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This research explores the challenges posed by rapid technological advancements to maritime security risk assessment, with a focus on enhancing traditional security evaluation methods. The study employs descriptive, analytical, and exploratory methods to address the challenges posed by immersive technologies in the maritime security evaluation equation and sequentially approaches, for smart development by focusing on Maritime Teleoperated Vessels (MTVs), and their Maritime Teleoperation Centers (MTCs). By incorporating comprehensive analysis of the security risk evaluation equation main factor groups and their associated parameters and integration of expert insights, and structured multi-criteria decision-making (MCDM) methodologies in identifying and prioritizing influential security parameters. This approach would bridge the gap between conventional security risk equation models and smart maritime industry practices, providing a robust foundation for future security risk assessment approaches and security plans. The research concludes by proposing an evaluation equation that may address the growing complexities of smart maritime operations practices supporting the continued evaluation empowered by fast technology development posed by MTVs and MTCs that impacted traditional approaches. [ABSTRACT FROM AUTHOR]

Introduction, objectives: Although cardiovascular events have been traditionally associated mainly with men, some data reflect an increase in women, which may even exceed their male counterparts, constituting the leading cause of death in working women in Spain. The objective of this present study was to analyze the level of cardiovascular risk in Spanish working women by assessing the influence of age, type of work, and tobacco consumption. Material, methods: A descriptive cross-sectional study was carried out in 172,282 working women from different Spanish geographical areas and from different companies between January 2018 and June 2020. A range of variables and risk factors were assessed and various cardiovascular risk scales were used to analyze the data. Results: An increase in cardiovascular risk was observed in the least qualified work groups, mainly corresponding to blue-collar workers, when using the SCORE or REGICOR risk equation. The prevalence of altered values for all the parameters analyzed (overweight and obesity, hypertension, dyslipidemia, diabetes, fatty liver, hepatic fibrosis, atherogenic indexes, and cardiovascular risk scales) was higher among blue-collar women. Age was the only factor that influenced all the cardiovascular risk scales studied, increasing risk when comparing the group of women aged 50 years and older with the others. Conclusions: Aging and belonging to the blue-collar job category meant worse results in the cardiovascular risk scales and in all the parameters analyzed. This is in line with numerous studies that argue that age and zip code are more influential than genetic code. [ABSTRACT FROM AUTHOR]

Abstract Background Obesity and overweight are major risk factors for several chronic diseases. There is limited systematic evaluation of risk equations that predict the likelihood of developing an obesity or overweight associated complication. Predicting future risk is essential for health economic modelling. Availability of future treatments rests upon a model’s ability to inform clinical and decision-making bodies. This systematic literature review aimed to identify studies reporting (1) equations that calculate the risk for individuals with obesity, or overweight with a weight-related complication (OWRC), of developing additional complications, namely T2D, cardiovascular (CV) disease (CVD), acute coronary syndrome, stroke, musculoskeletal disorders, knee replacement/arthroplasty, or obstructive sleep apnea; (2) absolute or proportional risk for individuals with severe obesity, obesity or OWRC developing T2D, a CV event or mortality from knee surgery, stroke, or an acute CV event. Methods Databases (MEDLINE and Embase) were searched for English language reports of population-based cohort analyses or large-scale studies in Australia, Canada, Europe, the UK, and the USA between January 1, 2011, and March 29, 2021. Included reports were quality assessed using an adapted version of the Newcastle Ottawa Scale. Results Of the 60 included studies, the majority used European cohorts. Twenty-nine reported a risk prediction equation for developing an additional complication. The most common risk prediction equations were logistic regression models that did not differentiate between body mass index (BMI) groups (particularly above 40 kg/m2) and lacked external validation. The remaining included studies (31 studies) reported the absolute or proportional risk of mortality (29 studies), or the risk of developing T2D in a population with obesity and with prediabetes or normal glucose tolerance (NGT) (three studies), or a CV event in populations with severe obesity with NGT or T2D (three studies). Most reported proportional risk, predominantly a hazard ratio. Conclusion More work is needed to develop and validate these risk equations, specifically in non-European cohorts and that distinguish between BMI class II and III obesity. New data or adjustment of the current risk equations by calibration would allow for more accurate decision making at an individual and population level.

Background: GPs frequently use 10-year-risk estimations of cardiovascular disease (CVD) to identify high- risk patients. Aim: To assess the performance of four models for predicting the 10-year risk of CVD in Dutch general practice. Design and setting: Prospective cohort study. Routine data (2009– 2019) was used from 46 Dutch general practices linked to cause of death statistics. Method: The outcome measures were fatal CVD for SCORE and first diagnosis of fatal or non- fatal CVD for SCORE fatal and non-fatal (SCORE- FNF), Globorisk-laboratory, and Globorisk-office. Model performance was assessed by examining discrimination and calibration. Results: The final number of patients for risk prediction was 1981 for SCORE and SCORE-FNF, 3588 for Globorisk-laboratory, and 4399 for Globorisk- office. The observed percentage of events was 18.6% (n = 353) for SCORE- FNF, 6.9% (n = 230) for Globorisk-laboratory, 7.9% (n = 323) for Globorisk-office, and 0.3% (n = 5) for SCORE. The models showed poor discrimination and calibration. The performance of SCORE could not be examined because of the limited number of fatal CVD events. SCORE-FNF, the model that is currently used for risk prediction of fatal plus non-fatal CVD in Dutch general practice, was found to underestimate the risk in all deciles of predicted risks. Conclusion: Wide eligibility criteria and a broad outcome measure contribute to the model applicability in daily practice. The restriction to fatal CVD outcomes of SCORE renders it less usable in routine Dutch general practice. The models seriously underestimate the 10-year risk of fatal plus non-fatal CVD in Dutch general practice. The poor model performance is possibly because of differences between patients that are eligible for risk prediction and the population that was used for model development. In addition, selection of higher-risk patients for CVD risk assessment by GPs may also contribute to the poor model performance. [ABSTRACT FROM AUTHOR]

Background: Obesity and overweight are major risk factors for several chronic diseases. There is limited systematic evaluation of risk equations that predict the likelihood of developing an obesity or overweight associated complication. Predicting future risk is essential for health economic modelling. Availability of future treatments rests upon a model's ability to inform clinical and decision-making bodies. This systematic literature review aimed to identify studies reporting (1) equations that calculate the risk for individuals with obesity, or overweight with a weight-related complication (OWRC), of developing additional complications, namely T2D, cardiovascular (CV) disease (CVD), acute coronary syndrome, stroke, musculoskeletal disorders, knee replacement/arthroplasty, or obstructive sleep apnea; (2) absolute or proportional risk for individuals with severe obesity, obesity or OWRC developing T2D, a CV event or mortality from knee surgery, stroke, or an acute CV event. Methods: Databases (MEDLINE and Embase) were searched for English language reports of population-based cohort analyses or large-scale studies in Australia, Canada, Europe, the UK, and the USA between January 1, 2011, and March 29, 2021. Included reports were quality assessed using an adapted version of the Newcastle Ottawa Scale. Results: Of the 60 included studies, the majority used European cohorts. Twenty-nine reported a risk prediction equation for developing an additional complication. The most common risk prediction equations were logistic regression models that did not differentiate between body mass index (BMI) groups (particularly above 40 kg/m2) and lacked external validation. The remaining included studies (31 studies) reported the absolute or proportional risk of mortality (29 studies), or the risk of developing T2D in a population with obesity and with prediabetes or normal glucose tolerance (NGT) (three studies), or a CV event in populations with severe obesity with NGT or T2D (three studies). Most reported proportional risk, predominantly a hazard ratio. Conclusion: More work is needed to develop and validate these risk equations, specifically in non-European cohorts and that distinguish between BMI class II and III obesity. New data or adjustment of the current risk equations by calibration would allow for more accurate decision making at an individual and population level. [ABSTRACT FROM AUTHOR]

Introduction: Recent findings suggest that the four-variable Kidney Failure Risk Equation (KFRE) may be useful in predicting the likelihood of allograft failure in adult kidney transplant (KT) recipients. However, research on its application in pediatric patients is lacking. This study aimed to assess the accuracy of the four-variable KFRE for prediction of the two-year and five-year risk of allograft failure in a cohort of pediatric KT recipients., Methods: A retrospective observational study of patients undergoing KT in a tertiary pediatric nephrology unit between 2007 and 2017 was conducted. The KFRE risk scores were determined using data collected one-year post-transplantation. Discrimination and calibration properties of the four-variable KFRE were assessed through the area under the receiver operating characteristic curves (AUC) and calibration plots., Results: Fifty-nine patients with a median age of 12.4 (9.1-15.7) years at KT were included. Eleven (18.6%) were living donor recipients. The median estimated glomerular filtration rate one-year post-transplantation was 62.0 (49.0-75.0) mL/min/1.73 m 2 . One (1.7%) and three (5.1%) patients experienced allograft failure within two and five years following the one-year post-transplantation date, respectively. The four-variable KFRE showed excellent and very good discrimination for the two-year and five-year risks, respectively (AUC 0.966, 95% confidence interval (CI) 0.914-1.000; AUC 0.887, 95% CI 0.732-1.000). Calibration plots demonstrated imprecise calibration., Conclusion: The four-variable KFRE shows promise in predicting kidney failure progression in pediatric KT recipients with a functioning allograft one-year post-transplantation. Larger-scale studies are essential to confirm its predictive accuracy and establish more definitive conclusions., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Comissão de Ética Santo António, Instituto de Ciências Biomédicas Abel Salazar issued approval 2024-082. This study received approval from the institution’s ethics committee on June 5, 2024. It complies with all relevant national regulations and institutional policies and is in accordance with the tenets of the Helsinki Declaration. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Nogueira Machado et al.)

The current paper provides a review and meta-analysis of the practical implications of disaster risk management related to the ventilated improved latrines in South Africa. This technology is evaluated through its legacy and novel challenges of disaster risk reduction. In the current article, the methodology adopted was a literature review and meta-analyses. The results indicate that the in-situ treatment and breakdown of faecal sludge in the ventilated improved pit latrines is not always taking place and that anaerobic digestion might not always be feasible. New strategies are proposed to manage the sanitation-related risks in South Africa by specifying more exact dimensions for the newly built ventilated improved pit latrines by suggesting the use of novel sanitation additives such as fly ash to enhance on-site and in situ treatment, as well as ex situ treatment of the pit latrine faecal sludge. Regular maintenance can lead to prevention of the dysfunctional character of the ventilated improved pit latrines as a functional sanitation technology and a user-friendly hygiene barrier to the spread of sanitation/WASH-related epidemics or infectious diseases. The implementation of the novel strategies should be enhanced by the application of the (Environmental) Technology Assessment in sanitation service delivery in South Africa. [ABSTRACT FROM AUTHOR]

This study was performed to develop and validate a predictive model for the risk of end-stage renal disease (ESRD) inpatients with diabetic nephropathy (DN) confirmed by renal biopsy. We conducted a retrospective study with 968 patients with T2DM who underwentrenal biopsy for the pathological confirmation of DNat the First Affiliated Hospital of Zhengzhou University from February 2012 to January 2015; the patients were followed until December 2018. The outcome was defined as a fatal or nonfatal ESRD event (peritoneal dialysis or hemodialysis for ESRD, renal transplantation, or death due to chronic renal failure or ESRD). The dataset was randomly split into development (75%) and validation (25%) cohorts. We used stepwise multivariablelogistic regression to identify baseline predictors for model development. The model’s performance in the two cohorts, including discrimination and calibration, was evaluated by the C-statistic and the P value of the Hosmer-Lemeshow test. During the 3-year follow-up period, there were 225 outcome events (47.1%) during follow-up. Outcomes occurred in 187 patients (52.2%) in the derivation cohort and 38 patients (31.7%) in the validation cohort. The variables selected in the final multivariable logistic regression after backward selection were pathological grade, Log Urinary Albumin-to-creatinine ratio (Log ACR), cystatin C, estimated glomerular filtration rate (eGFR) and B-type natriuretic peptide (BNP). 4 prediction models were created in a derivation cohort of 478 patients: a clinical model that included cystatin C, eGFR, BNP, Log ACR; a clinical-pathological model and a clinical-medication model, respectively, also contained pathological grade and renin-angiotensin system blocker (RASB) use; and a full model that also contained the pathological grade, RASB use and age. Compared with the clinical model, the clinical-pathological model and the full model had better C statistics (0.865 and 0.866, respectively, vs. 0.864) in the derivation cohort and better C statistics (0.876 and 0.875, respectively, vs. 0.870) in the validation cohort. Among the four models, the clinical-pathological model had the lowest AIC of 332.53 and the best P value of 0.909 of the Hosmer-Lemeshow test. We constructed a nomogram which was a simple calculator to predict the risk ratio of progression to ESRD for patients with DN within 3 years. The clinical-pathological model using routinely available clinical measurements was shown to be accurate and validated method for predicting disease progression in patients with DN. The risk model can be used in clinical practice to improve the quality of risk management and early intervention.

Objectives: The objective of this study was to estimate a risk of cardiovascular and cerebrovascular diseases for each worker and to determine whether this risk is associated with the incidence and costs of presenteeism, absenteeism, and medical/drug treatments. Methods: Established risk equations were used to estimate the 10‐year probability of developing coronary artery disease and ischemic stroke in male workers aged 40‐65 years who were recruited from four pharmaceutical companies in Japan. The incidence of presenteeism was defined as existence of presenteeism for the past a month, and the incidence of absenteeism was defined as existence of sick‐leave for the past three months by a self‐administered questionnaire. Each cost was calculated based on the human capital method. Data on medical/drug treatments were collected from health insurance claims. Results: The risks were calculated for 6047 workers. Individuals at moderate and high risk of coronary artery disease had a significantly higher rate of presenteeism and absenteeism than workers at low risk. Workers at moderate and high risk of ischemic stroke also had a significantly higher rate of presenteeism and absenteeism than workers at low risk. Mean costs for absenteeism and medical/drug treatments increased with the risk of developing coronary artery disease or ischemic stroke, while costs for presenteeism did not. Conclusions: To prevent the costs of presenteeism, workers not only at high risk but also at low and moderate risk of developing cardiovascular and cerebrovascular diseases should receive health care services. [ABSTRACT FROM AUTHOR]

Pulmonary arterial hypertension (PAH) is a subcategory of pulmonary hypertension (PH) that comprises a group of disorders with similar pulmonary vascular pathology. Though PH is common, the estimated incidence of IPAH is 1-3 cases per million, making it a rare disease. The hemodynamic definition of PAH is a mean pulmonary artery pressure at rest >OR = 25 mm Hg in the presence of a pulmonary capillary wedge pressure

This study reports about disaster risk assessment undertaken at Roburnia Plantation, Mpumalanga Province, South Africa. Both quantitative and qualitative approaches were followed to collect data. A total of eight experienced foresters and fire fighters were purposively sampled for interview at Roburnia Plantation. A questionnaire survey was also used to collect the data. Risk levels were quantified using the risks equations of Wisner et al. (2004) and the United Nations International Strategy for Disaster Reduction (UNISDR 2002). Data were analysed using descriptive and inferential statistics. Analysis of variance (ANOVA, single factor) was also applied. This study found that Roburnia Plantation is highly exposed to fire risks. The mean (± s.d.) output from the Wisner risk equation shows that fire is the highest risk at 7.7 ± 0.3, followed by harsh weather conditions at 5.6 ± 0.4 and least by tree diseases, pests and pathogens at 2.3 ± 0.2. Similarly, the mean (± s.d.) output from the UNISDR risk equation also shows that fire is the highest risk at 2.9 ± 0.2, followed by harsh weather conditions at 2.2 ± 0.3 and least by tree diseases, pests and pathogens at 1.3 ± 0.2. There was no significant deference in the risk analysis outputs (p = 0.13). This study also found that the number of fire incidents were low during summer, but increased during winter and spring. This variation is mainly due to a converse relationship with rainfall, because the availability of rain moistens the area as well as the fuel. When the area and fuel is moist, fire incidents are reduced, but they increase with a decrease in fuel moisture.

The objectives of this review are to discuss data on the cardiovascular risk increase associated with rheumatoid arthritis (RA), the effects of RA treatments on the cardiovascular risk level, and the management of cardiovascular risk factors in patients with RA. Overall, the risk of cardiovascular disease is increased 2-fold in RA patients compared to the general population, due to the combined effects of RA and conventional risk factors. There is some evidence that the cardiovascular risk increase associated with nonsteroidal anti-inflammatory drug therapy may be smaller in RA patients than in the general population. Glucocorticoid therapy increases the cardiovascular risk in proportion to both the current dose and the cumulative dose. Methotrexate and TNFα antagonists diminish cardiovascular morbidity and mortality rates. The management of dyslipidemia remains suboptimal. Risk equations may perform poorly in RA patients even when corrected using the multiplication factors suggested by the EUropean League Against Rheumatism (EULAR) (multiply the score by 1.5 when two of the following three criteria are met: disease duration longer than 10years, presence of rheumatoid factor or anti-cyclic citrullinated peptide (CCP) antibodies, and extraarticular manifestations). Doppler ultrasonography of the carotid arteries in patients at moderate cardiovascular risk may allow a more aggressive approach to dyslipidemia management via reclassification into the high-risk category of patients with an intima-media thickness greater than 0.9mm or atheroma plaque. [ABSTRACT FROM AUTHOR]

Background: GPs frequently use 10-year-risk estimations of cardiovascular disease (CVD) to identify high- risk patients., Aim: To assess the performance of four models for predicting the 10-year risk of CVD in Dutch general practice., Design and Setting: Prospective cohort study. Routine data (2009- 2019) was used from 46 Dutch general practices linked to cause of death statistics., Method: The outcome measures were fatal CVD for SCORE and first diagnosis of fatal or non- fatal CVD for SCORE fatal and non-fatal (SCORE- FNF), Globorisk-laboratory, and Globorisk-office. Model performance was assessed by examining discrimination and calibration., Results: The final number of patients for risk prediction was 1981 for SCORE and SCORE-FNF, 3588 for Globorisk-laboratory, and 4399 for Globorisk- office. The observed percentage of events was 18.6% ( n = 353) for SCORE- FNF, 6.9% ( n = 230) for Globorisk-laboratory, 7.9% ( n = 323) for Globorisk-office, and 0.3% ( n = 5) for SCORE. The models showed poor discrimination and calibration. The performance of SCORE could not be examined because of the limited number of fatal CVD events. SCORE-FNF, the model that is currently used for risk prediction of fatal plus non-fatal CVD in Dutch general practice, was found to underestimate the risk in all deciles of predicted risks., Conclusion: Wide eligibility criteria and a broad outcome measure contribute to the model applicability in daily practice. The restriction to fatal CVD outcomes of SCORE renders it less usable in routine Dutch general practice. The models seriously underestimate the 10-year risk of fatal plus non-fatal CVD in Dutch general practice. The poor model performance is possibly because of differences between patients that are eligible for risk prediction and the population that was used for model development. In addition, selection of higher-risk patients for CVD risk assessment by GPs may also contribute to the poor model performance., (© The Authors.)

This study reports about disaster risk assessment undertaken at Roburnia Plantation, Mpumalanga Province, South Africa. Both quantitative and qualitative approaches were followed to collect data. A total of eight experienced foresters and fire fighters were purposively sampled for interview at Roburnia Plantation. A questionnaire survey was also used to collect the data. Risk levels were quantified using the risks equations of Wisner et al. (2004) and the United Nations International Strategy for Disaster Reduction (UNISDR 2002). Data were analysed using descriptive and inferential statistics. Analysis of variance (ANOVA, single factor) was also applied. This study found that Roburnia Plantation is highly exposed to fire risks. The mean (± s.d.) output from the Wisner risk equation shows that fire is the highest risk at 7.7 ± 0.3, followed by harsh weather conditions at 5.6 ± 0.4 and least by tree diseases, pests and pathogens at 2.3 ± 0.2. Similarly, the mean (± s.d.) output from the UNISDR risk equation also shows that fire is the highest risk at 2.9 ± 0.2, followed by harsh weather conditions at 2.2 ± 0.3 and least by tree diseases, pests and pathogens at 1.3 ± 0.2. There was no significant deference in the risk analysis outputs (p = 0.13). This study also found that the number of fire incidents were low during summer, but increased during winter and spring. This variation is mainly due to a converse relationship with rainfall, because the availability of rain moistens the area as well as the fuel. When the area and fuel is moist, fire incidents are reduced, but they increase with a decrease in fuel moisture [ABSTRACT FROM AUTHOR]

Introduction HIV-positive patients receiving combination antiretroviral therapy (cART) frequently experience metabolic complications such as dyslipidemia and insulin resistance, as well as lipodystrophy, increasing the risk of cardiovascular disease (CVD) and diabetes mellitus (DM). Rates of DM and other glucose-associated disorders among HIV-positive patients have been reported to range between 2 and 14%, and in an ageing HIV-positive population, the prevalence of DM is expected to continue to increase. This study aims to develop a model to predict the short-term (six-month) risk of DM in HIV-positive populations and to compare the existing models developed in the general population. Methods All patients recruited to the Data Collection on Adverse events of Anti-HIV Drugs (D:A:D) study with follow-up data, without prior DM, myocardial infarction or other CVD events and with a complete DM risk factor profile were included. Conventional risk factors identified in the general population as well as key HIV-related factors were assessed using Poisson-regression methods. Expected probabilities of DM events were also determined based on the Framingham Offspring Study DM equation. The D:A:D and Framingham equations were then assessed using an internal-external validation process; area under the receiver operating characteristic (AUROC) curve and predicted DM events were determined. Results Of 33,308 patients, 16,632 (50%) patients were included, with 376 cases of new onset DM during 89,469 person-years (PY). Factors predictive of DM included higher glucose, body mass index (BMI) and triglyceride levels, and older age. Among HIV-related factors, recent CD4 counts of<200 cells/µL and lipodystrophy were predictive of new onset DM. The mean performance of the D:A:D and Framingham equations yielded AUROC of 0.894 (95% CI: 0.849, 0.940) and 0.877 (95% CI: 0.823, 0.932), respectively. The Framingham equation over-predicted DM events compared to D:A:D for lower glucose and lower triglycerides, and for BMI levels below 25 kg/m2. Conclusions The D:A:D equation performed well in predicting the short-term onset of DM in the validation dataset and for specific subgroups provided better estimates of DM risk than the Framingham. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate the ability of the Framingham risk function to predict the 10-year coronary heart disease (CHD) risk in French men. Methods: 3440 men, aged 45 to 60years, free of CHD at baseline, were selected from the SU.VI.MAX cohort. The expected number of event, obtained from applying the Framingham risk score to the baseline SU.VI.MAX biological and clinical data of 1994/1996, were compared to the actual risks observed in the cohort. The accuracy of the Framingham risk function was assessed using the area under the receiver operating characteristic (ROC) curve. Results: The overall Framingham risk function predicted twice as many CHD events than observed. The area under the ROC curve for Framingham risk score was 74%. Conclusion: The Framingham risk function may discriminate between high risk from low risk subjects, but it is not valid for estimating absolute 10-year CHD risk in this French population. [Copyright &y& Elsevier]

The objective of the study was to investigate risk factors and develop risk equations for end-stage renal disease (ESRD) in Chinese patients with type 2 diabetes. A prospective cohort of 4,438 patients with type 2 diabetes mellitus and without ESRD (median observation period 2.9 years, interquartile range 1.6–4.1 years) was included in the analysis. The end-point (ESRD) was defined by: (1) death due to diabetes with renal manifestations or renal failure; (2) hospitalisation due to renal failure; (3) estimated GFR (eGFR) <15 ml min−1 1.73 m−2. Cox proportional hazards regression was used to develop risk equations. The data were randomly and evenly divided into the training data for development of the risk equations and the test data for validation. The validation was performed using the area under the receiver operating characteristic curve (aROC), which takes into account follow-up time and censoring. During the observation period, 159 patients or 12.45 per 1,000 person-years (95% CI 10.52–14.37 per 1,000 person-years) developed ESRD. Known duration of diabetes, systolic blood pressure, log10 total cholesterol:HDL cholesterol ratio and retinopathy were significant predictors of ESRD. After further adjusting for eGFR, log10 spot albumin:creatinine ratio (ACR) and haematocrit, only eGFR, haematocrit and log10 ACR remained as independent predictors of ESRD. The risk equation derived from these three independent predictors had good discrimination, with an aROC of 0.97. Estimated GFR, haematocrit and ACR were independent predictors of ESRD and the derived risk equation performed well in Chinese patients with type 2 diabetes. [ABSTRACT FROM AUTHOR]