INNOVAPATHTM: Journal of Translational Medicine & Biotechnology is a premier scientific journal of the INNOVACORE Center for Research & Biotechnology and CorePath Laboratories. Our mission is to bridge the gap between scientific discovery and clinical application by publishing cutting-edge research in translational medicine, pathology, biotechnology, precision medicine, clinical research and innovations in healthcare. We aim to accelerate the development of innovative diagnostics, therapeutics, and biomedical technologies by fostering collaboration between researchers, clinicians, and industry leaders.
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The Impact of Artificial Intelligence Tools on Human Cognitive Abilities: A Comprehensive Review
Background: The rapid integration of artificial intelligence (AI) tools into daily cognitive tasks has raised questions about their impact on human cognitive abilities. Objective: This review synthesizes current research on how the use of AI tools affects cognitive domains, including critical thinking, memory, creativity, and decision-making. Methods: We reviewed empirical studies, including randomized controlled trials, field experiments, and neurophysiological investigations, that examined AI's cognitive effects across educational and professional settings. Results: Evidence reveals a complex, non-linear relationship between AI use and cognition. Moderate AI usage shows minimal cognitive impact, while excessive reliance correlates with decreased critical thinking abilities (cognitive offloading effect), reduced metacognitive accuracy, and lower retention on delayed assessments. Field studies with approximately 1,000 students demonstrated improved immediate performance but worse unassisted outcomes following AI removal, particularly with unrestricted AI access. Neurophysiological data showed reduced brain network connectivity during AI-assisted tasks. Age-related differences emerged, with younger users (17-25 years) exhibiting greater dependence and lower critical-thinking scores. However, well-designed AI tutoring systems with scaffolding produced superior learning gains compared with traditional instruction. Discussion: The findings reveal a fundamental paradox: AI assistance frequently improves immediate task performance while simultaneously undermining durable skill acquisition. Three primary mechanisms mediate these effects: reduced cognitive effort through offloading, diminished metacognitive monitoring, and altered practice patterns. Critically, the cognitive impact of AI is not deterministic but depends on implementation design, with scaffolded AI systems that maintain active engagement producing dramatically different outcomes than those providing direct solutions. Age-related vulnerabilities, particularly among younger users (17-25 years), raise developmental concerns, though higher educational attainment appears to provide protective effects against cognitive offloading tendencies. Conclusions: AI tools do not inherently impair or enhance cognition; rather, their impact depends critically on implementation design, user agency, and interaction patterns. Strategic use that maintains active cognitive engagement can augment human capabilities, while passive reliance risks skill atrophy. Educational interventions promoting AI literacy and metacognitive awareness are essential for optimizing cognitive outcomes.
Dow Entrepreneurial Network (DEN): A Presidential Initiative to Catalyze Physician-Led Innovation and Leadership Among Dow Graduates
Background: Physician leadership and entrepreneurship are increasingly recognized as essential for transforming health systems, yet most medical training still prioritizes individual clinical competence over systems thinking, innovation, and venture creation. Diaspora alumni associations represent an underused platform for cultivating these capabilities at scale. Objective: This narrative review describes the design and early implementation of the Dow Entrepreneurial Network (DEN), a 2025 presidential initiative of the Dow Graduates Association of North America (DOGANA). DEN aims to connect Dow alumni and students interested in entrepreneurship and leadership, using a structured series of virtual and in-person events, mentorship, and peer networking. Methods: We synthesized internal planning documents and program descriptions for the DEN activities in 2025 and interpreted them in light of published literature on physician leadership development and entrepreneurship education in medicine. The analysis focuses on program aims, structure, educational strategies, and anticipated benefits for participants and the wider Dow community. Results: DEN is organized around four core objectives: (1) fostering a global network of Dow alumni entrepreneurs; (2) providing a forum for dialogue on innovation, business models, and physician-led ventures; (3) educating students and alumni about entrepreneurial pathways; and (4) exploring programs that create jobs and opportunities for Dowites in North America, Pakistan, and globally. The initial implementation in 2025 includes a three-part virtual webinar series showcasing Dow alumni founders across clinical and non-clinical sectors, and an in-person DEN session at the DOGANA 2025 annual retreat featuring a health-system CEO as the keynote speaker. These activities are explicitly framed as a voluntary, non-commercial alumni platform with clear disclaimers regarding legal and financial liability. Discussion: DEN aligns closely with evidence that structured leadership and innovation programs improve physicians’ self-efficacy, broaden career trajectories, and can contribute to organizational performance when embedded in supportive ecosystems. By leveraging the Dow diaspora and DOGANA’s organizational infrastructure, DEN offers a low-cost, scalable model for seeding entrepreneurial mindsets, strengthening professional networks, and creating bidirectional pipelines between North American and Pakistan-based initiatives. Conclusion: DEN illustrates how an alumni-led initiative can operationalize physician entrepreneurship and leadership development without creating new degree programs or corporate structures. Future work should evaluate DEN’s impact on participant behavior, venture creation, and contributions to health and social outcomes.
Dow Graduates Association of North America
Advancing Glaucoma Care: Comparing Vision Language Models and Ophthalmology Foundation Models
NOTCH1-Targeted Endothelialized Patches for Bicuspid Aortic Valve Repair: Precision Strategies to Prevent Early Calcific Degeneration
This Perspective outlines a precision-engineered roadmap for NOTCH1-targeted endothelialized patches designed for bicuspid aortic valve (BAV) repair, a population uniquely susceptible to early and aggressive calcific aortic valve disease (CAVD). It is directed toward translational scientists, device engineers, and regulatory strategists aiming to develop biologically active repair materials that can modulate the earliest molecular triggers of valve calcification. NOTCH1 is a central protective regulator of aortic valve biology, governing mechano-transduction, endothelial homeostasis, and suppression of osteogenic pathways (1–3). Loss or dysregulation of NOTCH1 signaling—whether genetic or due to altered flow patterns inherent to BAV anatomy—drives endothelial dysfunction, inflammatory priming, and osteoblastic transition of valvular interstitial cells (VICs) (2,4). This Perspective synthesizes NOTCH1 biology, summarizes developmental and single-cell transcriptomic insights (1,5), proposes design criteria for patches that restore endothelial NOTCH1 activity, and presents a translational pipeline with mechanical, biochemical, and regulatory milestones. It concludes with an implementation-focused roadmap to accelerate the development of living, mechanosensitive, anti-calcific repair patches for BAV patients.
Aligning Allied Health Science Programs With Workforce Demand in the United States and Texas
Allied health professionals constitute the majority of the U.S. health workforce and are essential to addressing population aging, chronic disease, and rapid technological change. Recent projections, however, show uneven patterns of shortage and surplus across professions and geographies. This narrative, policy-oriented review synthesizes national and Texas data to identify allied health programs that are most aligned with workforce demand, with a particular focus on pathology diagnostics (histology, cytogenetics, and molecular diagnostics) and gateway entry roles such as medical assistants and phlebotomists. Using U.S. Bureau of Labor Statistics (BLS) projections, Health Resources and Services Administration (HRSA) workforce models, Texas workforce reports, vacancy surveys, and professional white papers, we find strong and persistent demand for diagnostic imaging, rehabilitation, respiratory care, clinical laboratory science, and anatomic/molecular pathology support roles, with especially acute shortages in Texas. Within laboratory medicine, histotechnology and clinical genomics, especially cancer cytogenetics and fluorescence in situ hybridization (FISH), emerge as high-need subspecialties where vacancy rates, retirement-driven openings, and the collapse of many formal National Accrediting Agency for Clinical Laboratory Sciences (NAACLS)-accredited cytogenetics programs combine to create structural workforce gaps. At the same time, rapid advances in the adoption of artificial intelligence (AI) are poised to reshape staffing models in these domains, shifting demand away from purely manual, repetitive bench work toward AI-enabled roles that emphasize data interpretation, quality oversight of automated workflows, informatics, and human–machine collaboration. In contrast, pharmacy and selected assistant-level occupations show signals of emerging surplus in some markets. Aligning academic portfolios with these patterns will require expanding and modernizing programs in histotechnology, clinical laboratory science, and cytogenetics/molecular diagnostics; explicitly integrating AI, digital pathology, and data science competencies into curricula; leveraging American Society for Clinical Pathology (ASCP)-recognized alternate training pathways and private–academic collaborations (such as Texas-based cytogenetics initiatives) to replace lost program capacity; using medical assistant and phlebotomy programs as structured on-ramps into higher-skill fields; and exercising caution in further expansion of programs where national projections point toward oversupply.
Fairness Begins at the Gate: Why Pakistan’s MDCAT Must Move Beyond Raw Scores
Background: The Medical and Dental College Admission Test (MDCAT) is the primary gatekeeper for entry into medical and dental education in Pakistan. Recent controversies surrounding MDCAT 2023–2024 paper leaks, skewed score distributions, and the use of raw scores across multiple sessions and years have raised serious concerns about fairness, validity, and public trust. Court judgments and parliamentary debates have further highlighted weaknesses in governance and psychometric practice. Objective: To critically evaluate the current use of raw scores in MDCAT across multiple test forms and years, compare this approach with international best practices in high-stakes testing, and propose a practical roadmap for psychometrically defensible and ethically robust reform. Methods: This narrative review synthesizes evidence from Pakistani legal documents, public notices, and media reports on MDCAT 2022–2024, alongside international standards in educational measurement and technical documentation from major testing agencies (e.g., ETS, NCCAOM, NCBE, AERAs Standards for Educational and Psychological Testing). Results: Findings indicate that: (1) MDCAT scores are currently reported and interpreted as raw percentages, while being declared valid for up to three years across cohorts under Section 17 of the PM&DC Act 2022; (2) multiple court proceedings and independent reviews have noted statistical anomalies, including very weak correlations between MDCAT and board marks, unusually high clusters of near-perfect scores, and credible allegations of paper leaks across sessions; and (3) international high-stakes examinations with multiple forms (e.g., MCAT, LSAT, GRE) rely on equating and scaled scores to ensure comparability, as required by professional standards. Discussion: Using unadjusted raw scores from non-equated forms in a multi-session, multi-year, high-stakes exam is psychometrically indefensible and ethically problematic. It risks hidden advantage, systemic disadvantage, and erosion of trust. Pakistan can align MDCAT with global best practice by legally mandating equated and scaled scoring, creating an independent National Center for Health Professions Assessment, adopting anchor-item designs and item response theory (IRT), and enhancing transparency. Conclusion: Scaling and equating are not statistical luxuries but instruments of justice. For a country where access to competent healthcare can mean life or death, fairness at the very first gate, who is allowed to become a doctor, is an ethical imperative.
Pakistan Medical & Dental Admission Test
Reimagining Health-Professions Education: A Roadmap for the AI University of Health and Medicine
Is AI a Bubble That Is About to Burst? A Systematic Review of Financial and Economic Evidence
Background: Extraordinary increases in equity valuations, expenditure, capital intelligence, and public attention have accompanied the rapid expansion of generative AI since 2022. Central banks, international financial institutions, and market analysts increasingly refer to a possible “AI bubble,” raising questions about whether the boom is sustainable or likely to end in a sharp correction. Objective: To systematically review recent evidence and expert assessments on whether current AI-related investments and asset valuations exhibit characteristics of a financial bubble that is likely to burst in the near term. Methods: A systematic search was conducted (January 2023–November 2025) across Google Scholar, SSRN, and websites of major financial institutions and research organizations (e.g., Bank of England, International Monetary Fund, Congressional Research Service, McKinsey Global Institute, Goldman Sachs Research, California Management Review), search terms combined concepts for AI with bubbles, market valuations, and macroeconomic impact. Eligible sources included empirical analyses, official reports, and analytical commentaries that (a) discussed AI in the context of asset valuations or macroeconomic outcomes and (b) provided explicit arguments regarding bubble-like or fundamental characteristics. Data were extracted on (i) valuation or investment metrics, (ii) productivity and growth estimates, and (iii) explicit bubble assessments. A narrative synthesis was performed because of heterogeneity in methods and outcomes. Results: Thirty-five sources met the inclusion criteria, grouped into four categories: (1) financial stability and bubble-risk assessments by central banks and international institutions; (2) macroeconomic modeling and productivity studies; (3) management and strategy reviews of AI and productivity; and (4) market and investment research on AI valuations. Central banks and the International Monetary Fund (IMF) highlight “stretched” valuations and the risk of a sharp market correction, explicitly comparing current AI exuberance to the late-1990s dot-com boom. Macroeconomic and consulting studies project sizable, long-run productivity and GDP gains from AI, although meta-analytic evidence finds no robust relationship between AI adoption and aggregate productivity to date. Primary market analyses acknowledge bubble-like features, rapid valuation growth, circular spending, and concentration, but argue that fundamentals and current earnings distinguish AI from prior purely speculative episodes. Conclusions: The evidence supports a hybrid view: segments of AI-exposed equity markets display speculative excess. They are vulnerable to correction, whereas AI, as a general-purpose technology, has credible long-run economic value. A complete collapse akin to a pure asset bubble appears unlikely; a pattern similar to the dot-com cycle, over-valuation, correction, and subsequent consolidation with lasting productivity effects is more consistent with the available data. For policymakers, firms, and investors, the key challenge is not to bet for or against “AI” in the abstract, but to distinguish bubble-like exposures from durable, productivity-enhancing applications.
Heat and the Heart: The Unseen Microvascular Pathway to Myocardial Infarction
Precision Elastin-Mimetic Electrospun Scaffolds for Aortic Root Reconstruction: Toward Regenerative, In-Situ Tissue Engineering
Reconstruction of the aortic root demands materials that endure complex cyclic loading while preserving native hemodynamics. Current prosthetic and biologic conduits restore patency but do not recapitulate the elastin-dependent compliance and fatigue resistance intrinsic to the aortic root, contributing to valve dysfunction, progressive dilation, and long-term failure. Elastin-mimetic electrospun scaffolds—combining elastin-like polypeptides (ELPs) or elastin-based recombinamers with structural biodegradable polymers such as polycaprolactone (PCL)—offer a rational path toward in-situ regeneration: immediate mechanical support, surface cues for endothelialization, and a degradative timetable that permits host extracellular matrix deposition. Here we synthesize current elastin and vascular tissue engineering literature, define quantitative design targets for aortic-root scaffolds, delineate a preclinical testing pipeline, and map regulatory considerations required for clinical translation. We present two tables that map design levers to mechanical/biologic criteria and preclinical endpoints with recommended assays and sample sizes. This Perspective aims to provide a concise, actionable roadmap for investigators and translational teams pursuing regenerative, elastin-mimetic solutions for aortic root reconstruction.
Unveiling a Giant Hydatid Cyst of the Brain: A Neurosurgical Experience with a Rare Zoonotic Infection
Cerebral hydatid disease is a rare but important manifestation of Echinococcus granulosus, comprising 0.5%–2% of all hydatid cases. It primarily affects children in endemic regions and often remains asymptomatic until the cyst reaches a considerable size, making early diagnosis challenging. An 11-year-old boy from rural Punjab, Pakistan, presented with progressive headache and head enlargement for four months, without seizures or neurological deficits. MRI revealed a large, well-defined cyst (10.9 × 10.2 × 11.2 cm) in the left parieto-occipital region, producing significant mass effect and moderate hydrocephalus. Serology was negative, and systemic imaging ruled out extracranial involvement. The patient underwent parieto-occipital craniotomy, and the cyst was excised intact using the Dowling-Orlando technique to prevent rupture. Histopathology confirmed hydatid disease. Postoperatively, albendazole (10 mg/kg) was administered for 30 days along with anticonvulsants. Recovery was uneventful, and follow-up imaging showed no recurrence. This case underscores the importance of early recognition, meticulous surgical planning, and postoperative monitoring for successful outcomes in cerebral hydatid disease, particularly in endemic areas.
Human Papillomavirus Vaccine in Pakistan: Misconceptions, Barriers, and Evidence-Based Safety.
The human papillomavirus (HPV) vaccine has proven to be effective in preventing cervical cancer. Recently, the vaccine was launched in Pakistan, but public acceptance remains low. Ignorance, social standards, and mixed cultural-religious barriers, such as fear of infertility, promiscuity, and haram ingredients, fuel misconceptions about the vaccine. Contrary to this, scientific evidence constantly proves its safety and debunks religious and cultural myths. Several measures are to be taken to increase the public’s acceptance of the vaccine, such as conducting culturally appropriate awareness campaigns and engaging community and religious leaders.
Universities in Ruins or on the Cusp of Renewal? Dark Academia, Global Data, Liberal Arts, and the Coming AI Shock
TGFBR2-Guided Biomaterial Scaffolds for Aortic Root Reconstruction in Loeys-Dietz Syndrome: Toward Precision Aortopathy Repair
Loeys-Dietz syndrome (LDS) is a rare heritable aortopathy characterized by aggressive aneurysm formation and early dissection, frequently involving the aortic root. Mutations in TGFBR1 and TGFBR2 disrupt canonical TGF-β signaling, resulting in medial degeneration, elastin fragmentation, and aberrant matrix remodeling. Despite advances in surgical and endovascular repair, conventional grafts remain biologically inert and fail to address the underlying molecular dysregulation, predisposing patients to progressive downstream dilation and reoperation. Recent biomaterials research has introduced the concept of bioactive scaffolds—engineered vascular grafts capable of modulating local cell behavior and extracellular matrix (ECM) homeostasis. Emerging data suggest that targeted modulation of TGF-β signaling pathways can restore structural integrity in aneurysm-prone tissue. Incorporating TGFBR2-specific signaling cues within scaffold microarchitecture—via peptide-functionalized polymers or microRNA-loaded nanofibers—offers a precision approach to promote adaptive remodeling and reduce maladaptive fibrosis (1–3). Early in vitro studies using smooth muscle cell (SMC) cultures from TGFBR2-mutant models demonstrate partial normalization of elastogenesis and reduced MMP-2 expression when exposed to receptor-modulating environments (4). Beyond material design, computational modeling and machine learning can optimize scaffold composition, predicting mechanical resilience and cytokine release kinetics under pulsatile flow (5,6). Such integration aligns with the emerging paradigm of intelligent biomaterials—structures that dynamically respond to biomechanical and biochemical feedback, particularly vital in genetically mediated aortic disease. Proposed Translational Framework Preclinical modeling: Evaluate TGFBR2-guided scaffold prototypes in Loeys–Dietz syndrome (LDS) murine or porcine models to assess their ability to stabilize aneurysms, integrate histologically with host tissue, and restore normal TGF-β/SMAD signaling. Key outcomes will include improved medial architecture, reduced matrix degradation, and normalized smooth muscle cell phenotype. Computational optimization: Utilize finite element analysis (FEA) and AI-based predictive modeling to refine scaffold architecture—specifically fiber orientation, pore size, and mechanical compliance—to closely match native aortic root dynamics and minimize local stress concentrations. Simulations will guide iterative design improvements before in vivo testing. Regulatory readiness: Develop GMP-compliant fabrication protocols with standardized sterilization, material traceability, and quality control measures. Conduct biocompatibility and cytotoxicity testing according to ISO 10993 standards to ensure safety, regulatory alignment, and scalability for eventual clinical-grade production. Clinical Translation: Initiate first-in-human compassionate-use implants under rigorous ethical and regulatory oversight in high-risk LDS patients who are unsuitable for standard graft repair. Early outcomes will focus on safety, feasibility, and short-term aortic stability to inform subsequent clinical trial design. SMART Objectives Specific: Design TGFBR2-responsive scaffolds that actively modulate dysregulated TGF-β/SMAD signaling in human aortic smooth muscle cells (SMCs) to promote tissue homeostasis. Measurable: Demonstrate a ≥30% reduction in pathological MMP activity compared to standard ePTFE grafts, along with improved elastic modulus and reduced inflammatory response in preclinical models. Achievable: Employ polymer–nanoparticle hybrid scaffolds with tunable ligand density and controlled mechanical properties, using established materials and fabrication platforms to ensure feasibility. Relevant: Target the high reoperation rates in LDS patients caused by graft maladaptation and progression of aortic pathology beyond the repair site, addressing an unmet clinical need. Time-bound: Complete prototype optimization, preclinical validation, and regulatory documentation within 24 months, progressing from computational design to in vivo testing. By converging molecular genetics with adaptive biomaterial engineering, TGFBR2-guided scaffolds represent a promising avenue for patient-specific aortic repair. Such precision solutions could redefine management of genetically mediated aneurysms, transforming outcomes in a disorder where conventional materials fall short.
Funding Brains, Not Bytes: Keeping Seed Grants Focused on Investigators
Care for the Caregivers: The Patient and Client First Paradox
The Forgotten Electrolyte in Dengue: Hypophosphatemia Matters
AI-Augmented Sleep Apnea Screening in Neurology Clinics: Bridging Sleep and Cognitive Health
Dear Editor, Sleep apnea is a prevalent yet underdiagnosed disorder with profound neurological implications, including cognitive decline, impaired memory, and increased stroke risk. Despite strong evidence linking sleep-disordered breathing to neurocognitive dysfunction, routine screening remains uncommon in neurology clinics due to reliance on polysomnography and limited interdisciplinary coordination. Artificial intelligence (AI)-based tools offer a translational pathway to bridge this gap by providing accurate, non-invasive, and cost-effective screening integrated into clinical workflows. Recent advances in machine learning and computer vision have enabled automated detection of obstructive sleep apnea (OSA) using facial images, wearable devices, and simple physiological inputs. Deep learning models analyzing craniofacial photographs demonstrated high diagnostic performance (AUC up to 0.916 for apnea–hypopnea index ≥5), suggesting clinical utility even without polysomnography (1). Meta-analyses of wearable AI systems report pooled sensitivity and specificity above 85%, outperforming traditional screening questionnaires (2,3). Furthermore, image-based algorithms incorporating facial and clinical features such as body mass index and neck circumference significantly improve accuracy and enable accessible community-level screening (4,5). Integrating AI-driven OSA screening into neurology clinics could transform patient management by facilitating early detection among individuals with stroke, Parkinson’s disease, or mild cognitive impairment—populations where untreated sleep apnea worsens outcomes. These tools also align with global health priorities by offering scalable diagnostic solutions adaptable to low-resource settings. To fully realize this potential, a collaborative translational framework is essential, linking data science innovation with clinical validation and ethical oversight. We call for urgent global action through three measures: Validate AI-based OSA screening in neurological populations across diverse ethnic and socioeconomic groups. Establish cross-disciplinary collaborations between neurologists, sleep physicians, and data scientists. Implement ethical guidelines ensuring transparency, data privacy, and equitable access to AI-assisted diagnostics. By bridging sleep and cognitive health through intelligent screening, translational neurology can move closer to precision-based, accessible, and data-driven patient care.
Building Leadership Capacity in Health Sciences: Rationale, Design, and Early Outcomes of the Emerging Leadership Academy at Dow University of Health Sciences
Abstract Background: Many universities, particularly medical schools, report persistent gaps in formal leadership training, despite a consensus that leadership development enhances individual performance, team function, and institutional outcomes. Objective: To describe the rationale, design, implementation, and early outcomes of the Emerging Leadership Academy (ELA) at Dow University of Health Sciences (DUHS), created to address this unmet training need across faculty, trainees, and administrative leaders. Methods: ELA was implemented as a hybrid, cohort-based program emphasizing servant leadership, core human skills, and applied problem-solving. Program architecture, eligibility criteria, and selection criteria, as well as competency maps, were defined prospectively. The curriculum integrates case-based seminars, simulations, peer-learning circles, and individualized coaching aligned with DUHS priorities. Evaluation utilizes multiple modalities, including application and selection metrics, participation and completion rates, pre– and post–self–assessments mapped to leadership competencies (e.g., self-awareness, communication, teamwork, conflict management, decision-making, and change leadership), and qualitative feedback from mentors and supervisors. A longitudinal tracker follows alumni milestones, including role expansion, project impact, and contribution to institutional initiatives. Results: Launched in September 2023, ELA has run multiple cohorts with sustained demand and capacity-limited enrollment. Participants report high perceived relevance and applicability to clinical, academic, and operational settings. Preliminary analyses indicate gains in leadership self-efficacy, teamwork behaviors, emotional intelligence, and communication clarity, with capstone projects demonstrating practical improvements in service quality, research operations, and learner experience. Early signals indicate a growing pipeline of graduates assuming formal and informal leadership roles. Conclusion: A structured leadership academy embedded within a health-sciences university is feasible, scalable, and responsive to the documented training gap. By combining competency-based design, hybrid delivery, mentorship, and project-based learning, ELA offers a reproducible model for cultivating leaders who can advance patient care, education, and research. Continued cohorts and longitudinal follow-up will clarify downstream effects on individual and organizational performance and culture.
Efficacy of Nanoparticle-based Localised Immunomodulation to Reduce Graft-versus-host Disease in Murine Model of Bone Marrow Transplantation: A Systematic Review
Background and Aim Bone marrow transplantation (BMT), 73.8% of all transplants, is a cornerstone therapy for various haematological disorders. It follows a life-threatening complication; acute graft vs host disease (aGVHD) with 30-60% of incidence. Despite being standard, conventional immunosuppressive therapies are frequently associated with toxicity, infections, and 70% of non-responding patient. A novel, highly targeted nanoparticle-based strategy, while being explored in solid organ transplantation, remains under-investigated in BMT. This systematic review aims to evaluate the efficacy of NP-based strategies to mitigate aGVHD following BMT. Methods A systematic search was conducted using PubMed, Cochrane Library, and Science Direct from April 23, 2001, to August 13, 2024 for propensity-matched studies evaluating efficacy of NP-based therapies in murine models to mitigate GVHD severity. Data were extracted independently by two reviewers. Study quality was assessed using SYRCLE tool. Descriptive analysis was performed as meta-analysis was not possible due to heterogeneity in intervention types. Results Of the 66 studies retrieved, 15 pre-clinical animal studies were selected sample size 2-30/group). Overall, risk of bias was moderate. 12/15 studies reported lower clinical GVHD scores (p< 0.001), 14/15 prevented weight loss (p<0.05), 14/15 prolonged survival with (HR 0.2055, p=0.0112). Histopathological assessments showed decreased tissue damage in the liver (10/11), the intestine (12/12), and the skin (7/7) with p<0.05. 14/15 reported lower levels of inflammatory cytokines (p<0.001). Conclusion NPs therapy has a promising efficacy in mitigating GVHD after BMT. Nevertheless, the heterogeneity of interventions makes generalizability still difficult. It underscores the need for future in-depth translational studies.
Expanding Treatment Options: Ceftobiprole Against Multidrug-Resistant Infections
Optimizing Heart Failure Care in Pakistan : Lessons From UAE Cardiac Center Models.
Heart failure (HF) is a major health concern in Pakistan with high rehospitalization rates and low adherence to guideline-directed medical therapy (GDMT). On the other hand, UAE has implemented effective HF care strategies, including the Get With The Guidelines®️ Heart Failure program, pharmacist-led interventions, and multidisciplinary training, which have improved adherence, reduced hospitalizations and improved quality of life. These differences and the UAE's scalable methods are shown by several studies from Pakistani and UAE sources (2000–2024). By standardizing procedures, including pharmacists, treating comorbidities like iron deficiency, and establishing national registries, Pakistan may be able to lower the burden of heart failure, enhance patient outcomes, and save lives.
Guideline-directed medical therapy (GDMT
Get With The Guidelines® – Heart Failure
Male HPV Vaccination in Pakistan: An Overlooked Preventive Strategy
Background: Human papillomavirus (HPV) vaccination has been introduced in Pakistan to protect girls against cervical cancer. However, the exclusive focus on females overlooks the significant burden of HPV-related diseases in men, including oropharyngeal, anal, and penile cancers, as well as anogenital warts. Discussion: Evidence demonstrates that male HPV vaccination reduces HPV infections, precancerous lesions, and genital warts, while also enhancing herd protection. In contexts where female vaccine uptake is suboptimal, such as Pakistan, gender-neutral vaccination strategies are particularly effective. Operationally, Pakistan’s immunization infrastructure, experience from polio campaigns, and the WHO’s endorsement of single-dose schedules provide feasible pathways for inclusion of boys. Conclusion: Restricting HPV vaccination to girls reinforces misconceptions of HPV as a “women’s disease,” neglects men’s right to protection, and slows progress toward elimination. Expanding HPV vaccination to include boys would accelerate population-level benefits, promote equity, and align Pakistan’s strategy with global best practices.
Virtual Reality Perimetry versus Conventional Perimetry: Balancing Patient Comfort and Reliability
Medical Camps as Catalysts for Health Equity: Reflections from Khyber Pakhtunkhwa, Pakistan
Mobile medical camps in rural Khyber Pakhtunkhwa address critical gaps in primary care and advance health equity by bringing free consultations, basic laboratory screenings, immunizations and health education directly to underserved villages. Drawing on firsthand volunteering experiences and regional data, this work highlights how camps organized by local NGOs and medical trainees overcome the prohibitive costs and geographic barriers that leave families traveling hours for simple care. A 2024 study in KP reported that primary health needs “were not met” largely because of cost and outreach deficits, while a Karachi survey of student volunteers found that 77 % improved their understanding of community health, 85 % gained confidence in outpatient care and 94 % developed communication and empathy skills, with nearly half influenced toward primary care careers. In flood‑affected Sindh, outreach teams served more than 16 000 attendees—offering check‑ups, essential immunizations and even psychological first aid—partnering with religious leaders and youth mobilizers to amplify prevention messages. When aligned with district health departments, camps not only treat acute illness but also seed longer‑term improvements by training community health workers, strengthening referral paths and informing policymakers about chronic disease burdens such as unmanaged hypertension and diabetes. Furthermore, medical students return with a deepened commitment to rural practice and policy advocacy, reinforcing the health system from within. While short‑term missions alone cannot resolve poverty or infrastructure gaps, ethically designed camps that emphasize capacity‑building, continuity of care and community partnership can spark sustainable change—rekindling trust in health services and catalyzing policy shifts toward equitable access for all.
Circumcision, Acetaminophen, and Autism: Untangling Association from Causation
Alternate Pathways to Integrate International Medical Graduates (IMGs) into the U.S. Healthcare Ecosystem: A Policy Analysis of Texas HB 2038 (“the DOCTOR Act”).
Background: The United States and Texas, in particular, face persistent and worsening physician shortages, disproportionately affecting rural and underserved communities. Texas HB 2038 (“the DOCTOR Act”) establishes alternative licensure pathways intended to streamline the entry of qualified International Medical Graduates (IMGs) into supervised clinical roles, with a focus on service in safety-net and shortage settings. Objective: To distill the policy architecture of HB 2038 into an implementation-ready framework describing eligibility, site requirements, supervision, geographic constraints, and procedural steps for two licensure routes: the Foreign-Licensed “Provisional” license and the “Physician Graduate” limited license. Methods: Descriptive policy analysis of an implementation presentation and its cited resources (professional association briefs, state board guidance, and the bill text). Information was extracted, categorized (by eligibility, sites, supervision, geography, and testing), and synthesized into operational checklists and proposed evaluation metrics. Results: Both pathways require an ECFMG-eligible primary medical qualification (from a WDOMS-listed school with a sponsor note), primary-source verification, and English proficiency as demonstrated by OET-Medicine. The “Provisional” license requires an active foreign license, completed postgraduate training abroad, a Texas employment offer, and completion of the Texas Medical Jurisprudence Exam; practice initially occurs at ACGME-accredited/affiliated sites and, upon renewal, is restricted to rural/MUA/HPSA settings. The “Physician Graduate” limited license requires Texas residency, valid U.S. work authorization/citizenship/permanent residence, a supervising practice agreement, and non-enrollment in a residency program. Practice is limited to clinics in counties with fewer than 100,000 residents and FQHC/FQHC-LAL sites. Conclusions: HB 2038 offers structured, supervised, and shortage-area–oriented on-ramps for IMGs. Effective execution will hinge on supervisory capacity, safety-net site readiness, jurisprudence, and access to language testing, as well as outcomes monitoring (including access, quality, and retention). (Texas Legislature, n.d.). (Texas Medical Board, n.d.)
AI Triage for Stroke Imaging: Promise vs risk of Deskilling Radiology Trainees
Dear Editor, Artificial intelligence (AI) has entered acute stroke care at remarkable speed. Commercial platforms now detect large-vessel occlusion (LVO) on CT angiography and immediately notify stroke teams. Randomized and real-world data confirm that these tools shorten notification and thrombectomy initiation times, translating into improved functional outcomes for patients (1,2). In spoke-and-hub networks, AI-assisted notification particularly strengthens equity of care by expediting transfers during nights and weekends (2). Alongside these benefits, one underrecognized concern is the potential deskilling of radiology trainees. Overreliance on automated alerts risks diminishing the very competencies that training should cultivate: visual pattern recognition, logical reasoning, and confident communication with clinicians. Survey-based studies suggest that while trainees appreciate AI’s efficiency, many worry about erosion of independent judgment (3). A second challenge is algorithmic variability. Reported sensitivity and specificity for LVO detection range widely—from 85–95% for anterior circulation to lower performance in posterior circulation or artifact-heavy studies (4,5). Such blind spots create a paradox: AI accelerates decisions in straightforward cases but risks missed diagnoses in the difficult ones—the very cases where human expertise is indispensable. The solution is not to resist AI but to integrate it deliberately into radiology education. With thoughtful design, AI can both streamline workflow and strengthen training. We propose three practical steps: 1. AI-enhanced teaching modules: Residency curricula should include structured sessions on AI fundamentals, limitations, and critical appraisal. For instance, case-based teaching where 20% of cases are AI-flagged and 80% require independent interpretation can balance efficiency with skill-building. 2. Dual-read policy during rollout: For the first 12–18 months post-implementation, trainees should interpret CT angiography independently before reviewing AI output. Discrepancies should be logged to track both trainee learning curves and AI reliability. 3. Continuous audit and feedback: Institutions should perform monthly audits comparing AI performance with ground-truth adjudication. Cases of false negatives or false positives can be integrated into morbidity-and-mortality or case conferences to reinforce learning. Such an approach acknowledges both the transformative benefits of AI in stroke triage and its risks to training. By embedding AI into structured teaching and feedback loops, future radiologists can remain technologically adept while preserving diagnostic rigor. Conflict of Interest: None Ethical Consideration: None Funding: None Declaration of AI Use: This letter was drafted and revised with the assistance of an AI language model (ChatGPT, GPT-5, OpenAI) for grammar refinement, structural reorganization, and clarity enhancement. All intellectual content, interpretation, and final approval of the text are solely the r esponsibility of the authors.
Reframing the Debate on Abortion Drugs in an Era of Misinformation
The Paradox of Ubiquity: Reassessing the Reported Association Between Prenatal Acetaminophen (Tylenol) Exposure and Autism
Background: Observational studies have reported small positive associations between prenatal acetaminophen (Tylenol) use and autism spectrum disorder (ASD). Because acetaminophen is widely used in pregnancy and the indications for its use (e.g., infection, migraine) are themselves associated with neurodevelopmental risk, even tiny imbalances between users and non-users can generate noncausal signals, the paradox of ubiquity. Objective: To review current human studies on prenatal acetaminophen and ASD, explain how, given the high prevalence of exposure confounding by indication, family factors, and exposure misclassification can distort results, and identify designs that best address these issues, especially sibling analyses. Methods: We conducted a rapid, structured meta-analysis of human studies through September 5, 2025. Priority was given to: (1) large population-based cohorts with family-based (sibling) comparisons; (2) biomarker-based exposure assessments (umbilical cord blood, meconium); (3) high-quality evidence syntheses (e.g., Navigation Guide); and (4) professional guidance from the American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention (CDC). The primary outcome was autism spectrum disorder (ASD); secondary outcomes were attention-deficit/hyperactivity disorder (ADHD) and intellectual disability (ID). Results: In the nationwide Swedish cohort (n = 2,480,797; 1995–2019), conventional models found marginal risk elevations (e.g., ASD hazard ratio [HR] 1.05, 95% confidence interval [CI] 1.02–1.08), but sibling-control analyses were null (ASD HR 0.98, ADHD HR 0.98, ID HR 1.01), and dose–response patterns vanished; absolute risk differences at age 10 were ≤ 0.21%. Biomarker work in selected cohorts reports higher odds of ASD/ADHD across exposure tertiles, but generalizability and residual confounding remain concerns. Multiple studies link maternal fever, especially in the second trimester and with repeated episodes, to higher ASD risk, consistent with confounding by indication. Conclusions: With ubiquitous exposures and indication-related use, naïve associations are prone to inflation. The strongest, bias-resistant designs (sibling comparisons) do not support a causal link between acetaminophen and ASD. Clinically, the use of acetaminophen remains appropriate when indicated, at the lowest effective dose and shortest duration. Fever, an independent risk factor, should be treated promptly.
Attention-deficit/hyperactivity disorder