Enhancing pooling levels strengthens the risk resilience of healthcare insurance: a case study of basic medical insurance fund operations data in Gansu, China.

BACKGROUND: In China, enhancing the pooling levels of basic health insurance has consistently been regarded as a pivotal measure to promote the refinement of the healthcare insurance system. From 2020 to 2022, the widespread outbreak of COVID-19 posed new challenges to China's basic health insurance. METHODS: The research utilizes Data Envelopment Analysis (DEA), Malmquist index assessment, and fixed-effects panel Tobit models to analyze panel data from 2020 to 2022, assessing the efficiency of basic health insurance in Gansu Province. RESULTS: From 2020 to 2022, the average overall efficiency of the municipal pooling of Basic Medical Insurance for Urban and Rural Residents was 0.941, demonstrating a stable trend with a modest increase. The efficiency frontier regions have expanded from 5 (35.71%) to 7 (50%). Operational efficiency exhibited a negative correlation with per capita hospitalization expenses and per capita fund balance but a positive correlation with per capita accumulated fund balance and reimbursement rates for hospitalized patients. In 2021, compared to 2020, the county-pooling Basic Medical Insurance for Urban Employees saw a decline of 0.126 in overall efficiency, reducing the efficiency frontier regions from 8 to 3. However, from 2021 to 2022, the municipal-coordinated Basic Medical Insurance for Urban Employees experienced a 0.069 increase in overall efficiency, with the efficiency frontier regions expanding from 3 to 5. Throughout 2020 to 2022, the operational efficiency of the Urban Employee Basic Medical Insurance showed a consistent negative correlation with per capita fund balance. CONCLUSION: From 2020 to 2022, the overall operational performance of basic health insurance in Gansu Province was satisfactory, and enhancing the pooling level is beneficial in addressing the impact of unforeseen events on the health insurance system.

A study of the spatial network structure of ethnic regions in Northwest China based on multiple factor flows in the context of COVID-19: Evidence from Ningxia.

As an underdeveloped and low-income region, the development of minority regions in Northwest China is crucial. As an important part of minority regions, Ningxia Hui Autonomous Region has insufficient endogenous power for stable economic development and high risk of returning to poverty. On the whole, the Ningxia county network shows a spatial pattern of high in the north and low in the south. However, there are great differences in the centrality of different factor flow networks. The factor connections between most counties are weak, and a close innovation network has not yet been formed. There is an obvious administrative clique structure, showing a certain degree of self-enclosure. The factor flows between counties are relatively uniform and greatly affected by geographic distance. From the perspective of integrated flow, the Ningxia county network presents a distinct core-periphery circle structure. Population size and GDP are the main factors affecting the spatial network. The policy implication of this study is that Ningxia Autonomous Prefecture should coordinate the planning of the region's economy, technology, and transportation, so as to reduce the development gap between counties by enhancing the closeness of the county spatial association network, and ultimately realize the region's high-quality development.

Facilitating or inhibiting? The impact of environmental information disclosure on enterprise investment value.

Environmental protection, which is beneficial for the present and the future, has become a global consensus, and environmental information disclosure (EID) is an effective way to realize and fulfill enterprise environmental responsibility. Although some scholars have studied the impact of EID on firms, there is less empirical evidence on the impact of EID on investors. In this study, we examine the impact of EID on enterprise investment value based on signaling theory using a time-varying difference-in-differences model and extract two channels of this effect. The study shows that the implementation of EID helps to enhance the value of enterprise investment. This enhancement will vary according to the location, the industry pollution type, and the nature of the enterprise: EID has a remarkable enhancement effect on the investment value of the eastern region, heavily polluted enterprises, and non-state-owned enterprises. To investigate the channel of EID's effect on enterprise investment value, we use the moderating effect model to analyze and find that enterprises with low tax ratios and small financing constraints can significantly enhance the effect of EID on investment value.

Have carbon emission trading pilot policy improved urban innovation capacity? Evidence from a quasi-natural experiment in China.

The carbon emission trading pilot policy is an important initiative to achieve synergistic economic-environmental development. Based on the data of 268 cities in China from 2006 to 2020, this paper analyzes the impact of carbon emission trading pilot policy on urban innovation capacity by using a time-varying difference-in-difference model. The study shows that, first, the implementation of the CETP improves the innovation capacity of cities, and the robustness test confirms the above findings. Second, the effect of the policy on enhancing urban innovation capacity is heterogeneous between the type of innovation and city type: the promotion of innovation capacity is stronger for utility model patents and non-capital cities. Third, there is a positive spillover effect of the implementation of the CETP on the promotion effect of the urban innovation capacity, which can lead to the improvement of the innovation capacity of neighboring cities. This paper has some reference value for building a unified carbon emission trading market and promoting low-carbon economic development within China.

The allometric relationship between carbon emission and economic development in Yangtze River Delta: fusion of multi-source remote sensing nighttime light data.

Exploring the allometric relationship between carbon emission and economic development can provide guidance for policy-makers who hope to accelerate carbon emission reduction and achieve high-quality development. First, based on the established DMSP/OLS and NPP/VIIRS nighttime light datasets, this study simulated the carbon emissions of the Yangtze River Delta from 2000 to 2020. Second, our research analyzed the spatiotemporal evolution characteristics of carbon emissions. Third, adopting allometric growth model, we explored the allometric relationship between economic development and carbon emissions in Yangtze River Delta. The main conclusions are as follows. First, four prediction models, namely, linear fitting, support vector machine, random forest, and CNN-BiLSTM deep learning, were compared to simulate the accuracy of carbon emissions. Consequently, the CNN-BiLSTM deep learning estimation model presented the best accuracy. Second, both the carbon emissions in YRD as a whole showed an increasing trend, with the largest growth rate appearing in Shanghai and the smallest growth rate occurring in Lishui. Moreover, the high-carbon emission areas were mainly distributed in the core city cluster, which are enclosed by Shanghai, Nanjing, and Hangzhou. Finally, the allometric relationship between economic development and carbon emissions was dominated by one-level negative during the sample period, and the relative growth rate of carbon emissions is lower than that of the economic development, which made the YRD at a basic coordinate stage of weak expansion of economy.

Can environmental tax improve the environmental investment? Evidence from a quasi-natural experiment in China.

The implementation of the Environmental Tax Law is a milestone in promoting China's green tax reform. However, the existence literature has lacked attention to whether it leads enterprises to invest in green environmental protection. To examine the Environmental Tax Law effects and mechanism on the environmental investment of heavy-polluted enterprises, this study used the data of heavy-polluted enterprises listed on the A-share market from 2012 to 2020 and regarded the Environmental Tax Law as a quasi-natural experiment to employ a difference-in-differences model. We found that environmental tax improves the green environmental investment of heavy-polluted enterprises, reflecting the guiding role of policy on enterprise investment allocation. Heterogeneity was found, and the promotion effect of environmental tax reform on enterprise environmental investment is more significant in non-nation-owned, central-western regions, and small-scale enterprises. Further analysis believed that market competition, as an external mechanism, helps strengthen environmental tax reform's implementation effect. The findings of this paper provide a new proof for a comprehensive understanding of the micro-effect of environmental tax reform and provide a reference for the implementation of green development strategies.

Does the low-carbon city pilot contribute to the blue sky defense? Evidence from China.

China's goal of ecological civilization construction simultaneously faces the dual strategic tasks of pollution control and carbon reduction (PCCR). In addition to carbon reduction, does the low-carbon city pilot (LCCP) further contribute to the blue sky defense? This study investigates the impact of the LCCP on air pollution by employing a multiperiod difference-in-differences (DID) model based on data from 276 Chinese cities. The results show the following: (1) Compared with nonpilot areas, the LCCP reduces PM2.5 levels in pilot areas by approximately 1.50% on average, which is achieved by "industrial restructuring", "government investment in science and technology (S&T)", and "green lifestyle". (2) The LCCP has heterogeneous effects on air quality across cities with different resource endowments and industrial attributes, showing a greater air quality improvement in nonresource-based cities (NREB cities) and old industrial base cities (OIB cities) than in other city types. (3) The positive impact of the LCCP on air improvement in the pilot areas is derived from "pollution control effects" rather than "pollution transfer effects". This study provides useful policy implications for the comprehensive green transition and exploration of synergistic governance for PCCR in China.

Spatial network and driving factors of low-carbon patent applications in China from a public health perspective.

Introduction: The natural disasters and climate anomalies caused by increasing global carbon emissions have seriously threatened public health. To solve increasingly serious environmental pollution problems, the Chinese government has committed itself to achieving the goals of peak carbon emissions and carbon neutrality. The low-carbon patent application is an important means to achieve these goals and promote public health. Methods: This study analyzes the basic situation, spatial network, and influencing factors of low-carbon patent applications in China since 2001 at the provincial and urban agglomeration levels using social network analysis based on data from the Incopat global patent database. Results: The following findings are established. (1) From the number of low-carbon patent applications, the total number of low-carbon patent applications in China increased year by year, while the number of applications in the eastern region was larger than those in the central and western regions, but such regional differences had been decreasing. (2) At the interprovincial level, low-carbon patent applications showed a complex and multithreaded network structure. In particular, the eastern coastal provinces occupied the core position in the network. The weighted degree distribution of China's interprovincial low-carbon patent cooperation network is affected by various factors, including economic development, financial support, local scientific research level, and low-carbon awareness. (3) At the urban agglomeration level, the eastern coastal urban agglomerations showed a radial structure with the central city as the core. Urban innovation capability, economic development, low-carbon development awareness, level of technology import from overseas, and informatization level are highly correlated with the weighted degree of low-carbon cooperation networks of urban agglomerations. Discussion: This study provides ideas for the construction and governance of low-carbon technology innovation system and perspectives for theoretical research on public health and high-quality development in China.

Can environmental tax reform promote carbon abatement of resource-based cities? Evidence from a quasi-natural experiment in China.

China is entering a new period characterized by reaching peak and carbon neutralization, and environmental taxes are increasingly crucial for breaking the "carbon curse" of resource-based cities. Accordingly, using the implementation of China's Environmental Protection Tax Law (EPT Law) as a quasi-natural experiment, this study utilizes the DID model to assess this environmental tax reform's effect in terms of reducing carbon emissions. The research results are as follows: (1) The environmental tax reform (ETR) reduced the intensity of carbon emissions; it additionally promoted reducing total carbon emissions from resource-based cities. (2) The carbon abatement effect can also be achieved by upgrading industrial structures and improving innovation in the area of green technology. (3) The ETR has impacted carbon abatement in resource-based cities more significantly in China's eastern region than in the central or western regions. In contrast, it had less effect on resource-based cities in the regenerative stage than on cities in other stages. (4) The spatial spillover effect of the ETR was significantly positive, aggravating the level of carbon emissions in neighboring cities. Thus, the "pollution haven hypothesis" was tested. Overall, this study deepens the knowledge of ETR and carbon emissions and provides theoretical support and policy suggestions for supporting resource-based cities in a green transformation.

The effects of environmental tax reform on urban air pollution: A quasi-natural experiment based on the Environmental Protection Tax Law.

Air pollution significantly impacts sustainable development and public health. Taking the implementation of China's Environmental Protection Tax Law in China as a quasi-natural experiment, this paper employs the difference-in-differences (DID) and spatial DID models to evaluate the effects of environmental tax reform on urban air pollution. The findings are as follows. (1) Environmental tax reform can significantly reduce urban air pollution, and a series of robustness tests have also been conducted to provide further evidence. (2) Green technology innovation and industrial structure upgrading from a vital transmission mechanism for environmental tax reform to improve air quality. (3) Environmental tax reform significantly inhibits urban air pollution in cities located north of the Qinling-Huaihe line and big cities. (4) Moreover, environmental tax reform not only promotes the improvement of local air quality but also has a significant negative spatial spillover effect, reducing air pollution in neighboring cities. The research conclusions provide theoretical support and policy suggestions for promoting sustainable economic development, rationally optimizing environmental protection tax policies and improving urban air quality.

Investigating the Applicability of Alignment-A Monte Carlo Simulation Study.

Traditional multiple-group confirmatory factor analysis (multiple-group CFA) is usually criticized for having too restrictive model assumption, namely the scalar measurement invariance. The new multiple-group analysis methodology, alignment, has become an effective alternative. The alignment evaluates measurement invariance and more importantly, permits factor mean comparisons without requiring scalar invariance which is usually required in traditional multiple-group CFA. Some simulation studies and empirical studies have investigated the applicability of alignment under different conditions, but some areas remain unexplored. Based on the simulation studies of Asparouhov and Muthén and of Flake and McCoach, this current simulation study is broken into two sections. The first study investigates the minimal group sizes required for alignment in three-factor models. The second study compares the performance of multiple-group CFA, multiple-group exploratory structural equation model (multiple-group ESEM), and alignment by including different proportions and magnitudes of cross-loadings in the models. Study 1 shows that when the model has no noninvariant parameters, the alignment requires relatively lower group sizes. Explicitly, the minimal group size required for alignment was 250 when the amount of groups was three, the minimal group size was 150 when the amount of groups was nine, and 200 when the amount of groups was 15. When there are noninvariant parameters in the model and the amount of groups is low, a group size of 350 is a safe rule of thumb. When there are noninvariant parameters in the model and the amount of groups is high, a group size of 250 is required for trustworthy results. The magnitude of noninvariance and the noninvariance rate do not affect the minimal group size required for alignment. Study 2 shows that multiple-group CFA provides accurate factor mean estimates when each factor had 20% factor loading (1 factor loading) with small-sized cross-loading. Multiple-group ESEM provides accurate factor mean estimates when the magnitude of cross-loading is small or when each factor had 20% factor loading (1 factor loading) with medium-sized cross-loading. Alignment provides accurate factor mean estimates when there are only small-sized cross-loadings in the model. The parameter estimates, coverage rates and ratios of average standard error to standard deviation for each methodology are not influenced by the amount of groups. Recommendations are concluded for using multiple-group CFA, multiple-group ESEM, traditional alignment and aligned ESEM (AESEM) based on the results. Multiple-group CFA is more suitable for use when scalar invariance is established. Multiple-group ESEM works best when there are small-sized or only a few medium-sized cross-loadings in the model. Traditional alignment allows for small-sized cross-loadings and a few noninvariant parameters in the model. AESEM integrates the advantages of alignment and ESEM, can provide accurate estimates when noninvariant parameters and cross-loadings both exist in the model. Compared to multiple-group CFA, multiple-group ESEM, the alignment methodology performs well in more situations.

Comparison of effectiveness, cost and safety between moderate sedation and deep sedation under esophagogastroduodenoscopy in Chinese population: a quasi-experimental study.

OBJECTIVE: Most endoscopists routinely perform moderate or deep sedation for esophagogastroduodenoscopy (EGD). Considering that there is no consensus on the optimal sedation depth and it varies from country to country, our study aims to compare the effectiveness, cost and safety of these two sedation methods in the Chinese population. METHODS: This quasi-experimental study included a total of 556 eligible patients from July 2020 to June 2021, and they entered the moderate sedation group or deep sedation group based on their choices. Baseline information, scores of Patient Satisfaction with Sedation Instrument (PSSI) and Clinician Satisfaction with Sedation Instrument (CSSI), examination time, sedation time, recovery time, expenses before medicare reimbursement, hypoxaemia and hypotension were compared between the two groups. Propensity Score Matching (PSM) analysis was conducted to balance the confounding factors. RESULTS: After PSM, 470 patients were involved in the analysis, with 235 for each group. The moderate sedation was clearly superior to the deep sedation group in terms of PSSI score (98.00 ± 0.94 vs. 97.29 ± 1.26), CSSI score (98.00 ± 0.78 vs. 97.67 ± 1.30), sedation time (11.90 ± 2.04 min vs. 13.21 ± 2.75 min), recovery time (25.40 ± 3.77 min vs. 28.0 ± 4.85 min), expenses (433.04 ± 0.00 Yuan vs. 789.85 ± 0.21 Yuan), with all p < .001. Examination time was not significantly different between the two groups (p = .124). In addition, the moderate sedation group had a lower occurrence rate of hypoxaemia (0.36% vs. 3.27%, p = .010) and hypotension (17.44% vs. 44.00%, p < .001) compared to the deep sedation group. CONCLUSIONS: Moderate sedation presented better effectiveness and safety and lower cost, and thereby it should be recommended as a widely used sedation method in clinical practice in China. Trial registration: This trial was registered on http://www.chictr.org.cn/index.aspx (ChiCTR2000038050).

Has COVID-19 Changed China's Digital Trade?-Implications for Health Economics.

Digital technologies have played a significant role in the defense against the COVID-19 pandemic. This development raises the question of whether digital technologies have helped Chinese exports recover quickly and even grow. To answer this question, we study monthly data on Chinese exports to 40 countries/regions from January 2019 to June 2020 and covering 97 product categories. The study takes the COVID-19 outbreak as a natural experiment and treats digital trade products as the treatment group. Using a generalized difference-in-differences (DID) approach, we empirically investigate how this major global public health crisis and digital trade have influenced Chinese exports. Our empirical analysis reveals that the COVID-19 pandemic has inhibited China's export trade overall, digital trade has significantly promoted trade, and the supply mechanism has played a significant role in promoting the recovery of exports. Heterogeneity tests on destination countries/regions reveal that digital trade has significantly promoted exports to countries/regions with different income levels, with a more significant effect on low-risk destinations than on high-risk destinations. The sector heterogeneity test demonstrates that digital trade has enhanced the export recovery of sectors dealing in necessities for pandemic prevention. Other robustness tests, including parallel trend and placebo tests, support the above conclusions. Finally, we extend the research conclusions and discuss their implication for health economics and the practice of fighting COVID-19.

Does the Price Support Policy Drive a Balanced Distribution of Profits in the Chinese Dairy Supply Chain? Implications for Supplier and Consumer Psychology.

Evaluating the price policy of raw milk is of great significance to the sustainable development of an industry supply chain. In this context, our study used the multi-period difference-in-difference method to systematically examine the impact of the policy implementation on product price and profit distribution in the supply chain. The results showed the following: (1) the price of raw milk in the implementation area of the price support policy is 13.54% higher than that of the unimplemented area; (2) the effect of price increase in the western region (15.5%) is higher than that in the eastern region (13%), and the central region (10.73%); (3) furthermore, the purchase price guidance policy of raw milk drives price increase or price suppression in the links of the supply chain to promote a balanced distribution of profits among the participants in the chain. These conclusions all have good stability and have reference significance for further improving and adjusting the price support policy of raw milk to realize the sustainable development of the Chinese dairy industry. This will enhance the production confidence of Chinese raw milk producers and improve Chinese consumers' expectations and consumer psychology regarding domestic dairy products.

Prevalence, expenditures, and associated factors of purchasing non-prescribed Chinese herbal medicine in Taiwan.

BACKGROUND AND AIMS: Purchasing Chinese herbal medicine (CHM) without a physician's prescription may have adverse effects on health. However, the recent status of purchasing non-prescribed CHM and the associated factors are not completely understood. We aimed to report the prevalence of purchasing CHM and associated factors. METHODS: Using data from the 2017 Taiwan Survey of Family Income and Expenditure, we identified 16,528 individuals (householders) aged 18 years and older. Sociodemographic factors, expenditures on medical services and health behaviours were compared between people with and without a history of purchasing non-prescribed CHM by calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs) in a multiple logistic regression analysis. RESULTS: The one-year prevalence of purchasing non-prescribed CHM was 74.8% in Taiwan. In addition to sociodemographics, marital status (OR 2.14, 95% CI 1.88-2.44), the use of traditional Chinese medicine (OR 3.62, 95% CI 3.30-3.97), the purchasing of non-prescribed biochemical medications (OR 3.09, 95% CI 2.75-3.48), the purchasing of health foods (OR 2.59, 95% CI 2.33-2.86), the use of folk therapy (OR 2.27, 95% CI 1.95-2.64), and a high level of expenditure on alcohol (OR 3.79, 95% CI 3.29-4.36) were strongly correlated with purchasing non-prescribed CHM. CONCLUSION: The one-year prevalence of purchasing non-prescribed CHM is very high in Taiwan and is correlated with sociodemographics, health behaviours, and the utilization of medical care. The interaction of non-prescribed CHM with physician-prescribed herbal medicine and biomedical medications requires more attention.

Development and Qualification of a Scale-Down Mammalian Cell Culture Model and Application in Design Space Development by Definitive Screening Design.

Scale-down models are indispensable and crucial tools for process understanding and continuous process improvement in product life-cycle management. In this study, a scale-down model representing commercial-scale cell culture process of adalimumab biosimilar HS016 was first developed based on constant power per volume (P/V) principle and then qualified by multivariate data analysis (MVDA) and equivalence test method. The trajectories of the bench-scale process lie in the middle of the control range of large-scale process, built by multivariate evolution model based on nutrients, metabolites, and process performance datasets. This indicates that the small-scale process performance is comparable with that of the full-scale process. The final product titer, integrated viable cell density (iVCD), viability, aggregates, acid peak content, total afucosylation level, and high mannose content recognized as key process attributes (KPAs) or critical quality attributes (CQAs) were equivalent across the scales upon comparison using equivalence test method. The qualified scale-down model was then used for process characterization using a definitive screening design (DSD) where five independent variables including pH, shifted temperature, inoculation seeding density, viable cell density (VCD) at first feeding, VCD at temperature shift were evaluated. Three quadratic polynomial models for final product titer, aggregation, and high mannose were then established using the DSD results. The design space was finally developed using a probability-based Monte Carlo simulation method and was verified with the operation setpoint and worst-case condition. The case study presented in this report shows a feasible roadmap for cell culture process characterization.

[Energy expenditure on different physical activities of rural adults in North China].

UNLABELLED: To test the energy metabolism of healthy adults in rural north China and to obtain the data of energy expenditure on different physical activities, in order to provide the basis for the Dietary Reference Intakes for Chinese people and the prevention and treatment of diseases related to energy and nutrition imbalance. METHOD: The energy expenditures on different physical activities of 30 healthy adult men and women were investigated under strictly controlled experimental conditions by using portable cardiopulmonary function determinator k4b2 to examine the oxygen consumption (VO2) and carbon dioxide production (VCO2) during basal metabolic conditions and seven kinds of physical activities (walking, brisk walking, jogging, cycling, stair climbing, and watching TV). The content of 24-hour urine nitrogen was measured by micro Kjeldahl method. Combining with the change of body weight, the energy expenditures on different physical activities of normal adult men and women in north China were obtained. RESULTS: The average energy expenditure on physical activities (kJ x h(-1) x kg(-1)) were: walking 12.60 +/- 5.54 (11.46 +/- 2.19 for male and 15.47 +/- 6.97 for female), brisk walking 20.79 +/- 10.46 (15.95 +/- 3.59 for male and 25.33 +/- 12.70 for female), jogging 34.78 +/- 16.00 (30.45 +/- 5.07 for male and 38.84 +/- 21.58 for female) cycling 16.47 +/- 3.95 (14.77 +/- 2.57 for male and 18.74 +/- 4.85 for female), going up stairs 23.55 +/- 5.05 (23.61 +/- 3.43 for male and 23.49 +/- 6.41 for female) going down stairs 12.46 +/- 6.30 (10.43 +/- 1.27 for male and 14.49 +/- 8.48 for female) and watching TV 3.85 +/- 1.97 (3.56 +/- 0.86 for male and 4.16 +/- 2.79 for female). CONCLUSION: The average energy expenditure on physical activities of males was lower than that of females (P < 0.05), except of going up stairs, which was roughly equal in males and females. The average energy expenditure on various physical activities was different. Walking, watching TV and going downstairs are low-intensity physical activities; brisk walking, cycling and climbing upstairs are medium-intensity physical activities; and jogging is a high-intensity physical activity.

[Velocity vector imaging for left ventricular diastolic function assessment and the reference values].

OBJECTIVE: To study value of velocity vector imaging (VVI) in assessment of normal left ventricular diastolic function and the corresponding reference values. METHODS: Ninety-seven healthy subjects were selected by combined clinical, ultrasound, and NT-proBNP examinations. Using a Siemens Acuson Sequoia C512 echocardiograph, VVI was adopted to examine the myocardial early diastolic velocity (E) of the septal, lateral, anterior, inferior, anterior septum, and posterior wall of the left ventricle at the level of mitral annulus. The images were analyzed for VVI and the mean diastolic velocity (E(m)) and hence the E/E(m) ratio was calculated based on the offline workstation interface. RESULTS: The reference range of E/E(m) ratio derived from the data of the 97 healthy subjects was (unilateral boundaries with 95% limit) and (1, 22.935), was (1, 22.300) in male subjects and (1, 24.766) in female subjects. The reference E/E(m) range was (0, 22.413) in male subjects under 50 years of age, (1, 24.766) in female subjects under 50 years, (1, 22.300) in male subjects over 50 years, and (1, 24.766) in female subjects over 50 years. CONCLUSION: VVI is a good method for non-invasive evaluation of the left ventricular diastolic function and provides an accurate and reliable means for clinical assessment of the left ventricular diastolic function.