Rome's Lost Aqueduct

Objective To analyze Rome Ⅱ and Rome Ⅲ criteria in clinical characteristics of functional dyspepsia (FD) diagnosis and the differences in subtypes of FD,and to assess the psychosocial status of FD patients.Methods From June 2008 to December 2008,1600 random outpatients who underwent upper gastrointestinal endoscopy in department of gastroenterology fulfilled the inquiry questionnaire.The subtype was diagnosed according to Rome Ⅲ and the Rome Ⅱ criteria and the results were analyzed.Results A total of 215 patients (13.44％) were in accordance with Rome Ⅱ criteria and 249 patients (15.56 ％) were in accordance with Rome Ⅲ criteria,there was no difference in FD detection rate between these two criteria (x2=2.176,P＞0.05).About 71.16％(153/215) of the FD patients diagnosed according to Rome Ⅱ criteria were also in accordance with Rome Ⅲ criteria,and 23.26％ (50/215) who had bothersome postprandial fullness,early satiation,epigastic pain or epigastric burning did not meet Rome Ⅲ criteria.About 61.45 ％ (153/249) of the FD patients diagnosed according to Rome Ⅲ criteria were also in accordance with Rome Ⅱ criteria,and the courses of disease of 28.92％(72/249) patients didn't met Rome Ⅱ criteria.According to RomeⅡ,51 (23.72％) patients were ulcer-like type,103 (47.91％)patients were dysmotility-like type,and 61 (28.37％) patients were non-idiotype.According to Rome Ⅲ criteria,76.31％ (190/249) patients were consistent with postprandial distress syndrome (PDS),52.61％ (131/249) patients were consistent with epigastric pain syndrome (EPS),and 28.92％ (72/249) patients met both PDS and EPS.The percentage of the FD patients with anxiety and depression was 16.83％ and 47.52％respectively.Of the FD patients in accordance with Rome Ⅲ criteria who were with both anxiety and depression,the total symptom scores of bothersome postprandial fullness,early satiation,epigastic pain or epigastic burning were the highest (x2 =49.637,P＜0.05).Conclusions Rome Ⅲ criteria is easier to understand and more practical.FD patients always have psychosocial disorders,which may worsen the clinical symptoms. Key words: Functional dyspepsia; Reference standards; Questionnaire; anxiety; depression

This paper discusses the widely held view that politics in fifth- and sixth-century Italy were largely driven by rivalry between the two great families of the Anicii and the Decii, supposedly following distinctive policies (pro- or anti-eastern, philo- or anti-barbarian, etc.). It is probable that individual members of these (and other) families had feuds and disagreements from time to time, but there is absolutely no evidence for continuing rivalry between Decii and Anicii as families, let alone on specific issues of public policy. Indeed by the mid-fifth century the Anicii fell into a rapid decline. The nobility continued to play a central rôle in the social and (especially) religious life of late fifth- and early sixth-century Italy. Their wealth gave them great power, but it was power that they exercised in relatively restricted, essentially traditional fields, mainly on their estates and in the city of Rome. The quite extraordinary sums they spent on games right down into the sixth century illustrate their overriding concern for popular favour at a purely local level. In this context there was continuing competition between all noble families rich enough to compete. Indeed, the barbarian kings encouraged the nobility to spend their fortunes competing with each other to the benefit of the city and population of Rome.

BackgroundThe Child Opportunity Index (COI) is a new and innovative tool designed to assess the environment in which children grow up, offering a broad evaluation of the opportunities available to them in different neighborhoods. This initiative aims to ensure improvements in children’s living conditions and future health outcomes.MethodsThe study was performed in the cities of Palermo and Rome. Our Italian COI consists of three main domains: education, health and environment, and economy, each subdivided into specific indicators. We collected information, when available, useful for our indicators from institutional sites and municipal archives. Furthermore, in the city of Rome, we distributed a questionnaire through local pediatricians, collecting data in 2 randomly chosen neighborhoods with questions on children’s health and quality of life, proposing an initial approach that, when implemented using data provided by the government and public and private health institutions, aims to evaluate the correlation between socio-economic opportunities and the psycho-physical health of children, as demonstrated in the literature.ResultsAs a result, many aspects, such as the rate of air pollution or the illegal occupation of houses, were not taken into consideration. We therefore consider our COI proposal only a starting model that will have to be implemented once all the necessary information has been obtained. However, what can be deduced from this first descriptive study is how the opportunities in different neighborhoods are not the same for all children. The number of educational opportunities as well as the number of environmental opportunities differs between the various districts and is not homogeneous between different cities or within the same city.ConclusionsIn conclusion, it is not simple to analyze in a scientific manner the child’s health impact of living in different areas. The COI could be a useful and simple tool that can give us this information. Pediatricians could collaborate with institutions to implement intervention plans and to reduce existing differences, social and health inequalities. Future studies will have to implement this pilot study to create and validate an Italian model of COI to be used as a useful tool in children’s assistance.

Objective To investigate the improvement of symptoms of the patients after treatment in patients with Rome Ⅳ or non-Rome Ⅳ irritable bowel syndrome (IBS), and to explore the influence of IBS diagnosed by different criteria on the patients. Methods From June 2nd to 8th in 2016, at Outpatients Department of Gastroenterology, Union Hospital Affiliated to Tongji Medical College, Huazhong Uiversity of Science and Technology in Wuhan, 1 500 outpatients aged over 18 years old and with intestinal symptom were selected for questionnaire. After treatment for six months, IBS patients, non-IBS patients, patients with Rome Ⅳ IBS and patients with non-Rome Ⅳ IBS were followed up by phone calls. After treatment, the improvement of symptoms of the patients was evaluated by irritable bowel syndrome symptom severity scale (IBS-SSS). The degree of influence of IBS diagnosed with different criteria on patients was evaluated by the patient′s daily work whether to choose colonoscopy examination, whether to choose medication, and the efficacy of medicine. Student′s t test, Mann-Whitney U test and chi-square test were performed for statistical analysis. Results A total of 352 patients with intestinal symptoms were followed-up, including 175 patients with IBS (84 patients with Rome Ⅳ IBS and 91 patients with non-Rome Ⅳ IBS) and 177 non-IBS patients, and 142 patients responded. There were no statistically significant differences in response rate between non-IBS patients and IBS patients (37.3%, 66/177 vs. 43.4%, 76/175), and between patients with Rome Ⅳ IBS and patients with non-Rome Ⅳ IBS (40.5%, 34/84 vs. 46.2%, 42/91) (χ2=1.379 and 0.573, P=0.240 and 0.449). Compared with the non-IBS patients, the degree of satisfaction of medicine was lower in IBS patients (71.4%, 30/42 vs. 47.5%, 19/40). Compared with non-Rome Ⅳ IBS patients, Rome type Ⅳ IBS patients were more likely to receive colonoscopy (35.7%, 15/42 vs. 58.8%, 20/34), and the differences were statistically significant (χ2=4.878 and 4.039, P=0.027 and 0.044). After six months of treatment, symptoms improved in both Rome Ⅳ IBS patients and non-Rome Ⅳ IBS patients (both P<0.05), however, the symptoms improved more significantly in Rome Ⅳ IBS patients and the total score of IBS-SSS was lower than that of non-Rome Ⅳ IBS patients (-130, -185 to 60 vs. -70, -100 to 28), and the difference was statistically significant (Z=-3.065, P=0.002). The difference was mainly showed the symptom of abdominal pain, and the IBS-SSS abdominal pain score of Rome Ⅳ IBS patients was lower than that of non-Rome Ⅳ IBS patients (-80, -100 to -40 vs. 0, -40 to 0), and the difference was statistically significant (Z=-4.631, P<0.01). Conclusions IBS symptoms influence a lot on the satisfaction degree of treatment in outpatients. Even with similar good therapeutic effects, the Rome Ⅳ IBS symptoms have a more severe impact on patients than non-Rome Ⅳ IBS symptoms. Key words: Irritable bowel syndrome; Diagnosis; Rome type Ⅳ; Treatment response

Objective To analyze the value of the serum HE4 and CA125 and ROMA index in the diagnose of patients with ovarian cancer. Methods The clinical data of 102 patients with pelvic tumor treated at our hospital from February, 2015 to December, 2017 was retrospectively analyzed, including 49 cases of ovarian cancer (observation group 1) and 53 cases of benign tumor (observation group2). 50 healthy persons who received health check-up were chosen at the same time from our hospital as a control group. The serum HE4 and CA125 and ROMA in the three groups were compared. The diagnose values of the HE4, CA125, and ROMA in the patients with ovarian cancer were analyzed. The values of the HE4, CA125, and ROMA in different stages of the patients with ovarian cancer were compared. Results The serum levels of HE4 and CA125 and ROMA were (242.3±123.7) pmol/L, (288.1±146.7) U/ml, and (80.6±15.4)% in the observation group 1, which were obviously higher than those in the observation group 2 and those in the control group (all P<0.05). The sensibility of the combined detection of the HE4, CA125, and ROMA in the patients with ovarian cancer was the highest (88.7%), and AUC was the highest (0.957). The positive rates of HE4, CA125, and ROMA increased as the clinical stages. The CA125 positive rates in different stages had statistical differences (P<0.05). Conclusion The combined detection of HE4, CA125, and ROMA is helpful for early diagnosing patients with ovarian cancer, which has obvious diagnositc value. Key words: Human epididymisprotein4 (HE4); Cancer antigen 125 (CA125); ROMA; Ovarian cancer; Diagnosis

Objective To compare the clinical significance of human epididymis protein 4(HE4), CA125, ROMA in the differential diagnosis of ovarian cancer. Methods From May 2016 to October 2017, 240 patients with ovarian tumor in Xuzhou Cancer Hospital were selected.According to the result of postoperative pathology, the patients were divided into benign ovarian disease group(n=120) and ovarian cancer group(n=120). And 100 healthy women from medical examination center were selected as control group.The electrochemiluminescence (ECLIA) technique was used to assess the serum levels of CA125, HE4, and ROMA was calculated.The clinical significance of HE4, CA125, ROMA in the differential diagnosis of ovarian cancer was analyzed by statistic methods. Results The CA125, HE4 concentrations and ROMA in the ovarian cancer group[(370.9±213.2)U/mL, (364.4±227.0)pmpl/L, (80.2±26.1)%]were higher than those in the benign ovarian disease group and the health control group(all P<0.01), there were no statistically significant differences between the benign ovarian disease group and the healthy control group(P=0.356, P=0.321, P=0.292). The sensitivity, specificity, positive and negative predictive values, accuracy of ROMA were higher than those of HE4 and CA125.By using the ROC analysis, the AUC for CA125, HE4, ROMA were 0.832, 0.888, 0.960, respectively, AUC(CA125)<AUC(HE4)<AUC(ROMA). Conclusion CA125 and HE4 have important value in the diagnosis of ovarian cancer, but the ROMA shows the best diagnostic performance and actual value. Key words: Ovarian neoplasms; CA-125 antigen; Human epididymis protein 4; ROC curve; Diagnosis, differential; ROMA

BackgroundPopulation-based surveys on the quality of life of people with Down syndrome (DS) are difficult to perform because of ethical and legal policies regarding privacy and confidential information, but they are essential for service planning. Little is known about the sample size and variability of quality of life of people with DS living in the city of Rome, which has a population of 2.7 million inhabitants. The aim of the present study is to explore the needs and challenges in health, social integration and daily life, of people with DS living in Rome.MethodologyA cross-sectional, census-based survey was conducted in 2006. All family doctors (3016 in total) of the National Health Service were involved by the Statistical Bureau of the Municipality of Rome. As per the census, every resident citizen is registered with a family doctor and every person with disabilities is coded. Associations for Down Syndrome encouraged their members to participate in the research. Questionnaires were completed by families of people with DS, in accordance with privacy laws.FindingsAn initial survey, conducted via a letter and a telephone contact with family doctors, identified 884 people with DS residing in the city of Rome. Data on the medical and social conditions of 518 people with DS, ranging in age from 0 to 64 years, were collected. Some 88% of these were living with their original family; 82.1% had one or more siblings, and 19.5% had lost one or both parents. A full 100% of children with DS were enrolled in the public school system. This ensures that they are fully occupied and entirely integrated in society. After secondary school there is a lack of opportunities. Thus, only 10% of adults were working with a regular contract. A mere 42.2% of people with DS aged 25–30 were involved in some form of regular activity (although not always on a daily basis). After the age of 30, the percentage of people demonstrating decline in function increased sharply, while disability-related support decreased. In other words, as people with DS age, daily life evolves increasingly around the home, with only occasional outdoor activities.ConclusionThe health, employment and social needs of the majority of people with DS in the city of Rome are not being met. The findings of this study underscore the urgent need for more comprehensive inclusion in society of adults with DS and for the provision of support services to create an enabling environment for inclusion. Because of the variability of performance among individuals with DS, there is a need to create more case-specific options in terms of work, living arrangements, social networking and medical services. Schooling and social inclusion in childhood alone do not guarantee a satisfactory quality of life in adulthood. It is argued herewith that policy of inclusion and support should extend over the entire lifetime of people with DS.

The Romans began to adopt actively the Greek education after the second century B.C. when they have conquered the Mediterranean world. In accepting the hellenistic civilization, they showed ambivalent attitude, that is, sometimes they accepted it enthusiastically and sometimes they were wary of accepting it. But at last they recognized that they need the Greek learning in order to run the great empire successfully. They found in the subjugated Greek East huge libraries full of massive books, which were outcomes of Greek academic researches. They took the books into the city of Rome and built great libraries in the city. The libraries built since the early part of the second century B.C., contributed greatly to create academic atmosphere and enhance the passion of Romans for Greek education and culture in the city of Rome. The libraries raised the reputation of the city of Rome as a center of learning and education, and played an important role in drawing the intellectuals of Greek East into the city of Rome. The leading Roman elites patronized the intellectuals and supported their academic and educational activities through their literary patronages. This cultural environment contributed greatly to make better the educational conditions in the city of Rome.

In order to improve the clinical teaching quality of functional gastrointestinal diseases (FGIDs), the teachers tried to apply the Rome Ⅳ criteria in the clinical teaching of FGIDs, including ward rounds, case analysis, and clinical practice. This article firstly summarizes the necessity and importance of teaching based on the Rome Ⅳ criteria, then gives an interpretation of the Rome Ⅳ criteria, and finally establishes a problem-centered teaching mode in combination with discussion of typical FGID cases. The interpretation of the Rome Ⅳ criteria and clinical practice guided by experts help the students to understand the Rome Ⅳ criteria and use it to guide clinical practice and scientific research. This article also provides a theoretical basis for the application and promotion of the Rome Ⅳ criteria in the clinical teaching of gastroenterology. Key words: Clinical teaching; Rome Ⅳ criteria; Functional gastrointestinal diseases; Gastroenterology

This article is the outcome of analysis of the nature and evolution of capitalism in Italy in the last 40 years, based on a review of the scientific literature and personal experience of the author. The aim of article is to formalize an ordered and concrete concept of actual Italian Capitalism, including creation of “Italian Capitalism Map”. The article compares the definitions of capitalism, used by different authors and academic institutions. These definitions reflect the history and process of economy development in Italy. The article conclude about the weak theoretical and methodological level of analysis of the nature of capitalism in Italy, where scientist are still use classic definitions of Adam Smith and Karl Marx. The author conducts a study of existing varieties of capitalism, both in Italy and in the world (how this phenomenon is seen in Italy). Special attention is paid to phenomenon of proto-capitalism, to the concept of crony capitalism, to division of capitalism in three sections: Personal-individual capitalism, Managerial capitalism and Rhenish-Japanese capitalism and to grade of state’s share in economy. The paper proposes to highlight five actors in Italian Capitalism: European Union Government Structures, National Government, Small & Medium Enterprises, Big Businesses, and Customers. The paper discusses relations and contradictions between these actors in Italian economy. Author also tries to predict a way of modern capitalism evolution in near future. As conclusion of research, Author proposed the “Italian Capitalism Map”, a kind of visualization of most important features of capitalism in Italy.

In 1985, archaeologists from Bulgaria and Britain began a collaborative work with the initiation of two complementary projects. The first one was entitled ‘The Roman and late Roman city; Nicopolis ad Istrum’ (1985–1992) when the archaeological research of both teams was concentrated upon the Roman city and its late antique successor. The ‘City of Victory’ was founded by the emperor Trajan and is one of the largest archaelogical sites in the Balkans. The second programme represents a continuation and an expansion of the first and was entitled ‘The city and the village in the Roman and late Roman Empire: Nicopolis ad Istrum and nucleated settlement in its territory’ (1996–2002). It initiated work on the site of the late antique fortified settlement near the village of Dichin. Nicopolis, like the other cities in Thrace, was organized according to the Greek model, on similar lines to those found in the cities of Asia Minor. This influence is reflected in the character of the town, its plan, its agora and in its principal buildings.

Aminopyrine and methacetin breath tests in HCV-related chronic liver disease: Marcello Candelli, Catholic University, Rome Italy; Alessandro Armuzzi, Tor Vergata University, Rome Italy; Maria A Zocco, Francesco Bartolozzi, Catholic University, Rome Italy; Antonio Grieco, Cathlic University, Rome Italy; Enrico C Nista, Giulia Pignataro, Luca Miele, Giovanni Gasbarrini, Antonio Gasbarrini, Catholic University, Rome Italy

The year 1932 marked an important stage of development for fascist Rome. The tenth anniversary of the March on Rome, the Decennale, offered the regime the opportunity to celebrate its achievements and especially to introduce new spaces and events in Rome. An English-language pamphlet of the state-sponsored tourist agency boasted that the regime had “completely transformed Italy” in its first decade. “Anyone visiting Rome after an absence of ten years can hardly believe that so many and such important works could have been accomplished during this short period of time.” It pointed to the Via dell’Impero, the new towns in the reclaimed areas of the Pontine Marshes, and the opening up of the city’s ancient monuments.1 Mussolini’s imprint already gave the city a new look appropriate to the rhythm of modern life, with one construction project after another superimposing a new and beautiful city on imperial Rome.2 “It is not exaggerated to affirm that side by side with old Rome and even within its walls, another city has sprung up or rather has been revealed during the last ten years: a new Rome that deserves to be visited as much as the old one generally described in guide-books.”3

Alcuin’s De Animae Ratione explains how the tripartite soul facilitates the perception of distant people and places. Perception is facilitated through mental images, built from experience of the bodily senses. Alcuin illustrates the differences between the perception of a known or unknown place with an analogy, using Rome and Jerusalem as examples. Texts that reflect the cityscape of Rome, and the people associated with the cityscape, would have been an important medium through which distant readers perceived Rome. Three such types of text are papal letters, pilgrim itineraries and syllogae collections of inscriptions. These were often composed in Rome but read elsewhere. The materiality of these texts would have had an influence on the perception of Rome that was possible for their readers. However, the extant historiography of these three types of text has rarely considered the message in the medium through which their earliest readers accessed them. This thesis focuses on the early manuscript witnesses of these texts to explore the perception of Rome possible for their readers. These early manuscript witnesses are interpreted via application of Alcuin’s explanation of perception of place in his De Aminae Ratione. Each chapter focuses on one or two core manuscripts. The first chapter will examine the dissemination of Alcuin’s De Animae Ratione, by conducting a detailed analysis of the ninth-century manuscript copies. Chapters 2, 3 and 4 each focus on one key manuscript containing an early copy of one or more of the topographical texts. Chapter 5 will examine how papal letters and epitaphs are displayed in the earliest surviving manuscripts of Bede’s Historia Ecclesiastica Gentis Anglorum. These manuscripts provide a route into understanding the circulation, reading experience and impact of these texts as they were accessed by their earliest readers in England and Francia.

Admiration for the graphic vigor of the past brought historic fonts back into use in the modern period and renewed scholars' discus sions of stylistic influence in type design. In this context, the British type historian, Stanley Morison, proposed in the 1920s a hypothesis that was to alter the writing of typographic history in the twentieth century. Then at the beginning of his career, and busy scouring ar chives for examples of fine printing, Morison observed that, at origin, the French roman types of the early sixteenth century shared traits with the romans used by the Italian Renaissance publisher, Aldus Manutius. The observation was at variance with the scholarly opin ion of the period. Aldus was known for his Greek type, and for hav ing had Francesco Griff o cut the first italic in 1501. Aldus's roman, by contrast, was overlooked by historians as they assessed the influ ence of Italian fonts on later French ones. Nicolaus Jenson's 1470 ro man was heralded instead as the most likely model for the designs. Praise for Jenson's roman was rampant in the literature. The most recent volley had come in 1922 with the publication of Daniel Berkeley Updike's landmark study, Printing Types, Their History, Forms, and Use.1 Updike identified the strengths of Jenson's font as readability, its mellowness of form, and the evenness of colour in mass, and continued: Jenson's roman types have been the accepted models for roman letters ever since he made them, and, repeatedly copied in our own day, have never been equalled.... No other man produced quite so fine a font, or had better taste in the composition of a page and its imposition upon paper.2 Updike went on to characterize the Aldine roman as distinctly inferior to Jenson's.3 Even so, with little debate, Morison's Aldine hypothesis was quickly considered proven. It was supplemented by others, and is incorporated as fact in the modern literature on the history of typography. Scholars who work in the area, however, constantly encounter both the value of Morison's insight and the limitations of his construct. My work on some of the principal theorists and prac titioners of French Renaissance typography,4 for instance, has raised many questions about the utility of the hypothesis, suggesting that it needs to be rethought and, if necessary, revised. 1 Daniel Berkeley Updike, Printing Types, Their History, Forms, and Use, A Study