Food-packaging materials protect food from spoilage by enhancing its shelf life, safety, and overall quality. Currently, a major portion of food-packaging materials are made from fossil-based synthetic polymers due to the cost and ease of processing; however, they have far-reaching consequences on the environment and human health. Their multifaceted impact on the environment is not only limited to carbon footprint throughout their life cycle but also worsened by microplastic release affecting the aquatic systems. The non-biodegradability of such petroleum-based polymers is exacerbating the waste generation upon disposal, negatively affecting soil fertility and raising massive landfill issues. The processing materials and functional additives that can migrate into food and pose toxicological risks also raise concerns. This state-of-the-art review briefly outlines the traditional production processes of available commercial food-packaging materials from different polymeric materials and additives prior to explaining their consequences and broader impacts on the environment and human health in detail. It further highlights promising alternatives, emphasizing biodegradable and renewable polymers paired with safer bio-based additives to maintain the functional performance. The paper concludes with a forward-looking perspective on advancing sustainable and environmentally responsible packaging solutions across industrial sectors.
Smart meter sensors in coastal environments suffer severe accuracy degradation due to salt fog corrosion, high humidity, and temperature cycling affecting current transformers, voltage dividers, and measurement circuits. This study proposes a reliability prediction framework addressing multi-stress degradation in harsh marine atmospheres. The framework integrates an enhanced Transformer with multi-scale attention, a Bidirectional Long Short-Term Memory (BiLSTM) network for local degradation patterns, and a standard Transformer, unified through particle swarm optimization for dynamic weight adjustment. Validation using six years of field data comprising 10.5 million records from 200 sensors on Meizhou Island, China, demonstrates superior performance, achieving a coefficient of determination of 0.944 and a root mean square error of 0.0121%, representing a 6.9% improvement over the best individual model. To capture coastal-specific effects, two novel indices are introduced: the Salt Fog Corrosion Index, quantifying cumulative chloride deposition, and the Electrochemical Activity Factor, modeling electrochemical corrosion potential. Feature analysis identifies load current-temperature interaction with correlation 0.76 as the dominant drift mechanism, consistent with Joule heating theory. Field deployment verifies the framework's ability to predict failures about 5 days in advance with 0.01 percentage point accuracy, enabling condition-based maintenance and reducing out-of-specification operation time by 85%. This research provides practical tools for sensor reliability in harsh environments beyond smart metering.
Acute heat injury is one of the main triggers among exogenous factors affecting human vital functions and survival, especially in a changing climate. Despite this, the processes occurring in the human body during acute overheating remain insufficiently studied. The effects of heat exposure on the heart and lungs have been studied in experimental animals. Острая тепловая травма является одним из основных триггеров среди экзогенных факторов, оказывающих влияния на жизнедеятельность и выживание человека, особенно в условиях меняющегося климата. Несмотря на это процессы, происходящие в организме человека в условиях острого перегревания, изучены недостаточно. В статье представлены результаты исследования влияния теплового воздействия на состояние сердца и легких на примере экспериментальных животных.
Recent crises involving zoonotic diseases (Ebola, COVID-19, and Mpox) have highlighted the limitations of fragmented public health systems for the prevention and response to health emergencies at the international and continental level, and particularly in Africa, more specifically in the Democratic Republic of the Congo (DRC). In this context, the One Health (OH) approach and its extension, One Digital Health (ODH), articulated with the findable, accessible, interoperable, reusable (FAIR) principles, offer a framework for rethinking the digital transition in health in the DRC. This study analyzes the reality of this transition in Kinshasa, DRC, and questions the feasibility of ODH in this context. This study aimed to (1) explore how stakeholders across human, animal, and environmental health sectors perceive and experience digital tool integration and data interoperability in Kinshasa; (2) identify structural, institutional, and technical constraints affecting cross-sectoral data sharing; and (3) analyze the sociotechnical conditions required for the operationalization of ODH in a fragmented digital health (DH) context. A qualitative study was conducted in Kinshasa, DRC, between November 10, 2025, and November 25, 2025, combining semistructured interviews with key actors (health professionals, administrative officials, digital experts, and engaged citizens) and a document review of strategic and regulatory texts related to DH in the DRC. The data were analyzed using a thematic approach to identify the representations, uses, and constraints related to DH and the operationalization of ODH. Overall, 22 stakeholders participated (n=9, 40.9% human health; n=8, 36.4% animal health; n=4, 18.2% environmental health; n=1, 4.50% digital sector), predominantly male (n=15, 68.2%) and mainly in operational roles (n=12, 54.5%). Three interrelated topics emerged. First, a dual-track digital ecosystem characterized by the coexistence of formal platforms (eg, District Health Information Software 2 and electronic records) and informal tools (eg, WhatsApp [Meta]), with persistent paper-digital double-entry generating inefficiencies. Second, structural and governance bottlenecks, including electricity instability, limited connectivity, software incompatibility, external data-hosting concerns that affect sovereignty, and institutional silos that privilege human health over animal and environmental sectors. Third, prerequisites for operationalizing ODH emphasize foundational infrastructure (energy and internet), sustainable capacity building beyond one-off training, interoperable "bridges" between fragmented systems, and high-level political leadership. These elements were synthesized into an ODH-FAIR DRC conceptual model structured around three enabling pillars linking sectors for integrated zoonotic surveillance. Operationalizing ODH in DRC requires addressing foundational enablers beyond tools: synchronized energy-digital policies, decompartmentalized governance, and context-adapted capacity building. These insights inform low- and middle-income countries' DH strategies, urging donors and ministries to prioritize interoperability over isolated pilots to achieve sustainable zoonotic surveillance.
Increasing atmospheric carbon dioxide (CO2) is transforming the climate space in which plants grow, severely affecting crop physiology and crop productivity. Elevated CO2 enhances photosynthesis and biomass; however, it can nitrogen (N) metabolism, inhibiting the nutritional value and the yield capacity of crops. The most important central N-regulated protein machineries are: transporters, nitrate reductase, nitrite reductase, glutamine synthetase, glutamate synthase, glutamate dehydrogenase, and urease which control N assimilation, distribution and remobilization in crop plants. With high CO2, these molecular components exhibit altered expression and activities mostly due to the reduction in N concentration. Complex systemic plant responses under N control like adaptation of photosynthetic capacity, flowering time, reproductive development and seed nutrient profiles further support the complexity of the interactions between C and N signaling. The high CO2 environment requires a more holistic analysis of the regulatory networks of N metabolism and anticipative crop improvement strategies. Future breeding and crop improvement strategies should focus on enhancing the resilience of N assimilation by optimizing the N transporter function and maintaining C-N stoichiometry, thereby sustaining crop performance and nutritive quality under changing climatic conditions. The present review identifies the molecular processes that regulate N responses in crops grown under elevated CO2, highlighting the differences between legume versus non-legume and C3 versus C4 plant responses and providing details that can ensure mitigation against negative impacts and outline future perspectives on crop improvement.
Consolation is a complex empathic behavior that varies considerably across individuals, yet the neural basis of this heterogeneity remains poorly understood. The medial preoptic area is a key hub for instinctive social behaviors, but it remains unclear which of its subregions - the medial preoptic nucleus (MPN) versus the surrounding area (MPA) - or which neuronal subtypes (GABAergic, glutamatergic, or galanin-expressing) contribute to individual differences in consolation. We used a social defeat-induced consolation paradigm in male mice and categorized them into low- and high-consolation groups based on allogrooming duration toward distressed partners. We performed c-Fos immunofluorescence to compare neuronal activation in the MPN versus MPA, and to identify the specific neuronal subtypes activated in each group. We then used chemogenetic approaches to manipulate MPN GABAergic neurons, as well as their projection to the periaqueductal gray (PAG), and examined the effects on consolation behavior, sociability, and anxiety. High-consolation mice showed selective c-Fos activation in the MPN, but not in the MPA, and this activation was specific to GABAergic neurons. Chemogenetic inhibition of MPN GABAergic neurons or the MPNGABA-PAG pathway selectively reduced allogrooming in high-consolation mice without affecting sociability or anxiety. The MPNGABA-PAG pathway is a critical modulator of individual variation in consolation-like behavior in mice, revealing a subregion- and cell-type-specific circuit mechanism underlying empathic heterogeneity.
Incomplete immune reconstitution (IIR) is a serious complication affecting 10 to 40% of people living with HIV (PLWH) despite effective antiretroviral therapy, leading to increased morbidity and mortality. Current risk prediction models rely on single-time point measurements and lack dynamic assessment capabilities. We developed a dynamic joint prediction system for IIR risk (DJPSIIR) using Bayesian joint modeling to analyze longitudinal data from 21,862 PLWH across 31 Chinese provinces (2003-2024). The system integrates continuous CD4+ T cell counts and CD4/CD8 ratios with clinical parameters to generate real-time risk predictions. DJPSIIR demonstrated strong discriminatory performance with area under receiver operating characteristic curves of 0.890 to 0.912 for 5- to 7-year predictions, consistently outperforming expert assessments and 19 machine learning algorithms across multiple validation cohorts. Our dynamic prediction system enables precise identification of high-risk individuals and could transform clinical decision-making by facilitating timely interventions to prevent IIR progression in HIV care.
This study investigates the biophysical interactions between pulmonary surfactant proteins (SP) and model lipid membranes. Using a combination of state-of-the-art nanoplasmonic sensing (NPS) and micro differential scanning calorimetry (MicroCal DSC), the effects of surfactant protein B (SP-B), surfactant protein C (SP-C), and their mixture on the structural and thermodynamic properties of liposomes composed of neutral phosphatidylcholines and anionic phosphatidylglycerol, (POPC : POPG and DPPC : DMPG, 80 : 20 molar ratio) were assessed. In a first-of-its-kind application for this system, NPS measurements provided real-time, label-free monitoring of the mass-sensing shifts associated with protein-lipid binding and membrane reorganization. Our results suggest that while SP-B primarily influences inter-membrane connectivity and surface-level interactions, SP-C penetrates deeper into the hydrophobic core. The combined SP-B and SP-C system exhibited non-additive effects, affecting the fluidity and stability of the surfactant model. Complementary MicroCal DSC analysis revealed that protein reconstitution into lung-mimicking lipid membranes is a kinetic process requiring extended timeframes to establish stable protein-lipid interactions. The inclusion of 2% (protein-to-lipid ratio) of each SP (and their equimolar mixtures) significantly modulated the thermotropic phase behavior of the anionic bilayers. These changes were characterized by a significant elevation in the gel-to-liquid crystalline transition temperature (Tm) and a concomitant broadening of the main transition endotherm. These thermotropic shifts suggest enhanced protein-lipid interactions, resulting in reduced transition enthalpy (ΔH) and attenuated molecular cooperativity within the lipid bilayer. Together, these findings provide critical insights into the molecular mechanisms by which these proteins maintain lung function, potentially offering a framework for the development of advanced synthetic surfactant therapies.
The MLO gene family plays a critical role in plant-pathogen interactions, regulating susceptibility and resistance to fungal diseases. In this study, we performed a genome-wide characterization of the MLO genes in soybean (Glycine max), integrating structural analysis, phylogenetic classification, expression profiling, functional validation by virus-induced gene silencing (VIGS), and SNP mining. We identified 40 MLO genes, including a novel member (GmMLO25) with an unusually small MLO domain (93 aa). Protein length varied from 130 to 600 aa, with differences in the number of transmembrane domains and conserved motifs, including calmodulin-binding domains (CaMBDs). Analysis of SNPs in coding sequences revealed missense substitutions affecting conserved motifs and transmembrane regions, particularly in clade V genes. RNA-seq and RT-qPCR analyses revealed differential regulation of clade V members between resistant (Rpp5) and susceptible (BRS 184) genotypes during Phakopsora pachyrhizi infection. Functional validation by VIGS demonstrated that silencing multiple clade V genes did not reduce the number of uredinia but drastically reduced fungal sporulation. This study identified GmMLO38 as a functional susceptibility gene in soybean and as a prime target for gene editing or RNAi-based strategies to enhance resistance to Asian soybean rust (ASR).
The HIV Prevention Trials Network 094 INTEGRA study sought to fill the gap in implementation science literature by exploring the delivery of integrated prevention and care for HIV and opioid use dependence (OUD) through mobile units to people who inject drugs (PWID). Five U.S. INTEGRA sites with diverse implementation landscapes disproportionately affected by the HIV and opioid epidemics (New York, Philadelphia, Washington, DC, Houston, Los Angeles) . In-depth qualitative interviews from an embedded implementation science evaluation were conducted with 37 clinical and research INTEGRA staff delivering integrated care through mobile units. Pragmatic qualitative analysis was guided by the PRISM framework to identify key implementation needs, challenges, and solutions for delivering the INTEGRA intervention via mobile units in local neighborhoods. Staff described how mobile delivery of INTEGRA reduced key barriers that limit PWID access to HIV and OUD services. Yet, they also detailed complex implementation needs, including the proactive coordination among staff to ensure sustained access to INTEGRA services, navigating internal and external spaces to deliver services, maintenance-related demands to keep the mobile unit's infrastructure operational, and interdependent efforts that bridged the mobile unit's service delivery within the extant health systems and community landscapes. Findings demonstrated that mobile integrated care models can reduce access barriers for PWID but require tailored implementation strategies to address operational, spatial, infrastructural, and community-level demands. Results may help inform an implementation blueprint for similar communities working to respond to the intersecting HIV and opioid epidemics affecting PWID across U.S. settings.
Chronic ankle instability and chronic low back pain are highly prevalent in musculoskeletal conditions. Emerging evidence suggests that they are interconnected through shared biomechanical, neuromuscular, and neurophysiological mechanisms, where deficits in proprioception, postural control, and load distribution contribute to persistent dysfunction across the kinetic chain. This study employed a narrative review with a conceptual framework, incorporating evidence from biomechanical, neuromuscular, and neurophysiological studies found through targeted database searches (PubMed, Scopus, and Google Scholar 2019-2025). Findings were thematically analyzed to establish connections between distal and proximal dysfunction within the kinetic chain. A total of 23 studies were included. Overall, the evidence suggests consistent distal-to-proximal alterations in individuals with chronic ankle instability, including impaired ankle biomechanics, compensatory lumbopelvic movement patterns, and deficits in proprioception and neuromuscular control. Emerging findings also indicate neurophysiological adaptations affecting sensorimotor integration. Collectively, these findings suggest a potential association between chronic ankle instability and chronic low back pain. Chronic ankle instability and chronic low back pain may coexist within a functionally interconnected kinetic system. Recognizing their potential interdependence supports a model of multi-segmental stability and highlights the importance of combined ankle-core rehabilitation strategies.
Myo1g, a short-tail class I myosin, has been extensively studied for its roles in cellular adhesion, migration, cytokine secretion and receptor recycling in T and B lymphocytes. However, its involvement in other immune cell populations, particularly natural killer (NK) cells, remains an open question in immunology. NKR-P1C is a type II integral membrane glycoprotein with a C-type lectin domain; it also plays roles in NK cell activation and differentiation, IFN-γ production, cytotoxic granule release. The expression of Myo1f and Myo1g mRNA in NK cells was previously found in the RIKEN database (https://gexc.riken.jp/). Thus, the present study began by confirming the presence of Myo1g protein in lysates from splenic NK cells of wild-type (WT) mice. Subsequently, it was found that mice deficient in Myo1g (Myo1g-/-) exhibited decreased frequency and absolute numbers of NK cells (defined as CD3-, CD19- and NKR-P1C+ lymphocytes) in the bone marrow, blood and spleen. Then, NK cell development was evaluated (CD122, CD49b and NKp46), demonstrating that the absence of Myo1g does not affect overall NK cell generation but does influence NKR-P1C expression. A functional analysis revealed reduced degranulation in NK cells from Myo1g-/- mice compared to WT controls. These findings were corroborated using purified NK cells, which demonstrated that NK cells from Myo1g-/- deficient mice exhibit reduced cytotoxicity. Collectively, these results suggest that Myo1g may serve as a potential target for modulating NK cell function and immune responses. To hypothesize potential mechanisms linking Myo1g to NKR-P1C expression and cytotoxicity, it is possible that Myo1g influences the stability or surface trafficking of NKR-P1C, given its known role in receptor recycling. Additionally, the absence of Myo1g could impair the cytoskeletal reorganisation required for NK cell function, affecting the formation of immunological synapses and the subsequent degranulation process.
Background: Acute myocardial infarction (MI) is an uncommon finding in the neonatal period, as well as in cases of hypoxic-ischemic encephalopathy (HIE). Case report: We report the case of a full-term newborn with HIE who developed extensive myocardial infarction secondary to perinatal asphyxia, accompanied by progressive neurological deterioration. Despite early initiation of therapeutic hypothermia (TH) and intensive supportive care, the infant developed refractory cardiogenic shock, rapid neurological decline, and died within the first hours of life. Postmortem examination revealed widespread subendocardial infarction affecting both ventricles, with structurally normal heart and coronary arteries. Conclusions: This case underscores the critical role of cardiovascular dysfunction in the pathogenesis of brain injury in neonates with HIE. Early interpretation of multimodal monitoring and timely detection and management of myocardial dysfunction may be essential to reduce secondary brain injury and improve outcomes in this high-risk population.
We evaluated a mating disruption strategy using a new sprayable microencapsulated (MEC) formulation to control the blackheaded fireworm (BHFW), Rhopobota naevana (Hübner), a major pest in cranberry production. In 4 organic cranberry farms in Quebec (Canada), all the key components of the mating disruption were monitored, including male moth trap catches, female mating status, next-generation larval densities, and crop damage. Adult male populations were monitored throughout the growing season using pheromone traps, and no reduction in captures was observed after MEC application. Female mating status and sex ratio were assessed by capturing adults with a sweep net, followed by sexing and dissection. The number of mated females was significantly reduced by 16% in mating-disruption-treated plots compared to control plots, without affecting the sex ratio. Larval densities were assessed using 30 quadrats in each field, with significantly lower occurrences in mating disruption plots. Crop damage was evaluated at the end of the season, with mating disruption treatment resulting in 59% less damage caused by BHFW larvae. Overall, the MEC formulation shows promise for BHFW management in cranberry production, providing evidence of successful mating disruption, as seen in female mating status, next generation of larval densities, and end-of-season damages while remaining compatible with integrated pest management (IPM) strategies. These findings emphasize the importance of assessing all components of the mating disruption process, since impacts on mating success, offspring development, and crop damage do not correlate with male captures in the present study.
Effective buyer-supplier negotiations are important for organizations to attain their goals and for wider society to have a reliable supply of goods and services. These negotiations also have distinctive characteristics that differentiate them from other negotiation settings, such as personal buyer-seller negotiations, which have attracted much of the attention in the negotiation literature. Given the differences between professional buyer-supplier and personal buyer-seller negotiations, some findings from personal negotiations may have limited applicability in supply chain settings, while others hold across contexts. These findings have important implications for both negotiation research and education, calling for careful contextualization based on the type of negotiation. By reviewing recent studies in the supply chain management literature, this article highlights several common dynamics of buyer-supplier negotiations and how they affect negotiation outcomes. These dynamics are broadly categorized into the non-exhaustive themes of power in ongoing buyer-supplier relationships, other relational factors (supply network complexity, cross-cultural relations, and AI adoption), and negotiation strategies in buyer-supplier relationships (distributive, integrative, and mixed strategies), providing scholars with an overview of selected recent research on buyer-supplier negotiations.
Background and objectives India ranks third in global cancer incidence. Groundwater often carries undetectable contaminants such as arsenic, a highly toxic element, and chromium, a probable carcinogen. This systematic review aims to identify patterns of arsenic and chromium exposure in Indian population through groundwater and surface water, and the resulting health effects, including cancer and other non-communicable diseases. Methods A comprehensive search was conducted in PubMed, Embase, and Scopus for English-language studies from inception to January 8, 2025. Studies assessing health effects of arsenic or chromium in groundwater or surface were included. After screening the articles, data on key health risk indices: hazard quotient (HQ) and carcinogenic risk, were extracted and categorised by standard thresholds. Heat maps and violin plots were used to represent health risk levels across studies and regions. Joanna Briggs Institute (JBI) critical appraisal tool was used for quality assessment. Results A total of 1259 articles were identified, with 63 included studies. All reported studies presented a low risk of bias. Arsenic ingestion indicated non-carcinogenic risks in 49% of adult and 60% of child-focused studies. Chromium ingestion risks were lower, reported in 12% and 14% of adult and children-focused studies, respectively. Carcinogenic risk was higher for both metals, particularly through ingestion. Higher non-carcinogenic risk was reported from groundwater than surface water, especially via dermal exposure in children. Affected regions were Punjab, West Bengal, Haryana, Delhi, Uttarakhand, and Jammu and Kashmir. Interpretation and conclusions Groundwater arsenic contamination poses a major public health threat in India, while evidence on chromium ingestion risks are limited.
Standardized motor batteries are widely used to assess motor competence in children with developmental coordination disorder (DCD), although it remains unclear whether they consistently capture the domains most affected by the disorder. This systematic review and meta-analysis aimed to examine the motor competence domains in which children and adolescents with DCD differ from their typically developing (TD) peers, as assessed through standardized motor batteries. A systematic search was conducted in four databases (PubMed, Scopus, Web of Science, and SPORTDiscus) up to November 12, 2025. Methodological quality was evaluated using the Mixed Methods Appraisal Tool. Thirty studies were included, comprising 3934 participants (1663 DCD groups and 2271 TD peers). Most studies used the MABC, with eight using the MABC-1 and 18 the MABC-2; two the TGMD-2, one the BOTMP, and one the KTK. Overall, children with DCD consistently demonstrated lower motor skills across all domains. However, the relative pattern of impairment across the various subdomains was not consistent, particularly in the MABC. Meta-analytic findings indicated that manual dexterity was relatively more affected in the MABC-1, whereas aiming and catching emerged as the relatively more affected domain in the MABC-2, in both DCD and TD groups. These findings suggest that standardized motor batteries are useful for operationalizing Criterion A, but their results should be interpreted cautiously and within a broader clinical and functional framework rather than as sufficient markers in isolation.
Venous leg ulcers (VLUs) are often accompanied by chronic pain, which is frequently managed through pharmacological treatments, including opioids, which can have undesirable effects and complications. Recent evidence advocates for the integration of non-pharmacological therapies to improve pain management and patient outcomes. This study reviewed the literature for non-pharmacological interventions to manage chronic pain in individuals affected by VLUs. An integrative literature review enabled inclusion and integration of diverse study methodologies. Studies were critically appraised. 16 studies met the eligibility criteria; eight were appraised as methodologically moderate, two as strong and six as weak. Non-pharmacological interventions included electrical stimulation therapy, compression therapy, social and peer support, virtual reality, light therapy, music therapy, aromatherapy and traditional Chinese medicine. Effective non-pharmacological therapies for managing chronic pain in VLUs exist and these can improve quality of life and overall wellbeing. Compression bandaging, electrical stimulation and virtual reality are the most effective and feasible for implementation. Research that adopts complex study methodologies would be most appropriate to evaluate the complexity of VLU care and provide a higher quality evidence base on which to expand and better support a holistic approach to VLU pain management.
Molluscum contagiosum (MC), caused by the molluscum contagiosum virus, is a common viral skin infection in children. MC may persist for months to years and can substantially impair the quality of life for affected children and their families through discomfort, pruritus, cosmetic concerns, social stigma, and household transmission. Newer US Food and Drug Administration (FDA)-approved therapies have demonstrated patient-acceptable clearance rates, providing clinicians with additional options to treat pediatric MC. The paper summarized literature on MC in childhood and provided evidence-based guidance to help clinicians manage pediatric MC. A panel of dermatologists developed a consensus paper to address the challenges of treating pediatric MC. The modified Delphi process comprised a two-pronged literature review, development of evidence-supported statements, physician review and modification, and a face-to-face panel meeting to discuss the systematic literature search results and draw on clinical experience and opinion to create six consensus statements, followed by voting. Consensus was achieved for 6 statements. Self-limiting, prolonged infection is common, particularly in children with impaired skin barrier conditions and immune deficiencies. Families may seek treatment to reduce patient discomfort from inflammatory symptoms, limit transmission, and reduce disease burden. Physicians should focus on patient and family quality of life through education and shared decision-making. Berdazimer gel 10.3% and cantharidin 0.7% are FDA-approved therapies that achieve meaningful lesion clearance (>50%) within 6 weeks to 3 months. The use of FDA-approved therapies with clinically meaningful clearance rates, combined with supportive management, provides an opportunity to improve outcomes and quality of life for children with MC.  .
The burden of mental disorders is high in conflict-affected populations. In Palestine, we piloted Inuka Coaching, a digital intervention adapted from the Friendship Bench delivered by trained and supervised lay coaches. This paper documents the implementation of the intervention in this highly volatile context after October 7, 2023. This study aimed to describe the implementation of Inuka Coaching, a digital mental health tool based on task shifting, in Palestine and examine contextual challenges, fidelity to the coaching model, and lessons learned regarding recruitment, retention, and delivery during escalating ethnic cleansing. Two Palestinian mental health professionals were trained and certified in the Inuka method as head coaches, and subsequently trained 5 lay coaches. Palestinian adults in Gaza and the West Bank were recruited primarily through social media and received up to 4 structured, text-based coaching sessions typically delivered over 4 weeks depending on participant availability and preference. Standardized mental health screening questionnaires (Self-Reporting Questionnaire-20 [SRQ-20] and Posttraumatic Stress Disorder Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [PCL-5]) were collected at baseline, immediately after the first coaching session, and 3 months after the final session. Session transcripts were reviewed to assess coaches' fidelity to the Inuka method, and a focus group discussion explored coaches' experiences with training, delivery, and contextual challenges. Between August 2023 and February 2024, a total of 70 participants were enrolled. Baseline assessments indicated high levels of psychological distress: 95.7% (67/70) scored above the PCL-5 threshold of 31, suggesting likely posttraumatic stress disorder, and 69.4% (43/62) scored in the "at risk" range on the SRQ-20. The effectiveness of the method could not be determined as retention was low, with only 7.1% (5/70) completing the program. Coach fidelity was high, with 94.6% (35/37) of transcripts adhering to all 5 steps of the intervention. Coaches reported positive experiences with the method but identified challenges related to recruitment, session continuity, platform usability, and the need for flexibility during acute crises. Key implementation learnings included the importance of early in-person collaboration and training, culturally sensitive framing, flexible delivery and session structures, and robust support for lay coaches. While digital, task-shifted mental health interventions can be delivered with fidelity in conflict settings, sustaining engagement during escalating violence remains challenging. Future implementations require flexible design, context-sensitive recruitment and retention strategies, adaptive delivery models, and strong support for lay coaches.