In the global infrastructure market, unsolicited public-private partnership (UPPP) proposals have been promoted, and a number of countries have established incentive programs to encourage such proposals. Although public-private partnerships (PPPs) have been growing in the United States, development of infrastructure through UPPP is still an area in need of further development. In this research, 18 major national and international PPP companies working in the United States were surveyed about their perceptions of unsolicited PPP proposals in terms of the management of such proposals, adequacy of regulations, incentive programs, procurement stages and negotiations, procurement time and fees, and competing proposals. The analysis shows that a significant percentage of the surveyed companies has pursued, shortlisted, or awarded UPPP. Surprisingly, little less than half of the surveyed companies would not encourage UPPP in the United States. The reasons were rooted in government mismanagement of UPPP, transparency problems, and the lack of competition. The companies reported a lack of adequate guidelines and complained about the short bidding times for preparing competing proposals. The majority of the companies were not in favor of the UPPP incentive programs. It was concluded that significant work is needed for improving UPPP regulations and procurement processes.

The successful implementation of public-private partnerships (PPPs) requires the contractual obligations and rights of the public and private parties to be clearly defined. The occurrence of risks in PPPs may negatively impact the parties’ abilities to perform their obligations. Force majeure (FM) risks represent a risk category that requires delicate management as it may cause tremendous losses to the private party. However, little has been published on how these risks were defined, allocated, and managed in PPPs. This paper investigates these issues through a case study approach that analyzes the agreements of five PPP transportation projects in British Columbia through content analysis. The findings show that not all FM events are dealt with as FM risks; only the most severe are called eligible FM (EFM) risks. These risks provide compensation events that relieve the parties from their obligations, allow termination of contracts, and provide for compensating the balance of the private debt, equity, and labor payments. Non-EFM events provide for continuation and compensation for the expenditure above the maximum insurance coverage. If the expenditure and restoration time exceed particular thresholds, termination may occur. The analysis should assist the PPPs on how to better manage the FM risks.

The aim of this study was to compare the effect of a single high-dose rosuvastatin versus atorvastatin preloading in ST-elevation myocardial infarction (STEMI) patients receiving primary percutaneous coronary intervention (PCI.) Methods: A total of 99 patients presented with STEMI and were randomly divided into three groups—a control group (n = 33) with no statin treatment, an atorvastatin group (n = 33) with a single 80 mg atorvastatin dose and the rosuvastatin group (n = 33) with a single 40 mg rosuvastatin dose in the emergency room (ER) prior to PCI. Post-interventional thrombolysis in myocardial infarction (TIMI) flow grade and corrected TIMI frame count (CTFC) were recorded, and ST-segment resolution was measured. Results: CTFC was significantly lower for the atorvastatin group (p-value < 0.01) than in the control group. A final TIMI flow grade 3 was achieved in 32 (97.0%) patients in the rosuvastatin group and 28 (84.8%) patients in the atorvastatin group compared with only 25 (75.8%) patients in the control group (p = 0.014). Peak CK-MB in the rosuvastatin group (263.2 [207.2–315.6]) and the atorvastatin group (208 [151.0–314.1]) was lower compared to that in the control group (398.4 [303.9–459.3]); p < 0.001. Conclusions: A single extensive dose of lipophilic atorvastatin prior to primary PCI in STEMI patients showed better improvement in microvascular myocardial perfusion compared to hydrophilic rosuvastatin.

As a matter of course, the private party in public–private partnerships (PPPs) assumes the responsibility for roadway safety management (RSM). However, because most PPPs are performance-based, public highway agencies must articulate the specifications and methods they develop to enforce RSM practices. Despite the increased interest in PPPs in recent decades, little has been published on developing and propagating the RSM practices used with this delivery system. To fill this research gap and explore RSM practices in PPPs, this work took a synthesis research approach, using content analysis to critically review and analyze 16 PPP agreements in seven states and provinces leading in PPP contracting in North America. The study discovered several methods and organized them under five mechanisms: Mechanism 1, integrating roadway safety into project performance specifications and initiating new tools such as safety compliance orders; Mechanism 2, imposing nonconformance monetary deductions based on point and classification systems; Mechanism 3, regulating safety payments on the basis of crash statistics; Mechanism 4, promoting safety initiative programs; and Mechanism 5, enforcing administrative countermeasures such as work suspension and default/termination triggers for persistent developer noncompliance. Mechanisms 1 and 5 were the default mechanisms in all toll- and availability-based projects, whereas Mechanism 2 was common in availability-only projects. The research reviewed the RSM packages in the PPP agreements, elucidating the particulars of the RSM mechanisms, highlighting RSM design considerations, presenting implementation guidelines, and articulating research needs. The research results were validated against PPP highways in five other states and provinces. This synthesis research provides highway agencies with an extensive practice review to support RSM package design for future PPP projects.

Over the years, PPPs in the USA have used different types of payments to compensate project developers. In the past decades, the dominant type was toll payment. Availability payments started to gain more popularity with performance-based PPP contracts. Internationally, some other payment types are also used in PPPs, such as operation and maintenance payment, safety payment, satisfaction payment, and end of term payment. A payment mechanism is a package that includes a set of payment type(s), performance measures, performance specifications, and penalties for not meeting the specifications. Since PPP payment mechanisms, other than toll payments, is new in the USA, it is not clear whether payment mechanisms as used in the USA projects would be similar to those used in the PPP international market regarding the payment types, payment structure, performance measures and specifications, penalties, and deduction schemes. This research investigated the payment mechanisms in transportation PPP projects in the USA and Canada. Comparative and content analyses of project agreements are used as research methods. The findings show that PPP projects in the USA tend to have payment mechanisms of fewer payment types, less sophisticated payment calculations, and less complex deduction schemes. Public agencies would use the outcome of this research to revisit and improve the design of payment mechanisms of their PPP projects.