaction effects on both HADS domains (anxiety: p = 0.004; depression: p = 0.028). Post hoc pairwise comparisons highlighted that tsDCS + ET decreased subjects’ anxiety at both T2 (p = 0.002) and T3 (p < 0.001) compared to baseline. Yet, significant comparisons were not found for depression. No significant interactions were detected on VAS, BPI, and SF-12 scores. Conclusions: Although between-group differences were not observed, the integration of neuromodulation with physical activity resulted in a significant improvement in patients’ anxiety-related symptoms severity, suggesting a potential added benefit. Full article

Background: Spinal cord injury (SCI) is associated with persistent motor impairment, neuropathic pain, and reduced quality of life. While spinal cord stimulation (SCS) is an established therapy for neuropathic pain, motor effects have largely been demonstrated in experimental settings with activity-based training protocols. Whether such effects can be achieved within routine clinical care remains unclear. Case Presentation: We report on motor effects after the clinical implementation of percutaneous SCS using a commercially available system in a patient with chronic, posttraumatic, incomplete thoracic SCI. Following a standard inpatient trial and implantation of two percutaneous leads for neuropathic pain, all subsequent management, programming, and rehabilitation were conducted in an outpatient setting. Task-specific stimulation programs were iteratively developed to support functional activities during routine rehabilitation. Lower-extremity muscle strength was assessed using standardized handheld dynamometry at baseline and at monthly intervals over six months under stimulation-ON and stimulation-OFF conditions. Results: Serial dynamometry showed early stimulation-associated increases in force generation, with higher values under stimulation-ON than stimulation-OFF conditions. Over time, absolute strength values under OFF conditions also increased across individual muscle measurements, while stimulation-associated ON–OFF differences became less pronounced during intermediate follow-up but remained evident at month six. These observations included both acute stimulation-associated differences in force generation and longitudinal improvements in OFF-state motor performance. Stimulation was well tolerated during daily use and successfully integrated into outpatient rehabilitation. Functional outcomes showed concordant improvements in ambulatory performance and patient-reported domains. No stimulation-related adverse effects were observed during follow-up. Conclusions: This case illustrates how clinically indicated percutaneous SCS can be combined with motor-oriented programming within routine outpatient rehabilitation. The observed stimulation-associated motor effects and longitudinal changes in stimulation-OFF strength are limited to this individual patient and cannot establish efficacy or causality. Prospective controlled studies are needed to determine the reproducibility and clinical relevance of these observations in chronic incomplete SCI. Full article

Digital behavior change tools increasingly integrate constructs from multiple theoretical traditions, yet there is limited cross-domain understanding of how these frameworks are combined and which outcomes they are used to explain. This scoping review therefore aimed to map integrated theoretical frameworks used in digital IT-based behavior change tools from 1999 to 2025, focusing on theory combinations, outcome types, intervention contexts, and research gaps. Following PRISMA-ScR and a registered protocol (PROSPERO CRD42022285741), searches across six databases identified 62 eligible studies. Twenty-nine theories and models were identified, with Self-Determination Theory (35%) and the Theory of Planned Behavior (29%) being the most prevalent. Behavior-change-oriented frameworks were more commonly associated with target behavioral outcomes, whereas technology-adoption-oriented frameworks primarily explained intention, acceptance, continuance, and technology use. Health and fitness interventions dominated the evidence base (44%), followed by online learning (23%) and mobile commerce (11%). Long-term follow-up and explicit theory-to-behavior-change-technique mapping remained limited. Overall, the review provides a 25-year cross-domain synthesis of theoretical integration in digital behavior change tools and highlights the need for clearer theory–intervention alignment, longer-term evaluation, and broader application across underrepresented digital contexts. Full article

Background/Objectives: In this prospective clinical follow-up study, we aimed to evaluate the long-term periodontal responses over a five-year follow-up period associated with Class II direct posterior restorations placed using two different restorative approaches. Materials and Methods: Thirty-one Class II posterior restorations in 25 patients were included. Eighteen were performed using a bulk-fill approach with Admira Fusion X-tra^® (VOCO, Cuxhaven, Germany), whereas thirteen used the proximal wall approach with Admira Fusion^® (VOCO, Cuxhaven, Germany). Periodontal parameters, including plaque control record, gingival bleeding index, probing depth, and clinical attachment loss, were recorded at baseline and five years using standardized periodontal examination procedures. Data were expressed as mean ± standard deviation and analyzed using repeated-measures ANOVA. Given the limited sample size, the statistical analyses were considered exploratory. Results: The plaque control record decreased from baseline to the five-year follow-up, with a significant overall effect of time (F = 4.789, p = 0.037), while the time × restorative approach interaction was not significant (p = 0.694). The gingival bleeding index showed a slight numerical increase over the five-year period (25.52 ± 27.20% at baseline versus 27.00 ± 26.11% at five years); however, neither the effect of time (F = 0.139, p = 0.712) nor the time × restorative approach interaction (F = 0.505, p = 0.483) was statistically significant. Probing depth and clinical attachment loss remained relatively stable throughout the observation period, with no statistically significant time or interaction effects. Overall, no statistically significant time × restorative approach interactions were observed, indicating that longitudinal changes in the evaluated periodontal parameters did not differ significantly between the restorative approaches. Conclusions: Within the limitations of this exploratory clinical study, both ormocer-based restorative protocols were not associated with detectable deterioration in the evaluated periodontal parameters over the five years of follow-up. Full article

Background/Objectives: Mandibular angle volumization with hyaluronic acid is used to redefine facial contours and improve the aesthetics of the lower third of the face. However, beyond the aesthetic outcomes, it is important to understand the impact of this intervention on the aesthetic perception of subjects undergoing the procedure. This preliminary prospective, non-randomized, uncontrolled clinical trial aimed to evaluate post-treatment aesthetic satisfaction and facial appearance perception in subjects who underwent mandibular angle volumization with hyaluronic acid. Methods: Ten adults (eight women and two men) with a mean age of 34.30 ± 11.20 years participated in the study. Subjects underwent injection of 2 mL of hyaluronic acid per hemiface, following the Medical Codes protocol. Volumetric analysis of the mandibular angle region was performed using the Vectra 3D imaging system. Aesthetic perception and facial self-image were assessed 60 days after the procedure using the Orofacial Esthetic Scale and FACE-Q questionnaires. Results: Volumetric analysis demonstrated descriptively higher values throughout the clinical follow-up on both sides, although no statistically significant differences were observed (p > 0.05). The questionnaires revealed high levels of aesthetic satisfaction and positive perception of facial appearance. On the Orofacial Esthetic Scale, a predominance of high aesthetic satisfaction was observed among subjects. Likewise, FACE-Q results demonstrated high levels of satisfaction related to facial appearance and self-image. Conclusions: Within the limitations of this preliminary secondary analysis, mandibular angle volumization with hyaluronic acid was associated with high post-treatment aesthetic satisfaction and favorable facial appearance perception at the 60-day follow-up. These findings are descriptive and warrant confirmation in larger controlled studies. Full article

Forward head posture (FHP) is common in young adults using technological devices and often accompanied by increased thoracic kyphosis. This study reports the design and custom manufacturing of a 3D-printed craniocervical orthosis and a pilot application evaluating its effects on the craniocervical angle (CVA), thoracic kyphosis angle (TKA), and user satisfaction. In this prospective, single-arm, within-subject pilot study, each participant underwent 3D scanning, and a custom orthosis was manufactured from their scan data using a common three-point CAD template via FDM 3D printing. Ten volunteers aged 18–25 years completed the study without a priori sample size calculation. The CVA and TKA were assessed photogrammetrically at baseline and weeks 2, 4, and 6, under orthosis-assisted and non-assisted conditions, with devices iteratively adjusted over six weeks. Satisfaction was evaluated at follow-up completion using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0-TR), and data were analyzed using a linear mixed model. Of the 13 individuals screened, 10 completed the protocol (one discontinued owing to discomfort and two withdrew voluntarily); no serious adverse events occurred. The CVA was significantly higher, and the TKA significantly lower, under the orthosis condition at every time point (all p < 0.001), reflecting an acute, device-on effect rather than a demonstrated lasting, unassisted postural correction. Mean device satisfaction was 4.88 ± 0.12/5 and mean service satisfaction was 5.00 ± 0.00/5 among the 10 completers; these scores exclude the participant who discontinued owing to discomfort and two who withdrew for unrelated reasons, which likely inflates the apparent satisfaction level. The custom-manufactured orthosis was feasible to design and fabricate, tolerable after iterative adjustment, and associated with improved craniocervical and thoracic alignment when worn; these findings reflect an acute, device-on effect and do not yet establish lasting postural correction without the orthosis. Given the single-arm, non-blinded pilot design, findings are preliminary and hypothesis-generating, supporting further confirmatory trials. Full article

Gallbladder mucocele is a common extrahepatic biliary condition in dogs, traditionally managed with cholecystectomy, while conservative approaches combining clinical and nutritional strategies remain underexplored. This case series reports four dogs diagnosed with gallbladder mucocele, all presenting with hyperlipidemia, three with overweight or obesity, and one with hypothyroidism. The dogs were treated using a multimodal protocol combining pharmacological therapy with nutritional strategies. The pharmacological protocol included ursodeoxycholic acid, silymarin, S-adenosyl-L-methionine, bezafibrate, and omega-3 fatty acids, with doses adjusted according to body weight. Nutritional interventions were individualized and included weight-loss diets and a low-fat gastrointestinal diet. Clinical and ultrasonographic outcomes varied among cases, with partial or complete resolution observed over different follow-up periods. These findings suggest that clinical management combined with individualized nutritional protocols may be a potential approach for asymptomatic dogs with gallbladder mucocele, particularly when surgery is not feasible, and could inform future investigations. Full article

Objective: To compare radiographic changes following regenerative endodontic procedures in immature permanent teeth with pulp necrosis of traumatic or carious origin. Methods: A retrospective study was conducted in 20 immature permanent teeth from 20 patients (10 traumatic and 10 carious cases) treated with a standardized regenerative endodontic protocol. Root length, dentinal wall thickness, periapical status, and type of repair were assessed using standardized periapical radiographs at baseline and 12 months. Radiographs were independently evaluated by two investigators blinded to etiology, and inter-examiner agreement for type of repair was assessed using Cohen’s kappa. Results: No statistically significant differences were found in root-length change between the groups. A statistically significant greater increase in dentinal wall thickness was observed in the carious group compared with the traumatic group; however, the groups differed substantially in tooth type. No statistically significant differences were observed in Periapical Index scores after 12 months of follow-up, and periapical healing (PAI 1–2) was observed in all cases. Periodontal-associated repair was observed in all traumatic cases, whereas pulpal-associated repair was observed in all carious cases. Conclusions: Regenerative endodontic procedures were associated with favorable radiographic outcomes in immature permanent teeth with pulp necrosis of traumatic or carious origin. However, the small sample size, short follow-up, absence of a control group, and substantial differences in tooth type between etiological groups limit causal interpretation of the observed differences. Full article

Background and Objectives: Intra-corporeal esophagojejunostomy after totally laparoscopic total gastrectomy (TLTG) remains one of the most technically demanding steps of minimally invasive gastric surgery. The management of the common entry hole in linear stapler-based reconstructions still relies on advanced intra-corporeal suturing. The sutureless L-shape esophagojejunostomy with endoscopic assistance (SLEJ) technique, previously described by our group, was developed to overcome this limitation by combining an L-shaped linear stapler configuration with intraoperative endoscopic quality control. Building upon our initial results on the perioperative feasibility of the technique, the present study aimed to evaluate its intermediate-term anastomotic, functional, and oncological outcomes. Materials and Methods: Patients who underwent TLTG with D2 lymph node dissection and SLEJ reconstruction for gastric cancer between July 2024 and January 2026 were evaluated. Eligibility criteria included a minimum postoperative follow-up of six months, clinical and endoscopic surveillance, and complete contrast-enhanced thoraco-abdominopelvic computed tomography records. Protocol-based upper gastrointestinal endoscopy was performed at six-month intervals irrespective of symptoms to objectively assess anastomotic lumen width, mucosal healing, reflux findings, and possible intraluminal recurrence. The primary endpoint was anastomosis complication-free survival (anastomotic stenosis, alkaline reflux/reflux esophagitis, marginal ulcer, bleeding due to ulceration, and intraluminal recurrence); secondary endpoints were disease-free survival (DFS), local recurrence and changes to nutritional status. Results: A total of 26 patients (18 men and 8 women; mean age 59.0 ± 7.8 years) were analyzed. Anastomotic stricture developed in two patients and was successfully managed with two sessions of endoscopic balloon dilation in both. Similarly, alkaline reflux was documented in two additional patients and resolved under medical treatment. None of the patients required surgical revision. The mean ACFS follow-up duration was 12.42 months with ACFS rates of 92.3% at six months and 81.1% from the twelfth month onward. No local anastomotic recurrence was detected during follow-up. Disease progression occurred in four patients (15.4%), presenting as distant organ metastasis (n = 2) or peritoneal carcinomatosis (n = 2). The mean DFS follow-up duration was 12.62 ± 6.18 months, and the twelve-month OS and DFS rates were 82.1% and 84.0%. Postoperative body weight decreased significantly compared with preoperative values (76.69 ± 15.59 kg vs. 63.23 ± 10.55 kg; p < 0.001). A significant decrease was observed in the mean SMI between the preoperative and follow-up assessments (p < 0.001). The mean preoperative SMI was 49.90 ± 9.04 cm²/m², compared with 44.53 ± 7.98 cm²/m² at follow-up. No statistically significant changes were observed between the preoperative and follow-up periods for serum albumin and PNI variables (p = 0.703 and p = 0.970). Conclusions: The present intermediate-term analysis suggests that the SLEJ technique is feasible and associated with acceptable intermediate-term anastomotic, functional, and oncological outcomes in this preliminary single-center cohort. By standardizing common entry-hole management without intra-corporeal suturing and incorporating intraoperative endoscopic quality control, the technique offers a feasible alternative to established linear stapler-based reconstructions. Full article

Background: Lateral elbow tendinopathy (LET) is a common upper-limb musculoskeletal disorder causing pain during gripping activities, reduced work capacity, and functional limitation. LET is currently considered a predominantly degenerative condition characterized by collagen disorganization, extracellular matrix changes, neovascularization, and impaired tendon healing. Objective: To evaluate short-term clinical and functional outcomes of a multimodal protocol including focused extracorporeal shock wave therapy (f-ESWT), ultrasound-guided intralesional injection of low-molecular-weight peptides (LWPs) derived from hydrolyzed bovine collagen and therapeutic exercise in patients with chronic LET unresponsive to standardized conservative therapy. Methods: This retrospective observational study included 11 screened patients; 10 completed follow-up. Eligibility required age ≥ 18 years, symptoms ≥ 3 months, positive provocation tests, ultrasound-confirmed common extensor tendon pathology, and incomplete response to prior treatment. All patients received f-ESWT before ultrasound-guided LWPs injection and performed progressive loading exercises. Outcomes included Patient-Rated Tennis Elbow Evaluation (PRTEE), grip strength, and clinical provocation tests at baseline (T0; Day 0) and at T1 (Day 51, 30 days after injection). Results: PRTEE pain improved by 31.2 points (95% CI 22.2–40.2; Cohen’s d_z = 2.48) and PRTEE function by 32.6 points (95% CI 26.7–38.5; d_z = 3.95). Mean maximal strength and maximal strength improved by 4.61 kg (95% CI 2.89–6.32) and 4.02 kg (95% CI 2.36–5.68), respectively. Clinical test severity decreased by an estimated 2.5 points (95% CI 2.0–3.0). No adverse events were reported. Conclusions: Patients showed clinically meaningful short-term improvements in pain, function, and strength following the sequential multimodal management strategy. However, the retrospective design, small sample, lack of control group, and short follow-up preclude causal attribution and require confirmation in prospective controlled studies. Full article

Objectives: The primary objective of this retrospective pilot study was to evaluate the long-term radiographic stability of peri-implant marginal bone levels (MBLs) at a five-year follow-up, comparing two different socket preservation protocols against spontaneous healing. Materials and Methods: A total of 24 patients who underwent tooth extraction followed by delayed implant placement were divided into three groups of 8 subjects each. Test Group 1 was treated with a heterologous cortico-cancellous bone graft covered by a slow-resorbing bovine pericardium membrane. Test Group 2 received the same bone graft but covered by a rapidly resorbing native porcine collagen membrane. The Control Group was left to heal spontaneously. Marginal bone loss (MBL) was calculated radiographically by measuring the difference in bone levels between the time of osseointegration (T0) and the 5-year follow-up (T1). For each implant, mesial and distal MBL values were averaged to obtain a single mean per-implant MBL value for group-level analysis. Results: The 5-year implant survival rate was 100% across all analyzed groups. Test Group 1 demonstrated the highest peri-implant bone stability, recording a mean MBL of $0.17\pm 0.20$ mm. In contrast, Test Group 2 and the Control Group exhibited greater resorption, with mean MBL values of $0.46\pm 0.12$ mm and $0.45\pm 0.27$ mm, respectively. Descriptive analysis indicated a trend toward improved peri-implant bone preservation in the group treated with biomaterial and a slow-resorbing pericardium membrane compared to both the short-resorbing collagen membrane group and the spontaneous healing control group. Conclusions: Within the limitations of this pilot study, the results suggest that the choice of barrier membrane in socket preservation procedures could affect 5-year marginal bone stability. The application of a slow-resorbing membrane provided a prolonged barrier action and showed a descriptive trend of lower mean marginal bone loss. However, the extremely small sample size precludes establishing clinical superiority over standard collagen membranes or spontaneous healing. Further randomized clinical trials with larger cohorts are necessary to confirm these long-term findings. Full article

Diastasis Recti Abdominis is a common postpartum condition characterized by separation of the rectus abdominis muscles. Accurate measurement of inter-recti distance (IRD) is important for diagnosis and longitudinal monitoring, but the extent to which digital caliper and ultrasound measurements agree across abdominal sites remains uncertain. This study examined between-visit test–retest reliability within each method, caliper–ultrasound agreement, and associations with palpation at 4.5 cm above the umbilicus, at the umbilicus, and 4.5 cm below the umbilicus. Thirty healthy primiparous women 8–16 weeks after vaginal delivery completed two visits three days apart. Test–retest reliability was good to excellent (absolute-agreement ICC = 0.83–0.98; TE = 0.09–0.25 cm; CV = 2.84–8.28%; MDC = 0.24–0.70 cm). Caliper–ultrasound agreement varied by site and visit (absolute-agreement ICC = 0.72–0.95; TE = 0.12–0.30 cm; CV = 3.89–9.91%). Lin’s concordance correlation coefficient (CCC) ranged from 0.72 to 0.95, and inter-method minimal detectable change percentages (MDC%) ranged from 10.8% to 27.5%. Caliper values were systematically lower than ultrasound values above the umbilicus by 0.081 cm at Visit 1 and 0.068 cm at Visit 2 (both p = 0.031), while the widest limits of agreement occurred at the umbilicus and below the umbilicus at Visit 1. Visit 1 correlations between palpation and instrument-based measurements were moderate to very strong (Spearman’s ρ = 0.641–0.920). Thus, each instrument was sufficiently stable for repeated assessment under this protocol, but cross-method disagreement was site-dependent, and the data did not permit a definitive judgment of clinical interchangeability without a validated acceptability threshold. Using the same method across follow-up assessments is therefore recommended. Full article