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Defending against future pandemics may require vaccine platforms that protect across a range of related pathogens. The presentation of multiple receptor-binding domains (RBDs) from evolutionarily-related viruses on a nanoparticle scaffold elicits a strong antibody response to conserved regions. Here we produce quartets of tandemly-linked RBDs from SARS-like betacoronaviruses coupled to the mi3 nanocage through a SpyTag/SpyCatcher spontaneous reaction. These Quartet Nanocages induce a high level of neutralizing antibodies against several different coronaviruses, including against viruses not represented on the vaccine. In animals primed with SARS-CoV-2 Spike, boost immunizations with Quartet Nanocages increased the strength and breadth of an otherwise narrow immune response. Quartet Nanocages are a strategy with potential to confer heterotypic protection against emergent zoonotic coronavirus pathogens and facilitate proactive pandemic protection.

Purpose: This quality improvement project aimed to create a standardized process to improve hospital throughput and decrease the length of stay through the support of multidisciplinary teams at Banner University Medical Center Tucson. Background: Hospitals across the country have experienced crowding and high patient volumes. This problem has existed in hospitals over the last 30 years but continues to worsen. The global pandemic of COVID-19 has put an additional unforeseen strain on top of a preexisting issue, exacerbating crowding, patient wait times, and increased hospital length of stay. Hospitals are strained to provide care to meet their patient demands and require alternate strategies to provide process improvement to meet these needs. Methods: Building upon ongoing improvement projects already in place at Banner University Medical Center Tucson, a multidisciplinary team was formed, aided by a tool to guide hospital throughput. This team collaborated through daily meetings using this tool to demonstrate demand and capacity within the hospital to focus efforts, ask pointed questions and decrease the length of stay. Results: This project was implemented over the course of one week and length of stay data was then gathered after completion. The length of stay results from the project implementation dates was 4.93, which is a 20% reduction from the highest length of stay seen in 2021, 5.22.