The barriers to sustainable risk transfer in the cyber-insurance market

Efficient risk transfer is an important condition for ensuring the sustainability of a market according to the established economics literature. In an inefficient market, significant financial imbalances may develop and potentially jeopardise the solvency of some market participants. The constantly evolving nature of cyber-threats and lack of public data sharing mean that the economic conditions required for quoted cyber-insurance premiums to be considered efficient are highly unlikely to be met. This paper develops Monte Carlo simulations of an artificial cyber-insurance market and compares the efficient and inefficient outcomes based on the informational setup between the market participants. The existence of diverse loss distributions is justified by the dynamic nature of cyber-threats and the absence of any reliable and centralised incident reporting. It is shown that the limited involvement of reinsurers when loss expectations are not shared leads to increased premiums and lower overall capacity. This suggests that the sustainability of the cyber-insurance market requires both better data sharing and external sources of risk tolerant capital.Comment: 32 pages, 9 figures, 17 table

Pricing cyber-insurance for systems via maturity models

Pricing insurance for risks associated with information technology systems presents a complex modelling challenge, combining the disciplines of operations management, security, and economics. This work proposes a socioeconomic model for cyber-insurance decisions compromised of entity relationship diagrams, security maturity models, and economic models, addressing a long-standing research challenge of capturing organizational structure in the design and pricing of cyber-insurance policies. Insurance pricing is usually informed by the long experience insurance companies have of the magnitude and frequency of losses that arise in organizations based on their size, industry sector, and location. Consequently, their calculations of premia will start from a baseline determined by these considerations. A unique challenge of cyber-insurance is that data history is limited and not necessarily informative of future loss risk meaning that established actuarial methodology for other lines of insurance may not be the optimal pricing strategy. The model proposed in this paper provides a vehicle for agreement between practitioners in the cyber-insurance ecosystem on cyber-security risks and allows for the users to choose their desired level of abstraction in the description of a system.Comment: 31 pages, 12 figures, 11 table

The barriers to sustainable risk transfer in the cyber-insurance market

Efficient risk transfer is an important condition for ensuring the sustainability of a market according to the established economics literature. In an inefficient market, significant financial imbalances may develop and potentially jeopardize the solvency of some market participants. The constantly evolving nature of cyber-threats and lack of public data sharing mean that the economic conditions required for quoted cyber-insurance premiums to be considered efficient are highly unlikely to be met. This paper develops Monte Carlo simulations of an artificial cyber-insurance market and compares the efficient and inefficient outcomes based on the informational setup between the market participants. The existence of diverse loss distributions is justified by the dynamic nature of cyber-threats and the absence of any reliable and centralized incident reporting. It is shown that the limited involvement of reinsurers when loss expectations are not shared leads to increased premiums and lower overall capacity. This suggests that the sustainability of the cyber-insurance market requires both better data sharing and external sources of risk tolerant capital

General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

Protection against Noise-Induced Hearing Loss in Young CBA/J Mice by Low-Dose Kanamycin

Animal studies indicate that a combination of kanamycin (KM) and noise produces a synergistic effect, whereby the threshold shift from the combination is greater than the sum of the shifts caused by either agent alone. Most such studies have focused on adult animals, and it has remained unclear whether younger, presumably more susceptible, animals show an even greater synergistic effect. The present study tested the hypothesis that young CBA/J mice receiving a low dose of KM (300 mg/kg, 2×/day, s.c.) from 20 to 30 days post-gestational age followed by brief noise exposure (110 dB SPL; 4–45 kHz, 30 s) would show greater noise-induced permanent threshold shifts (NIPTS) than mice receiving either treatment alone. Noise exposure produced 30–40 dB of NIPTS and moderate hair cell loss in young saline-treated mice. KM alone at this dose had no effect on thresholds. Surprisingly, mice receiving KM plus noise were protected from NIPTS, showing ABR thresholds not significantly different from unexposed controls. Mice receiving KM prior to noise exposure also showed significantly less outer hair cell loss than saline-treated mice. Additional experiments indicated protection by KM when the noise was applied either 24 or 48 h after the last KM injection. Our results demonstrate a powerful protective effect of sub-chronic low-dose kanamycin against NIPTS in young CBA/J mice. Repeated kanamycin exposure may establish a preconditioned protective state, the molecular bases of which remain to be determined