Maine et al., report post-hoc modeling of a secondary outcome of a Phase 1 clinical trial that assessed the long-term immunogenicity of a next-generation self-replicating RNA vaccine, RBI-4000 for rabies. The durability of immune responses from RBI-4000 is equal to or superior to a commercial vaccine using statistical decay modeling.

Hartmann et al. use ultra-high field 7 T fMRI to investigate shared neurobiological mechanisms between Crohn’s disease (CD) and major depressive disorder (MDD). Their findings reveal overlapping abnormalities in brain activity and connectivity, suggesting a neuropsychological link that may inform integrated treatment strategies.

Niimura et al. investigates the potential of an integrated glyco-nanovaccine (iGN) comprising gold nanoparticles conjugated with a synthetic Toll-like receptor 7 ligand, sugar chains, and peptide antigens for cancer immunotherapy. Treatment with iGN increases tumor-infiltrating CD8+ T cells and inhibits tumor growth.

Le, Phung, Bui et al. investigate nasal-spraying Bacillus spore probiotics (LiveSpo Navax) as a supportive treatment for Respiratory Syncytial Virus pneumonia with bacterial co-infections in young children. Use of the probiotic reduces symptoms, antibiotic use, viral and bacterial loads, and improves immune and nasal microbiota.

Tahir et al. demonstrate the cumulative predictive value of mortality risk factors such as bacteremia, chemotherapy, and hematological parameters through a prognostication model for cancer patients with febrile neutropenia. The model’s high accuracy and interpretability make it relevant and potentially deployable in clinical settings.

Mahmud, Chang et al., model malaria transmission encompassing human mobility and epidemiological data in Bangladesh to guide elimination efforts. Local vector control efforts have the greatest impact when targeted to places with both high transmission intensity and high connectivity.

Ward-Caviness et al. use a time-stratified case-crossover approach to estimate associations between PM_2.5 and COVID19-related hospitalizations across the US. Higher concentrations of PM_2.5 are associated with higher risk of COVID19-related hospitalizations, with heterogeneity seen across regions.

Kuodi et al., assess the impact of BNT162b2 COVID-19 vaccination on long COVID outcomes in a longitudinal cohort spanning over 2 years, in northern Israel. COVID-19 vaccination and subsequent booster doses administered before infection provide immediate as well as ongoing protection against long COVID.

Yan et al. present DietAI24, a unified framework that identifies foods, estimates portion sizes, and computes 65 nutrients from real-world food photos using multimodal large language models. This tool outperforms existing methods and standardizes outputs for downstream analysis, enabling efficient, reproducible dietary measurement.

Liu, Gao et al. develop EmoScan, an LLM-based system to screen for emotional disorders. Findings reveal that EmoScan effectively screens for emotional disorders with high accuracy and can provide detailed explanations, enhancing transparency and trust in automated mental health assessments.

Connolly et al. describe the International Health Cohorts Consortium (IHCC), a global initiative that is closing gaps in genomic databases by representation of different ancestral groups, promoting academic and industry collaborations, and supporting cutting-edge research in global health. A summary of the collective resources of 69 member cohorts, representing over 34 million people is discussed.

Sagandira highlights how agile local API manufacturing could serve as a strategic approach for enhancing health and economic security. This could reshape Africa’s pharmaceutical sector enabling sustainable medicine access.

On June 30, 2021, Communications Medicine published its first article. What began as a bold vision - to create an open-access journal that bridges translational, clinical, and public health research - has since grown into a global platform for high-quality research that advances our understanding, prevention, diagnosis and treatment of diseases. As we celebrate our fourth anniversary, we take this moment to look back on the journey and envision the path forward.

Nyarko and Santa et al. explore AI and digital health utilization for childhood cancer care in Ghana. Collaborative efforts among the government, health institutions, and international organizations are essential to drive investments in digital infrastructure, capacity building, and policy development in Ghana.

Alkassi, Cole et al. provide a conceptual framework for understanding how the molecular characteristics and spatiotemporal distribution of HIF2α variants impact the disease phenotype in Pacak–Zhuang Syndrome. This schema has application not only to this syndrome, but also hereditary cancer syndromes and other mosaic diseases.

Kayalioglu et al. explore the underutilization of data science (DS) to improve health outcomes in Africa and advocate for increased, strategic investment in DS infrastructure, talent development, and research funding. They highlight current challenges while proposing collaborative efforts to build sustainable, locally driven DS growth across Africa.