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On appeal, the Petitioner reiterated prior assertions without identifying or discussing specific evidence. AAO deemed the issue waived due to lack of specificity.

AAO agreed with the Director that the Petitioner met the work experience criterion.

The AAO found that the Petitioner's evidence — including general legal market trend articles, an unsupported business plan, and an expert opinion that did not specifically discuss prospective national impact — failed to establish that her specific proposed endeavor has national importance with broader implications beyond her own clients and company.

The AAO found that the business plans' projected creation of 11 jobs and modest tax revenue in Florida did not demonstrate substantial economic benefits commensurate with national importance. The expert letters were insufficiently probative, did not address the broader implications of the endeavor on the real estate or financial investment consulting field, and one letter raised significant questions about its authorship. The general importance of the industry or the U.S.-Brazil trade initiative does not substitute for demonstrating the prospective impact of the specific proposed endeavor.

AAO analyzed each association individually and found that none demonstrated a requirement that members have outstanding achievements as judged by recognized national or international experts. TOPEK's examination-based membership did not establish outstanding achievement; TOTBID's bylaws did not specify achievement-based criteria; the TOTBID branch requirements (two meetings, two articles, two references) did not rise to outstanding achievements; the Medical Malpractice Association had unclear and apparently open membership; and the Turkish Medical Association admitted members based solely on education and employment in the profession.

AAO found that training certificates, teaching activities, publications, and conference presentations did not individually or collectively establish original contributions of major significance. The Petitioner's 31 cumulative citations and low per-article citation counts were not shown to be commensurate with major significance absent comparative data. The best paper award did not appear in citation records and the record lacked evidence of widespread commentary. Recommendation letters were not sufficiently specific or corroborated to demonstrate major significance.

AAO agreed with the Director that the submitted materials were about symptoms, origins, and treatments for medical conditions such as bone cancer and carpal tunnel syndrome, rather than about the Petitioner himself. While the materials identified the Petitioner by name and quoted him, they did not discuss him, his background, his clinical practice, or his research.

AAO agreed the Petitioner failed prong two because the investor proposal, business plan, and customer letters all post-dated the August 2022 filing date and could not establish eligibility at time of filing. Additionally, the Petitioner's background in medical equipment maintenance did not relate to running a company to develop and market a smartphone app, and he had no documented prior experience with the type of business described in the proposed endeavor.

AAO finds the 2016 Nature Communications paper on the prodrug-based NLG919 molecule, supported by detailed expert letters describing its novelty and influence, a noteworthy citation record, and its role as preliminary data for an NCI-funded grant proposal, establishes a majorly significant original contribution by a preponderance of the evidence.

AAO accepts the Director's prior determination that the authorship criterion was satisfied; not disputed on appeal.