Abstract: This report summarizes the findings of the 2011 Institute of Medicine Committee on dietary intake requirements for calcium and vitamin D in North America, and provides updated data from the previous Institute of Medicine report of 1997. The Committee extensively reviewed existing published evidence on dietary and supplemental intake requirements for calcium and vitamin D with respect to both skeletal health and extraskeletal chronic disease outcomes. Calcium and vitamin D intake requirements were examined for several risk indictors of bone and skeletal health as well as extraskeletal outcomes (including cancer, cardiovascular disease, diabetes, and autoimmune disorders, infectious diseases, neuropsychological function, and disorders of pregnancy). Recommended Dietary Allowance (RDA) was defined as the level of intake of calcium or serum 25-hydroxyvitamin D that would meet the requirements of at least 97.5% of the population. The available scientific data supported an important role for calcium and vitamin D in bone and skeletal health outcomes that was consistent with a cause-and-effect relationship. However, data from randomized clinical trials for extraskeletal health outcomes were limited and inconclusive regarding a possible relationship with calcium and vitamin D intake requirements, and no evidence was found for dose-response or other established criteria for cause-and-effect. For bone health outcome, RDAs of calcium ranged from 700 to 1300 mg/d for life-stage groups at ≥1 year of age, and RDAs of vitamin D were 600 IU/d for ages 1 to 70 years and 800 IU/d for ages ≥71 (corresponding to a serum 25-hydroxyvitamin D level of at least 20 ng/mL [50 nmol/L]). There was an assumption of minimal or no sun exposure for estimation of RDA levels because of the wide variation in vitamin D synthesis from ultraviolet light and concern over risk of skin cancer. No consistent evidence was found that dietary or supplemental intake of vitamin D levels above the RDA provides additional benefit for bone health or extraskeletal outcomes; several investigators have found an U-shaped curve for several outcomes related to vitamin D intake, with increased risks at both low and high levels. The findings of this report suggest that prevalence of vitamin D deficiency in North America has been overestimated. The data show that almost all individuals in this population meet their RDA for vitamin D.

Abstract: Smart materials with an in-built ability to repair damage caused by normal wear and tear could prove useful in a wide range of applications. Most healable polymer-based materials so far developed require heating of the damaged area. But Burnworth et al. have now produced materials — in the form of polymer strands linked through metal complexes — that can be mended through exposure to light. The metal complexes in these materials can absorb ultraviolet light that is then converted into heat, which temporarily unlinks the polymer strands for quick and efficient defect healing. In principle, healing can take place in situ and while under load. Polymers with the ability to repair themselves after sustaining damage could extend the lifetimes of materials used in many applications1. Most approaches to healable materials require heating the damaged area2,3,4. Here we present metallosupramolecular polymers that can be mended through exposure to light. They consist of telechelic, rubbery, low-molecular-mass polymers with ligand end groups that are non-covalently linked through metal-ion binding. On exposure to ultraviolet light, the metal–ligand motifs are electronically excited and the absorbed energy is converted into heat. This causes temporary disengagement of the metal–ligand motifs and a concomitant reversible decrease in the polymers’ molecular mass and viscosity5, thereby allowing quick and efficient defect healing. Light can be applied locally to a damage site, so objects can in principle be healed under load. We anticipate that this approach to healable materials, based on supramolecular polymers and a light–heat conversion step, can be applied to a wide range of supramolecular materials that use different chemistries.

Abstract: Most azobenzene-based photoswitches use UV light for photoisomerization. This can limit their application in biological systems, where UV light can trigger unwanted responses, including cellular apoptosis. We have found that substitution of all four ortho positions with methoxy groups in an amidoazobenzene derivative leads to a substantial (∼35 nm) red shift of the n−π* band of the trans isomer, separating it from the cis n−π* transition. This red shift makes trans-to-cis photoswitching possible using green light (530–560 nm). The cis state is thermally stable with a half-life of ∼2.4 days in the dark in aqueous solution. Reverse (cis-to-trans) photoswitching can be accomplished with blue light (460 nm), so bidirectional photoswitching between thermally stable isomers is possible without using UV light at all.

Abstract: Cellulose acetate polymer is used to make a variety of consumer products including textiles, plastic films, and cigarette filters. A review of degradation mechanisms, and the possible approaches to diminish the environmental persistence of these materials, will clarify the current and potential degradation rates of these products after disposal. Various studies have been conducted on the biodegradability of cellulose acetate, but no review has been compiled which includes biological, chemical, and photo chemical degradation mechanisms. Cellulose acetate is prepared by acetylating cellulose, the most abundant natural polymer. Cellulose is readily biodegraded by organisms that utilize cellulase enzymes, but due to the additional acetyl groups cellulose acetate requires the presence of esterases for the first step in biodegradation. Once partial deacetylation has been accomplished either by enzymes, or by partial chemical hydrolysis, the polymer’s cellulose backbone is readily biodegraded. Cellulose acetate is photo chemically degraded by UV wavelengths shorter than 280 nm, but has limited photo degradability in sunlight due to the lack of chromophores for absorbing ultraviolet light. Photo degradability can be significantly enhanced by the addition of titanium dioxide, which is used as a whitening agent in many consumer products. Photo degradation with TiO2 causes surface pitting, thus increasing a material’s surface area which enhances biodegradation. The combination of both photo and biodegradation allows a synergy that enhances the overall degradation rate. The physical design of a consumer product can also facilitate enhanced degradation rate, since rates are highly influenced by the exposure to environmental conditions. The patent literature contains an abundance of ideas for designing consumer products that are less persistent in the outdoors environment, and this review will include insights into enhanced degradability designs.

Abstract: Exposure to the shortest wavelengths in sunlight, ultraviolet light, constitutes a deleterious ecological factor for many microorganisms. The use of secondary metabolites as sunscreens has emerged as an important photoprotective mechanism in certain groups of large-celled microorganisms, such as cyanobacteria, fungi and many protists. In this Review, we describe our current understanding of microbial 'sunscreen' compounds, including scytonemin, the mycosporines and the naphthalene-based melanins. Study of these sunscreens has led to the discovery of new classes of compounds, new metabolic pathways, a deeper understanding of microbial photobiology and the potential for dermatological or biomedical applications.

Abstract: Recent advances in basic fabrication techniques of TiO 2 -based nanomaterials such as nanoparticles, nanowires, nanoplatelets, and both physical- and solution-based techniques have been adopted by various research groups around the world. Our research focus has been mainly on various deposition parameters used for fabricating nanostructured materials, including TiO 2 -organic/inorganic nanocomposite materials. Technically, TiO 2 shows relatively high reactivity under ultraviolet light, the energy of which exceeds the band gap of TiO 2 . The development of photocatalysts exhibiting high reactivity under visible light allows the main part of the solar spectrum to be used. Visible light-activated TiO 2 could be prepared by doping or sensitizing. As far as doping of TiO 2 is concerned, in obtaining tailored material with improved properties, metal and nonmetal doping has been performed in the context of improved photoactivity. Nonmetal doping seems to be more promising than metal doping. TiO 2 represents an effective photocatalyst for water and air purification and for self-cleaning surfaces. Additionally, it can be used as an antibacterial agent because of its strong oxidation activity and superhydrophilicity. Therefore, applications of TiO 2 in terms of photocatalytic activities are discussed here. The basic mechanisms of the photoactivities of TiO 2 and nanostructures are considered alongside band structure engineering and surface modification in nanostructured TiO 2 in the context of doping. The article reviews the basic structural, optical, and electrical properties of TiO 2 , followed by detailed fabrication techniques of 0-, 1-, and quasi-2-dimensional TiO 2 nanomaterials. Applications and future directions of nanostructured TiO 2 are considered in the context of various photoinduced phenomena such as hydrogen production, electricity generation via dye-sensitized solar cells, photokilling and self-cleaning effect, photo-oxidation of organic pollutant, wastewater management, and organic synthesis.

Abstract: Leishmaniasis is a protozoan vector-borne disease and is one of the biggest health problems of the world. Antileishmanial drugs have disadvantages such as toxicity and the recent development of resistance. One of the best-known mechanisms of the antibacterial effects of silver nanoparticles (Ag-NPs) is the production of reactive oxygen species to which Leishmania parasites are very sensitive. So far no information about the effects of Ag-NPs on Leishmania tropica parasites, the causative agent of leishmaniasis, exists in the literature. The aim of this study was to investigate the effects of Ag-NPs on biological parameters of L. tropica such as morphology, metabolic activity, proliferation, infectivity, and survival in host cells, in vitro. Consequently, parasite morphology and infectivity were impaired in comparison with the control. Also, enhanced effects of Ag-NPs were demonstrated on the morphology and infectivity of parasites under ultraviolet (UV) light. Ag-NPs demonstrated significant antileishmanial effects by inhibiting the proliferation and metabolic activity of promastigotes by 1.5- to threefold, respectively, in the dark, and 2- to 6.5-fold, respectively, under UV light. Of note, Ag-NPs inhibited the survival of amastigotes in host cells, and this effect was more significant in the presence of UV light. Thus, for the first time the antileishmanial effects of Ag-NPs on L. tropica parasites were demonstrated along with the enhanced antimicrobial activity of Ag-NPs under UV light. Determination of the antileishmanial effects of Ag-NPs is very important for the further development of new compounds containing nanoparticles in leishmaniasis treatment.

Abstract: The widespread forgery in all kinds of paper documents and certificates has become a real threat to society. Traditional fluorescent anti-counterfeiting materials generally exhibit unicolor display and suffer greatly from substitution, thus leading to a poor anti-counterfeiting effect. In this work, unseen but significant enhanced blue down-conversion emission from oleic acid-stabilized lanthanide-doped fluoride nanocrystals is first present and the mechanism is proposed and validated. This not only endows these nanocrystals with dual-mode fluorescence, but also offers a simplified synthesis approach for dual-mode fluorescent nanocrystals involving no further complicated assembly or coating procedures, unlike the traditional methods. Furthermore, by changing the host/dopant combination or the content of dopant, these nanocrystals can exhibit simultaneously multicolor up-conversion emission under excitation at near-infrared light and unalterable blue down-conversion emission under ultraviolet light. A preliminary investigation of their anti-counterfeiting performance has been made, and the results indicate that this color tuning capability and high concealment makes these nanocrystals behave in a similar way to chameleons and can provide a strengthened and more reliable anti-counterfeiting effect.

Abstract: The retina uses two photoreceptor types to encode the wide range of light intensities in the natural environment. Rods mediate vision in dim light, whereas cones mediate vision in bright light. Mouse photoreceptors include only 3% cones, and the majority of these coexpress two opsins (short- and middle-wavelength sensitive, S and M), with peak sensitivity to either ultraviolet (360 nm) or green light (508 nm). The M/S-opsin ratio varies across the retina but has not been characterized functionally, preventing quantitative study of cone-mediated vision. Furthermore, physiological and behavioral measurements suggested that mouse retina supports relatively slow temporal processing (peak sensitivity, ∼2–5 Hz) compared to primates; however, past studies used visible wavelengths that are inefficient at stimulating mouse S-opsin. Here, we measured the M/S-opsin expression ratio across the mouse retina, as reflected by ganglion cell responses in vitro, and probed cone-mediated ganglion cell temporal properties using ultraviolet light stimulation and linear systems analysis. From recordings in mice lacking rod function (Gnat1−/−, Rho−/−), we estimate ∼70% M-opsin expression in far dorsal retina, dropping to

Abstract: The synthesis of large lattice mismatch metal-semiconductor core–shell hetero-nanostructures remains challenging, and thus the corresponding optical properties are seldom discussed. Here, we report the gold-nanorod-seeded growth of Au–CdS core–shell hetero-nanorods by employing Ag2S as an interim layer that favors CdS shell formation through a cation-exchange process, and the subsequent CdS growth, which can form complete core–shell structures with controllable shell thickness. Exciton–plasmon interactions observed in the Au–CdS nanorods induce shell thickness-tailored and red-shifted longitudinal surface plasmon resonance and quenched CdS luminescence under ultraviolet light excitation. Furthermore, the Au–CdS nanorods demonstrate an enhanced and plasmon-governed two-photon luminescence under near-infrared pulsed laser excitation. The approach has potential for the preparation of other metal-semiconductor hetero-nanomaterials with complete core–shell structures, and these Au–CdS nanorods may open up intriguing new possibilities at the interface of optics and electronics.

Abstract: Hospital-acquired Legionnaires' disease is directly linked to the presence of Legionella in hospital drinking water. Disinfecting the drinking water system is an effective preventive measure. The efficacy of any disinfection measures should be validated in a stepwise fashion from laboratory assessment to a controlled multiple-hospital evaluation over a prolonged period of time. In this review, we evaluate systemic disinfection methods (copper-silver ionization, chlorine dioxide, monochloramine, ultraviolet light, and hyperchlorination), a focal disinfection method (point-of-use filtration), and short-term disinfection methods in outbreak situations (superheat-and-flush with or without hyperchlorination). The infection control practitioner should take the lead in selection of the disinfection system and the vendor. Formal appraisals by other hospitals with experience of the system under consideration is indicated. Routine performance of surveillance cultures of drinking water to detect Legionella and monitoring of disinfectant concentrations are necessary to ensure long-term efficacy.

Abstract: Background The emergence of plasmid-mediated carbapenemases, such as NDM-1 in Enterobacteriaceae is a major public health issue. Since they mediate resistance to virtually all β-lactam antibiotics and there is often co-resistance to other antibiotic classes, the therapeutic options for infections caused by these organisms are very limited. Methodology We characterized the first NDM-1 producing E. coli isolate recovered in Hong Kong. The plasmid encoding the metallo-β-lactamase gene was sequenced. Principal Findings The plasmid, pNDM-HK readily transferred to E. coli J53 at high frequencies. It belongs to the broad host range IncL/M incompatibility group and is 88803 bp in size. Sequence alignment showed that pNDM-HK has a 55 kb backbone which shared 97% homology with pEL60 originating from the plant pathogen, Erwina amylovora in Lebanon and a 28.9 kb variable region. The plasmid backbone includes the mucAB genes mediating ultraviolet light resistance. The 28.9 kb region has a composite transposon-like structure which includes intact or truncated genes associated with resistance to β-lactams (blaTEM-1, blaNDM-1, ΔblaDHA-1), aminoglycosides (aacC2, armA), sulphonamides (sul1) and macrolides (mel, mph2). It also harbors the following mobile elements: IS26, ISCR1, tnpU, tnpAcp2, tnpD, ΔtnpATn1 and insL. Certain blocks within the 28.9 kb variable region had homology with the corresponding sequences in the widely disseminated plasmids, pCTX-M3, pMUR050 and pKP048 originating from bacteria in Poland in 1996, in Spain in 2002 and in China in 2006, respectively. Significance The genetic support of NDM-1 gene suggests that it has evolved through complex pathways. The association with broad host range plasmid and multiple mobile genetic elements explain its observed horizontal mobility in multiple bacterial taxa.

Abstract: Nature provides impressive examples of chiral photonic crystals, with the notable example of the cubic so-called srs network (the label for the chiral degree-three network modeled on SrSi2) or gyroid structure realized in wing scales of several butterfly species. By a circular polarization analysis of the band structure of such networks, we demonstrate strong circular dichroism effects: The butterfly srs microstructure, of cubic I4132 symmetry, shows significant circular dichroism for blue to ultraviolet light, that warrants a search for biological receptors sensitive to circular polarization. A derived synthetic structure based on four like-handed silicon srs nets exhibits a large circular polarization stop band of a width exceeding 30%. These findings offer design principles for chiral photonic devices.

Abstract: Phototherapy is a mainstay in the treatment of psoriasis and is available as psoralen plus UVA (PUVA), broadband UVB (BB-UVB), and narrowband UVB (NB-UVB). Phototherapy can be administered in the hospital, outpatient clinic, or in the patient's home. The purpose of this review is to provide some practical guidance to general dermatologists and residents on the specifics of using phototherapy, which, despite its decreasing use, remains one of our most safe and effective treatment strategies for psoriasis care. We conducted a literature review of home phototherapy, BB-UVB, NB-UVB, and PUVA phototherapy using PubMed, MD Consult, and reference lists. A variety of protocols for BB-UVB, NB-UVB, and PUVA have been used in clinical trials. NB-UVB is more effective than BB-UVB and safer than PUVA. Typical regimens for NB-UVB involve dosing 3 times per week for at least 3 months. Treatment must be independently developed to suit each participant's needs. Ultraviolet light is an effective, relatively safe modality that is a valuable tool in the treatment of psoriasis. NB-UVB phototherapy is considered the first-line treatment for extensive plaque type psoriasis.

Abstract: AlN/GaN short-period superlattices (SLs) is experimentally shown to have a different polarization property from AlGaN. As the GaN well thickness decreases from 2.5 to 0.9 monolayers, the emission wavelength decreases from 275.8 to 236.9 nm due to a quantum size effect. Because the quantized energy level for holes originates from the heavy hole band of GaN, the emission is polarized for electric field perpendicular to the c-axis (E⊥c). Consequently, the SLs show intense C-plane emission compared with AlGaN, whose emission is inherently polarized for electric field parallel to the c-axis (E||c). Using the SLs, we demonstrate a E⊥c-polarized deep-ultraviolet (UV) light-emitting diode (LED).

Abstract: The effectiveness of UV-C light exposure on safety and quality of fresh-cut fruit was investigated with reference to melon cubes. UV-C light was applied during cutting operations and before packaging. Melon cubes were then analysed for microbial counts, colour, firmness, juice leakage, sensory properties and preference during storage at 6 °C for up to 14 days. Fruit exposure to UV-C light leaded to 2 log reductions for both total viable count and Enterobacteriaceae , whose counts remained 2 log units lower than that of the untreated sample during storage. No significant effect of UV-C light treatment on product colour and firmness was detected during storage. By contrast, the exposure to UV-C light decreased melon leakage, probably due to the formation of a thin dried film on the product surface. UV-C treated samples were also associated to a better flavour which made them significantly preferred to the untreated ones. UV-C light treatment was demonstrated to be a high potential novel technology for surface decontamination of ready-to-eat food surface. Industrial Relevance UV-C light treatment represents a high potential novel technology allowing to achieve surface decontamination of ready-to-eat fruit products while improving their sensory properties.

Abstract: Summary Background. Frequent, purposeful exposure to ultraviolet (UV) light may induce a compulsive desire to tan despite the negative consequences being known, suggesting a behavioural complex similar to addictive disorders. Aim. To assess the presence of addictive-like behaviours in subjects using indoor tanning salons. Methods. Subjects (n = 100) were surveyed by two questionnaires: a modified CAGE questionnaire to assess behaviours consistent with problem tanning and a modified Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) (‘substance dependence’ criteria) to assess behaviours consistent with a dependence-like disorder. Results. In total, 41% of subjects met criteria consistent with a ‘tanning addictive disorder’, and an additional 33% met criteria for problematic tanning behaviour based on the modified CAGE criteria or subthreshold criteria on the modified DSM-IV criteria. Female gender and early age of onset were associated with meeting tanning addiction criteria. Conclusion. A high percentage of subjects who tan frequently in indoor salons experience behaviours and consequences to their tanning consistent with other identified addictive disorders.

Abstract: Er3+ doped Bi2MoO6 nanosheets with enhanced photocatalytic activity were synthesized for the first time using a simple hydrothermal method. The morphology of Bi2MoO6 can be controlled from nanosheets to nanowires by adjusting the pH values. The samples were characterized by transmission electron microscopy (TEM), X-ray diffraction (XRD), Brunauer–Emmett–Teller (BET), photoluminescence spectra (PL) and X-ray photoelectron spectroscopy (XPS). Er3+ doped Bi2MoO6 nanosheets selectively exposed {0 1 0} facets as the main external surfaces and the nanowires grew along the (0 1 0) direction. The nanosheets were found to be highly active for photocatalytic degradation of dyes and phenol. The activities of the Er3+ doped Bi2MoO6 nanosheets were much superior to that of commercial Degussa P25. The effect of Er3+ on the photocatalytic activity of Bi2MoO6 was investigated in detail. The enhanced photocatalytic activity of Bi2MoO6 nanosheets can be attributed to the exposed {0 1 0} facets and the dopant Er3+ which can transform visible light into ultraviolet light.

Abstract: Multifunctional single crystalline tin-doped indium oxide (ITO) nanowires with tuned Sn doping levels are synthesized via a vapor transport method. The Sn concentration in the nanowires can reach 6.4 at.% at a synthesis temperature of 840 ◦ C, significantly exceeding the Sn solubility in ITO bulks grown at comparable temperatures, which we attribute to the unique feature of the vapor–liquid–solid growth. As a promising transparent conducting oxide nanomaterial, layers of these ITO nanowires exhibit a sheet resistance as low as 6.4 �/ and measurements on individual nanowires give a resistivity of 2.4 × 10 −4 � cm with an electron density up to 2.6 × 10 20 cm −3 , while the optical transmittance in the visible regime can reach ∼80%. Under the ultraviolet excitation the ITO nanowire samples emit blue light, which can be ascribed to transitions related to defect levels. Furthermore, a room temperature ultraviolet light emission is observed in these ITO nanowires for the first time, and the exciton-related radiative process is identified by using temperature-dependent photoluminescence measurements. S Online supplementary data available from stacks.iop.org/Nano/22/195706/mmedia (Some figures in this article are in colour only in the electronic version)

Abstract: Vesicle-capped nanotubes made from amphiphilic molecules with photoswitchable cores undergo controlled disassembly when exposed to ultraviolet light, and this process can be followed in real time with fluorescence microscopy.

Abstract: Effect of irradiation on graphene oxide by sunlight, UV light and KrF excimer laser has been investigated in detail. Both sunlight and ultraviolet light reduce graphene oxide well after prolonged irradiation, but laser irradiation produces graphene with negligible oxygen functionalities within a short time. Laser irradiation is also useful for one-step synthesis of metal particle decorated graphene. Laser irradiation of graphene oxide appears to be an efficient procedure for large-scale synthesis of graphene.

Abstract: Light quality and quantity affect plant adaptation to changing light conditions. Certain wavelengths in the visible and nearvisible spectrum are known to have discrete effects on plant growth and development, and the effects of red, far-red, blue, and ultraviolet light have been well described. In this report, an effect of green light on Arabidopsis (Arabidopsis thaliana) rosette architecture is demonstrated using a narrow-bandwidth light-emitting diode-based lighting system. When green light was added to a background of constant red and blue light, plants exhibited elongation of petioles and upward leaf reorientation, symptoms consistent with those observed in a shaded light environment. The same green light-induced phenotypes were also observed in phytochrome (phy) and cryptochrome (cry) mutant backgrounds. To explore the molecular mechanism underlying the green light-induced response, the accumulation of shade-induced transcripts was measured in response to enriched green light environments. Transcripts that have been demonstrated to increase in abundance under far-red-induced shade avoidance conditions either decrease or exhibit no change when green light is added. However, normal far-red light-associated transcript accumulation patterns are observed in cryptochrome mutants grown with supplemental green light, indicating that the greenabsorbing form of cryptochrome is the photoreceptor active in limiting the green light induction of shade-associated transcripts. These results indicate that shade symptoms can be induced by the addition of green light and that cryptochrome receptors and an unknown light sensor participate in acclimation to the enriched green environment.

Abstract: Single-crystalline WO3 nanowires were synthesized on carbon papers through a chemical vapor deposition process without using any catalysts. WO3 nanowire field-effect transistors (FETs) were constructed to discuss the mechanism of electronic transport based on a thermal-activation model and a displacive transition. Photoconductive measurements showed that individual WO3 nanowire photodetector was sensitive to the ultraviolet light, and the photoresponse was further improved using WO3 nanowires on carbon papers, demonstrating significantly shortened response and decay times, and enhanced stability. Field-emission measurements showed that WO3 nanowires were excellent field-emitters: an ultralow turn-on field of 1.8 V μm−1 and a threshold field of 3.3 V μm−1, and a high field-enhancement factor of 6.9 × 103. These results indicate that present unique WO3 nanowires on carbon papers are promising candidates for constructing high-performance electronic and optoelectronic devices.

Abstract: Background Herpes simplex labialis (HSL), also known as cold sores, is a common disease of the lips caused by the herpes simplex virus, which is found throughout the world. It presents as a painful vesicular eruption, forming unsightly crusts, which cause cosmetic disfigurement and psychosocial distress. There is no cure available, and it recurs periodically. Objectives To assess the effects of interventions for the prevention of HSL in people of all ages. Search methods We searched the following databases up to 19 May 2015: the Cochrane Skin Group Specialised Register, the Oral Health Group Specialised Register, CENTRAL in the Cochrane Library (Issue 4, 2015), MEDLINE (from 1946), EMBASE (from 1974), LILACS (from 1982), the China National Knowledge Infrastructure (CNKI) database, Airiti Library, and 5 trial registers. To identify further references to relevant randomised controlled trials, we scanned the bibliographies of included studies and published reviews, and we also contacted the original researchers of our included studies. Selection criteria Randomised controlled trials (RCTs) of interventions for preventing HSL in immunocompetent people. Data collection and analysis Two authors independently selected trials, extracted data, and assessed the risk of bias. A third author was available for resolving differences of opinion. Main results This review included 32 RCTs, with a total of 2640 immunocompetent participants, covering 19 treatments. The quality of the body of evidence was low to moderate for most outcomes, but was very low for a few outcomes. Our primary outcomes were 'Incidence of HSL' and 'Adverse effects during use of the preventative intervention'.The evidence for short-term (≤ 1 month) use of oral aciclovir in preventing recurrent HSL was inconsistent across the doses used in the studies: 2 RCTs showed low quality evidence for a reduced recurrence of HSL with aciclovir 400 mg twice daily (risk ratio (RR) 0.26, 95% confidence interval (CI) 0.13 to 0.51; n = 177), while 1 RCT testing aciclovir 800 mg twice daily and 2 RCTs testing 200 mg 5 times daily found no similar preventive effects (RR 1.08, 95% CI 0.62 to 1.87; n = 237; moderate quality evidence and RR 0.46, 95% CI 0.20 to 1.07; n = 66; low quality evidence, respectively). The direction of intervention effect was unrelated to the risk of bias. The evidence from 1 RCT for the effect of short-term use of valaciclovir in reducing recurrence of HSL by clinical evaluation was uncertain (RR 0.55, 95% CI 0.23 to 1.28; n = 125; moderate quality evidence), as was the evidence from 1 RCT testing short-term use of famciclovir.Long-term (> 1 month) use of oral antiviral agents reduced the recurrence of HSL. There was low quality evidence from 1 RCT that long-term use of oral aciclovir reduced clinical recurrences (1.80 versus 0.85 episodes per participant per a 4-month period, P = 0.009) and virological recurrence (1.40 versus 0.40 episodes per participant per a 4-month period, P = 0.003). One RCT found long-term use of valaciclovir effective in reducing the incidence of HSL (with a decrease of 0.09 episodes per participant per month; n = 95). One RCT found that a long-term suppressive regimen of valaciclovir had a lower incidence of HSL than an episodic regimen of valciclovir (difference in means (MD) -0.10 episodes per participant per month, 95% CI -0.16 to -0.05; n = 120).These trials found no increase in adverse events associated with the use of oral antiviral agents (moderate quality evidence).There was no evidence to show that short-term use of topical antiviral agents prevented recurrent HSL. There was moderate quality evidence from 2 RCTs that topical aciclovir 5% cream probably has little effect on preventing recurrence of HSL (pooled RR 0.91, 95% CI 0.48 to 1.72; n = 271). There was moderate quality evidence from a single RCT that topical foscarnet 3% cream has little effect in preventing HSL (RR 1.08, 95% CI 0.82 to 1.40; n = 295).The efficacy of long-term use of topical aciclovir cream was uncertain. One RCT found significantly fewer research-diagnosed recurrences of HSL when on aciclovir cream treatment than on placebo (P 0.05). Another RCT found that the group who used 2-hydroxypropyl-β-cyclo dextrin 20% gel for 6 months had significantly more recurrences than the placebo group (P = 0.003).These studies found no increase in adverse events related to the use of topical antiviral agents.Two RCTs found that the application of sunscreen significantly prevented recurrent HSL induced by experimental ultraviolet light (pooled RR 0.07, 95% CI 0.01 to 0.33; n = 111), but another RCT found that sunscreen did not prevent HSL induced by sunlight (RR 1.13, 95% CI 0.25 to 5.06; n = 51). These RCTs did not report adverse events.There were very few data suggesting that thymopentin, low-level laser therapy, and hypnotherapy are effective in preventing recurrent HSL, with one to two RCTs for each intervention. We failed to find any evidence of efficacy for lysine, LongoVital® supplementation, gamma globulin, herpes simplex virus (HSV) type I subunit vaccine, and yellow fever vaccine in preventing HSL. There were no consistent data supporting the efficacy of levamisole and interferon, which were also associated with an increased risk of adverse effects such as fever. Authors' conclusions The current evidence demonstrates that long-term use of oral antiviral agents can prevent HSL, but the clinical benefit is small. We did not find evidence of an increased risk of adverse events. On the other hand, the evidence on topical antiviral agents and other interventions either showed no efficacy or could not confirm their efficacy in preventing HSL.