Seattle Children's, formerly Children's Hospital and Regional Medical Center, formerly Children's Orthopedic Hospital, is a children's hospital in the Laurelhurst neighborhood of Seattle, Washington. The hospital specializes in the care of infants, children, teens, and young adults aged 0–21 in several specialties. The hospital is also ranked #10 children's hospital nationwide by the U.S. News and World Report.
Deep research agents perform multi-step research to produce long-form, well-attributed answers. However, most open deep research agents are trained on easily verifiable short-form QA tasks via reinforcement learning with verifiable rewards, which does not extend to realistic long-form tasks. We address this with , where rubrics are constructed and maintained to with the policy model during training. This allows the rubrics to incorporate newly explored information from search and contrasting model responses, enabling better fact checking and more discriminative on-policy feedback. Using RLER, we develop , the first fully open model that is directly trained for open-ended, long-form deep research. Across four long-form deep research benchmarks in science, healthcare, and general domains, DR Tulu-8B substantially outperforms existing open deep research agents (by 15.6% over Tongyi DR on average) and matches or exceeds proprietary deep research agents (by 0.7% over OpenAI DR on average), while being significantly smaller and cheaper per query (1000x cheaper than OpenAI DR per query).
Human influenza viruses rapidly acquire mutations in their hemagglutinin (HA) protein that erode neutralization by antibodies from prior exposures. Here, we use a sequencing-based assay to measure neutralization titers for 78 recent H3N2 HA strains against a large set of children and adult sera, measuring ~10,000 total titers. There is substantial person-to-person heterogeneity in the titers against different viral strains, both within and across age cohorts. The growth rates of H3N2 strains in the human population in 2023 are highly correlated with the fraction of sera with low titers against each strain. Notably, strain growth rates are less correlated with neutralization titers against pools of human sera, demonstrating the importance of population heterogeneity in shaping viral evolution. Overall, these results suggest that high-throughput neutralization measurements of human sera against many different viral strains can help explain the evolution of human influenza.
There are environmental and financial benefits to reducing iodinated contrast media (ICM) waste. While Imaging Bulk Package (IBP) bottles have been demonstrated to reduce contrast waste in adult hospitals, lower computed tomography (CT) volumes and smaller contrast doses pose challenges for utilizing IBP in children’s hospitals. Primary outcome: quantification of CT contrast waste during a 6-month period at a single children’s hospital. Secondary outcomes: quantification of single-use product waste and greenhouse gas emissions, identification of the 12-h periods of highest contrast use, and estimation of reductions in contrast waste, single-use product use, costs, and greenhouse gas emissions by using IBP ICM during peak hours. All contrast-enhanced CT performed from January through June 2025 were reviewed. Volume of contrast wasted was calculated. The 12-h time period with the highest contrast-enhanced CT volume was determined. Reductions in contrast waste, single-use products, cost, and greenhouse gas emissions by using IBP ICM during these peak hours were estimated. Approximately 291 contrast-enhanced CT exams were performed per month. Mean contrast waste was 37 mL per study, totaling 66 L of wasted contrast over 6 months. Peak hours were 9 AM to 9 PM on weekdays. The mean ICM waste per exam was 37 mL using single-dose bottles versus 17 mL using IBP bottles during peak hours (P<0.001). Using IBP ICM during peak hours and single-use ICM at other times could reduce contrast waste by 56
Introduction: Medical training assessment frameworks have continued to evolve to effectively capture clinical competency and graduation readiness. Entrustable Professional Activities are being integrated into training programs and describe the activities expected in practice to guide education and assessment. U.S. Pediatric cardiology fellowship programs have been working on creating and implementing these since 2015. We sought to investigate the current landscape of EPA implementation and perceptions amongst fellowship training program directors. Methods: This was a mixed-methods study with grounded theory employing both qualitative and quantitative assessments utilizing a survey instrument distributed to the Society of Pediatric Cardiology Training Program Directors from August 2023 to October 2023. Open-ended prompts were manually coded by two independent team members followed by theme creation. Demographics and descriptive statistics were summarized by frequencies with percentages and Likert-scale responses were tabulated. Results: 24 of 62 pediatric cardiology program directors (39
