Background and Aim: In The Gambia, malaria transmission persists due to insecticide resistance and residual vector behavior, despite extensive use of indoor residual spraying and insecticide-treated nets. Community-led larval source management using Bacillus thuringiensis var. israelensis (Bti) offers a sustainable vector control alternative. This study aimed to assess the effectiveness and feasibility of community-led Bti application for reducing Anopheles mosquito populations, compared to expert-supervised application and non-intervention control arms. Materials and Methods: A non-randomized controlled trial was conducted across malaria-endemic regions in The Gambia from 2023 to 2024. Intervention arms included: (1) community-led Bti application, (2) expert-supervised Bti application, and (3) untreated control. Trained volunteers and entomologists applied Bti to breeding sites at weekly or biweekly intervals. Entomological surveys were conducted biweekly to monitor larval, pupal, and adult mosquito densities. Data were analyzed using generalized linear mixed models and negative binomial regression, adjusting for environmental covariates. Results: By round 10, community-led and expert-supervised interventions achieved 96.8% and 98.6% reductions in larval density, 97.4% and 99.1% reductions in pupal emergence, and 96.2% and 98.8% reductions in adult mosquito populations, respectively. Statistically significant declines in mosquito densities were observed by 2024 (p < 0.001). Community participation enabled high coverage and operational sustainability, with over 85% of participants reporting visible mosquito reduction. Conclusion: Seasonal Bti application, especially when led by trained community members, significantly suppresses Anopheles populations. Although expert-supervised methods yielded slightly higher efficacy, community-led biolarviciding offers a scalable, sustainable, and environmentally safe vector control strategy, supporting The Gambia’s malaria elimination goals. Keywords: Anopheles mosquitoes, Bacillus thuringiensis israelensis, biolarviciding, community participation, larval source management, malaria control, The Gambia.

Introduction: ADHD is a common neurodevelopmental condition often managed with stimulant medications such as methylphenidate. While pharmacotherapy remains effective for symptom controlgrowing attention has focused on the role of nutrition in modulating treatment outcomes and overall management of ADHD. However, concerns remain regarding long-term outcomes, adverse effects, and dependence on medication. In recent years, research has increasingly emphasized a more integrative perspective beyond pharmacotherapy, incorporating environmental and nutritional factors to a more comprehensive understanding, including the role of environmental factors, diet, and nutrition. Methods: This case report discusses a 20-year-old female college student with a history of ADHD who presented with behavioral disturbances and sleep deprivation. She had previously shown improvement in focus and academic performance with methylphenidate (CONCERTA), but experienced weight gain as a side effect, motivating her to study nutritional science. Nutritional factors and food–drug interactions appeared to influence both the expression of ADHD symptoms and the tolerability of pharmacotherapy. Discussion: This case highlights individual variability in response to methylphenidate, particularly concerning metabolic effects. The effectiveness and adverse reactions to ADHD medications may be influenced by dietary interactions, suggesting the importance of a personalized treatment approach. A well-balanced diet may enhance cognitive performance and improve pharmacologic tolerability, especially when it includes adequate intake of protein, unsaturated fats, and essential micronutrients. Conclusion: The management of ADHD should consider both pharmacological and nutritional factors. Integrating dietary support into treatment plans may enhance outcomes and reduce side effects, offering a more holistic and individualized model of care.

Aripiprazole is often regarded as having a comparatively favorable metabolic profile among second-generation antipsychotics; however, clinically relevant changes in body weight, glucose regulation, and lipid metabolism may still occur in some patients. AMP-activated protein kinase (AMPK) is a central regulator of cellular energy homeostasis, glucose uptake, lipid oxidation, and mitochondrial function, but its effects are tissue- and context-dependent. Tithonia diversifolia (Mexican sunflower) is a medicinal plant with emerging preclinical evidence relevant to metabolic regulation, including reported changes in AMPK phosphorylation in human mesenchymal stem cells, insulin sensitivity and mitochondrial DNA copy number in diabetic rodents, and glucose uptake-related effects of isolated constituents. This review will critically evaluate the evidence linking aripiprazole-associated metabolic dysregulation, tissue-specific AMPK signaling, and the phytochemical and pharmacological properties of T. diversifolia. A structured, multilingual literature search will identify clinical, animal, and cellular studies addressing aripiprazole metabolic outcomes, AMPK signaling, T. diversifolia phytochemistry, metabolic endpoints, toxicity, and potential drug interactions. The central translational question is whether standardized T. diversifolia preparations or isolated constituents warrant further investigation as metabolic modulators in the setting of aripiprazole exposure. At present, the evidence is preclinical and does not establish efficacy, safety, or benefit from co-administration in patients. Direct combination studies, mechanistic validation, pharmacokinetic assessment, and toxicological evaluation are required before clinical consideration.