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Abstract Manual delineation of liver segments on computed tomography (CT) images for primary/secondary liver cancer (LC) patients is time-intensive and prone to inter/intra-observer variability. Therefore, we developed a deep-learning-based model to auto-contour liver segments and spleen on contrast-enhanced CT (CECT) images. We trained two models using 3d patch-based attention U-Net ( $${{\text{M}}}_{{\text{paU}}-{\text{Net}}})$$ M paU - Net ) and 3d full resolution of nnU-Net ( $${{\text{M}}}_{{\text{nnU}}-{\text{Net}}})$$ M nnU - Net ) to determine the best architecture ( $${\text{BA}})$$ BA ) . BA was used with vessels ( $${{\text{M}}}_{{\text{Vess}}})$$ M Vess ) and spleen ( $${{\text{M}}}_{{\text{seg}}+{\text{spleen}}})$$ M seg + spleen ) to assess the impact on segment contouring. Models were trained, validated, and tested on 160 ( $${{\text{C}}}_{{\text{RTTrain}}}$$ C RTTrain ), 40 ( $${{\text{C}}}_{{\text{RTVal}}}$$ C RTVal ), 33 ( $${{\text{C}}}_{{\text{LS}}}$$ C LS ), 25 (CCH) and 20 (CPVE) CECT of LC patients. $${{\text{M}}}_{{\text{nnU}}-{\text{Net}}}$$ M nnU - Net outperformed $${{\text{M}}}_{{\text{paU}}-{\text{Net}}}$$ M paU - Net across all segments with median differences in Dice similarity coefficients (DSC) ranging 0.03–0.05 (p 0.05), however, both were slightly better than $${{\text{M}}}_{{\text{Vess}}}$$ M Vess by DSC up to 0.02. The final model, $${{\text{M}}}_{{\text{seg}}+{\text{spleen}}}$$ M seg + spleen , showed a mean DSC of 0.89, 0.82, 0.88, 0.87, 0.96, and 0.95 for segments 1, 2, 3, 4, 5–8, and spleen, respectively on entire test sets. Qualitatively, more than 85% of cases showed a Likert score $$\ge$$ ≥ 3 on test sets. Our final model provides clinically acceptable contours of liver segments and spleen which are usable in treatment planning.

Cerebrovascular reactivity (CVR) is a prognostic indicator of cerebrovascular health. Estimating CVR from endogenous end-tidal carbon dioxide (CO2) fluctuation and MRI signal recorded under resting state can be difficult due to the poor signal-to-noise ratio (SNR) of signals. Thus, we aimed to improve the method of estimating CVR from end-tidal CO2 and MRI signals. We proposed a coherence weighted general linear model (CW-GLM) to estimate CVR from the Fourier coefficients weighted by the signal coherence in frequency domain, which confers two advantages. First, it requires no signal alignment in time domain, which simplifies experimental methods. Second, it limits the GLM analysis within the frequency band where CO2 and MRI signals are highly correlated, which automatically suppresses noise and nuisance signals. We compared the performance of our method with time-domain GLM (TD-GLM) and frequency-domain GLM (FD-GLM) in both synthetic and in-vivo data; wherein we calculated CVR from signals recorded under both resting state and sinusoidal stimulus. In synthetic data, CW-GLM has a remarkable performance on CVR estimation from narrow band signals with a mean-absolute error of 0.7 % (gray matter) and 1.2 % (white matter), which was lower than all the other methods. Meanwhile, CW-GLM maintains a comparable performance on CVR estimation from resting signals, with a mean-absolute error of 4.1 % (gray matter) and 8 % (white matter). The superior performance was maintained across the 36 in-vivo measurements, with CW-GLM exhibiting limits of agreement of -16.7 % – 9.5 % between CVR calculated from the resting and sinusoidal CO2 paradigms which was 12 % – 209 % better than current time-domain methods. Evaluating of the cross-coherence spectrum revealed highest signal coherence within the frequency band from 0.01 Hz to 0.05 Hz, which overlaps with previously recommended frequency band (0.02 Hz to 0.04 Hz) for CVR analysis. Our data demonstrates that CW-GLM can work as a self-adaptive band-pass filter to improve CVR robustness, while also avoiding the need for signal temporal alignment.

Wireless short-range communication has become widespread in the modern era, partly due to the advancement of the Internet of Things (IoT) and smart technology. This technology is now utilized in various sectors, including lighting, medical, and industrial applications. This article aims to examine the historical, present, and forthcoming advancements in wireless short-range communication. Additionally, the review will analyze the modifications made to communication protocols, such as Bluetooth, RFID and NFC, in order to better accommodate modern applications. Batteryless technology, particularly batteryless NFC, is an emerging development in short-range wireless communication that combines power and data transmission into a single carrier. This modification will significantly influence the trajectory of short-range communication and its applications. The foundation of most low-power, short-range communication applications relies on an ultra-low-power microcontroller. Therefore, this study will encompass an analysis of ultra-low-power microcontrollers and an investigation into the potential limitations they might encounter in the future. In addition to offering a thorough examination of current Wireless short-range communication, this article will also attempt to forecast future patterns and identify possible obstacles that future research may address.

Underwater archaeological excavations present unique challenges, particularly when conducted at significant depths where divers face limited time on the archaeological site. Traditional methods of recording excavation progress, such as manual documentation and drawings, are too time-consuming when the time on the site totals no more than 12 min. To address these limitations, this paper introduces an innovative approach for daily recording and observation of underwater archaeological excavations using 3D photogrammetric models and point of view (PoV) cameras developed specifically for the excavation of a shipwreck situated at a depth of 110 m. The proposed system leverages advancements in photogrammetry and 3D modelling techniques to capture and analyse detailed visual data of the excavation site on a daily basis. Three-dimensional photogrammetric models offer a comprehensive and easily accessible representation of the excavation site, enabling the team to record and analyse excavation levels and features in a highly precise and detailed manner. By comparing the 3D models captured on consecutive days, researchers can precisely measure changes in the excavation area, identify new artifacts or structures, and record the progress of the excavation. The PoV cameras contribute to the planning of daily tasks required on the site. Overall, this paper showcases innovative methods for underwater archaeological excavations at significant depths, employing 3D photogrammetric models for daily recording as well as PoV cameras for observation. The proposed system represents a substantial advancement in the field of underwater archaeology, offering a more accurate, efficient, and reliable approach to documenting and analysing excavation progress, whilst also producing results that can be subsequently adapted and applied to other deep water archaeological sites.

I will take it that general intelligence is intelligence of the kind that a typical human being—Fred, say—manifests in his role as a cognitive agent, that is, as an acquirer, receiver and circulator of knowledge in his cognitive economy. Framed in these terms, the word “general” underserves our ends. Hereafter our questions will bear upon the all-purpose intelligence of beings like Fred. Frederika appears as Fred’s AI-counterpart, not as a fully programmed and engineered being, but as a presently unrealized theoretical construct. Our basic question is whether it is in principle possible to equip Frederika to do what Fred does as an all-purpose participant in his own cognitive economy. Can she achieve a sufficiency of relevant similarity to him to allow us to say that she herself can do what Fred can do, perhaps even better? One of the things that Fred can do—or at least could learn from experience to do—is discharge the duties of an Appeals Court judge. As set down in the ancient doctrine of lex non scripta, Fred must be able to detect, understand and correctly apply certain tacit and implicit rules of law which defy express propositional formulation and linguistic articulation. Fred has an even more widespread capacity for the epistemically tacit and implicit, clearly one of his most cost-saving kinds of intelligence. Indeed, most by far of what Fred will ever know he will know tacitly and implicitly. So we must ask: how tightly bound to the peculiarities of Fred’s cognitive enablement conditions is the character of the intelligence that he manifests? And how far down Fred’s causal make-up does intelligence actually go?

Background: An unplanned hospital admission of a nursing home resident distresses the person, their family and nursing home staff, and is costly to the NHS. Improving health care in care homes, including early detection of residents’ health changes, may reduce hospital admissions. Previously, we identified four conditions associated with avoidable hospital admissions. We noted promising ‘within-home’ complex interventions including care pathways, knowledge and skills enhancement, and implementation support. Objectives: Develop a complex intervention with implementation support [the Better Health in Residents in Care Homes with Nursing (BHiRCH-NH)] to improve early detection, assessment and treatment for the four conditions. Determine its impact on hospital admissions, test study procedures and acceptability of the intervention and implementation support, and indicate if a definitive trial was warranted. Design: A Carer Reference Panel advised on the intervention, implementation support and study documentation, and engaged in data analysis and interpretation. In workstream 1, we developed a complex intervention to reduce rates of hospitalisation from nursing homes using mixed methods, including a rapid research review, semistructured interviews and consensus workshops. The complex intervention comprised care pathways, approaches to enhance staff knowledge and skills, implementation support and clarity regarding the role of family carers. In workstream 2, we tested the complex intervention and implementation support via two work packages. In work package 1, we conducted a feasibility study of the intervention, implementation support and study procedures in two nursing homes and refined the complex intervention to comprise the Stop and Watch Early Warning Tool (S&W), condition-specific care pathways and a structured framework for nurses to communicate with primary care. The final implementation support included identifying two Practice Development Champions (PDCs) in each intervention home, and supporting them with a training workshop, practice development support group, monthly coaching calls, handbooks and web-based resources. In work package 2, we undertook a cluster randomised controlled trial to pilot test the complex intervention for acceptability and a preliminary estimate of effect. Setting: Fourteen nursing homes allocated to intervention and implementation support (n = 7) or treatment as usual (n = 7). Participants: We recruited sufficient numbers of nursing homes (n = 14), staff (n = 148), family carers (n = 95) and residents (n = 245). Two nursing homes withdrew prior to the intervention starting. Intervention: This ran from February to July 2018. Data sources: Individual-level data on nursing home residents, their family carers and staff; system-level data using nursing home records; and process-level data comprising how the intervention was implemented. Data were collected on recruitment rates, consent and the numbers of family carers who wished to be involved in the residents’ care. Completeness of outcome measures and data collection and the return rate of questionnaires were assessed. Results: The pilot trial showed no effects on hospitalisations or secondary outcomes. No home implemented the intervention tools as expected. Most staff endorsed the importance of early detection, assessment and treatment. Many reported that they ‘were already doing it’, using an early-warning tool; a detailed nursing assessment; or the situation, background, assessment, recommendation communication protocol. Three homes never used the S&W and four never used care pathways. Only 16 S&W forms and eight care pathways were completed. Care records revealed little use of the intervention principles. PDCs from five of six intervention homes attended the training workshop, following which they had variable engagement with implementation support. Progression criteria regarding recruitment and data collection were met: 70% of homes were retained, the proportion of missing data was

Previous research indicates that patient self-measured blood pressure (SMBP) is a cost-effective strategy for improving hypertension (HTN) diagnosis and control. However, it is unknown which specific uses of SMBP produce the most value. Our goal is to estimate, from an insurance perspective, the return-on-investment (ROI) and net present value associated with coverage of SMBP devices when used (a) only to diagnose HTN, (b) only to select and titrate medication, (c) only to monitor HTN treatment, or (d) as a bundle with all three uses combined. We employed national sample of claims data, Framingham risk predictions, and published sensitivity-specificity values of SMBP and clinic blood-pressure measurement to extend a previously-developed local decision-analytic simulation model. We then used the extended model to determine which uses of SMBP produce the most economic value when scaled to the U.S. adult population. We found that coverage of SMBP devices yielded positive ROIs for insurers in the short-run and at lifetime horizon when the three uses of SMBP were considered together. When each use was evaluated separately, positive returns were seen when SMBP was used for diagnosis or for medication selection and titration. However, returns were negative when SMBP was used exclusively to monitor HTN treatment. When scaled to the U.S. population, adoption of SMBP would prevent nearly 16.5 million false positive HTN diagnoses, thereby improving quality of care while saving insurance plans $254 per member. A strong economic case exists for insurers to cover the cost of SMBP devices, but it matters how devices are used.

Introduction In the UK, a compulsory ‘6-week hip check’ is performed in primary care for the detection of developmental dysplasia of the hip (DDH). However, missed diagnoses and infants incorrectly labelled with DDH remain a problem, potentially leading to adverse consequences for infants, their families and the National Health Service. National policy states that infants should be referred to hospital if the 6-week check suggests DDH, though there is no available tool to aid examination or offer guidelines for referral. We developed standardised diagnostic criteria for DDH, based on international Delphi consensus, and a 9-item checklist that has the potential to enable non-experts to diagnose DDH in a manner approaching that of experts.Methods and analysis We will conduct a controlled trial randomised by practice that will compare a diagnostic aid against standard care for the hip check. The primary objective is to determine whether an aid to the diagnosis of DDH reduces the number of clinically insignificant referrals from primary care to hospital and the number of late diagnosed DDH. The trial will include a qualitative process evaluation, an assessment of professional behavioural change and a full health economic evaluation. We will recruit 152 general practitioner practices in England. These will be randomised to conduct the hip checks with use of the study diagnostic aid and/or as per usual practice. The total number of infants seen during a 15-month recruitment period will be 110 per practice. Two years after the 6-week hip check, we will measure the number of referred infants that are (1) clinically insignificant for DDH and (2) those that constitute appropriate referrals.Ethics and dissemination This study has approval from the Health Research Authority (16/1/2020) and the Confidentiality Advisory Group (18/2/2020). Results will be published in peer-reviewed academic journals, disseminated to patient organisations and the media.Trial registration number NCT04101903; Pre-results.

To successfully operate in a harsh environment like the Arctic Ocean, one must be able to understand and predict how that environment will evolve over different spatial and temporal scales. This is particularly challenging given the on-going and significant environmental changes that are occurring in the region. Access to the most recent environmental information provides timely knowledge that enables ship-based operations to proceed efficiently, effectively and safely in this difficult arena. Knowledge of the evolving environmental conditions during a field campaign is critical for effective planning, optimal execution of sampling strategies, and to provide a broader context to data collected at specific times and places. We describe the collaborations and processes that enabled an operational system to be developed to provide a remote field-team, located on USCGC Healy in the Beaufort Sea, with near real-time situational awareness information regarding the weather, sea ice conditions, and oceanographic processes. The developed system included the punctual throughput of near real-time products such as satellite imagery, meteorological forecasts, ice charts, model outputs, and up to date locations of key sea ice and ocean-based assets. Science and operational users, as well as onshore personnel, used this system for real-time practical considerations such as ship navigation, and to time scientific operations to ensure the appropriate sea ice and weather conditions prevailed. By presenting the outputs of the system within the context of case studies our results clearly demonstrate the benefits that improved situational awareness brings to ship-based operations in the Arctic Ocean, both today and in the future.

In situ hyperspectral remote-sensing reflectance (Rrs(λ)) is used to derive water quality products and perform autonomous monitoring of aquatic ecosystems. Conventionally, above-water Rrs(λ) is estimated from three spectroradiometers which measure downwelling planar irradiance (Ed(λ)), sky radiance (Ls(λ)), and total upwelling radiance (Lt(λ)), with a scaling of Ls(λ)/Ed(λ) used to correct for surface-reflected radiance. Here, we incorporate direct and diffuse irradiance, (Edd(λ)) and Eds(λ)), from a hyperspectral pyranometer (HSP) in an Rrs(λ) processing algorithm from a solar-tracking radiometry platform (So-Rad). HSP measurements of sun and sky glint (scaled Edd(λ)/Ed(λ) and Eds(λ)/Ed(λ)) replace model-optimized terms in the 3C (three-glint component) Rrs(λ) algorithm, which estimates Rrs(λ) via spectral optimization of modelled atmospheric and water properties with respect to measured radiometric quantities. We refer to the HSP-enabled method as DD (direct-diffuse) and compare differences in Rrs(λ) and Rrs(λ) variability (assessed over 20 min measurement cycles) between 3C and DD as a function of atmospheric optical state using data from three ports in the Western Channel. The greatest divergence between the algorithms occurs in the blue part of the spectrum where DD has significantly lower Rrs(λ) variability than 3C in clearer sky conditions. We also consider Rrs(λ) processing from a hypothetical two-sensor configuration (using only the Lt(λ) spectroradiometer and the HSP and referred to as DD2) as a potential lower-cost measurement solution, which is shown to have comparable Rrs(λ) and Rrs(λ) variability to DD in clearer sky conditions. Our results support that the HSP sensor can fulfil a dual role in aquatic ecosystem monitoring by improving precision in Rrs(λ) alongside its primary function to characterize aerosols.

ImportanceMost research to understand postacute sequelae of SARS-CoV-2 infection (PASC), or long COVID, has focused on adults, with less known about this complex condition in children. Research is needed to characterize pediatric PASC to enable studies of underlying mechanisms that will guide future treatment.ObjectiveTo identify the most common prolonged symptoms experienced by children (aged 6 to 17 years) after SARS-CoV-2 infection, how these symptoms differ by age (school-age [6-11 years] vs adolescents [12-17 years]), how they cluster into distinct phenotypes, and what symptoms in combination could be used as an empirically derived index to assist researchers to study the likely presence of PASC.Design, setting, and participantsMulticenter longitudinal observational cohort study with participants recruited from more than 60 US health care and community settings between March 2022 and December 2023, including school-age children and adolescents with and without SARS-CoV-2 infection history.ExposureSARS-CoV-2 infection.Main outcomes and measuresPASC and 89 prolonged symptoms across 9 symptom domains.ResultsA total of 898 school-age children (751 with previous SARS-CoV-2 infection [referred to as infected] and 147 without [referred to as uninfected]; mean age, 8.6 years; 49% female; 11% were Black or African American, 34% were Hispanic, Latino, or Spanish, and 60% were White) and 4469 adolescents (3109 infected and 1360 uninfected; mean age, 14.8 years; 48% female; 13% were Black or African American, 21% were Hispanic, Latino, or Spanish, and 73% were White) were included. Median time between first infection and symptom survey was 506 days for school-age children and 556 days for adolescents. In models adjusted for sex and race and ethnicity, 14 symptoms in both school-age children and adolescents were more common in those with SARS-CoV-2 infection history compared with those without infection history, with 4 additional symptoms in school-age children only and 3 in adolescents only. These symptoms affected almost every organ system. Combinations of symptoms most associated with infection history were identified to form a PASC research index for each age group; these indices correlated with poorer overall health and quality of life. The index emphasizes neurocognitive, pain, and gastrointestinal symptoms in school-age children but change or loss in smell or taste, pain, and fatigue/malaise-related symptoms in adolescents. Clustering analyses identified 4 PASC symptom phenotypes in school-age children and 3 in adolescents.Conclusions and relevanceThis study developed research indices for characterizing PASC in children and adolescents. Symptom patterns were similar but distinguishable between the 2 groups, highlighting the importance of characterizing PASC separately for these age ranges.

Background: With a prevalence of up to 16.5%, depression is one of the commonest mental disorders in people with advanced cancer. Depression reduces the quality of life (QoL) of patients and those close to them. The National Institute for Health and Care Excellence (NICE) guidelines recommend treating depression using antidepressants and/or psychological treatments, such as cognitive–behavioural therapy (CBT). Although CBT has been shown to be effective for people with cancer, it is unclear whether or not this is the case for people with advanced cancer and depression. Objectives: To assess the clinical effectiveness and cost-effectiveness of treatment as usual (TAU) plus manualised CBT, delivered by high-level Improving Access to Psychological Therapy (IAPT) practitioners, versus TAU for people with advanced cancer and depression, measured at baseline, 6, 12, 18 and 24 weeks. Design: Parallel-group, single-blind, randomised trial, stratified by whether or not an antidepressant was prescribed, comparing TAU with CBT plus TAU. Setting: Recruitment took place in oncology, hospice and primary care settings. CBT was delivered in IAPT centres or/and over the telephone. Participants: Patients (N = 230; n = 115 in each arm) with advanced cancer and depression. Inclusion criteria were a diagnosis of cancer not amenable to cure, a DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) diagnosis of depressive disorder using the Mini-International Neuropsychiatric Interview, a sufficient understanding of English and eligibility for treatment in an IAPT centre. Exclusion criteria were an estimated survival of

The seabed can be considered as the world’s largest museum, and underwater sites explored and studied so far provide priceless information on human interaction with the sea. In recognition of the importance of this cultural resource, UNESCO, in its 2001 Convention on the Protection of the Underwater Cultural Heritage, determined that objects/sites should be preserved in situ, whilst also advocating for public access and sharing. The implementation of these principles is not without difficulties. Some states have opened up underwater sites to the public—mainly through diving, yet the vast majority of the world’s population does not dive. In Malta, 7000 years of human occupation is reflected in and on the landscape, and recent offshore surveys show that the islands’ long and complex history has also left an indelible mark on the seabed. Besides difficulties related to their protection and management, these sites also present a challenge with regard to sharing and communicating. Recent advances in underwater imaging and processing software have accelerated the development of 3D photogrammetry of submerged sites and the idea for a virtual museum was born. The virtual museum, UnderwaterMalta, was created out of a need to share the plethora of underwater sites located on the seabed of the Maltese Islands. A multitude of digital tools are used to share and communicate these sites, offering visitors a dry dive into submerged sites that would otherwise remain invisible to the vast majority of the public. This paper discusses the basic principle of the sharing of underwater cultural heritage and the difficulties that beset the implementation of such a principle. A detailed explanation and evaluation of the methods used to gather the raw data needed is set in the context of the particular and unique working conditions related to deep water sites. The workings of this paper are based on first-hand experiences garnered through the recording of numerous wrecks over the years and the creation and launch of The Virtual Museum-Underwater Malta—a comprehensive virtual museum specifically built for “displaying” underwater archaeological sites that are otherwise invisible to the general public.

Storylines of Family Medicine is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'IX: people and places-diverse populations and locations of care', authors address the following themes: 'LGBTQIA+health in family medicine', 'A family medicine approach to substance use disorders', 'Shameless medicine for people experiencing homelessness', '''Difficult" encounters-finding the person behind the patient', 'Attending to patients with medically unexplained symptoms', 'Making house calls and home visits', 'Family physicians in the procedure room', 'Robust rural family medicine' and 'Full-spectrum family medicine'. May readers appreciate the breadth of family medicine in these essays.

Abstract Background Heart failure related to cardiac siderosis remains a major cause of death in transfusion dependent anaemias. Replacement fibrosis has been reported as causative of heart failure in siderotic cardiomyopathy in historical reports, but these findings do not accord with the reversible nature of siderotic heart failure achievable with intensive iron chelation. Methods Ten whole human hearts (9 beta-thalassemia major, 1 sideroblastic anaemia) were examined for iron loading and fibrosis (replacement and interstitial). Five had died from heart failure, 4 had cardiac transplantation for heart failure, and 1 had no heart failure (death from a stroke). Heart samples iron content was measured using atomic emission spectroscopy. Interstitial fibrosis was quantified by computer using picrosirius red (PSR) staining and expressed as collagen volume fraction (CVF) with normal value for left ventricle

Networked visual applications such video streaming have grown exponentially in recent years, yet are known to be sensitive to network impairments. However, available measurement techniques that adopt a full reference model are impractical in real‐time streaming because they require the original video sequence available at the receivers side. The primary aim of this study is to present a hybrid no‐reference prediction model for the perceptual quality of 4kUHD H.265‐coded video in the wireless domain. The contributions of this paper are two‐fold: first, an investigation of the impact of quality of service (QoS) parameters on 4kUHD H.265‐coded video transmission in an experimental environment; second, objective model based on fuzzy logic inference system is developed to predict the visual quality by mapping QoS parameters to the measured quality of experience. The model is evaluated in contrast to random neural networks. The results show that good prediction accuracy was obtained from the proposed hybrid prediction model. This study will help in the development of a reference‐free video quality prediction model and QoS control methods for 4kUHD video streaming.

IMPORTANCE: The prevalence, pathophysiology, and long-term outcomes of COVID-19 (post-acute sequelae of SARS-CoV-2 [PASC] or Long COVID) in children and young adults remain unknown. Studies must address the urgent need to define PASC, its mechanisms, and potential treatment targets in children and young adults. OBSERVATIONS: We describe the protocol for the Pediatric Observational Cohort Study of the NIHs REsearching COVID to Enhance Recovery (RECOVER) Initiative. RECOVER-Pediatrics is an observational meta-cohort study of caregiver-child pairs (birth through 17 years) and young adults (18 through 25 years), recruited from more than 100 sites across the US. This report focuses on two of four cohorts that comprise RECOVER-Pediatrics: 1) a de novo RECOVER prospective cohort of children and young adults with and without previous or current infection; and 2) an extant cohort derived from the Adolescent Brain Cognitive Development (ABCD) study (n = 10,000). The de novo cohort incorporates three tiers of data collection: 1) remote baseline assessments (Tier 1, n = 6000); 2) longitudinal follow-up for up to 4 years (Tier 2, n = 6000); and 3) a subset of participants, primarily the most severely affected by PASC, who will undergo deep phenotyping to explore PASC pathophysiology (Tier 3, n = 600). Youth enrolled in the ABCD study participate in Tier 1. The pediatric protocol was developed as a collaborative partnership of investigators, patients, researchers, clinicians, community partners, and federal partners, intentionally promoting inclusivity and diversity. The protocol is adaptive to facilitate responses to emerging science. CONCLUSIONS AND RELEVANCE: RECOVER-Pediatrics seeks to characterize the clinical course, underlying mechanisms, and long-term effects of PASC from birth through 25 years old. RECOVER-Pediatrics is designed to elucidate the epidemiology, four-year clinical course, and sociodemographic correlates of pediatric PASC. The data and biosamples will allow examination of mechanistic hypotheses and biomarkers, thus providing insights into potential therapeutic interventions. CLINICAL TRIALS.GOV IDENTIFIER: Clinical Trial Registration: http://www.clinicaltrials.gov. Unique identifier: NCT05172011.