Global university rankings increasingly position the Sustainable Development Goals (SDGs) as indicators of institutional responsibility, yet their methodologies often privilege selective reporting, superficial compliance and audit-driven performance. This article offers a conceptual alternative by developing an institutional ideal-type framework: a nine-stage Maturity Model for Authentic SDG Engagement in Higher Education. Extending and reinterpreting Crowther's CSR maturity framework, the model introduces a non-linear spectrum from -1 Regressive Compliance to 7 Stewardship, capturing both organizational progression and the possibility of regression. Each stage is articulated through five analytical dimensions-intentionality; structures and processes; behavioural and cultural dynamics; risks and limitations; and implications for SDG integrity-drawing on institutional theory and Weberian ideal-type construction. This design enables a systematic mapping of how universities embed, distort or symbolically enact the SDGs under varying governance contexts and ranking pressures. While grounded in concerns raised in the literature and in an empirical critique of the Times Higher Education Impact Rankings, the model does not aim to replace ranking systems. Instead, it offers a field-informed diagnostic and developmental tool that clarifies the organizational conditions enabling meaningful SDG engagement. The article thus contributes to theory by advancing a new ideal-type model of SDG maturity and to practice by supporting higher education institutions in strengthening the integrity, coherence and long-term credibility of their sustainability commitments.
Follicular dendritic cell sarcoma (FDCS) is a rare neoplasm with morphologic and phenotypic features resembling those of normal follicular dendritic cells (FDCs). FDCS has been classified into two distinct entities based on their association with Epstein-Barr Virus (EBV): classic FDCS (cFDCS) and EBV-positive inflammatory FDCS (EBV + IFDCS). Diagnosis relies on characteristic histopathology and immunohistochemistry using FDC markers and EBV in situ hybridization (EBER). This study aimed to compare the clinical presentations, histologic features, and immunoprofiles between these two entities in a Taiwanese cohort. We retrospectively reviewed histological features of in-house and consultation cases of FDCS. Immunohistochemistry with novel markers including serglycin (SRGN), FDC-secreted protein (FDCSP) was applied, together with conventional FDC markers (CD21, CD23, CD35) and EBER. Programmed death ligand-1 (PD-L1), a potential therapeutic marker, was additionally evaluated and scored. Clinical and histological parameters, inflammatory cell infiltration, mitotic rate, and PD-L1 tumor proportion score (TPS) were compared statistically. We identified 30 patients including 16 cFDCS and 14 EBV + IFDCS. The median age was 56 years old (range, 22–80), with a female preponderance in EBV + IFDCS. EBV + IFDCS occurred exclusively in extra-nodal sites, while cFDCS more commonly involved lymph nodes. EBV + IFDCS showed significantly higher PD-L1 TPS (p = 0.012), more prominent inflammatory cell infiltration (90.0
Patients with interstitial cystitis/bladder pain syndrome (IC/BPS) may present with different cystoscopic bladder conditions. The current study investigated the treatment outcomes of repeated intravesical platelet-rich plasma (PRP) injections for various bladder conditions. This study included 66 patients with IC/BPS, including five with Hunner’s IC and 61 with non-Hunner’s IC, who were not successfully managed with conventional treatments. The eligible patients underwent videourodynamic studies, completed voiding diaries, and received intravesical PRP injections once a month for a total of four treatments. Cystoscopic hydrodistention was performed, and the maximal bladder capacity and glomerulation grade were recorded. Treatment outcomes were examined using the global response assessment (GRA), and patients with a GRA score of 2 or 3 were considered to have achieved treatment success. In total, 33 (50
Intermittent hypoxia (IH), the key physiological stressor in obstructive sleep apnea, is commonly quantified by respiratory event frequency. However, clinical heterogeneity in hypertension among patients with comparable apnea-hypopnea index (AHI) suggests that episode timing, including the duration and frequency of desaturation-reoxygenation cycles, may exert distinct biological effects even under equal cumulative burden. To test this, male Wistar-Kyoto rats were exposed for 21 days (8 h/day) to IH with either 10-s hypoxia duration at 30 cycles/h (10s-30c) or 5-s hypoxia duration at 60 cycles/h (5s-60c), while room air served as a control. Cardiovascular regulation was evaluated by continuous measurement of mean arterial pressure, heart-rate variability, and baroreflex sensitivity, and broader systemic effects were assessed through sleep-wake architecture, EEG activity, spatial memory, and cortical/hippocampal protein markers. Both IH groups had elevated blood pressure and disrupted autonomic balance compared with controls. The 5s-60c group produced more sustained hypertension, blunted nocturnal dipping, greater baroreflex impairment, and enhanced beta power during sleep, indicating persistent sympathetic drive. By contrast, the 10s-30c group was associated with increased paradoxical sleep, impaired spatial memory, reduced NeuN expression, and stronger upregulation of IBA-1 and NF-κB. These findings demonstrate that equivalent cumulative hypoxic exposure with different temporal structures yields divergent cardiovascular and neurocognitive outcomes. High-frequency, short-duration episodes preferentially promoted cardiovascular dysregulation, whereas longer episodes were linked to neurocognitive vulnerability. Consideration of hypoxic episode duration may improve the mechanistic interpretation of cardiovascular heterogeneity associated with sleep-disordered breathing.
PURPOSE:Bone mineral density (BMD) alone is insufficient to fully capture fracture risk. This study investigated the association between lumbar spine BMD (LS-BMD) and trabecular bone score (TBS) and constructed age- and sex-specific centile reference curves for both measures in a Taiwanese population. METHODS:This cross-sectional study included 1,196 participants. LS-BMD was measured at L1-L4 by dual-energy X-ray absorptiometry (DXA), and TBS was derived from the same images using TBS iNsight software (Med-Imaps). Pearson correlation and multiple linear regression were performed to examine BMD-TBS associations and identify predictors of TBS variation. Generalized Additive Models for Location, Scale and Shape (GAMLSS) with cubic spline smoothing was applied separately by sex to generate continuous age-specific centile curves (5th-95th percentiles) for ages 20-90 years. RESULTS:The cohort comprised 530 (44.3%) participants with normal BMD, 493 (41.2%) with osteopenia, and 173 (14.5%) with osteoporosis. LS-BMD and TBS were positively correlated (r = 0.68). LS-BMD, BMI, and age were significant independent predictors of TBS (adjusted R² = 0.672); menopausal status was not. GAMLSS centile curves revealed that female LS-BMD peaked at ages 30-40 years and declined sharply after age 50, while male upper BMD centiles remained stable despite concurrent TBS decline, a BMD-TBS dissociation undetectable by mean-based analyses. CONCLUSION:LS-BMD and TBS provide complementary information on bone quantity and microarchitectural integrity. The sex-specific GAMLSS-derived centile curves constitute the first full-distribution normative reference standards for LS-BMD and TBS in a Taiwanese population, extending beyond conventional T-score classification.
