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Three decades of public-private partnerships (PPPs) have witnessed significant evolution in policies and practices. However, the critical success factors for PPPs influence their early and late stages differently. Natural experiments provide one of the best settings to identify these differences. This paper exploits one such instance in the context of road project up gradations in India. The fundamentals established by the first road PPP project in India were completely revamped during the re-conceptualization of the project twenty-five years later. Comparing and contrasting the two projects provided evidence of the differences in the influence of critical success factors at the two stages. At the institutional level, the findings reflect an evolution in motivations, maturity in regulatory frameworks, and changes in performance perceptions. Significant differences between the PPP models deployed in the two stages were also found. The government’s willingness to take greater financial and economic risks were found to drive these changes. Upon comparison with the existing literature, this conclusion is indicative of different drivers of change in business models across emerging economies.

Cloud-based enterprise resource planning (CLERP) provides scalability, flexibility, and cost-savings. The advantages of CLERP are most prominent in developing economies where access to robust information technology (IT) resources is difficult. However, despite the advantages, diffusion of CLERP in such regions remains low. This study aims to explore the drivers of CLERP selection and adoption by proposing a sociotechnical framework integrating three technology adoption theories: diffusion of innovations, task-technology fit, and extended technology acceptance model. The framework is tested using case study methodology based on semi-structured interviews in three higher educational institutions in India. The findings have important implications for both CLERP providers and clients aiming to enhance the rate of diffusion. The results suggest that vendors should focus on providing cost-effective, reliable, secure, standardized, long-term, convenient, and better quality of service and support to clien...

Angiolymphoid hyperplasia with eosinophilia (ALHE) is an idiopathic acquired condition characterized by erythematous papulo-nodular lesions with a predilection for the head and neck. The lesions are cosmetically disfiguring, resistant to most medical and surgical therapies and tend to recur. We report the novel use of radiofrequency equipment in the management of nodular ALHE on forehead of a 53-year-old man. Intra-lesional radiofrequency ablation was done using a modified 18 gauge intravenous cannula and three sittings over a period of four years yielded cosmetically acceptable results with no recurrence and minimal side effects.

Renal injuries are classified, based on the American Association for the Surgery of Trauma classification, in to five grades of injury. Several imaging modalities have been available for assessing the grade of renal injury, each with their usefulness and limitations. Currently, plain radiographs and intravenous urography have no role in the evaluation of patients with suspected renal injury. Ultrasonography (USG) has a limited role in evaluating patients with suspected retroperitoneal injury; however, it plays an important role during follow up in patients with urinoma formation. USG helps to monitor the size of a urinoma and also for the drainage procedure. The role of selective renal arteriography is mainly limited to an interventional purpose rather than for diagnostic utility. Retrograde pyelography is useful in assessing ureteral and renal pelvis integrity in suspected ureteropelvic junction injury and for an interventional purpose, like placing a stent across the site of ureteric injury. Magnetic resonance imaging has no role in acute renal injuries. Multidetector computed tomography is the modality of choice in the evaluation of renal injuries. It is also useful in evaluating traumatic injuries to kidneys with preexisting abnormalities and can help to define the extent of penetrating injuries in patients with stab wounds in the flank region. The combination of imaging findings along with clinical information is important in the management of the individual patient. This article will describe a spectrum of renal injuries encountered in a trauma setting.