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Objective: The aims of the present study were: (a) to obtain new normative data of the Italian version of the Mini-Mental Examination State (MMSE) (Measso et al. in Dev Neuropsychol 9:77–85, 1993) by administering the tool to a sample of normal Italian individuals more representative of the current Italian population; (b) to compare the sensitivity of this tool in detecting patients suffering from Alzheimer’s disease (AD according to NIA-AA), as compared to the those reported in previous normative Italian studies. Methods: MMSE was administered to 314 normal subjects recruited among individuals (and/or their relatives) attending the Offices of General Practitioners (GP) or Memory Clinics in Campania (Italy) by convenience sampling. A group of 47 patients with AD were included into the study. The effect of demographic variables on the raw MMSE scores of normal subjects was checked by multiple linear regression assuming MMSE scores as dependent variable and age, gender and education as the independent one(s). Therefore, a simultaneous regression model was constructed to correct the raw scores according the sensitive variables. Correction grid and equivalent scores were devised to classify subject’s performance. Results: The mean raw MMSE score was 27.78 (SD = 1.80) (range 22–30/30). There was no significant difference between scores achieved by men or women (p = 0.688). Multiple linear regression analysis showed a significant effect of age and years of school attendance on the MMSE raw score, whereas gender did not show any significant effect. The cutoff score, distinguishing between pathological and normal performances, was fixed at the fifth centile corresponding to 24.9/30, higher than the current score of 23.8/30. The new cutoff value was able to identify 44/47 patients with AD, in contrast to 38/47 subjects detected by currently used norms. Conclusions: (1) A more updated and representative population sample; (2) a new cutoff threshold able to distinguish between normal and pathological performances; (3) a correction grid that reduces the risk of false-positive and false-negative values due to the influence of the main demographic factors; (4) greater sensitivity, compared to previous Italian normative studies in identifying people with dementia. Objective: The aims of the present study were: (a) to obtain new normative data of the Italian version of the Mini-Mental Examination State (MMSE) (Measso et al. in Dev Neuropsychol 9:77–85, 1993) by administering the tool to a sample of normal Italian individuals more representative of the current Italian population; (b) to compare the sensitivity of this tool in detecting patients suffering from Alzheimer’s disease (AD according to NIA-AA), as compared to the those reported in previous normative Italian studies. Methods: MMSE was administered to 314 normal subjects recruited among individuals (and/or their relatives) attending the Offices of General Practitioners (GP) or Memory Clinics in Campania (Italy) by convenience sampling. A group of 47 patients with AD were included into the study. The effect of demographic variables on the raw MMSE scores of normal subjects was checked by multiple linear regression assuming MMSE scores as dependent variable and age, gender and education as the independent one(s). Therefore, a simultaneous regression model was constructed to correct the raw scores according the sensitive variables. Correction grid and equivalent scores were devised to classify subject’s performance. Results: The mean raw MMSE score was 27.78 (SD = 1.80) (range 22–30/30). There was no significant difference between scores achieved by men or women (p = 0.688). Multiple linear regression analysis showed a significant effect of age and years of school attendance on the MMSE raw score, whereas gender did not show any significant effect. The cutoff score, distinguishing between pathological and normal performances, was fixed at the fifth centile corresponding to 24.9/30, higher than the current score of 23.8/30. The new cutoff value was able to identify 44/47 patients with AD, in contrast to 38/47 subjects detected by currently used norms. Conclusions: (1) A more updated and representative population sample; (2) a new cutoff threshold able to distinguish between normal and pathological performances; (3) a correction grid that reduces the risk of false-positive and false-negative values due to the influence of the main demographic factors; (4) greater sensitivity, compared to previous Italian normative studies in identifying people with dementia.

Background: Plant-based diets have spread widely in the general population and among athletes too, both for well-documented health benefits and for eco-sustainability and ethical concerns. Despite appropriate nutrition is essential for satisfying training, performance, and recovery needs in athletes, little is known about the effects of plant-based diets on body composition in athletes. Appropriate training and nourishment strategies are a daily priority to arrive at victory and achieving an optimal body composition helps achieve success. Our study aimed to shed light on the adequacy of a vegetarian or vegan diet on the body composition of the athlete, in comparison with an omnivorous diet. In particular, we had tried to clarify the effects of well-structured plant-based nutrition in competitive athletes, who, previously, had never followed a diet under specialist supervision. Methods: The groups were followed for 8 months and subjected to a well-planned diet under medical supervision. Anthropometric parameters and body composition evaluation through Bioelectrical Impedance Analysis (BIA) were performed in each participant. Results: All subjects, especially vegans, showed an improvement in cellular efficiency, muscle mass, and a re-distribution of body water thanks to a better distribution of macronutrients with dietary plans. These changes demonstrate improvement in the athlete's body composition thanks to well-structured plant-based diets that meet the nutrient requirements, without a change in physical training, especially in vegan athletes. Conclusions: The administration of well-structured dietetic schemes for each group has reduced the differences between omnivores, vegetarians, and vegans, underling their more difficult autonomous management and the important role of the nutrition specialist. Given the evidence collected, we demonstrate that plant-based diets are sustainable for athletes and that the role of nutritionist is central to sports and food choices to achieve an optimal body composition.

Introduction: Microparticles (MPs) are a heterogeneous population of small cell-derived vesicles. The composition is influenced by the cellular origin and the cellular processes starting their formation. The MPs have various biochemical composition, depending on the site in which they originate: from platelets or endothelium, MPs are involved in many disease, in particular in cardiovascular disease but also in cancer and in central nervous system disease. They are involved in many cellular processes and in particular in apoptosis and in cellular rearrangement. MPs could promote the recruitment of more immune cells in vascular inflammatory areas. Material and method: We performed a data literature analysis from PubMed. We analyze data from multiple studies, reporting that in central nervous system (CNS), the MPs have an important biological role, they can be derived from platelets, endothelial cells, neurons or glial cells. RESULT: We found that the CNS cells in the neurovascular unit, including the endothelial lining and neural cells are also subject to stress by a variety of stimuli such as oxygen radicals and inflammation. Indeed, it is induced membrane shedding in vascular cells. For these reasons, it is possible that the shedding in the neurovascular network may be linked not only to the development and progression of various CNS diseases, but also to the physiological development of the nervous system. In fact, the MPs attend, also, to a regeneration and repair of nerve injury. The MPs are involved in neuroimmune response, indeed, during the various negative stimuli, the microglial release a MPs containing pro-inflammatory cytokines. The MPs can be considered as a biomarkers from a specific tissue undergoing activation or damage. The plasma membrane is considerate as a sensor of cell interactions with the microenvironment. Conclusion: Given these evidences, we can conclude that the releasing of MPs is an indicator of a physiological and/ or pathophysiological activation in CNS, and then these vesicles are strongly involved in various CNS disease such as stoke, multiple sclerosis and Alzheimer’s disease.

Orexin system regulates sleep/wake states and its deficiency result in narcolepsy thus indicating the crucial role of orexins in maintaining wakefulness. There are two types of orexin peptides: the orexin-A (OXA or hypocretin 1) and orexin-B (OXB or hypocre- tin 2). The Majority of the central nervous system orexin peptides are synthesized in neurons located in the lateral and back hypotha- lamus and send projections throughout the brain regions Orexin neurons are “multi-tasking” hence regulating also energy homeosta- sis, reward systems and feeding behaviour through connection with hypothalamic nuclei and through responsiveness to leptine and glucose. It has recently been found a connection with lymbic system suggesting a further possible role of orexins in regulating emo- tions. All the studies conducted confirm that orexin system regulates vigilance states, energy homeostasis, reward system, and emo- tions. These crucial role might be the target to develope treatments of narcolepsy, obesity, emotional stress, and drug addiction.

The consciousness is the expression of an enormous and complex variety of neurobiological events, phenomenological and psychological that, from the early stages of development, prepare the emergence soil of the Self. It is a complex of tangible and intan- gible characters distinct from one another - neural infrastructure, awareness, temporality, qualitative subjectivity, intentionality - to such an extent as to seem welded faces of the same prism. Consciousness is not a simple function of the mind, but its organization. In this paper we intend to show how its order is not strictly hierarchical, but sustained by multiple horizontal levels, each of which in a structural and functional continuum with several emerging phenomena. The same distinction between quantitative aspects (surveil- lance) and qualitative (content of consciousness) of consciousness is founded on the premise that the supervision is regulated by widespread in projection systems of the brain stem, hypothalamus and thalamus; while the content of consciousness depends on the cortical activity, and particularly from the associative areas of the cortex connected between them. The so-called disturbances of consciousness (vegetative state, the minimally conscious state, a coma, the Locked in syndrome) suggests the existence of an altera- tion of a common underlying system. Although the current heterogeneity of the data makes it impossible to attribute with certainty whether positive or negative about the alleged absence of consciousness in the individual patient, the search is deriving significant benefits from the accumulation of neuroimaging evidence in paintings like coma, general anesthesia , sleep, epilepsy and somnambu- lism. In this sense, it seems increasingly urgent a deeper understanding of the neural correlates during sleep or general anesthesia, as well as the relationships between neural processes and altered states of consciousness generated by pharmacological manipulations.

Recent findings showed that obesity represent a risk factor to developingbrain illness such as cognitive impairments and psychopathological disorders. Weight increase additively afflicts brain structure of cognitively impaired patients but is linked with poor brain volumes even in healthysubjects. Further, several studies show that subjects with psychiatric disorders are more likely than general population to be obese. Hovewer, the process by which weight gain injures cognitive abilities and psychological well-being remain unclear.In this review we analyze the relationships between obesity andbrain illness and underline the role played by covariates to determine this link.

The Mediterranean diet has been recognized historical and cultural heritage of great importance, nutritional and culinary excellence to scratch. In the Mediterranean diet 50-60% of kilocalories should come from carbohydrates, 25-30% from lipids and the remaining 10-15% from protein, the dough thus represents the main source of complex carbohydrates, ideal energy source is essential for the daily activities ensuring the good health state. The beneficial properties and the nutritional values of pasta are numerous Pasta is a ally of the diet: satiating has great power and is an excellent solution for stress. It also contains vitamins of the B group essential for the proper functioning of the nervous system, the starch paste is free glucose, which promotes the synthesis of serotonin, which gives well-being. Some studies have shown that, among the carbohydrates, the pasta has the lowest glycemic index not therefore increases the levels of C-reactive protein, which proved to be correlated with cardiovascular risk does not increase the risk of hypertension because it contains very little sodium and fiber, the latter fundamental in the prevention of cancer.

Glucose uptake in skeletal muscle is dependent on the translocation of GLUT4 glucose transporters to the plasma membrane. The most important stimulators of glucose transport in skeletal muscle are insulin and exercise. Glucose uptake in skeletal muscle during exercise induces acceleration of many processes compared to the resting state. The scientific literature does not underline the role played by muscle contraction to increase glucose uptake with insulin-independent mechanisms. Search on Pub Med (May 05, 2015) using the key words "contraction and glucose uptake and muscle" gives 717 reports, while a search using the key words "insulin and glucose uptake and muscle" cites 5676 publications. The present paper describes the role of exercise in the muscle glucose uptake. Contraction of muscle induces GLUT4 translocation in the absence of insulin. There are different intracellular "pools" of GLUT4, one stimulated by insulin and another one stimulated by exercise. The roles exerted by AMPK, AICAR, calcium, NO, glycogen and hypoxia in the glucose uptake during exercise are emphasized. The effects of these phenomena on human wellness are reported.

Although testicular germ cell tumors (TGCTs) are relatively uncommon, they are particularly important, as they tend to affect children and young men, the most common tumor being in males aged from 20 to 40 years, and the incidence has been increasing in the last years. TGCTs comprise two major histologic groups: seminomas and non-seminomas germ cell tumors (NSGCTs). NSGCTs can be further divided into embryonal, carcinoma, Teratoma, yolk sac tumor, and choriocarcinoma. Seminomas and NSGCTs present significant differences in clinical features, therapy, and prognosis, and both show characteristics of the Primordial Germ Cells (PGCs). For proper diagnosis of the different histological subgroups, immunohistochemistry is required using different molecular markers, such as Aurora B, GPR30, Nek2, HMGA1, HMGA2, and others, and they could represent useful novel molecular targets for antineoplastic strategies. More insight into the pathogenesis of TGCTs is likely to contribute not only to better treatment of these tumors but also to a better understanding of stem cells and oncogenesis.

The prevalence of obesity is increasing in the industrialized world, so that the World Health Organization considers obesity as a “pandemia” in rich populations. The autonomic nervous system plays a crucial role in the control of energy balance and body weight. This review summarizes our own data and perspectives, emphasizing the influence exerted by autonomic nervous system on energy expenditure and food intake, which are able to determine the body weight. Activation of the sympathetic discharge causes an increase in energy expenditure and a decrease in food intake, while reduction of food intake and body weight loss determines a reduction of the sympathetic activity. On the other hand, pathophysiological mechanisms of the obesity involve alterations of the sympathetic nervous system in accordance with the “Mona Lisa Hypothesis,” an acronym for “most obesities known are low in sympathetic activity.” Furthermore, the parasympathetic influences on the energy expenditure are analyzed in this review, showing that an increase in parasympathetic activity can induce a paradoxical enhancement of energy consumption.

Caffeine is the most commonly consumed psychoactive stimulant in the world. Caffeine is often found to enhance vigilance, alertness and performance in sustained attention tasks for extended periods. It has been implicated in the enhancement of certain higher-order cognitive processes, such as those involved in the active monitoring and coordination of behavior. Caffeine influences also performance in real-life motor tasks, such as handwriting, and in simulated-motor tasks, such as driving. Although the positive effects of caffeine are well documented, controversy surrounds the relationship between regular consumption of caffeine and its beneficial effects.

Exercise and insulin and exercise are the most relevant stimulators of glucose transport in skeletal muscle. Glucose uptake in skeletal muscle during exercise involves acceleration of several processes compared to the resting state. The scientific literature hould put more emphasis on the role played by muscle contraction to enhance glucose uptake with insulin-independent mechanisms. Indeed, a search on Pub Med using the key words "contraction and glucose uptake and muscle" gives 566 reports, while a search using the key words "insulin and glucose uptake and muscle" cites 4156 publications (May,2009). This chapter describes extensively the mechanisms permitting the insulinindependent glucose uptake in response to muscle utilization during exercise. The muscle contraction stimulates GLUT4 translocation in the absence of insulin. There are different intracellular "pools" of GLUT4, one stimulated by insulin and one stimulated by exercise. The roles exerted by AMPK, AICAR, calcium, NO, glycogen and hypoxia in the glucose uptake during exercise are underlined. The consequences of these phenomena on human wellness are discussed. Furthermore, the scarce treatment of insulin-independent glucose uptake in scholastic textbooks is underlined, to induce authors to treat this important argument more extensively.

Inflammation is the first event that follows a muscle lesion and is also the first step of the muscle regeneration process; thus, it can be argued that inflammatory cells are involved in the induction of muscle fibres regeneration, possibly through the action of soluble mediators that regulate the myogenic regulatory factors expressed by muscle cells during development and regeneration. This paper reports evidences from literature about the involvement of cyclooxygenase products (prostaglaninds) in the muscle regeneration process and shows that cyclooxygenase inhibitory drugs can affect the normal expression of myogenic regulatory factors in muscle fibres during regeneration. The implications of these phenomena in therapeutic strategies are discussed.

This expert commentary reports the role exerted by cerebral cortex in the thermoregulation. Generally, the thermoregulation is described almost exclusively with the role of the hypothalamus, while the control exerted by other cerebral structures is not sufficiently underlined. Also the influences of cerebral cortex on body temperature are neglected. Indeed, a search on “PubMed” with the words “thermoregulation and cerebral cortex” reports only 261 articles, while the search of the words “thermoregulation and hypothalamus” produces 2485 papers. This commentary underlines especially the experimental evidences regarding the effects of functional decortication (obtained with cortical spreading depression) on thermogenic changes due to various conditions in different experimental models.

The influence of the hypothalamic peptide orexin A on feeding behavior is highlighted. The purpose of this mini-review is to show that orexin A influences food intake through changes in body temperature. The involvement of the sympathetic nervous system in the reactions induced by orexin A is also reported, emphasizing the relationship between this peptide and the autonomic nervous system in controlling body weight.

Aging is associated with a redistribution of both fat and lean tissue within the body. There are distinct sex-dependent differences in the regional fat distribution. Women carry more fat subcutaneously whereas men carry more fat viscerally. During menopause, not only are there hormonal changes, but they also directly affect the distribution of subcutaneous fat and influence energy balance. Leptin and estrogen are both involved in the regulation of adipose tissue deposition and feeding behavior. The purpose of this review is: 1) to identify factors influencing circulating leptin in postmenopausal women; 2) to determine whether hormone-replacement therapy (HRT) influences serum leptin after adjusting for confounding factors; 3) to identify potential independent effects of HRT or leptin on resting energy expenditure (REE).