A cohort-based Partial Internal Model for demographic risk

We investigate the quantification of demographic risk in a framework consistent with the market-consistent valuation imposed by Solvency II. We provide compact formulas for evaluating inflows and outflows of a portfolio of insurance policies based on a cohort approach. In this context, we maintain the highest level of generality in order to consider both traditional policies and equity-linked policies: therefore, we propose a market-consistent valuation of the liabilities. In the second step we evaluate the Solvency Capital Requirement of the idiosyncratic risk, linked to accidental mortality, and the systematic risk one, also known as trend risk, proposing a formal closed formula for the former and an algorithm for the latter. We show that accidental volatility depends on the intrinsic characteristics of the policies of the cohort (Sums-at-Risk), on the age of the policyholders and on the variability of the sums insured; trend risk depends both on accidental volatility and on the longevity forecasting model used

Partition functions of non-Lagrangian theories from the holomorphic anomaly

The computation of the partition function in certain quantum field theories, such as those of the Argyres-Douglas or Minahan-Nemeschansky type, is problematic due to the lack of a Lagrangian description. In this paper, we use the holomorphic anomaly equation to derive the gravitational corrections to the prepotential of such theories at rank one by deforming them from the conformal point. In the conformal limit, we find a general formula for the partition function as a sum of hypergeometric functions. We show explicit results for the round sphere and the Nekrasov-Shatashvili phases of the $\Omega$ background. The first case is relevant for the derivation of extremal correlators in flat space, whereas the second one has interesting applications for the study of anharmonic oscillators.Comment: 37 page

Determinazione del valore di macchiatico per la vendita dei soprassuoli in piedi: presupposti teorici e procedimenti di calcolo

Objective of forestry firm is the sale of its standing. The forestry firm, however, before he wants to know its value. Authors take in consideration innovations registered by the forest system in the recent years, presented a detailed analysis of procedures for estimating the stumpage value, focusing mainly, on analytical process

The importance of hematocrit for oxygen delivery and hemodynamics

Anemia is common in elderly patients undergoing surgery and in critical patients. A 72-year-old man submitted to a revision of hip replacement implant was diagnosed with tuberculosis, followed by pulmonary fibrosis, pulmonary heart disease and compensatory erythrocytosis. In the postoperative period, he got anemia which improved his clinical status. Anemia reduces viscosity, i.e. one of the components of vascular resistance to laminar (according to the law of Hagen-Poiseuille) and turbulent flows. In conditions of decreased hematocrit, shear thinning occurs more easily and in larger caliber vessels. Hemodiluition reduces both right and left cardiac afterloads, thus provoking an improvement of the blood flow. As the hematocrit decreases, oxygen delivery increases, because the increase in the cardiac output is greater than the decrease in the concentration of hemoglobin. Further studies are needed to confirm this physical model and to establish the variable and degree of the transfusion trigger

Synthesis and CNS activities of pyridopyrazinone and pyridodiazepinone derivatives

New tricyclic derivatives with cyclocondensed pyrido-pyrazine 7,10 and pyrido-diazepine 20a,20b skeletons were synthetized and biologically investigated. The compounds, preliminarily tested on explorative, muscle relaxing, antinociceptive, spontaneous motor activities and influence on the narcotic effect of Evipan, revealed interesting CNS depressant and analgesic activities. The pyrido[2,3-e]pyrrolo[1,2-a]pyrazine structure of 7 appeared the most promising for analgesic and neuroleptic activities. The above compounds were assayed also for their capacity to inhibit DNA synthesis in Ehrlich ascites tumor cells; 20a appeared to be able of inducing a significant inhibition

An undertaking specific approach to address diversifiable demographic risk within Solvency II framework

This study addresses the assessment of capital requirements in life insurance for idiosyncratic demographic risks arising from mortality and longevity in compliance with the Solvency II framework. A closed-formula methodology, using a cohort-based risk theoretical approach, is introduced to properly capture the volatility associated with policyholder deaths or survivals. This approach not only accounts for portfolio size effects but it also considers the impact of variability in sums insured within cohorts and coverage types with an additional specific address to distribution tails. The proposed methodology offers a viable alternative within the Solvency II context, addressing limitations identified in previous studies for the Standard Formula nowadays in force. Focusing only on the diversifiable part of demographic risk, the approach considers company’s specific parameters through a risk-based formula, as opposed to a simple scenario approach with demographic stress on the Best Estimate of underlying contracts valid for the whole business. Numerical results show its accuracy in approximating capital requirements for a large range of life insurance contract

SARS-CoV-2-related encephalitis with prominent parkinsonism: clinical and FDG-PET correlates in two patients

Considering the similarities with other pandemics due to respiratory virus infections and subsequent development of neurological disorders (e.g. encephalitis lethargica after the 1918 influenza), there is growing concern about a possible new wave of neurological complications following the worldwide spread of SARS-CoV-2. However, data on COVID-19-related encephalitis and movement disorders are still limited. Herein, we describe the clinical and neuroimaging (FDG-PET/CT, MRI and DaT-SPECT) findings of two patients with COVID-19-related encephalopathy who developed prominent parkinsonism. None of the patients had previous history of parkinsonian signs/symptoms, and none had prodromal features of Parkinson's disease (hyposmia or RBD). Both developed a rapidly progressive form of atypical parkinsonism along with distinctive features suggestive of encephalitis. A possible immune-mediated etiology was suggested in Patient 2 by the presence of CSF-restricted oligoclonal bands, but none of the patients responded favorably to immunotherapy. Interestingly, FDG-PET/CT findings were similar in both cases and reminiscent of those observed in post-encephalitic parkinsonism, with cortical hypo-metabolism associated with hyper-metabolism in the brainstem, mesial temporal lobes, and basal ganglia. Patient's FDG-PET/CT findings were validated by performing a Statistical Parametric Mapping analysis and comparing the results with a cohort of healthy controls (n = 48). Cerebrum cortical thickness map was obtained in Patient 1 from MRI examinations to evaluate the structural correlates of the metabolic alterations detected with FDG-PET/CT. Hypermetabolic areas correlated with brain regions showing increased cortical thickness, suggesting their involvement during the inflammatory process. Overall, these observations suggest that SARS-CoV-2 infection may trigger an encephalitis with prominent parkinsonism and distinctive brain metabolic alterations

Characteristics, comorbidities and laboratory measures associated with disease severity and poor prognosis in young and elderly patients with COVID-19 admitted to medical wards in Emilia-Romagna region, Italy: a multicentre retrospective study

Background and Objectives. A relatively small number of studies have investigated the characteristics, comorbidities and laboratory measures associated with prognosis in patients with COVID-19, admitted to Internal Medicine Units (IMU) in Italy. Therefore, we performed a retrospective multicentre study to identify baseline features, predisposing to severe disease and poor outcomes, in adult individuals with SARS-CoV2 infection, hospitalized in 5 IMUs in the Emilia-Romagna region (Italy). Materials and Methods. We included 129 consecutive patients (male 75, median age 68 years) from 1st March 2020 to 31st October 2021. Patients' baseline characteristics, comorbidities, laboratory measures, and outcomes were collected. Results. At admission, the factors significantly associated with a higher risk of in-hospital mortality included: age (median 68 vs. 83 years in survived vs. dead patients, P=0.000), diabetes [Odds Ratio (OR) 4.00, P=0.016], chronic obstructive pulmonary disease (OR 4.60, P=0.022), cancer (OR 5.81, P=0.021), acute- (OR 9.88, P=0.000) and chronicrenal failure (OR 6.76, P=0.004). During the study period, 16 individuals died (12.4%), all over 70 years old. In deceased vs. non-deceased patients were detected: i) more elevated white blood cells and neutrophils-counts and lower lymphocytes count; ii) higher levels of total/direct bilirubin, creatinine, C-reactive-protein, lactate-dehydrogenase, ferritin, but only a slight Interleukin-6 increase; iii) a trend of lower vitamin D values. Conclusions. We proposed a new I index, a modified form of the Age-Adjusted Charlson Comorbidity Index, by considering pO(2)/FiO(2) ratio, to better characterize the severity of COVID-19. Furthermore, we critically discuss our results with the current assumption which considers COVID-19 as a pathological condition associated with cytokine storm

Magnetic resonance imaging: Is there a role in clinical management for acute ischemic colitis?

AIM: To validate the utility of magnetic resonance imaging (MRI) for the clinical management of acute ischemic colitis (IC). METHODS: This is a magnetic resonance (MR) prospective evaluation of 7 patients who were proved to have acute IC on the basis of clinical, endoscopic and computed tomography (CT) findings and who were imaged in our institution between February 2011 and July 2012. The mean age of the patients was 72.28 years. Abdominal CTs were obtained using a 64-detector row configuration for all patients with un-enhanced and contrast-enhanced scans, in the late arterial phase (start delay 45-50 s) and in the portal venous phase (start delay 70-80 s). The MR examinations were performed using a 1.5T superconducting magnet, using Fast Imaging Employing Steady State Acquisition and T2-weighted fast-recovery fast-spin echo sequences in axial and coronal plane. CT and MRI examinations were analysed for the presence of colonic abnormalities and associated findings. RESULTS: Segmental involvement was seen in 6 patients (85.71%), with a mean length of involvement of 412 mm (range 145.5-1000 mm). Wall thickness varied between 6 mm and 17.5 mm (mean 10.52 mm) upon CT examinations and from 5 to 15 mm (mean 8.8 mm) upon MR examinations. The MRI appearance of the colonic wall varied over the time: Type I appearance with a 3 layer sandwich sign was seen in 5 out of 12 examinations (41.66%), patients underwent MR within a mean of 36 h (ranging from 1 to 54 h) after the CT examination. Type II and III appearance with a 2 layer sign, was seen in 4 examinations (33.33%), patients underwent MR within a mean of 420.5 h (ranging from 121 to 720 h) after the CT examination. In the remaining three MRI examinations, performed within a mean of 410 h (ranging from 99.5 to 720 h) the colonic wall appeared normal. CONCLUSION: MRI, only using precontrast images, may be used as a substitute for invasive procedures in diagnosis and follow-up of acute IC