Contrast-enhancement cardiac magnetic resonance imaging beyond the scope of viability

The clinical applications of cardiovascular magnetic resonance imaging with contrast enhancement are expanding. Besides the direct visualisation of viable and non-viable myocardium, this technique is increasingly used in a variety of cardiac disorders to determine the exact aetiology, guide proper treatment, and predict outcome and prognosis. In this review, we discuss the value of cardiovascular magnetic resonance imaging with contrast enhancement in a range of cardiac disorders, in which this technique may provide insights beyond the scope of myocardial viability

MRI and CT in the diagnosis of coronary artery disease: indications and applications

In recent years, technical advances and improvements in cardiac computed tomography (CT) and cardiac magnetic resonance imaging (MRI) have provoked increasing interest in the potential clinical role of these techniques in the non-invasive work-up of patients with suspected coronary artery disease (CAD) and correct patient selection for these emerging imaging techniques. In the primary detection or exclusion of significant CAD, e.g. in the patient with unspecific thoracic complaints, and also in patients with known CAD or advanced stages of CAD, both CT and MRI yield specific advantages. In this review, the major aspects of non-invasive MR and CT imaging in the diagnosis of CAD will be discussed. The first part describes the clinical value of contrast-enhanced non-invasive CT coronary angiography (CTCA), including the diagnostic accuracy of CTCA for the exclusion or detection of significant CAD with coronary artery stenoses that may require angioplastic intervention, as well as potentially valuable information on the coronary artery vessel wall. In the second section, the potential of CT for the imaging of myocardial viability and perfusion will be highlighted. In the third and final part, the range of applications of cardiac MRI in CAD patients will be outlined

Financing and investment for sugar cane and bioenergy in Africa

Investment is an indispensable element in the realization of any venture, ranging from large commercial enterprises to undertakings in the informal sector, such as the building of a rural house or hut; all such activities require the use of human resources, land, tools and raw materials. Smaller projects may require only the use of locally available resources made accessible to the project owner by legal rights or barter. Beyond the small local investments, capital becomes part of the project realization; this capital can come from national or foreign grants, loans or equity, or more typically a combination of these. This chapter focuses especially on investment and financing for sugar cane-­ based bioenergy, which in some respects is a sub-­ sector of biomass-­ based energy, but is also related to agricultural investment. Although sugar cane has a long history in some parts of Africa, investments on the energy side of sugar cane remain quite limited, but have received greater attention in recent years due to concerns over climate change, energy security and rural development. Sustainable investments are those that societal and environmental impacts into the financial calculus of the investor. This investment segment has grown to a nonnegligible ­ size during the last decade and has found many advocates within as well as outside the investment community, including academics, analysts, commercial investors, NGOs and fund trustees (Cerin and Dobers, 2008). Currently, the UN initiative for responsible investments, the Principles for Responsible Investments (PRI), established in 2006, has already gathered signatories with a total of US$19 trillion under asset management, involving some 210 asset owners and 437 investment managers. For investments in bioenergy to be sustainable, the allocated capital in the developed projects will need to respect socio-­ economic and environmental issues (FAO, 2008). The need for “informed” investments implies that investments should be preceded by a systematic collection and analysis of the information required for a sustainable project design.</p