Cranial artery dissection

Stroke is a very common cause for mortality and morbidity, especially in the elderly where the cause is usually generalized arteriosclerosis. In persons less than 45 years of age with stroke, there is a group of uncommon illnesses that are often identified. This includes cranial artery dissection, accounting for approximately 20% of these acute neurological events. Cranial artery dissection can involve the carotids or vertebral system, and symptoms can be quite diverse depending on the area of brain ischemia. Anticoagulation is the usual treatment, and overall there is a good long-term prognosis from this entity.     

Screening potential elderly preferred markers: exploratory analysis of Cardiovascular Health Study (CHS) data

The Cardiovascular Health Study (CHS) analyzes risk factors for coronary heart disease and stroke in people age 65 and older. Since CHS is designed to comprehensively study cardiovascular risk factors in an elderly population, it provides a unique opportunity to study the association of risk factors with mortality, as well as morbidity risk. With the growth of the elderly as population and life insurance market segments, the need to more precisely stratify mortality within a standard risk group of the elderly has grown as well. This exploratory analysis assesses medical factors that could be used to improve mortality risk stratification within a "standard" mortality population, using the CHS public use data set. Participants with a personal history of cardiovascular disease, diabetes, or major electrocardiographic abnormalities were excluded from the analysis in order to mimic a standard life insurance selection process. Then, Cox proportional hazards regression was used to study 10 medical risk factors. This model suggested that forced vital capacity >80% predicted, serum creatinine <1.5 mg/dL (133 mcmol/L), hemoglobin >11 g/dL (110 g/L), and serum albumin >3.5 mg/L (35 mmol/ L) are significantly associated (p = 0.05) with favorable mortality. C-reactive protein <1 mg/L is associated with favorable mortality at borderline significance levels (p = 0.09). On the other hand, a family history of cardiovascular disease (MI and/or stroke) and low BMI (<26 kg/m2) are associated with unfavorable mortality in the analysis. Total to HDL cholesterol ratio of <6, presence of supine systolic blood pressure < or = 140 mmHg, and the presence of minor rest electrocardiographic findings were not statistically significant factors in the multivariate model. Further assessment of the predictive value of the "significant" medical factors identified is required in insured lives.     

Metabolic syndrome

This paper reviews current diagnostic criteria for Metabolic Syndrome, and provides in-depth discussion of the component abnormalities. A cluster of abnormalities defines Metabolic Syndrome including insulin resistance, hypertension, obesity, hypertriglyceridemia, and low HDL cholesterol. Evidence that inflammation is another component of Metabolic Syndrome raises the possibility that this is an additional process that links Metabolic Syndrome to cardiovascular disease (CVD) risk. Population studies strongly suggest the existence of a relationship between the metabolic abnormalities associated with Metabolic Syndrome and the development of diabetes and cardiovascular disease. It appears that lifestyle modifications can contribute to the prevention of progression to diabetes and the reduction of individual CVD risk factors. Whether use of insulin sensitizing drugs can significantly delay or prevent the progression to diabetes is under investigation. Because of its contribution to the growing prevalence of type 2 diabetes, and the associated increased CVD risk, the recognition of Metabolic Syndrome and its consequences are critical in the course of morbidity and mortality risk assessment.     

Ankle/arm blood pressure index: an insurance perspective

Recent studies conclude that the ankle/arm blood pressure index (AAI) is a useful clinical tool for refining cardiovascular risk classification in the elderly. A reduction in the AAI to 0.9 or less is associated with increased risk for both coronary heart disease and total cardiovascular disease morbidity and mortality, as well as all-cause mortality. This relationship persists after adjusting for traditional risk factors and known cardiovascular disease. AAI will appear more common in attending physician's statements, prompting a need to educate underwriters about this technology. AAI may be of particular interest to insurers dealing in the elderly market, to those with strong physician examiner systems, and in markets where blood or urine tests are not commonly used in underwriting.     

Gene-environment interactions and the complexity of human genetic diseases

In the assessment of mortality and morbidity risk, the ability of family history and genetic test results to predict the age of occurrence, severity, and long-term prognosis of 'genetic' diseases is important. An increasing number of gene-gene and gene-environment interactions have been demonstrated in a number of monogenic Mendelian diseases. These interactions can significantly modify the clinical presentation (disease phenotype) of diseases previously regarded purely as 'genetic.' As a result, 'genetic' diseases can be positioned in a continuum between classic Mendelian and complex disease where the extremes, pure genetic or solely non-genetic, do not exist. The position of any given disease in this continuum is defined by three components: the major gene(s) contributing to the phenotype, the variability added by modifier genes and the significance of environmental factors influencing the phenotype. As the predictive value of genetic test results can be significantly influenced by additional genetic and environmental risk factors, a better understanding of these factors may influence the quantification of mortality and morbidity risk.     

Total efficient risk priority number (TERPN): a new method for risk assessment

Safety is one of the most important issues in modern industrial plants and industrial activities. The Safety Engineering role is to ensure acceptable safety levels of production systems, not only to respect local laws and regulations, but also to improve production efficiency and to reduce manufacturing costs. For these reasons, the choice of a proper model for risk assessment is crucial. In this context, the present research aims to propose a new method, called Total Efficient Risk Priority Number (TERPN), able to classify risks and identify corrective actions in order to obtain the highest risk reduction with the lowest cost. The main scope is to suggest a simple, but suitable model for ranking risks in a company, to reach the maximum effectiveness of prevention and protection strategies. The TERPN method is an integration of the popular Failure Mode Effect and Criticality Analysis (FMECA) with other important factors in risk assessment.     

Farmers’ motivations,risk perceptions and risk management strategies in a developing economy: Bangladesh experience

Aquaculture farmers’ risk perceptions and risk management strategies have still received little attention in agricultural research. Therefore, an exploratory study has been undertaken to provide empirical insight into Bangladeshi coastal shrimp farmers’ risk perceptions and risk management responses. Data from our study show that 95% of farmers have no formal training in shrimp aquaculture. Shrimp farmers’ cooperative societies operate in only 13.3% of the studied areas and only 15% of shrimp farmers are involved with these cooperative societies. The results reveal that shrimp diseases, price and availability of quality shrimp seeds, exploitation by intermediaries and uncertainty about the future demand for shrimp in foreign markets are perceived as the most important sources of risk. On the other hand, prevention of disease, timely supply of shrimp seeds, elimination of middlemen from the supply chain and farm management training are considered among the best methods to manage the risks in the shrimp‐farming business. We also observe some disparities in farmers’ perceptions. For instance, farmers mentioned that removal of influence of middlemen from supply chain is essential for the betterment of their business. However, they did not consider market monitoring, direct contract with processors and improved marketing facilities as important risk management strategies, although these factors play a significant role in reducing the influence of intermediaries and private money lenders.     

Cattle farmers’ perceptions of risk and risk management strategies: evidence from Northern Ethiopia

This study analyzes cattle farmers’ perceptions of risk and risk management strategies in Tigray, Northern Ethiopia. We use survey data from a sample of 356 farmers based on multistage random sampling. Factor analysis is employed to classify scores of risk and management strategies, and multiple regression is then used to investigate the relationship between scores and farmers’ characteristics. The results demonstrate that shortage of family labor, high price of fodder, and limited farm income were perceived as the most important risks. Use of veterinary services, parasite control, and loan utilization were perceived as the most important strategies for managing risks. Livestock disease and labor shortage were perceived as less of a risk by farmers who adopted the practice of zero grazing compared to other farmers, pointing to the potential of this practice for risk reduction. We find strong evidence that farmers engage in multiple risk management practices in order to reduce losses from cattle morbidity and mortality. The results suggest that government strategies that aim at reducing farmers’ risk need to be tailored to specific farm and farmer characteristics. Findings from this study have potentially important policy implications for risk management strategies in developing countries.     

Mortality in rheumatoid disease

This paper provides an overview of rheumatoid disease from the perspective of its impact on mortality. The term, rheumatoid arthritis, may promote the misconception that this disease is relatively trivial and easily managed; therefore, "rheumatoid disease" is preferred. Numerous long-term studies in many settings have established that significant excess mortality is associated with rheumatoid disease, and that this excess mortality is related to cardiovascular disease deaths. Inflammation in rheumatoid and cardiovascular diseases shares the same biologic mechanisms. Severity of extraarticular disease, decline in functional level, and level of inflammatory activity are associated with increased risk of mortality. Detection and measurement of novel inflammatory biomarkers may provide tools to assess prognosis and to monitor therapy. Close attention to the management of traditional cardiovascular risk factors is essential in these patients. Whether disease modifying antirheumatic drug (DMARD) therapy will reduce all-cause and cardiovascular disease mortality in rheumatoid disease is the subject of ongoing studies.     

LVH: consequences associated with cardiac remodeling

With increased hemodynamic stress, the heart must adjust to meet the greater demands placed upon it. This adjustment frequently involves an alteration or remodeling in its structure or geometry, which augments its performance and helps to maintain adequate function under changing conditions. One of the most important forms of remodeling that the heart may undergo is an increase in muscle mass in response to a pressure or volume overload or myocardial injury. This increase in muscle mass is known as left ventricular hypertrophy (LVH). LVH is of great importance from a risk selection perspective for two reasons: it is common, and it is associated with a significant increase in both morbidity and mortality risk. Thus, it is critical that both underwriters and medical directors be aware of this form of remodeling, its causes, diagnosis and consequences.     

系统性金融风险文献综述:现状、发展与展望

防范风险是我国金融业的永恒主题。如何有效应对金融系统的异常波动、缓释国际市场的外部冲击、精准处置重点领域风险,仍将是我国“十四五”期间的重要任务。本文分别基于系统性金融风险的有效测度、传染溢出、驱动因素、前瞻预测,以及其与宏观经济的相互作用关系、风险调控政策与政策的有效性、监管理念发展等不同视角,对272篇国内外顶级(权威)文献进行了全面、深入的梳理与总结,并展望该领域的重点研究方向,从而为我国构建金融风险防控长效机制、完善“双循环”新格局下的金融监管体系提供参考,以牢牢守住不发生系统性金融风险的底线,推动经济社会高质量发展。     

Underwriting the elderly: the utility of DWR, part II

Cognitive function is an important predictor of mortality in the elderly. Over the past few years, an increasing number of life insurance companies have incorporated screening for cognitive impairment into the underwriting process at older ages. Many different test instruments provide a measurement of cognitive function. Among these, the 10 word delayed word recall test (DWR) offers the best opportunity to study mortality directly, because of a long history of use in long-term care risk assessment. This article revises and extends a previous report published in the Journal in 2006 looking at the relationship between DWR score and mortality.     

Household portfolio choices,health status and health care systems: A cross-country analysis based on SHARE

Health risk is increasingly viewed as an important form of background risk that affects household portfolio decisions. However, its role might be mediated by the presence of a protective full-coverage national health service that could reduce households’ probability of incurring current and future out-of-pocket medical expenditures. We use SHARE data to study the influence of current health status and future health risk on the decision to hold risky assets, across ten European countries with different health systems, each offering a different degree of protection against out-of-pocket medical expenditures. We find robust empirical evidence that perceived health status matters more than objective health status and, consistent with the theory of background risk, health risk affects portfolio choices only in countries with less protective health care systems. Furthermore, portfolio decisions consistent with background risk models are observed only with respect to middle-aged and highly-educated investors.     

从债务期限影响因素看中小企业债券市场发展

融资难是当前困扰我国中小企业发展的最大瓶颈,大力发展中小企业债券市场,是降低间接融资系统性风险、提高中小企业融资规模的重要途径。本文首先以上市公司债务期限结构为对象,实证研究影响市场资金供求双方的影响因素,在现阶段我国债券市场的市场制度、风险偏好、发行人资质等综合条件下,发行短期债券是当前中小企业发展最现实的选择,受信息不对称、违约风险等因素的影响,保障企业稳定发展的中长期资金难以获得。     

A Hermite-spline model of post-retirement mortality

ABSTRACT

We present a model for post-retirement mortality where differentials automatically reduce with increasing age, but without the fitted mortality rates for subgroups crossing over. Selection effects are catered for, as are age-modulated time trends and seasonal variation in mortality. Central to the model are Hermite splines, which permit parsimonious modelling of complex risk factors in even modest-sized portfolios. The model is therefore suitable for the stand-alone analysis of experience data for reinsurance, bulk annuities and longevity swaps. We also illustrate the contrast between the statistical significance of a risk factor and its financial significance and discuss reasons why one might include risk factors like season that are not directly financially significant.     

我国证券公司治理绩效的因子分析

证券公司是资本市场最重要的行为主体之一,我国证券公司虽已建立了董事会、监事会、独立董事等现代公司治理框架,但在实际运作中其职能行使上存在许多不规范的地方。2008年金融危机告诫我们,不仅需要提高证券公司的风险防范机制,更需要建立完善的公司治理结构,促使证券公司风险防范机制作用顺利发挥。通过因子分析法将证券公司内部治理变量综合成为四个因子,即规模激励因子、结构因子、监管因子和独立性因子,进而分析内部治理因子对证券公司经营绩效的影响。     

供应链金融资产证券化的产品信用风险研究--基于QYSJ-ABS和RXZL-ABS的案例分析

以“QYSJ知识产权供应链金融资产支持专项计划”和“RXZL2017年一期资产支持专项计划”为例,研究供应链金融资产证券化产品信用风险控制问题。首先通过分析交易结构和产品设计,对比两案例的风险分散和控制情况;其次基于证券化前后的财务数据,通过Z值变动判断资产证券化对公司信用风险的影响,分析专项计划的实施效果。研究发现:合理选择基础资产、使用信用增级措施和采用供应链这种交易结构均能够对证券化项目的信用风险防范起到一定促进作用。同时,借鉴QYSJ-ABS的成功经验,从证券化项目交易结构的设计、证券化项目基础资产的选择和信用增级举措的选择三方面总结了版权证券化的风险管理流程。最后,从风险管理体系建设方面入手,对未来拟进行供应链金融资产证券化的企业提出发展建议。     

Linking simulation argument to the AI risk

Metaphysics, future studies, and artificial intelligence (AI) are usually regarded as rather distant, non-intersecting fields. There are, however, interesting points of contact which might highlight some potentially risky aspects of advanced computing technologies. While the original simulation argument of Nick Bostrom was formulated without reference to the enabling AI technologies and accompanying existential risks, I argue that there is an important generic link between the two, whose net effect under a range of plausible scenarios is to reduce the likelihood of our living in a simulation. This has several consequences for risk analysis and risk management, the most important being putting greater priority on confronting “traditional” existential risks, such as those following from the misuse of biotechnology, nuclear winter or supervolcanism. In addition, the present argument demonstrates how – rather counterintuitively – seemingly speculative ontological speculations could, in principle, influence practical decisions on risk mitigation policies.     

A General Semi-Markov Model for Coupled Lifetimes

Joint-life annuities with a high last survivor benefit play an important role in the optimal annuity portfolio for a retired couple. The dependence between coupled lifetimes is crucial for valuing joint-life annuities. Existing bivariate modeling of coupled lifetimes is based on outdated data with limited observation periods and does not take into account mortality improvement. In this article, we propose a transparent and dynamic framework for modeling coupled lifetime dependence caused by both marital status and common mortality improvement factors. Dependence due to marital status is captured by a semi-Markov joint life model. Dependence due to common mortality improvement, which represents the correlation between mortality improvement patterns of coupled lives, is incorporated by a two-population mortality improvement model. The proposed model is applied to pricing the longevity risk in last survivor annuities sold in the United States and the United Kingdom.     

The role of economic structural factors in determining pandemic mortality rates: Evidence from the COVID-19 outbreak in France

Among the majority of research on individual factors leading to coronavirus mortality, age has been identified as a dominant factor. Health and other individual factors including gender, comorbidity, ethnicity and obesity have also been identified by other studies. In contrast, we examine the role of economic structural factors on COVID-19 mortality rates. Particularly, focusing on a densely populated region of France, we document evidence that higher economic “precariousness indicators” such as unemployment and poverty rates, lack of formal education and housing are important factors in determining COVID-19 mortality rates. Our study will help inform policy makers regarding the role of economic factors in managing pandemics.