Cultura

Public Infrastructure Financing Models in Emerging Economies: A Conceptual and Comparative Review

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Jorge Luis Argoty Burbano

Abstract

The persistent gap between infrastructure investment needs and fiscal capacity in Latin American countries represents one of the most critical bottlenecks for sustainable economic development. The region requires investing approximately 3.12% of its gross domestic product (GDP) annually through 2030 to maintain and expand infrastructure in key sectors including transportation, energy, water, and sanitation yet historical average investment has not exceeded 1.8% of GDP.

Infrastructure projects face structural challenges stemming from the magnitude of initial capital outlays, multi-decade payback horizons, and complex risk distribution across construction, demand, operations, financing, and regulatory dimensions. Against this backdrop, a diverse family of financing instruments has emerged, evolving from traditional models budgeted public works and classical concessions toward sophisticated schemes that mobilize private capital, such as public-private partnerships, project finance, asset securitization, shadow tolls, turnkey contracts, public leasing, and revolving funds.

This article provides a comprehensive review of these models, integrating standard financial evaluation tools (net present value, internal rate of return, debt service coverage indicators) with contemporary literature on renegotiations, cost overruns, and contingent fiscal risks in infrastructure projects. Additionally, a methodological framework is proposed for comparative empirical research that combines statistical and econometric analysis with project performance assessment. The resulting recommendations aim to strengthen technical capacity in public entities, improve regulatory frameworks for private participation, and establish robust databases for systematic quantitative analysis in Latin American and Colombian contexts.

Keywords : .
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty