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Integrating network pharmacology and experimental verification to explore the protective effects of Evodia rutaecarpa in ischemic stroke

Background Evodia rutaecarpa is a traditional Chinese herbal medicine known for its potential benefits in the treatment of cardiovascular and cerebrovascular diseases. Despite its recognized effects, the effects of Evodia rutaecarpa on ischemic stroke (IS), along with the primary active compounds and precise mechanisms of action, require elucidation. Methods Network pharmacology analyses and molecular docking were performed to integrate information related to Evodia rutaecarpa and IS. Cell oxygen–glucose deprivation (OGD) and rat middle cerebral artery occlusion (MCAO) models were established to simulate cerebral ischemic injury. The effects of rutaecarpine on these models were evaluated to assess its effect on IS. Results Network pharmacological analysis indicated that rutaecarpine from Evodia rutaecarpa showed therapeutic effects against IS. The mechanism underlying these effects mainly involved the mitogen-activated protein kinase (MAPK), and targets such as matrix metalloproteinase (MMP)-9, caspase 3 and MMP-2 may be activated to exert these effects. In vitro studies showed that rutaecarpine significantly improved the mitochondrial membrane potential of HT22 cells, reduced the production of reactive oxygen species, and reversed OGD-induced cytotoxicity. In the MCAO rat model, pretreatment with rutaecarpine significantly reduced neuronal death, decreased infarct volume, and improved neurological functional deficits. In addition, rutaecarpine alleviated damage to the blood–brain barrier in the brain tissue. These effects may be related to the regulation of the MAPK-mediated MMPs pathway. Conclusion This study revealed the neuroprotective effects and molecular mechanisms of rutaecarpine on IS, providing a new theoretical basis for the clinical application of Evodia rutaecarpa.

The development of numerical mapping in preschool children

The developmental order of numerical mapping and the symmetry of the mapping direction in preschool children remain controversial. In light of this context, this study investigated the developmental characteristics of numerical mapping among preschool children in China. In Experiment 1, 128 children aged 2–4 years were recruited to participate in six numerical mapping tasks with small and large numbers. The results showed no reliable differences between the mapping directions. Notably, the developmental orders of small- and large-number mapping differed, potentially confirming two systems of number representation. Furthermore, previous studies have found that counting or not could affect children’s performance on numerical tasks. Therefore, in Experiment 2, we introduced the condition of “reminding children to count” and recruited 97 children aged 3–4 years to explore its influence on numerical mapping. Our findings revealed that reminding children to count could improve their performance on numerical mappings, resulting in alterations in the symmetry of the mapping direction and developmental order of mapping paths. In conclusion, number size and counting reminders would affect researchers’ assessments of the developmental order of numerical mapping in preschool children, which serves as a guide for nurturing and evaluating the numerical mapping ability of preschool children.

Correction: ChatGPT versus human in generating medical graduate exam multiple choice questions—A multinational prospective study (Hong Kong S.A.R., Singapore, Ireland, and the United Kingdom)

Analysing fast food consumption behaviour patterns: The case of Jordan

This study aimed to examine the factors influencing fast food consumption among a Jordanian population by utilizing the extended theory of planned behavior as its theoretical framework. The research employed theory-related scales, income, BMI, ability to consume (intention), indirect intention, and a retrospective measure of fast-food consumption within a cross-sectional sample of 408 university students aged 18–23 years. Structural equation modeling was used to analyze the determinants of consumption. The findings indicated that the self-reported intention measure failed to mediate the attitude-behavior relationship. However, the use of projective intention (indirect) measures revealed that personal factors such as attitude, subjective norms, and self-identification significantly explained over 50% of the variation in the intention to consume fast food, suggesting that participants often underestimated their intention to consume fast food. Furthermore, the study identified available personal funds, perceived and actual behavioral control, and BMI as significant external predictors of fast-food consumption. The originality of this study lies in its contribution to understanding the growing preference for fast food in the Middle East, particularly in Jordan. It introduces a theoretical model that employs projection-based assessments to implicitly gauge intentions and explores the relationship between income, BMI, and consumption behavior. The practical implications of these findings underscore the importance of key psychosocial elements in developing and implementing preventive strategies aimed at promoting healthy eating behaviors among university students.

Biased echoes: Large language models reinforce investment biases and increase portfolio risks of private investors

Large language models are increasingly used by private investors seeking financial advice. The current paper examines the potential of these models to perpetuate investment biases and affect the economic security of individuals at scale. We provide a systematic assessment of how large language models used for investment advice shape the portfolio risks of private investors. We offer a comprehensive model of large language model investment advice risk, examining five key dimensions of portfolio risks (geographical cluster risk, sector cluster risk, trend chasing risk, active investment allocation risk, and total expense risk). We demonstrate across four studies that large language models used for investment advice induce increased portfolio risks across all five risk dimensions, and that a range of debiasing interventions only partially mitigate these risks. Our findings show that large language models exhibit similar “cognitive” biases as human investors, reinforcing existing investment biases inherent in their training data. These findings have important implications for private investors, policymakers, artificial intelligence developers, financial institutions, and the responsible development of large language models in the financial sector.

Subjective assessment of sensory function and oral function decline in older adults

Sensory decline in older adults significantly affects quality of life and contributes to cognitive decline, depression, falls, and injuries. Although several studies exist in this area, most were focused on individual senses, with few being conducted on comprehensive assessments of all five senses. The aim of this study was to investigate the relationship between subjective sensory assessment and oral function, to developing health strategies. This study was conducted as part of the Mima-SONGS Study for examining relationships between oral, cognitive, and physical functions, social factors, nutrition, and health, in older adults living in a mountainous region of Japan. The cohort included 62 participants (40 women and 22 men; mean age: 80.8 yrs.) as of December 2023. Participants completed a questionnaire assessing sensory perception and eating enjoyment rated on a four-point scale. Oral health was evaluated based on the conditions of remaining teeth, tongue coating, oral dryness, occlusal force, oral diadochokinesis, and repetitive salivary swallow test. Sensory assessments indicated minimal overall issues, with auditory problems scoring the highest and taste/tactile issues scoring the lowest. Males scored higher in hearing and maximum occlusal force. Eating enjoyment was generally high and negatively correlated with olfactory and taste problems. Subjective sensory issues were less strongly associated with oral function and age. Most older adults were not subjectively aware of sensory problems, especially olfaction, taste, and tactile problems. Subjective sensory problems showed a moderate but meaningful association with oral health conditions and age. The findings might be valuable data developing future support measures.

Machine learning for the prediction of spontaneous preterm birth using early second and third trimester maternal blood gene expression: A cautionary tale

Spontaneous preterm birth (sPTB) remains a significant global health challenge and a leading cause of neonatal mortality and morbidity. Despite advancements in neonatal care, the prediction of sPTB remains elusive, in part due to complex etiologies and heterogeneous patient populations. This study aimed to validate and extend information on gene expression biomarkers previously described for predicting sPTB using maternal whole blood from the All Our Families pregnancy cohort study based in Calgary, Canada. The results of this study are two-fold: first, using additional replicates of maternal blood samples from the All Our Families cohort, we were unable to repeat the findings of a 2016 study which identified top maternal gene expression predictors for sPTB. Second, we conducted a secondary analysis of the original gene expression dataset from the 2016 study using five modelling approaches (random forest, elastic net regression, unregularized logistic regression, L2-regularized logistic regression, and multilayer perceptron neural network) followed by external validation using a pregnancy cohort based in Detroit, USA. The top performing model (random forest classification) suggested promising performance (area under the receiver operating curve, AUROC 0.99 in the training set), but performance was significantly degraded on the test set (AUROC 0.54) and further degraded in external validation (AUROC 0.50), suggesting poor generalizability, likely due to overfitting exacerbated by a low feature-to-noise ratio. Similar performance was observed in the other four learning models. Prediction was not improved when using higher complexity machine learning (e.g., neural network) approaches over traditional statistical learning (e.g., logistic regression). These findings underscore the challenges in translating biomarker discovery into clinically useful predictive models for sPTB. This study highlights the critical need for rigorous methodological safeguards and external validation in biomarker research. It also emphasizes the impact of data noise and overfitting on model performance, particularly in high-dimensional omics datasets. Future research should prioritize robust validation strategies and explore mechanistic insights to improve our understanding and prediction of sPTB.

B-spline curve fitting based on dynamic adjustment of knot vector using feature points

An essential challenge in B-spline curve fitting is how to produce a B-spline curve that satisfies the accuracy requirement with a minimal number of knots and control points. This paper suggests a better algorithm based on feature points method. During the curve approximation process, the projection points of data points and their parameters are calculated, and the data point parameters are corrected to achieve dynamic adjustment of the knot vector. At the same time, traditional methods are improved in terms of initial feature point selection and new feature points determination. The experimental results indicate that the B-spline curve produced using the method in this work has higher fitting accuracy, fewer control points, and shorter fitting time.

Genome-wide landscape of miRNA-mRNA-lncRNA-circRNA ceRNA network in Nanos2 deficient mice

Nanos2 plays a key role in self-renewing spermatogenic stem cells (SSCs) and maintains the stem cell state during spermatogenesis. Alleles of the Nanos2 gene knockout showed germline ablated but otherwise structurally normal. To identify the probable ceRNA regulator involved in the process of spermatogenesis by Nanos2, whole transcriptome sequencing was performed in the testes between Nanos2 knock out mice and wild type mice. Finally, a total of 8644 Differentially expressed (DE) mRNAs,180 DE miRNAs, 9538 DE lncRNA and 481 DE circRNAs were identified. Three of each RNAs were selected randomly and identified by real-time PCR to verify the accuracy of sequencing. GO and KEGG functional enrichment analyses revealed similar result of DE mRNAs and target of DE miRNAs/lncRNAs/ circRNAs, mainly involved in the generation, composition, and activity of sperm cells. Furthermore, the regulatory ceRNA network of miRNA(up)-circRNA-lncRNA-mRNA and miRNA(down)-circRNA-lncRNA-mRNA were constructed based on the common targeted miRNA.The results enable us to better understand the interaction of coding RNA and non coding RNA in regulating the generation of spermatogenic stem cells through Nanos2 pathway, and also provided novel insights into molecular mechanism of spermatogenesis.

Neutrophil extracellular traposis in cancer patients with acute ischemic stroke

Background Patients with cancer exhibit an increased risk of acute ischemic stroke (AIS), and neutrophil extracellular traposis (NETosis) has been proposed as a mechanism underlying cancer-associated hypercoagulability. However, studies validating these findings in independent cohorts are limited. Objective We sought to explore whether NETosis-associated markers (plasma DNA and nucleosomes) are increased in patients with active cancer and AIS, and whether these increases correlate with coagulopathy markers in cancer patients. Methods We analyzed NETosis-associated markers in cancer patients with and without AIS and healthy controls, and assessed the correlation between these markers and coagulopathy markers. Additionally, we compared the levels of Netosis-associated markers between cancer patients with conventional stroke mechanisms (CSM) and those with embolic stroke of undetermined source (ESUS). Results Plasma DNA and nucleosome levels were significantly higher in cancer patients with AIS than in cancer controls and healthy controls (p < 0.001, respectively). Both markers correlated with D-dimer levels in cancer patients with AIS. In a sub-analysis, cancer patients with ESUS showed higher levels of NETosis-associated markers compared to those with CSM, whereas vascular risk factors were more frequently observed in cancer patients with CSM. Conclusion These findings suggest that NETosis may contribute to hypercoagulability in patients with active cancer and AIS, particularly in those with ESUS. These results provide additional evidence supporting the establishment of pathophysiology-based therapeutic approaches.

An empirical study on the teaching mode of cultural translation in college English based on the Production Oriented Approach (POA)

Under the circumstances of “Curriculum ideological and political”, in order to adapt to the reform of college English teaching and the needs of Education for Sustainable Development (ESD), as well as optimize the A-level distinguishable teaching mode of college English stratified teaching, this paper takes the fifth stage of “Production Oriented Approach” (POA) as the theoretical basis and completes a one-semester mixed teaching experiment for the Chinese culture translation section in New Horizon College English. Taking the paragraph translation of “Tai Chi” as an example, a detailed teaching design and implementation process were presented, attempting to construct a sustainable blended teaching model for the cultural translation section of college English. Quantitative and qualitative data statistics and analysis were used to evaluate and reflect on the effectiveness of teaching practice. The research results indicate that compared to traditional college English teaching, blended teaching model based on POA can enhance the English language and cultural output ability of A-level students. The mode is of sustainable value, which is beneficial to students understanding of Chinese culture, thereby enhancing their cultural confidence. In addition, this model can effectively enhance teachers’ ability to apply theoretical knowledge in blended teaching design, which has certain significance for the college English curriculum reform and the practice of “curriculum-based political and ideological education”.

Exploring perceptions of health literacy, healthcare access, and utilisation among higher education students in Alentejo, Southern Portugal: A qualitative study

Introduction Health Literacy (HL), defined as the ability to access, understand, appraise and apply health information to make informed decisions, is essential for individual and public health. However, in rural regions such as Alentejo, Portugal, higher education students often encounter specific challenges that hinder the development and effective use of these skills. This study aimed to explore the perceptions of higher education students in Alentejo, Portugal, with regard to health literacy, access to and utilisation of healthcare, and to identify barriers, facilitators and interventions to inform strategies that promote equity, build student capacity and sustainably improve health outcomes. Methodology A qualitative, exploratory, and descriptive study was conducted using three focus groups held on 11th, 13th, and 18th December 2023, with a purposive non-probability sample of 29 participants across first-year, intermediate, and final-year levels. The participants shared their experiences, challenges, and resources related to health literacy, healthcare access, and utilisation. The focus group discussions were audio-recorded, transcribed verbatim, and analysed through a systematic process of open, axial, and selective coding. Codes were organised into categories, and thematic identification was facilitated using a constant comparative method. Content analysis was conducted with MAXQDA® 22 software. Ethical approval was obtained from the Ethics Committee of the University of Évora, Portugal, and informed consent was secured from all participants. Results The students’ perception was that health literacy, access to and utilisation of healthcare are influenced by a dynamic interaction of barriers and facilitators. The identified barriers encompassed the presence of misinformation, financial and logistical challenges, and emotional stigma, particularly in the context of mental and sexual health. Conversely, facilitators were identified as encompassing access to digital tools, a family and peer support network, professional guidance and institutional resources such as libraries and workshops. The students recommended that interventions to improve health literacy be integrated into the higher education curriculum, that navigation support systems be improved and that structural inequalities be explored in order to improve access to and participation in healthcare. Conclusion Digital resources have the potential to improve access to health information; however, persistent challenges such as misinformation, financial constraints and stigma limit their impact. This study underscores the significance of specific interventions to enhance health literacy and healthcare navigation skills. These interventions include the integration of health literacy into academic curricula, the provision of specialised workshops, and the facilitation of access to healthcare services. The study identifies nursing interventions and institutional support as key strategies to promote equitable access to healthcare and improve student wellbeing.

Isotopic niche plasticity of American alligators within the southern Everglades

Hydrologic alterations within the Everglades have degraded American alligator (Alligator mississippiensis) habitat, reduced prey base, and increased physiological stress. Alligator body condition declined across many management areas from 2000 through 2014, prompting us to investigate the relationship between their intraspecific isotopic niche dynamics and body condition. Alligators within the estuary had a larger niche driven by a wider range in stable carbon isotope ratios than those sampled in freshwater habitats. Spatially, model predictability was higher at the smaller scale, reflecting the variability in basal sources and biochemistry among capture sites. Male niches were often larger than those of females, driven by wider ranges of δ13C values, suggesting that they differ in their proportional use of habitats and or resources. However, the similar ranges of δ15N values indicated both sexes foraged within the same trophic level. Furthermore, while not significantly different, large alligators often had a larger niche with elevated δ15N values compared to medium-sized alligators. Although alligators utilize similar stable carbon and nitrogen isotope pools through time, there was considerable temporal variability. These temporal variations in alligators’ isotopic niche were likely influenced by seasonal hydrologic fluctuations within each site, with their niches often being larger in the spring captures than the fall captures. Alligators’ body condition estimates were correlated with intraspecific niche characteristics, including the mean centroid distance between sexes and the interaction between male and female niche size and overlap, within a site, capture period, and year. The variability in intraspecific niche dynamics, landscape heterogeneity, and dynamic hydrology are considerations for designing sustainable management strategies to conserve and enhance alligator populations within the Everglades landscape.

Reinsurance–investment game between two α-maxmin mean–variance insurers

This paper examines a non-zero-sum stochastic differential reinsurance-investment game between two competitive insurers under the α-maximin mean-variance criterion. Both insurers can purchase proportional reinsurance and invest in a financial market consisting of one risk-free asset and one risky asset, and each insurer is concerned with its terminal surplus and relative performance compared to its competitor. The insurers aim to maximize the α-maximin mean-variance utility, which allows them to exhibit different attitudes towards model ambiguity. By solving the extended Hamilton-Jacobi-Bellman (HJB) equations for both insurers, we derive the α-robust equilibrium reinsurance and investment strategies. Finally, several numerical examples are provided to illustrate the impact of some model parameters on the equilibrium strategies.

Influence of lighting on sleep behaviour, circadian rhythm and spontaneous blink rate in stabled riding school horses (Equus caballus)

Modern horse husbandry involves significant time spent indoors, often in suboptimal lighting conditions and with frequent night-time disturbances by humans for management purposes. The aim of this study was to investigate the influence of a customised light-emitting diode (LED) lighting system and a standard fluorescent lighting fixture on equine sleep behaviours, circadian rhythmicity and spontaneous blink rates in horses. Ten riding school horses experienced two stable lighting conditions for four weeks each in a cross-over study running from January to March, 2023. The treatment lighting consisted of an LED system that provided timed, blue-enriched white polychromatic light by day and dim red light at night, and control lighting was a fluorescent tube that was turned on and off manually morning and evening. During week 4 of each experimental period, spontaneous blink rate was recorded twice for 30 min, behaviour of horses in their stables was recorded continuously for 72 h, and hair samples for circadian clock gene analysis were collected at 4-h intervals for 52 h. No differences were detected for total sleep, lateral or sternal recumbency, wakefulness, standing, standing sleep, or spontaneous blink rate (P > 0.05), between lighting conditions. The lighting period (Day versus Night) influenced total sleep (P < 0.01), total recumbency (P < 0.01), wakefulness (P < 0.01), and standing sleep (P < 0.05) in both conditions. For the treatment condition only, higher wakefulness was recorded during Day (P < 0.05). An overall effect of time for clock genes PER2 and DBP was detected (P < 0.01), but there was no effect of treatment, or time by treatment interaction. Cosinor analysis detected significant 24-h rhythmicity for PER2 and DBP (P < 0.01) in both lighting conditions. Results imply that dim red light at night does not negatively impact normal sleep patterns or circadian rhythmicity, and provide evidence supporting further research to better understand the role of blue-enriched LED light at promoting increased wakefulness during daytime in stabled horses.

Illegal drugs sensor: Performance evaluation and identification based on terahertz photonic crystal fiber

Excessive hormone release, the possibility of sleep disturbances, and a brief and quick improvement in the functioning of many organs, the physiological system, the nerves, etc. are all consequences of the abuse of incentive medications. Illegal narcotics have terrible long-term impacts on human health, including the possibility of death, in addition to their immediate effects. These consequences highlight the need for more obviousness and accuracy in the detection of illicit drugs, as well as for their detection to be done gently, effectively, and consistently. This work introduces an illicit drug sensor based on PCF, with an eye toward these as the primary targets. Three illegal drugs – ketamine, amphetamine, and cocaine – have been simulated for the sensor. Two types of circular air holes in cladding of varying sizes have been developed for a single core PCF. The cladding has three-layer chain and wind turbine-shaped air holes, and a circular air hole in the core region that will be used to field test drug samples, all included to achieve low confinement losses and high sensitivity. A maximum Relative Sensitivity (RS) of 99.92%, 99.12% and 98.83% at ketamine, amphetamine, and cocaine respectively is revealed by the recently established PCF analysis, which was presented out right away. Furthermore, we looked at the Confinement Loss (CL) associated with these illicit drugs, which was around 1.275 × 10−7 dB/m, 2.653 × 10−9 dB/m, and 4.106 × 10−10 dB/m, besides Effective Material Loss (EML) of 0.0042 cm-1, 0.0044 cm-1 and 0.0045 cm-1. Refractive index changes in PCF are usually the cause of action for PCF-based biosensors. These modifications have an impact on how light travels within the fiber. Drug molecules interact with light as a result of changes in the optical properties of the core that occur during light propagation through it.

Evaluating the potential of underwater television to contribute to marine litter assessments alongside bottom trawling

Marine litter presents a global threat to marine ecosystems, human health, and safety. Therefore, it is important to increase our knowledge about spatiotemporal trends of litter in the environment. Bottom trawl surveys provide a practical method for monitoring seafloor litter on the continental shelf, but can have severe negative impacts on the environment. Here we evaluate the potential of an ongoing underwater television survey (UWTV) to also collect litter density data, and develop model-based indices of litter densities integrating coastal and offshore trawl survey data using geostatistical models. Based on our case study along the Swedish west coast, we find that UWTV in its current format may be limited as an alternative to trawling in areas with relatively low densities. There are also clear spatial trends in litter, with the highest densities in near-shores areas currently only included in the national monitoring program. Our results illustrate the potential of combining data, but also the importance of careful sampling designing for marine litter monitoring.

Mode of birth and maternal depression/severe anxiety: Findings from Millennium Cohort Study

Introduction Limited evidence exists on the association between mode of birth and long-term depression and/or severe anxiety in mothers. We aimed to examine the association between mode of birth and depression and/or severe anxiety by 14 years postpartum. Methods We used data from the Millennium Cohort Study. Data on mode of birth were collected when mothers were 9 months postpartum, and categorized as spontaneous vaginal birth (VB), assisted VB, induced VB, emergency cesarean section (CS), planned CS, and CS after induction. Depression/severe anxiety were collected as one variable and self reported by mothers at 9 months, 3, 5, 7, 11, and 14 years postpartum based on a doctor diagnosis. The primary outcome measure was a diagnosis of depression/severe anxiety up to 14 years postpartum. We used multivariable logistic regression models to estimate crude and adjusted odds ratios (OR) for the association between mode of birth and depression/severe anxiety by 14 years postpartum. Results There were 10,507 singleton mothers included in our analyses. Fully adjusted odds ratio (aOR)for the association between mode of birth and depression/severe anxiety by 14 years postpartum was induced VB, (aOR, 1.13 [95% CI], 1.01–2.28), assisted VB (aOR, 1.03 [95% CI], 0.89–1.19), Emergency CS, (aOR, 1.08 [95% CI], 0.92–1.27), planned CS (aOR, 1.09 [95% CI], 0.93–1.27), and CS after induction (aOR, 1.08 [95% CI], 0.91–1.28). Fully adjusted models did not report any significant association between mode of birth and depression/severe anxiety at other postpartum time points. Conclusions The present findings provide support for association between induction of labor and the risk of long-term depression/severe anxiety by 14 years postpartum. The findings provide no evidence to support association between other modes of birth and maternal depression/anxiety.

Effectiveness of interactive dashboards as audit and feedback tools in primary care: A systematic review

Interactive audit and feedback dashboards, which summarize performance using quality indicators, are increasingly used to enhance care processes and outcomes, but their effectiveness in primary care remains underexplored. This systematic review aimed to evaluate the impact of these dashboards in primary care settings by analyzing studies that compared their use to usual care or similar interventions without dashboards. A comprehensive search across MEDLINE (via Ovid), Embase, Cochrane Library, Scopus, and Web of Science through November 2024 was conducted. Risk of bias was assessed using Cochrane tools, and evidence quality was evaluated with GRADE. Relevant data, including features of the interactive dashboards, were extracted, and findings were synthesized narratively and visualized with forest plots. Six studies met the inclusion criteria, comprising five randomized controlled trials and one non-randomized trial, all with low or moderate risk of bias. Four studies incorporating dashboards into multifaceted interventions showed improvements in at least one primary outcome, while two studies using standalone dashboards reported mixed results. Significant heterogeneity in dashboard design, study settings, targeted health conditions, and quality indicators limits the generalizability of these findings. Nonetheless, the results highlight the potential of interactive dashboards to improve quality indicators performance in primary care, particularly as part of broader intervention strategies. Standardized evaluation frameworks and rigorous, consistent reporting are needed in future research to better isolate the effects of interactive dashboards and enhance the robustness and applicability of the evidence in varied primary care contexts. Registration Prospero (CRD42024506727).

Pain, fatigue, and associated gene expressions over chemotherapy in patients with colorectal cancer

Context Patients with colorectal cancer undergoing chemotherapy often experience significant pain and fatigue. Limitations in understanding the complex phenotypes and biological mechanisms of these symptoms hinder effective interventions. Objectives This study aimed to identify the pain and fatigue patterns during one chemotherapy cycle and associated gene expression profiles. Method In a prospective longitudinal study, 34 patients with colorectal cancer from a major cancer center in the Northeastern US were recruited. Self-reported outcome measures of pain and fatigue and blood samples were collected at baseline, post-chemotherapy, and at the end of the chemotherapy cycle. RNA sequencing followed by differential expression analysis identified changes in gene expression. Linear mixed models examined associations between symptoms and possible biomarkers over time. Results The sample had a mean age of 58.4 years old, with 97% being white and non-Hispanic. Among participants, 44.1% had stage III cancer, and 26.5% were undergoing initial chemotherapy. Abdominal pain was the most frequently reported symptom. Fatigue levels significantly worsened post-chemotherapy (P = 0.011) and after recovery (P = 0.018). Critical pathways involved inflammatory response and myeloid cell development (FDR < 5%). Mixed-effect linear regression analysis revealed statistically significant associations between the upregulation of LILRA6 and higher pain interference (β = −6.621, p = 0.010) and fatigue (β = −6.621, p = 0.010), as well as between the downregulation of CACNG6 (β = −1.043, p = 0.047) and PRSS33 upregulation (β = 1.384, p = 0.038) and increased pain interference. Given the small sample size, these findings should be interpreted with caution. Conclusion These findings suggest inflammation and specific biomarkers may drive pain and fatigue during chemotherapy. Further preclinical models or clinical cohorts are needed to validate these results and explore potential implications for targeted interventions to reduce symptom burden in patients with colorectal cancer.