De Finetti on the insurance of risks and uncertainties

In the insurance literature, it is often argued that private markets can provide insurance against ‘risks’ but not against ‘uncertainties’ in the sense of Knight ([1921]) or Keynes ([1921]). This claim is at odds with the standard economic model of risk exchange which, in assuming that decision-makers are always guided by point-valued subjective probabilities, predicts that all uncertainties can, in theory, be insured. Supporters of the standard model argue that the insuring of highly idiosyncratic risks by Lloyd's of London proves that this is so even in practice. The purpose of this article is to show that Bruno de Finetti, famous as one of the three founding fathers of the subjective approach to probability assumed by the standard model, actually made a theoretical case for uncertainty within the subjectivist approach. We draw on empirical evidence from the practice of underwriters to show how this case may help explain the reluctance of insurers to cover highly uncertain contingencies

Mild behavioral impairment in Parkinson's disease: Data from the Parkinson's disease cognitive impairment study (PACOS)

Neuropsychiatric symptoms (NPS) have been frequently described in Parkinson's disease (PD), even in the earliest stages of the disease. Recently the construct of mild behavioral impairment (MBI) has been proposed as an at-risk state for incident cognitive decline and dementia. The aim of the present study is to evaluate the prevalence and associated factors of MBI in PD. Cross-sectional data from 429 consecutive PD patients enrolled in the PArkinson's disease COgnitive impairment Study (PACOS) were included in the study. All subjects underwent neuropsychological assessment, according to the MDS Level II criteria. NPS were evaluated with the Neuropsychiatric Inventory. Multivariate logistic regression models were used to evaluate clinical and behavioral characteristics, which are associated with PD-MBI. The latter was ascertained in 361 (84.1%) subjects of whom 155 (36.1%) were newly diagnosed patients (disease duration ≥1 year) and 206 (48.0%) had a disease duration <1 year. Furthermore, 68 (15.9%) out of 429 subjects were PDw (without MBI). Across the MBI domains, Impulse Dyscontrol was significantly more prevalent among PD-MBI with disease duration <1 year than newly diagnosed patients. The frequency of Social Inappropriateness and Abnormal Perception significantly increased throughout the entire PD-MBI sample with increasing Hoehn andYahr (H&Y) stages. PD-MBI in newly diagnosed PDwas significantly associated with H&Y stage (OR 2.35, 95% CI 1.05-5.24) and marginally with antidepressant drug use (OR 2.94, 95% CI 0.91-9.47), while in patients with a disease duration >1 year was associated with UPDRS-ME (OR 3.37, 95% CI 1.41-8.00). The overall MBI frequency in the PACOS sample was 84% and 36% among newly diagnosed patients. The presence of MBI mainly related to motor impairment and disability

De Finetti on uncertainty

The well-known Knightian distinction between quantifiable risk and unquantifiable uncertainty is at odds with the dominant subjectivist conception of probability associated with de Finetti, Ramsey and Savage. Risk and uncertainty are rendered indistinguishable on the subjectivist approach insofar as an individual’s subjective estimate of the probability of any event can be elicited from the odds at which she would be prepared to bet for or against that event. The risk/uncertainty distinction has however never quite gone away and is currently under renewed theoretical scrutiny. The purpose of this article is to show that de Finetti’s understanding of the distinction is more nuanced than is usually admitted. Relying on usually overlooked excerpts of de Finetti’s works commenting on Keynes, Knight and interval valued probabilities, we argue that de Finetti suggested a relevant theoretical case for uncertainty to hold even when individuals are endowed with subjective probabilities. Indeed, de Finetti admitted that the distinction between risk and uncertainty is relevant when different individuals sensibly disagree about the probability of the occurrence of an event. We conclude that the received interpretation of de Finetti’s understanding of subjective probability needs to be qualified on this front

Incidence of mild cognitive impairment and dementia in Parkinson's disease: The Parkinson's disease cognitive impairment study

Background: Cognitive impairment in Parkinson's disease (PD) includes a spectrum varying from Mild Cognitive Impairment (PD-MCI) to PD Dementia (PDD). The main aim of the present study is to evaluate the incidence of PD-MCI, its rate of progression to dementia, and to identify demographic and clinical characteristics which predict cognitive impairment in PD patients. Methods: PD patients from a large hospital-based cohort who underwent at least two comprehensive neuropsychological evaluations were retrospectively enrolled in the study. PD-MCI and PDD were diagnosed according to the Movement Disorder Society criteria. Incidence rates of PD-MCI and PDD were estimated. Clinical and demographic factors predicting PD-MCI and dementia were evaluated using Cox proportional hazard model. Results: Out of 139 enrolled PD patients, 84 were classified with normal cognition (PD-NC), while 55 (39.6%) fulfilled the diagnosis of PD-MCI at baseline. At follow-up (mean follow-up 23.5 ± 10.3 months) 28 (33.3%) of the 84 PD-NC at baseline developed MCI and 4 (4.8%) converted to PDD. The incidence rate of PD-MCI was 184.0/1000 pyar (95% CI 124.7-262.3). At multivariate analysis a negative association between education and MCI development at follow-up was observed (HR 0.37, 95% CI 0.15-0.89; p = 0.03). The incidence rate of dementia was 24.3/1000 pyar (95% CI 7.7-58.5). Out of 55 PD-MCI patients at baseline, 14 (25.4%) converted to PDD, giving an incidence rate of 123.5/1000 pyar (95% CI 70.3-202.2). A five time increased risk of PDD was found in PD patients with MCI at baseline (RR 5.09, 95% CI 1.60-21.4). Conclusion: Our study supports the relevant role of PD-MCI in predicting PDD and underlines the importance of education in reducing the risk of cognitive impairment

Cardiovascular autonomic function and MCI in Parkinson's disease

Introduction: dysautonomic dysfunction and cognitive impairment represent the most disabling non-motor features of Parkinson's Disease (PD). Recent evidences suggest the association between Orthostatic Hypotension (OH) and PD-Dementia. However, little is known on the interactions between cardiovascular dysautonomia and Mild Cognitive Impairment (MCI). We aimed to evaluate the association between cardiovascular dysautonomia and MCI in patients with PD. Methods: non-demented PD patients belonging to the PACOS cohort underwent a comprehensive instrumental neurovegetative assessment including the study of both parasympathetic and sympathetic function (30:15 ratio, Expiratory-Inspiratory ratio [E-I] and presence of Orthostatic Hypotension [OH]). Diagnosis of MCI was made according to the MDS criteria level II. Results: we enrolled 185 PD patients of whom 102 (55.1%) were men, mean age was 64.6 ± 9.7 years, mean disease duration of 5.6 ± 5.5 years with a mean UPDRS-ME score of 31.7 ± 10.9. MCI was diagnosed in 79 (42.7%) patients. OH was recorded in 52 (28.1%) patients, altered 30:15 ratio was recorded in 39 (24.1%) patients and an altered E-I ratio was found in 24 (19.1%) patients. Presence of MCI was associated with an altered 30:15 ratio (adjOR 2.83; 95%CI 1.25–6.40) but not with an altered E-I ratio, while OH was associated only with the amnestic MCI subgroup (OR 2.43; 95% CI 1.05–5.06). Conclusion: in our study sample, MCI was mainly associated with parasympathetic dysfunction in PD

Use of biodegradable materials as alternative packaging of typical Calabrian Provola cheese

Calabrian Provola cheese is typically manufactured in the Southern Italy. The request of a more suitable expansion in the national market has promoted this research, based on the evaluation of biodegradable packaging on its qualitative characteristics as alternative of the conventional plastic multilayer film. The tested materials were: Polyethylene/Ethylene vinyl alcohol/Polyamide/Polyethylene (PE/EVOH/PA/PE), Polylactic acid (PLA), coated with a silicon oxide barrier, and Cellophane, coated with resins. The results of this study evidenced that the material based on PLA can be considered a valid alternative packaging because of the quality maintenance of Calabrian Provola cheese and its sustainable characteristics

study of the aggregation properties of a novel amphiphilic C60 fullerene derivative

none7An amphiphilic C60-derivative, AFE, characterized by the presence of the chiral fragment of L-acetyl carnitine in its hydrophilic appendage has been synthesized. In binary (THF/H2O) and ternary (THF/MeOH/H2O) solutions, AFE exhibits a strong tendency to self-aggregation, provided that the Hildebrand polarity index, ä, of the solvent is higher than about 15. A stable aqueous solution of aggregated AFE was obtained. Partition experiments between n-octanol and water show that AFE cannot be spontaneously transferred from water into the organic solvent (and vice versa), although it is effectively “salted-out” by common electrolytes. Light scattering and reversed-phase liquid chromatography experiments carried out on the aqueous solution of AFE suggest for the aggregates an average diameter of 120 nm.openANGELINI G.; DE MARIA P.; FONTANA A.; PIERINI M.; MAGGINI M.; GASPARRINI F.; ZAPPIA G.Angelini, G.; DE MARIA, P.; Fontana, A.; Pierini, M.; Maggini, M.; Gasparrini, F.; Zappia, Giovann

Usefulness of movement time in the assessment of Parkinson’s disease

Abstract Reaction time (RT) and movement time (MT) are reported to be delayed in Parkinson's disease (PD), but their clinical utility and relationship with clinical findings is still uncertain. We investigated RT and MT in 22 PD patients at baseline conditions and following acute oral trials of levodopa and biperiden, an anticholinergic drug. At baseline conditions, RT and MT of PD patients were abnormally delayed compared with those of 16 normal control subjects. Both RT and MT were longer in more severely affected patients compared with the mild PD patients; in the mild PD patients with asymmetrical signs both responses were longer on the more affected side. Bradykinesia was the clinical symptom that best correlated with the objective measurements, with a stronger correlation for MT than for RT. The oral administration of levodopa significantly improved both the responses, whereas biperiden was ineffective. The magnitude of RT and MT improvement after levodopa differed; MT improvement was related to PD severity, whereas RT improvement was not. These results suggest that MT, rather than RT, is an objective, simple, and reliable tool to evaluate bradykinesia and its levodopa-induced modifications in PD