The Association of Cerebral Oxygen Desaturation with Postoperative Cognitive Dysfunction in Older Patients: A Review.

Postoperative cognitive dysfunction (POCD) is a neurological complication associated with surgery and anesthesia that is commonly observed in older patients, and it can significantly affect patient prognosis and survival. Therefore, predicting and preventing POCD is important. Regional cerebral oxygen saturation (rSO2) reflects cerebral perfusion and oxygenation, and decreased intraoperative cerebral oxygen saturation has been reported to increase the risk of POCD. In this review, we elucidated the important relationship between the decline in rSO2 and risk of POCD in older patients. We also emphasized the importance of monitoring rSO2 during surgery to predict and prevent adverse perioperative cognitive outcomes. The findings reveal that incorporating intraoperative rSO2 monitoring into clinical practice has potential benefits, such as protecting cognitive function, reducing perioperative adverse outcomes, and ultimately improving the overall quality of life of older adults.

Arsenic trioxide augments immunogenic cell death and induces cGAS-STING-IFN pathway activation in hepatocellular carcinoma.

The treatment of hepatocellular carcinoma (HCC) is particularly challenging due to the inherent tumoral heterogeneity and easy resistance towards chemotherapy and immunotherapy. Arsenic trioxide (ATO) has emerged as a cytotoxic agent effective for treating solid tumors, including advanced HCC. However, its effectiveness in HCC treatment remains limited, and the underlying mechanisms are still uncertain. Therefore, this study aimed to characterize the effects and mechanisms of ATO in HCC. By evaluating the susceptibilities of human and murine HCC cell lines to ATO treatment, we discovered that HCC cells exhibited a range of sensitivity to ATO treatment, highlighting their inherent heterogeneity. A gene signature comprising 265 genes was identified to distinguish ATO-sensitive from ATO-insensitive cells. According to this signature, HCC patients have also been classified and exhibited differential features of ATO response. Our results showed that ATO treatment induced reactive oxygen species (ROS) accumulation and the activation of multiple cell death modalities, including necroptosis and ferroptosis, in ATO-sensitive HCC cells. Meanwhile, elevated tumoral immunogenicity was also observed in ATO-sensitive HCC cells. Similar effects were not observed in ATO-insensitive cells. We reported that ATO treatment induced mitochondrial injury and mtDNA release into the cytoplasm in ATO-sensitive HCC tumors. This subsequently activated the cGAS-STING-IFN axis, facilitating CD8+ T cell infiltration and activation. However, we found that the IFN pathway also induced tumoral PD-L1 expression, potentially antagonizing ATO-mediated immune attack. Additional anti-PD1 therapy promoted the anti-tumor response of ATO in ATO-sensitive HCC tumors. In summary, our data indicate that heterogeneous ATO responses exist in HCC tumors, and ATO treatment significantly induces immunogenic cell death (ICD) and activates the tumor-derived mtDNA-STING-IFN axis. These findings may offer a new perspective on the clinical treatment of HCC and warrant further study.

The long rod-shaped Sr2 MgSi2 O7 :Eu2+ ,Dy3+ with ultrahigh afterglow performance.

The afterglow properties of long afterglow luminescent materials are greatly affected by their defects, which are distributed on the grain surface. Increasing the exposed surface area is an important method to improve the afterglow performance. In this research, long rod-shaped long afterglow materials Sr2 MgSi2 O7 :Eu2+ ,Dy3+ were prepared using the hydrothermal-coprecipitation method. When the reaction time reached 96 h, the length of the afterglow materials could grow to 2 mm, and the sintering temperature was just 1150°C. The emission spectra of all obtained samples upon excitation at 397 nm had a maximum of 465 nm, which belonged to the representative transition of Eu2+ . The initial brightness was 1.35 cd/m2 . The afterglow time could reach 19 h, giving a good afterglow performance. The research on this kind of material has essential significance in the exploration of luminescence mechanisms and their applications.

Latest advances and clinical application prospects of resveratrol therapy for neurocognitive disorders.

Neurocognitive disorders, such as Alzheimer's disease, vascular dementia, and postoperative cognitive dysfunction, are non-psychiatric brain syndromes in which a significant decline in cognitive function causes great trauma to the mental status of the patient. The lack of effective treatments for neurocognitive disorders imposes a considerable burden on society, including a substantial economic impact. Over the past few decades, the identification of resveratrol, a natural plant compound, has provided researchers with an opportunity to formulate novel strategies for the treatment of neurocognitive disorders. This is because resveratrol effectively protects the brain of those with neurocognitive disorders by targeting some mechanisms such as inflammation and oxidative stress. This article reviews the status of recent research investigating the use of resveratrol for the treatment of different neurocognitive disorders. By examining the possible mechanisms of action of resveratrol and the shared mechanisms of different neurocognitive disorders, treatments for neurocognitive disorders may be further clarified.

Effects of xenon anesthesia on postoperative neurocognitive disorders: a systematic review and meta-analysis.

The latest clinical trials have reported conflicting outcomes regarding the effectiveness of xenon anesthesia in preventing postoperative neurocognitive dysfunction; thus, this study assessed the existing evidence. We searched the PubMed, Embase, Cochrane Library, and Web of Science databases from inception to April 9, 2023, for randomized controlled trials of xenon anesthesia in postoperative patients. We included English-language randomized controlled studies of adult patients undergoing surgery with xenon anesthesia that compared its effects to those of other anesthetics. Duplicate studies, pediatric studies, and ongoing clinical trials were excluded. Nine studies with 754 participants were identified. A forest plot revealed that the incidence of postoperative neurocognitive dysfunction did not differ between the xenon anesthesia and control groups (P = 0.43). Additionally, xenon anesthesia significantly shortened the emergence time for time to opening eyes (P < 0.001), time to extubation (P < 0.001), time to react on demand (P = 0.01), and time to time and spatial orientation (P = 0.04). However, the Aldrete score significantly increased with xenon anesthesia (P = 0.005). Postoperative complications did not differ between the anesthesia groups. Egger's test for bias showed no small-study effect, and a trim-and-fill analysis showed no apparent publication bias. In conclusion, xenon anesthesia probably did not affect the occurrence of postoperative neurocognitive dysfunction. However, xenon anesthesia may effectively shorten the emergence time of certain parameters without adverse effects.

A cutting-edge strategy for spinal cord injury treatment: resident cellular transdifferentiation.

Spinal cord injury causes varying degrees of motor and sensory function loss. However, there are no effective treatments for spinal cord repair following an injury. Moreover, significant preclinical advances in bioengineering and regenerative medicine have not yet been translated into effective clinical therapies. The spinal cord's poor regenerative capacity makes repairing damaged and lost neurons a critical treatment step. Reprogramming-based neuronal transdifferentiation has recently shown great potential in repair and plasticity, as it can convert mature somatic cells into functional neurons for spinal cord injury repair in vitro and in vivo, effectively halting the progression of spinal cord injury and promoting functional improvement. However, the mechanisms of the neuronal transdifferentiation and the induced neuronal subtypes are not yet well understood. This review analyzes the mechanisms of resident cellular transdifferentiation based on a review of the relevant recent literature, describes different molecular approaches to obtain different neuronal subtypes, discusses the current challenges and improvement methods, and provides new ideas for exploring therapeutic approaches for spinal cord injury.

Structural identification of pyridinopyrone compounds with anti-neuroinflammatory activity from streptomyces sulphureus DSM 40104.

This study investigated the chemical composition and biosynthesis pathway of compounds produced by Streptomyces sulphureus DSM 40104. With the guild of molecular networking analysis, we isolated and identified six uncommon structural characteristics of compounds, including four newly discovered pyridinopyrones. Based on genomic analysis, we proposed a possible hybrid NRPS-PKS biosynthesis pathway for pyridinopyrones. Notably, this pathway starts with the use of nicotinic acid as the starting unit, which is a unique feature. Compounds 1-3 exhibited moderate anti-neuroinflammatory activity against LPS-induced BV-2 cell inflammation. Our study demonstrates the diversity of polyene pyrone compounds regarding their chemical structure and bioactivity while providing new insights into their biosynthesis pathway. These findings may lead to the development of new treatments for inflammation-related diseases.

Do Bad People Deserve Empathy? Selective Empathy Based on Targets' Moral Characteristics.

The relation between empathy and morality is a widely discussed topic. However, previous discussions mainly focused on whether and how empathy influences moral cognition and moral behaviors, with limited attention to the reverse influence of morality on empathy. This review summarized how morality influences empathy by drawing together a number of hitherto scattered studies illustrating the influence of targets' moral characteristics on empathy. To explain why empathy is morally selective, we discuss its ultimate cause, to increase survival rates, and five proximate causes based on similarity, affective bonds, the appraisal of deservingness, dehumanization, and potential group membership. To explain how empathy becomes morally selective, we consider three different pathways (automatic, regulative, and mixed) based on previous findings. Finally, we discuss future directions, including the reverse influence of selective empathy on moral cognition, the moral selectivity of positive empathy, and the role of selective empathy in selective helping and third-party punishment.

The effects of physical activity on depression and quality of life in Chinese perimenopausal women.

BACKGROUND: Women are more likely to experience depressive symptoms and poor quality of life (QoL) during perimenopause. The effectiveness of physical activity (PA) in perimenopause on mental well-being and health outcomes has been frequently reported. This study aimed to investigate the mediating effect of PA on the relationship between depression and QoL in Chinese perimenopausal women. METHODS: A cross-sectional study was performed, and participants were recruited through a multistage, stratified, probability proportional to size sampling method. Depression, PA, and QoL were measured by Zung Self-rating Depression Scale, Physical Activity Rating Scale-3, and World Health Organization Quality of Life Questionnaire. The direct and indirect effects of PA on QoL were analyzed by PA in a mediation framework. RESULTS: 1100 perimenopausal women participated in the study. PA mainly plays partial mediating roles in the relationship between depression and physical (ab = -0.493, 95 % CI: -0.582 to -0.407; ab = -0.449, 95 % CI: -0.553 to -0.343) and psychological (ab = -0.710, 95 % CI: -0.849 to -0.578; ab = -0.721, 95 % CI: -0.853 to -0.589; ab = -0.670, 95 % CI: -0.821 to -0.508) domains of QoL. Additionally, intensity (ab = -0.496, 95 % CI: -0.602 to -0.396; ab = -0.355, 95 % CI: -0.498 to -0.212) and duration (ab = -0.201, 95 % CI: -0.298 to -0.119; ab = -0.134, 95 % CI: -0.237 to -0.047) intermediated the relationship between moderate-to-severe depression and physical domain; frequency (ab = -0.130, 95 % CI: -0.207 to -0.066) only had a mediation influence between moderate depression and physical domain; intensity (ab = -0.583, 95 % CI: -0.712 to -0.460; ab = -0.709, 95 % CI: -0.854 to -0.561; ab = -0.520, 95 % CI: -0.719 to -0.315), duration (ab = -0.433, 95 % CI: -0.559 to -0.311; ab = -0.389, 95 % CI: -0.547 to -0.228; ab = -0.258, 95 % CI: -0.461 to -0.085), and frequency (ab = -0.365, 95 % CI: -0.493 to -0.247; ab = -0.270, 95 % CI: -0.414 to -0.144) all interceded between the psychological domain and all levels of depression, except for the frequency between severe depression and psychological domain; in terms of social relationship and environment domains, intensity (ab = -0.458, 95 % CI: -0.593 to -0.338; ab = -0.582, 95 % CI: -0.724 to -0.445), duration (ab = -0.397, 95 % CI: -0.526 to -0.282; ab = -0.412, 95 % CI: -0.548 to -0.293), and frequency (ab = -0.231, 95 % CI: -0.353 to -0.123; ab = -0.398, 95 % CI: -0.533 to -0.279) were mediators only on mild depression. LIMITATIONS: The cross-sectional study and self-reported data are major limiting factors. CONCLUSION: PA and its components partially mediated the association between depression and QoL. Suitable prevention methods and interventions for PA may improve the QoL for perimenopausal women.

Progress in Electrochemical Sensing of Heavy Metals Based on Amino Acids and Its Composites.

A detailed overview toward the advancement of amino acid-based electrochemical sensors on the detection of heavy metals is presented. Discussion is focused on the unique properties of various amino acids (AAs) and its composites which allow them being employed in a diverse range of sensing platforms. Formation of metal-ligand complexes in between metal ions and different AAs has been discussed. The essential insights on the interaction between amino acid-based sensors and target heavy metal ions (HMIs) are provided, along with the discussion on their pros and cons. Voltammetry analysis of metal ions based on various interfaces of electrochemical sensors has been highlighted, together with the incorporation of AAs with organic, inorganic and bio-materials. In all these cases, the amino acid modified electrodes have demonstrated large active surface area with abundant adsorption sites for HMIs. The developed sensors are promising for environmental applications, as evidenced by the high selectivity, high sensitivity, high catalytic activity, and low detection limits. The materials involved, fabrication techniques and its sensing mechanism were comprehensively discussed, and the future outlooks of electrochemical sensing platforms are emphasized in this review.

Rational Design of a Fluorescent Chromophore as a Calcium Receptor via DFT and Multivariate Approaches.

Computational and experimental approaches were adopted to utilize a chromophore diglycolic functionalized fluorescein derivative as a Ca2+ receptor. Fluorescein diglycolic acid (Fl-DGA, 1) was synthesized and used in multivariate determination of Ca2+ and K+. Full-structure computation shows that the complexes of 1 and Ca2+ have comparable energies regardless of additional interaction with lactone moiety. The initial formation of diglycolic-Ca2+ complex followed by macrocyclization is thermodynamically disfavored. A U-shaped pre-organized 1 allows Ca2+ to interact simultaneously with diglycolic and lactone motifs. Both motifs actively participate in Ca2+ recognition and the eleven methylene units in the undecyl arm provides excellent flexibility for reorganization and optimum interaction. Principal component analysis (PCA) of computational molecular properties reveals a simple method in evaluating motifs for cation recognition. Fragment models support full-structure results that negative charge causes significant structural changes, but do not reproduce the full extent of C-O bond breaking observed in the latter. Experimental optical responses show that 1 is selective towards Ca2+ and discriminates against K+ and Mg2+. PCA of emission intensities affords distinct clusters of 0.01, 0.1 and 1 mM Ca2+ and K+, and suggests applicability of this technique for simultaneous determination of cationic plant macronutrients in precision agriculture and a wide variety of other applications.

The structure and electronic properties of the MoSe2/PtS2 van der Waals heterostructure.

The structure and electronic properties of the MoSe2/PtS2 van der Waals heterostructure and their dependence on the interlayer coupling, biaxial strain and external electric field are systematically investigated by using first-principles calculations. Herein, six stacking patterns are taken into consideration. The most energy favorable one is the AC stacking pattern, which is an indirect band gap semiconductor with type-I band alignment. The interlayer coupling, biaxial strain and external electric field can not only tune the band alignment of the MoSe2/PtS2 heterostructure from type-I band alignment to the type-II one, but also effectively modulate the band gap, ranging from 0 eV to 0.805 eV. These interesting properties induced by interlayer charge transfer, such as tunable band gaps and the characteristic of type-II band alignment, are beneficial for the application of the 2D MoSe2/PtS2 van der Waals heterostructure in future electronic and optoelectronic devices.

Flame-Retardant Properties and Mechanism of Polylactic Acid-Conjugated Flame-Retardant Composites.

The DOPO derivative-conjugated flame retardant 4, 4'-{1'', 4'' - phenylene - bis [amino - (10‴ - oxy -10‴-hydro-9‴-hydrogen-10‴ λ5 -phosphaphenanthrene-10''-yl)-methyl]}-diphenol (P-PPD-Ph) with two hydroxyl groups was synthesized. Polylactic acid conjugated flame-retardant composites with P-PPD-Ph were papered by using a twin-screw extruder. The flame-retardant properties of polylactic acid-conjugated flame-retardant composites were investigated. The flame-retardant properties of PLA-conjugated flame-retardant composites were characterized by the limiting oxygen index (LOI) and the vertical burning test (UL94). The results showed that the PLA-conjugated flame-retardant composites achieved a V-0 rating (UL-94, 3.2 mm) when the conjugated flame retardant was added at 5 wt%, and increase in LOI value from 22.5% to 31.4% relative to composites without added conjugated flame retardant. The flame-retardant mechanism of PLA-conjugated flame-retardant composites were further studied by TG-FTIR, the results showed that the P-PPD-Ph promoted the PLA-conjugated flame-retardant composites to decompose and also released fragments with quenching and dilution, which suggests that P-PPD-Ph for PLA-conjugated flame-retardant composites mainly play a role of the gas-phase flame retardant.

Effects of photographer physical attractiveness on photograph aesthetic value assessment.

Existent studies have demonstrated that being physically attractive leads to preferences and rewards in various scenarios involving performance evaluation. In this study, we explored whether a photographer's physical attractiveness could affect others' assessment of a photograph's aesthetic value. Participants (N=54) accomplished an online task to pair portraits and non-portrait photographs, followed by completing two questionnaires on cognitive reflection and empathy. Analytical results revealed that an attractive photographer was more likely to be associated with a highly aesthetic photograph, and this bias was moderated by the participant's level of cognitive reflection and empathy. Meanwhile, it could be reduced by the participant's professional experience.

The complete mitochondrial genome of Hemiclepsis yangtzenensis (Clitellata: Glossiphoniidae).

We present the complete mitochondrial genome sequence of a recently described new leech species named Hemiclepsis yangtzenensis Yang & Bolotov 2021 collected in central China. The mitochondrial genome is 14,984 bp in length and consists of 13 protein-coding genes, 2 ribosomal RNA genes, and 22 transfer RNA genes, all of which are encoded on a single strand. It exhibited a strong A + T bias of 72.87%. There is a large non-coding region (614 bp) located between the tRNA-Arg and tRNA-His genes, wherein we identified 40 short dispersed repeats, 13-22 bp long, 8 of which were direct, 20 inverted, and 12 palindromic. Phylogenetic analysis of 20 Hirudinea mitogenome sequences resolved monophyletic Glossiphoniidae, and H. yangtzenensis formed a sister lineage with Glossiphonia concolor.

New designs of paper based analytical devices (PADs) for completing replication analysis of a sample within a single run by employing smartphone.

Paper-based analytical devices (PADs) with four new designs could be fabricated using commercially available home-based scan-and-cut printer. They serve for miniaturised platforms for chemical analysis. Replication analysis of a sample together with the calibration (using the analyte standards at different concentrations) can be completed in a single run, by utilising smartphone as the detector. Some new approaches for choosing detection zones were suggested. The four proposed PAD designs here were used as models in microliter scale operation to demonstrate the well-known chemistries of colorimetric determinations of iron, phosphate, and hardness using 1,10-phenanthroline and simple aqueous guava leaf extract; molybdate, and EBT-EDTA complexometric titration, respectively, through calibrations: where Blue (B) value = 88.2log [Fe3+] - 80.8, R2 = 0.989; B value = 1.75 [Fe3+] + 0.198, R2 = 0.999; Grey scale (I) value = 1.77 [Fe3+] - 1.22, R2 = 0.997; Red (R) value = 16.1log [PO43-] + 8.95, R2 = 0.999; Hue (H) value = 43.3log [Ca2+] + 233, R2 = 0.994, respectively. For the hardness, using one of the PAD designs, true titration was also possible. Applications of the proposed devices and procedures were demonstrated for real world samples with validation. Additionally, kinetic study of the molybdenum blue for phosphate was demonstrated using one of the PADs.

[Nuclear magnetic resonance-based metabolomics revealed metabolite profiles participate in intervention effect of refined moxibustion in gastric ulcer model rats].

OBJECTIVE: To investigate the effect of refined moxibustion on expression of gastric mucosal epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF), and changes of metabolite profiles in gastric ulcer (GU) rats, so as to analyze its mechanism underlying improvement of GU. METHODS: Male SD rats were randomized into control, model, acupoint moxibustion groups (n=6 per group). The GU model was induced by cold-restraint stress. The ignited refined moxa was applied to bilateral "Liangmen" (ST21) and "Zusanli" (ST36) for 3 cones/acupoint, once daily for 7 days. Then, we employed 1H NMR-based metabolomics approach to analyze the metabolic profiles of serum and stomach tissue samples. The conventional histopathological changes of the gastric mucosa were observed by H.E. stain and the expressions of EGFR and VEGF in the gastric mucosa were detected by immunohistochemistry. RESULTS: Compared to the control group, the expression levels of EGFR and VEGF were significantly increased in the model group (P<0.01, P<0.05), and further notably up-regulated in the acupoint moxibustion group (P<0.001, P<0.01). Results of H.E. staining showed damage of the folds of gastric mucosa, disordered arrangement of the glands, infiltration of inflammatory cells and unclear structure of gastric mucosa in the model group, which was relatively milder in the acupoint moxibustion group. 1H-NMR technical analysis showed that in comparison with the control group, 11 and 11 metabolites in the stomach extract and plasma were increased, 10 in the gastric tissue and 3 in the plasma were decreased in the GU model group; while in comparison with the model group, 17 differently expressed metabolites in the gastric extract and 10 metabolites in the plasma restored to their levels of control group after the acupoint moxibustion intervention. These metabolites participate in 12 metabolic pathways including glycine, serine and threonine metabolism, glutathione metabolism, glycine metabolism, alanine, aspartic acid and glutamic acid metabolism, purine metabolism, glyoxylic acid and digarboxylic acid metabolism, biosynthesis of aminoacyl-tRNA, amino sugar and nucleotide sugar metabolism, cysteine and methionine metabolism, citrate cycle, pyruvate metabolism, and the mutual conversion of pentose and glucuronate，suggesting their involvement in moxibustion-induced improvement of GU. CONCLUSION: Refined moxibustion at ST21 and ST36 can up-regulate the expression of EGFR and VEGF in the gastric mucosa and lessen gastric mucosal injury, which may be related to its effects in reducing GU-induced metabolic disorders, including sugar, purine, amino acid, and phospholipid metabolism and antioxidant defense system.

Soil amendments inhibited the cadmium accumulation in Ligusticum striatum DC. and improved the plant growth.

Soil aggregates display a significant influence on the bioavailability of heavy metals in soil. In this study, we conducted a field experiment in the main producing area of Ligusticum striatum DC. to explore the effects of the amendments on cadmium (Cd) distribution in soil aggregates and plant growth. L. striatum was planted in natural Cd-polluted soils added with mixed amendments, composed of heavy/light calcium carbonate (Type 1/Type 2 amendments), calcium-bentonite, potassium dihydrogen phosphate, biochar, sodium silicate, and attapulgite, with the application rate of 0.5 t ha-1, 1.5 t ha-1, and 5.0 t ha-1. The results demonstrated that the application of the amendments promoted the formation of soil macroaggregates (250-2000 µm and >2000 µm) and, altered soil Cd distribution among aggregates fractions by translocating Cd from macroaggregates into small one (microaggregate; <250 µm). Soil amendments addition greatly alleviated the phytotoxic effects of Cd on plants and promoted the biomass of the rhizome of L. striatum by 14.38-53.47%. Based on the structural equation modeling, the decrease of available Cd in the fraction of large macroaggregates greatly contributed to the less accumulation of Cd in plants (r = 0.70; p < 0.05). In general, the amendments inhibited the plant Cd accumulation by re-distribution of Cd among soil aggregates and, improved the plant growth by supplying available nutrients.

Population origin, maternal effects, and hydric conditions during incubation determine embryonic and offspring survival in a desert-dwelling lizard.

While the effects of incubation environment on embryonic development and offspring traits have been extensively studied in oviparous vertebrates, studies into how genetic inheritance (population origin), maternal effects, and incubation environment interact to produce varying phenotypes, are rare. To elucidate the interactive role of those three factors during incubation in shaping offspring phenotypes through hydric conditions, we conducted a fully factorial experiment [arid and semiarid populations × maternal dry and wet treatments (MDT and MWT) × embryonic dry and wet treatments (EDT and EWT)] with a desert-dwelling lacertid lizard (Eremias argus). Female lizards in dry conditions produced larger clutch sizes but smaller eggs. The incubation period and hatching success were significantly affected by embryonic but not by maternal moisture treatments. Eggs in the EDT hatched later than those in the EWT in both arid and semiarid populations. Hatching success was lower in EDT than in EWT in the semiarid population, but not in the arid population. Hatchlings from the EDT had a slower post-hatch increase in body mass than those from the EWT. EDT would decrease the survival rates of hatchlings in the semiarid population only. In addition, structural equation models revealed that population had a stronger effect on embryonic and offspring survival than maternal and embryonic moisture. Our study demonstrates locally adaptive strategies of drought resistance at multiple life-history stages in lizard populations from diverse hydric habitats and highlights the importance of genetic factors in determining embryonic drought resistance in oviparous lizards.

What are Your Eyes Revealing? The Contemporary Bedside Neuro-Ophthalmological Examination.

The neuro-ophthalmological evaluation is done to assess the integrity of cranial nerves II, III, IV, VI. This work does not intend to substitute the examination in a fully equipped ophthalmology suite. The aim of this manuscript is to describe bedside examination of the eye by using simple apparatus that are easily available. This work incorporates the usage of smartphone application, as smartphone is deemed an accessory in almost every resident's pocket during review of patients as a consult in the emergency department. However, the essence of traditional physical examination remains the fundamental. Understanding of neuroanatomy and neurophysiology of the eye and the central nervous system can enhance the clinician's performance at the bedside.