Purpose The aim of this study was to review the available literature and define clinical practice guidelines for the use of agents for the prevention and treatment of gastrointestinal mucositis. Methods A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, and no guideline possible.Results A total of 251 clinical studies across 29 interventions were examined. Panel members were able to make one new evidence-based negative recommendation; two new evidence-based suggestions, and one evidence-based change from previous guidelines. Firstly, the panel recommends against the use of misoprostol suppositories for the prevention of acute radiation-induced proctitis. Secondly, the panel suggests probiotic treatment containing Lactobacillus spp., may be beneficial for prevention of chemotherapy and radiotherapy-induced diarrhea in patients with malignancies of the pelvic region. Thirdly, the panel suggests the use of hyperbaric oxygen as an effective means in treating radiation-induced proctitis. Finally, new evidence

Synopsis Microclimatic variation has emerged as an important driver of many ecological and evolutionary processes. Nonetheless, fine-scale temperature data are still rare in most habitats, limiting our ability to understand the consequences of microclimatic variation under current and future conditions. We measured fine-scale thermal variation in a common, species-rich, but rarely studied habitat with respect to temperature: the airspaces under rocks on intertidal zone boulder shores. The effects of thermal variation were investigated using physiological, behavioral, and demographic responses of the porcelain crab Petrolisthes cinctipes. Habitat temperatures were measured at fine spatial and temporal resolution over 18 months, producing 424,426 temperature records. Microclimatic variation increased with increasing intertidal elevation, particularly with respect to heat extremes. However, mean temperatures were similar across the entire intertidal zone. Overheating risk for P. cinctipes increases with intertidal elevation but is size dependent, as large animals are more heat sensitive than small animals. Still, microclimatic variation high in the intertidal zone provided thermal refugia even under the warmest conditions. Size-dependent thermal responses predicted that large crabs should be rare high in the intertidal zone, which was supported by demographic data. Furthermore, simulations parameterized by our microclimate and organismal data recapitulated demographic patterns. Therefore, interactions between microclimatic variation and size-dependent thermal responses may have significant ecological repercussions that warrant greater attention.

Anthropogenic global change is predicted to increase the physiological stress of organisms through changes in abiotic conditions such as temperature, pH, and pollution. However, organisms can also experience physiological stress through interactions with other species, especially parasites, predators, and competitors. The stress of species interactions could be an important driver of species' responses to global change as the composition of biological communities change through factors such as distributional and phenological shifts. Interactions between biotic and abiotic stressors could also induce non-linear physiological stress responses under global change. One of the primary means by which organisms deal with physiological stress is through the cellular stress response (CSR), which is broadly the upregulation of a conserved set of genes that facilitate the removal and repair of damaged macromolecules. Here, we present data on behavioral interactions and CSR gene expression for two competing species of intertidal zone porcelain crab (Petrolisthes cinctipes and Petrolisthes manimaculis). We found that P. cinctipes and P. manimaculis engage in more agonistic behaviors when interacting with heterospecifics than conspecifics; however, we found no evidence that heterospecific interactions induced a CSR in these species. In addition to our new data, we review the literature with respect to CSR induction via species interactions, focusing on predator-prey systems and heterospecific competition. We find extensive evidence for predators to induce cellular stress and aspects of the CSR in prey, even in the absence of direct physical contact between species. Effects of heterospecific competition on the CSR have been studied far less, but we do find evidence that agonistic interactions with heterospecifics can induce components of the CSR. Across all published studies, there is clear evidence that species interactions can lead to cellular stress and induction of the CSR. Nonetheless, our understanding of species-induced cellular stress lags far behind our understanding of abiotic cellular stress.

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