Increasing Service Quality at a University: A Continuous Improvement Project

This paper evaluates a continuous improvement project (CIP) at a Mexican university designed to increase engineering graduate student loyalty. A plan-do-check-act problem-solving methodology was implemented, and a SERVQUAL survey was conducted on 67 master’s engineering students. Five factors were found to affect student loyalty: facility cleanliness, faculty teaching skills, evening student services, master’s degree student management roles at work and master’s degree students’ ages. After the implementation of the improvement and control actions, there was a 7.7% increase in the engineering master’s degree students’ loyalty scores. This research work took a different approach in assessing student satisfaction and student loyalty in a higher education institution (HEI) by using the SERVQUAL survey as the data collection instrument for the conduct of the CIP. However, there were several research limitations: data availability (such as student loyalty, student satisfaction and a small master’s degree student population size) and factors outside the CIP’s scope (such as the country’s economic situation, university rankings, master’s programme accreditations and COVID-19). Practical implications—The findings from this research study could be used by other HEIs to improve student loyalty and as a reference when conducting similar studies in other service organisations such as hospitals and hotels.N/

Euglycemic Diabetic Ketoacidosis in a patient using Sodium-Glucose Cotransporter-2 inhibitor (SGLT 2 inhibitor)

Background: Diabetic Ketoacidosis (DKA) is a life-threatening complication of Diabetes Mellitus type-1 and occasionally type-2 diabetes, associated with high blood glucose levels\u3e250 mg/dl. Normal glucose levels in all diabetic patients may delay diagnosis and management of DKA and result in increased morbidity and mortality. Case Presentation: A 68-year-old male having a medical history of Diabetes Mellitus type-2, atrial fibrillation, aortic stenosis status post total valve replacement, coronary artery disease, gastric bypass surgery, and previous stroke presented with two episodes of hematemesis a few hours prior to admission. The patient denied using drugs or ingestion of methanol, ethylene glycol, and salicylate. His home medications include apixaban (Eliquis), Empagliflozin (Jardiance) SGLT-2 inhibitor, and metformin. Physical exam was unremarkable except for dry mucous membrane. While in the emergency department, the patient suffered shortness of breath with increased respiratory rate 24/min (12-16/min) and use of accessory muscles. IV fluid was administered, and initial laboratory data indicated negative ethanol and salicylate levels, with normal parameters including electrolytes and glucose level of 192mg/dl (\u3c250mg/dl). To eliminate the rare probability of Euglycemic Diabetic Ketoacidosis (EDKA), an extensive lab work showed PH 7.07 (7.35-7.45), bicarbonate 3.5mmol (23-30mmol/L), anion gap 24mmol/L (3-10mmol/L), serum ketone 8mmol/L (0.6-1.5mmol/L), serum osmolality 323mmol/kg (285-295mmol/kg) and osmolar gap 28mmol/kg (\u3c10mml/kg). Euglycemic DKA was diagnosed, and treatment started with insulin drip, IV fluid, discontinuation of Jardiance and Eliquis. Endoscopy showed stomach inflammation with no ulcer. Pathology confirmed mild active gastritis, but no intestinal metaplasia, dysplasia, or malignancy was identified. The patient’s condition improved drastically and was discharged on the third day. Conclusion: Diagnosis of DKA is challenging especially with normal glucose levels. SGLT-2 inhibitor was believed to be the culprit. Ketones should be checked in all admitted diabetic patients with high anion gap metabolic acidosis, regardless of blood glucose level

Characterizing the Statistics of a Bunch of Optical Pulses Using a Nonlinear Optical Loop Mirror

We propose in this work a technique for determining the amplitude distribution of a wave packet containing a large number of short optical pulses with different amplitudes. The technique takes advantage of the fast response of the optical Kerr effect in a fiber nonlinear optical loop mirror (NOLM). Under some assumptions, the statistics of the pulses can be determined from the energy transfer characteristic of the packet through the NOLM, which can be measured with a low-frequency detection setup. The statistical distribution is retrieved numerically by approximating the solution of a system of nonlinear algebraic equations using the least squares method. The technique is demonstrated numerically in the case of a packet of solitons