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Byline: Atif. Ahmed Shaikh, Monika. Das, Anupama. Roy, Bini. Baby, Dolcy. Dhar, Jebalin. Abigayil, Vitty. Varghese, Vivek. Mathew, Sanjith. Aaron, Ajith. Sivadasan, Paul. Premkumar, Tharan. Suresh, Appaswamy. Prabhakar Introduction: Entrapment [...]

This paper describes an investigatory project to pilot an SMS based game to enhance the training of peer educators of MSM (Males having Sex with Males) groups in India. The objective of this research was to increase the efficacy of the MSM peer educators by bridging the gap between the training needs and their real life experiences. An SMS based game was designed using participatory approaches as a learning support, upholding their real life experiences in game form. The game was designed on an existing platform which provides text role-play games accessed through SMS messages. This paper examines the learning benefits. The findings show that after the intervention the peer educators had better understanding of peer education and organizational support. They also learnt to think critically.

Introduction/Aims: In Guillain–Barré syndrome (GBS), the sensitivity and specificity of phrenic compound muscle action potential (CMAP) measurements to predict endotracheal mechanical ventilation are unknown. Hence, we sought to estimate sensitivity and specificity. Methods: We performed a 10‐year retrospective analysis of adult GBS patients from our single‐center laboratory database (2009 to 2019). The phrenic nerve amplitudes and latencies before ventilation were recorded along with other clinical and demographic features. Receiver operating curve (ROC) analysis with area under the curve (AUC) was used to determine the sensitivity and specificity with 95% confidence interval (CI) for phrenic amplitudes and latencies in predicting the need for mechanical ventilation. Results: Two hundred five phrenic nerves were analyzed in 105 patients. The mean age was 46.1 ± 16.2 years, with 60% of them being male. Fourteen patients (13.3%) required mechanical ventilation. The average phrenic amplitudes were lower in the ventilated group (P =.003), but average latencies did not differ (P =.133). ROC analysis confirmed that phrenic amplitudes could predict respiratory failure (AUC = 0.76; 95% CI, 0.61 to 0.91; P <.002), but phrenic latencies could not (AUC = 0.60; 95% CI, 0.46 to 0.73; P =.256). The best threshold for amplitude was ≥0.6 mV, with sensitivity, specificity, and positive and negative predictive values of 85.7%, 58.2%, 24.0%, and 96.4%, respectively. Discussion: Our study suggests that phrenic CMAP amplitudes can predict the need for mechanical ventilation in GBS. In contrast, phrenic CMAP latencies are not reliable. The high negative predictive value of phrenic CMAP amplitudes ≥0.6 mV can preclude mechanical ventilation, making these a useful adjunct to clinical decision‐making. [ABSTRACT FROM AUTHOR]