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In this paper, we explore potential surplus modelling improvements by investigating how well the available models describe an insurance risk process. To this end, we obtain and analyse a real-life data set that is provided by an anonymous insurer. Based on our analysis, we discover that both the purchasing process and the corresponding claim process have seasonal fluctuations. Some special events, such as public holidays, also have impact on these processes. In the existing literature, the seasonality is often stressed in the claim process, while the cash inflow usually assumes simple forms. We further suggest a possible way of modelling the dependence between these two processes. A preliminary analysis of the impact of these patterns on the surplus process is also conducted. As a result, we propose a surplus process model which utilises a non-homogeneous Poisson process for premium counts and a Cox process for claim counts that reflect the specific features of the data.
Some problems arising from loss modeling may be analytically intractable. Many of these problems, however, can be formulated in a stochastic framework, with a solution that can be estimated empirically. This approach is called Monte Carlo simulation. It involves drawing samples of observations randomly according to the distribution required, in a manner determined by the analytic problem.
In this chapter, we discuss some applications of Monte Carlo methods to the analysis of actuarial and financial data. We first revisit the tests of model misspecification introduced in Chapter 13.
Some models assume that the failure-time or loss variables follow a certain family of distributions, specified up to a number of unknown parameters. To compute quantities such as average loss or VaR, the parameters of the distributions have to be estimated. This chapter discusses various methods of estimating the parameters of a failure-time or loss distribution.
As insurance companies hold portfolios of insurance policies that may result in claims, it is a good management practice to assess the exposure of the company to such risks. A risk measure, which summarizes the overall risk exposures of the company, helps the company evaluate if there is sufficient capital to overcome adverse events.
Credibility models were first proposed in the beginning of the twentieth century to update predictions of insurance losses in light of recently available data of insurance claims. The oldest approach is the limited-fluctuation credibility method, also called the classical approach, which proposes to update the loss prediction as a weighted average of the prediction based purely on the recent data and the rate in the insurance manual. Full credibility is achieved if the amount of recent data is sufficient, in which case the updated prediction will be based on the recent data only. If, however, the amount of recent data is insufficient, only partial credibility is attributed to the data, and the updated prediction depends on the manual rate as well.
Toxoplasmosis caused by the protozoan parasite Toxoplasma gondii occurs worldwide. Infections range from asymptomatic to life-threatening. T. gondii infection is acquired either via bradyzoites in meat or via oocysts in the environment, but the relative importance of these path ways and the different sources remains unclear. In this study, possible risk factors for toxoplasmosis in the Netherlands were investigated. A case–control study was conducted including persons with recent infection and individuals with a negative test result for IgM and IgG for T. gondii between July 2016 and April 2021. A total of 48 cases and 50 controls completed the questionnaire. Food history and environmental exposure were compared using logistic regression. Consumption of different meats was found to be associated with recent infection. In the multivariable model, adjusted for age, gender, and pregnancy, consumption of large game meat (adjusted odds ratio (aOR) 8.2, 95% confidence interval 1.6–41.9) and sometimes (aOR 4.1, 1.1–15.3) or never (aOR 15.9, 2.2–115.5) washing hands before food preparation remained. These results emphasize the value of the advice to be careful with the consumption of raw and undercooked meat. Good hand hygiene could also be promoted in the prevention of T. gondii infection.
The study investigated the sero-status of human immunodeficiency virus among healthcare workers in Addis Ababa public hospitals. A multi-centered, institutional-based, cross-sectional study was conducted from 18 September 2022 to 30 October 2022. A simple random sampling method and a semi-structured, self-administered questionnaire were used to collect the data, which were analyzed using the Statistical Package for Social Sciences (SPSS) version 25. A binary logistic regression model was used to identify the factors associated with the human immunodeficiency virus sero-status of healthcare workers post exposure to infected blood and body fluids. Of the 420 study participants who were exposed to blood and body fluids, 403 (96%) were non-reactive. Healthcare workers who had 20–29 years of work experience had approximately six times higher odds of testing positive for the human immunodeficiency virus (AOR = 6.21, 95% CI: 2.39, 9.55). Healthcare workers who did not use personal protective equipment properly had five times higher odds of testing positive for the human immunodeficiency virus (AOR = 5.02, CI: 3.73, 9.51). This study showed that, among those healthcare workers who tested positive for the human immunodeficiency virus infection, the majority were from the emergency department. Healthcare workers who did not use personal protective equipment properly had higher odds of testing positive for the human immunodeficiency virus.
Burn patients are at high risk of central line–associated bloodstream infection (CLABSI). However, the diagnosis of such infections is complex, resource-intensive, and often delayed. This study aimed to investigate the epidemiology of CLABSI and develop a prediction model for the infection in burn patients. The study analysed the infection profiles, clinical epidemiology, and central venous catheter (CVC) management of patients in a large burn centre in China from January 2018 to December 2021. In total, 222 burn patients with a cumulative 630 CVCs and 5,431 line-days were included. The CLABSI rate was 23.02 CVCs per 1000 line-days. The three most common bacterial species were Acinetobacter baumannii, Staphylococcus aureus, and Pseudomonas aeruginosa; 76.09% of isolates were multidrug resistant. Compared with a non-CLABSI cohort, CLABSI patients were significantly older, with more severe burns, more CVC insertion times, and longer total line-days, as well as higher mortality. Regression analysis found longer line-days, more catheterisation times, and higher burn wounds index to be independent risk factors for CLABSI. A novel nomogram based on three risk factors was constructed with an area under the receiver operating characteristic curve (AUROC) value of 0.84 (95% CI: 0.782–0.898) with a mean absolute error of calibration curve of 0.023. The nomogram showed excellent predictive ability and clinical applicability, and provided a simple, practical, and quantitative strategy to predict CLABSI in burn patients.
Human monkeypox (mpox) virus is a viral zoonosis that belongs to the Orthopoxvirus genus of the Poxviridae family, which presents with similar symptoms as those seen in human smallpox patients. Mpox is an increasing concern globally, with over 80,000 cases in non-endemic countries as of December 2022. In this review, we provide a brief history and ecology of mpox, its basic virology, and the key differences in mpox viral fitness traits before and after 2022. We summarize and critique current knowledge from epidemiological mathematical models, within-host models, and between-host transmission models using the One Health approach, where we distinguish between models that focus on immunity from vaccination, geography, climatic variables, as well as animal models. We report various epidemiological parameters, such as the reproduction number, R0, in a condensed format to facilitate comparison between studies. We focus on how mathematical modelling studies have led to novel mechanistic insight into mpox transmission and pathogenesis. As mpox is predicted to lead to further infection peaks in many historically non-endemic countries, mathematical modelling studies of mpox can provide rapid actionable insights into viral dynamics to guide public health measures and mitigation strategies.